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HomeMy WebLinkAboutR.J. Noble Company - 2017-01-17 77 RECEIVED BY: /,` CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office (Name) ! after signing/dating (Date) �, CITY OF HUNTINGTON BEACH ram, INTERDEPARTMENTAL COMMUNICATION f TO: City Treasurer FROM: City Clerk / DATE: O r / 7 -- D SUBJECT: Bond Acceptance I have received the bonds for J (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 ! 1 l (Council Approval Date) CC No. � Agenda Item No. MSC No. City Clerk Vault No. Other No. SIRE System ID No. g:/forms/bond transmittal to'treasurer r CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION DATE: 10/9/2017 TO: THOSE LISTED HEREON FROM: John Griffin, PW Contract Administrator SUBJECT: Retention Release Payment- PO#22825 OJ Supplier#18195 Co.#213 Edinger Avenue and Warner Avenue, Project#CC-1516 Contractor's Name: R.J. Noble Co-Orange Address: 15505 E. Lincoln Ave. City, State and Zip Code: Orange, CA 92865 Phone Number: (714)637-15509 City Business License Number: A005420 Notice of Completion (Date by City Clerk): 6/23/2017 The conformed copy of the Notice of Completion for the above contract has been filed. The thirty-five (35) day waiting period has elapsed or will elapse before payment is made. Processing of the retention payment is recommended so long as no stop notices or outstanding invoices are on file with the City. I certify that no stop notices are on file. ate Travis K. Fropkins, Director of Public Works I certify that there are no outstanding invoices on file. 101 [aI Iq U �V, Date Joyce Zacks, Oe ty 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. 1,011711-7 Date Robin Estanislau, City Clerk Attachments 1. Notice of Completion 2. Maintenance Bond 3. Certificate of Compliance with Prevailing Wage Laws 4. Contractor's Certificate 5. Certificate of Compliance with Title 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 92648 Re: Certification of Compliance with Prevailing Wage Laws Contract: EDINGER AVENUE&WARNER AVE Project: PROJECT #CC 1516 The undersigned contractor on the above-referenced project("Project')hereby certifies that all laborers,mechanics,apprentices,trainees,watchmen and guards employed by him or by any subcontractor performing work under the contract for the Project have been paid pursuant to the minimum wage and bona fide fringe benefit requirements specified for each particular classification of work,as set forth in the wage-rate determinations of the State of California, Department of Industrial Relations,and/or the United States Department of Labor. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this 17TH day of JULY 92017 at ORANGE California. , X (ConlraCtor/kame STEVE MENDOZA,SECRETARY R.J.NOBLE COMPANY APPROVEDAS TO FORB.4 By: - Mi�1"isel E.Gates Oily Attomey 1 CONTRACTOWS CER MCAT]E 1, STEVE MENDOZA ,state and certify that: (Name of Declarant) I R.J.NOBLE COMPANY is the general contractor to the City of Huntington Beach("City'l on Contract No.CC-1516 (the"Contract'l for the construction of the public work of improvement entitled: EDINGER AVENUE&WARNER AVE (the"Project'l. 2. All work to be performed pursuant to the Contract has been completed in accordance with the Contract Documents(as such term is defined in the Contract). 3. Except for the claims listed below and the disputed claims listed in paragraph five(5),all persons supplying labor,services,materials and equipment to the Project,including all claims against the contractor arising from the performance of the Contract,have been paid and satisfied(list unpaid debts and claims;if none,write"NONE"): NONE 4. Attached hereto are the lien waivers required by the Contract Documents,which lien waivers have been executed by all persons who performed work on or supplied labor, services,materials,and/or equipment for use at the Project. 5. Set forth below is a list of disputed claims or claims that are the subject of a Notice to Withhold filed pursuant to the Civil Code of the State of California(list all disputed claims;if none,write"NONE"). NONE I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at 15505 E.LINCOLN AVE,ORANGE,CA on this 17TH dgy of JULY ,2U 17 X (SIV&we IDedarant) APPROVED AS TO FORM STEVE MENDOZA,SECRETARY Michael-E. Gates City`Attomey t Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O.Box 190 Huntington Beach,CA 92648 Re: Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 Contract: CC-1516 Project: EDINGER AVE&WARNER AVE The undersigned contractor on the above-referenced project("Project")hereby certifies that it has complied with tide 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 fer employment because of race,color,religion,sex,sexual orientation,gender identity,national origin,age or disability. The undersigned contractor also certifies that it has not maintained any segregated facilities at its establishments on the basis of race,color,religion,sex,sexual orientation,gender identity,national origin,age or disability(with the exception of access for the disabled). 1 declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this 17TH day of JULY 1 20 17 at ORANGE California. x %)Z/ (Contractor ame)IqTEVE MENDOZA,SECRETARY R.J.NOBLE COMPANY APPROVED AS TO FORM By: '' s Michael E.Gates Citk Attorney 1 RECEIVED BY: CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office (Name) after signing/dating (Date) . Me CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: City Treasurer FROM: City Clerk DATE: /0 — / 7 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. Warranty or Maintenance Bond No. � 3f 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 (Council Approval Date) CC No. Agenda Item No. MSC No. City Clerk Vault No. - ��O Other No. SIRE System ID No. g:/forms/bond transmittal to treasurer Bond#30003631 M MAINTENANCE BOND KNOW ALL PERSONS BY THESE PRESENTS: That R.J.NOBLE COMPANY (contractor's name) 15505E LINCOLN AVENUE ORANGE CA 92865 _ (contractors street address,city and state and zip code) as Principal(hereinafter called Contractor),and: Western Surety Company (surety's name) 915 Wilshire Blvd Suite 1650 Los Angeles CA 90017 (surety's street address,city and state and zip code) a corporation organized and existing under the laws of the State of South Dakota with its principal office in the City of Sioux Falls as Surety(hereinafter called Surety),are held firmly bound unto CITY OF HUNTINGTON BEACH as Obligee (hereinafter called Owner), in the amount of Dollars ($ 1,338,592.94 1, equivalent to the entire contract amount*including all orders, for the payment whereof Contractor and Surety bind themselves, their heirs, executors,administrators,successors,and assigns,jointly and severally,firmly by these presents, One million three hundred thirty eight thousand rive hundred ninety two and 94100 WHEREAS,Surety is a duly admitted surety Insurer under the laws of the State of California;and Surety is certified and listed in the U.S.Department of the Treasury Circular 570.and able to provide proof of bonding limitation shown in said circular is sufficient to provide bonds in the amount required by said Contract;and Surety has provided financial strength ratings from reputable companies,such as from A.M.Best,Moody's,Standard &Poor's,to validate that Surety has positive ratings of being secure or stable;and Surety is registered and listed with the California Department of Insurance;and Contractor has by written agreement dated 03/06 ,2017,entered into a contract with Owner for the Edinger Avenue and Warner Avenue Project#CC-1 516 in accordance with drawings and specifications prepared by which contract is by reference made a part hereof(hereinafter referred to as the Contract);and The Contract provides that the principal will guarantee,for a period of one year,the work performed as part of the Contract from and against all defects in materials and workmanship:and The Contract also provides that the Contractor shall secure 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 June 23. ,20_,17 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 atteration or extension of time made by the Owner. Whenever Contractor shall be,and declared by Owner to be in default under the Contract,the Surety shall,within thirty (30) days following Owner's written notice of default, either. (a) remedy the default, or (b) shall promptly complete the Contract in accordance with its terns and conditions. Surety shall save the Owner harmless from any claims,judgments,liens or losses arising from the Surety's failure to either remedy the default or to complete the Contract In accordance with its terms and conditions in a timely manner. 15-4584/1 HIM 1 Whenever the Principal shall be,and declared by the Owner to be in default under the Contract,which shall include without limitation,any breach or default of the Contract,then,after written notice from the Owner to the Surety,as provided for below,the Surety shag either: (a)remedy the default or breach by the Principal;or(b)shall promptly and faithfully take charge of the Work and complete the Work In accordance with the requirements of the Contract with a contractor other than the Principal,at Its own expense,and make available as work progresses sufficient funds to pay the cost of completion less the unpaid balance of the Contract Including other costs and damages for which the surety may be gable hereunder,provided,however,that the procedure by which the Surety undertakes to discharge its obligations under this Bond shall be subject to the advance written approval of the Owner. Within thirty(30) days after Surety's receipt of a written notice from Owner of the failure of performance of the Contract by the Principal, It shall be the duty of the Surety to give to the Owner a notice.In writing,of the Surety's election to(a)remedy the defauk(s)of the Principal promptly,or(b)arrange for performance of the Contract promptly by a contractor other then the Principal,time being of essence to this Bond. In said Notice of Election,the Surety shall state the date of commencement of its cure or remedy of the Principal's default(s)or its performance of the Contract. The Surety's obligations for cure or remedy,include but are not limited to: correction of defective work and completion of the Contract, additional legal, design professional and delay costs arising from Surety's actions or failure to act and liquidated damages (or if no liquidated damages are specified in the Contract,actual damages caused by delayed performance or non-performance by the Principal). the Surety shall give prompt written notice to the Owner upon completion of the cure or remedy of the Principal's defauli(s)of its performance of the Contract. if the Surety does issue its Notice of Election and does not proceed to cure or remedy the Principal's default(s)of its performance of the Work within thirty(30)days after receipt of a written notice from Owner,Surety shall be deemed to be in default on this bond,and the Owner shall be entitled to enforce any remedy available to Owner. No right of action shall accrue on this bond to or for the use of any person or corporation other than the owner narned herein or the successors of Owner. Signed and sealed this 141h day of Jul 20 77 . Principal Raised Corporate Seal R.J. NOBLE COMPANY [MUST BE AFFIXED) HN(Contractor Name) ey: X U (Seal) STEVE Myf D0 ,SECRETARY Principal Raised Corporate Seal [MUST BE AFFIXED] (Title) Western Surety Company (Sure �Nan, By: (Seal) James Scott Salaffdi;-Attorney-in-fact APPROVED AS TO-FORK, �S By: - NOTES: Michael E. Gates,City Attorney 1. Acknowledgments must be completed and returned 1Al y as part of the bond. 2. Raised Corporate Seal&are mandatory. 3. Please attach Power of Attorney. 15-4584/1 IS IN 2 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document State of California ) County of ORANGE ) On 07/17/2017 before me, J.DE IONGH,NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared STEVE MENDOZA Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the persons} whose name(*is/are- subscribed to the within instrument and acknowledged to me that he/she/they-executed the same in hisA9er/their authorized capadtyo*,and that by his/her/their signature(oon the instrument the person*, or the entity upon behalf of which the person(s)acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of Califomia that the foregoing paragraph is true and correct. J.DE I _'*,�', WITNESS my hand and o I seal. Commission #2128504 - I Notary Public-California z / 0 y �;° � ' Orange County n Signature � V f,Ay Comm.Expires Oct 28,20119 :, Signature o N tary Public J.DE IONGH Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: 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 C 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.NatbnalNotary.org•1-800-US NOTARY(1-800-876-6827) Item#5907 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange On July 14, 2017 before me, Kelly A. Vincent, a Notary Public (insert name and title of the officer) personally appeared .lames Scott Salandi, Attorney-in-Fact who proved to me on the basis of satisfactory evidence to be the person(s)whose name(%) is/aNx subscribed to the within instrument and acknowledged to me that helshe"executed the same in his/keltfz ak authorized capacity(ieo, and that by hislhm*hak signature(t) 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. ► � KELLY A.VINCENT WITNESS my hand and official seal. C" f�; COMM.*220124e;0 d NOTARY PUBLIC-MFORNIA N _. ORANGE COUNTY N MY COMM.EV.JUNE 21,2021 Signature (Seal) Western Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents,That WESTERN SURETY COMPANY,a South Dakota corporation,is a duty organized and existing corporation having its principal office in the City of Sioux Falls,and State of South Dakota,and that it does by virtue of the signature and seal herein affixed hereby make,constitute and appoint James Scott Salandi,Leonard Ziminsky,David Jacobson,Individually of Irvine,CA,its true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign,seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature -In Unlimited Amounts- and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney,pursuant to the authority hereby given,are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By-Law printed on the reverse hereof,duly adopted,as indicated,by the shareholders of the corporation. In Witness Whereof,WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to he hereto affixed on this 20th day of April,2017. �. SURETyr, WESTERN SURETY COMPANY p `o q. Rq �> �TB.�flatVicePresident State of South Dakota 1 JT County of Minnehaha ss On this 20th day of April,2017,before me personally came Paul T.Bruflat,to me known,who,being by me duly sworn,did depose and say: that he resides in the City of Sioux Falls,State of South Dakota;that he is the Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument;that he knows the seal of said corporation;that the seal affixed to the said instrument is such corporate seal;that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority,and acknowledges same to be the act and deed of said corporation. My commission expires J.MOHR NOTAMPLSM June 23,2021 J.Mohr,Notary Public CERTIFICATE 1,L.Nelson,Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force,and further certify that the By-Law of the corporation printed on the reverse hereo is still in force. In testimony whereof[have hereunto subscribed my name and affixed the seal of the said corporation this day �E''c`'a WESTERN SURETY COMPANY reo 't1le� Nlp* T `�on><O� L.Nelson,Assistant Secretary Form F4280-7-2012 Document-3501669-Page-1 Page 1 of 1 ' PLEASE COMPLETE THIS INFORMATION Recorded in Official Records,Orange County S Hugh Nguyen,Clerk-Recorder RECORDING REQUESTED BY: II I I II II II I I II III I I I I I II II NO FEE * $ R 0 0 0 9 3 7 1 9 1 0 $ 2017000263461 3:49 PM 06126117 232 407 N12 1 WHEN RECORDED MAIL TO: 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 i CITY OF HUNTINGTON BEACH PUBLIC WORKS DEPARTMENT John Griffin P.O.Box 190—2000 Main Street s, Huntington Beach,CA 92648 THIS SPACE FOR RECORDER'S USE ONLY f TITLE OF DOCUMENT i NOTICE OF COMPLETION t NOTICE IS HEREBY GIVEN by the City of Huntington Beach,owner in fee,2000 Main Street,Huntington Beach,CA 92646,that the contract heretofore awarded to R.J.Noble Co-Orange,who was the company thereon for doing the following work to-wit: Edinger Avenue and Warner Avenue,Project#CC-1516 That said work was completed 06/23/2017 by said company according to plans and specifications and to the satisfaction of the City Engineer of the City of Huntington Beach and that said work was accepted by the Director of Public Works on 06/23/2017,per City Council Resolution No.2003-70 adopted October 6,2003. j i i That upon said contract Western Surety Company,was surety for the bond given by the said company as required by law. i 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. i &6re/iz Direc or of-Public 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 regularly ordered to be recorded in the Office of the County Recorder of Orange County. ' E This document is solely the official business of `' the City of Huntington Beach,as contemplated under Government code section. 6103 and Director of P�.rr Datef should be recorded free of charge. City of Huntington Beach,California THIS PAGE IS ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION (Additional recording fee applies) i about:blank 6/28/2017 'y► OCTA FUNDED CONSTRUCTION CONTRACT BETWEEN THE, CITY OF HUNTINGTON BEACH AND R J NOBLE COMPANY FOR EDINGER AVENUE & WARNER AVENUE REHABILITATION PROJECT CC NO.1516 THIS AGREEMENT ("Agreement") made and entered into by and between the City of Huntington Beach, a municipal corporation of the State of California, hereinafter referred to as "CITY," and R J Noble Company, a California Corporation, hereinafter referred to as "CONTRACTOR." WHEREAS, the Orange County Transportation Authority ("OCTA") is providing partial funding for this Contract to CITY; WHEREAS, CITY has solicited bids for a public works project, hereinafter referred to as "PROJECT," more fully described as Edinger Avenue and Warner Avenue Rehabilitation Project, CC NO.1516 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 pursuant to this Agreement and the Contract Documents (as hereinafter defined) and furnish, at its own cost and expense, all labor, plans, tools, equipment, supplies, transportation, utilities and all other items, services and facilities necessary to complete and construct the PROJECT in a good and workmanlike manner. SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).doex/rev.05/2016 D- 1of54 CONTRACTOR agrees to fully assuine the risk of all loss or damage arising out of the nature of the PROJECT, during its progress or prior to acceptance by CITY, froin the action of the elements, froin any unforeseen difficulties which may arise or be encountered in the prosecution of work, and for all other risks of any description in connection with the work, including, but not limited to, all expenses incurred by or in consequence of the suspension or discontinuance of work, except such as are herein expressly stipulated to be borne by CITY, and for well and faithfully completing the work within the stipulated time and in the manner shown and described in this Agreement, and in accordance with the requirements of CITY for the compensation set forth in the accepted bid proposal. 2. ACCEPTANCE_, OF CONDITIONS OF WORK; PLANS AND SPECIFICATIONS CONTRACTOR acknowledges that it is fully familiar with all the terms, conditions and obligations of this Agreement and the Contract Documents (as defined below in this Section), the location of the job site, and the conditions under which the work is to be performed, and that it enters into this Agreement based upon its thorough investigation of all such matters and is relying in no way upon any opinions or representations of CITY. It is agreed that the Contract Documents are incorporated into this Agreement by this reference, with the same force and effect as if the same were set forth at length herein, and that CONTRACTOR and its subcontractors, if any, shall be bound by the Contract Documents insofar as they relate in part or in any way, directly or indirectly, to the work covered by this Agreement. "Contract Documents" as defined herein mean and include: A. This Agreement; SF:16-5234/Complete Spec Contract See D(6-2-16) (2).docx/rev. 05/2016 D- 2of54 B. Bonds covering the work herein agreed upon; C. The CITY's standard Plans and Specifications and special contractual provisions, including those on file in the office of the Director of Public Works of CITY and adopted by the City Council, and any revisions, amendments or addenda thereto; D. The edition of Standard Specifications fbr Public Works Construction, published by Builders' News, Inc., 10801 National Boulevard, Los Angeles, CA 90064, and all amendments thereto, written and promulgated by the Southern California chapter of the American Public Works Association and the Southern California District Associated General Contractors of the California Joint Cooperative Committee as specified in the particular Plans, Specifications, Special Provisions and Addenda applicable to the Project; E. Bid documents including the Notice Inviting Bids, the Special Instructions to Bidders, the CONTRACTOR's proposal, (attached as Exhibit "A"), and Exhibit 12-G (as amended) to the Local Assistance Procedures Manual of the California Department of Transportation (attached as Exhibit "B"). Any conflict between Exhibit B and this Contract shall be resolved in favor of the Contract; 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 SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx/rev. 05/2016 D-3of54 in both. In case of a discrepancy between any Plans, Specifications, Special provisions, or Addenda, the matter shall be iirunediately submitted by CONTRACTOR to the Department of Public Works of CITY (hereinafter referred to as "DPW"), and CONTRACTOR shall not attempt to resolve or adjust the discrepancy without the decision of DPW, save only at its own risk and expense. Should there be any conflict between the terms of this Agreement and the bid or proposal of CONTRACTOR, then tlus Agreement shall control and nothing herein shall be considered as an acceptance of the terms of the bid or proposal which is in conflict herewith. 3. COMPENSATION CITY agrees to pay and CONTRACTOR agrees to accept as full compensation for the faithful performance of this Agreement, subject to any additions or deductions made under the provisions of this Agreement or the Contract Documents, a sum not to exceed One million, four hundred and sixteen thousand, two hundred ninety eight dollars and fifty cents Dollars ($1,416,298.50), as set forth in the Contract Documents, to be paid as provided in this Agreement. 4. COMMENCEMENT OF PROJECT CONTRACTOR agrees to continence the PROJECT within ten (10) working days after the Notice To Proceed is issued and diligently prosecute the PROJECT to completion within sixty five (65) consecutive working days from the day the Notice to Proceed is issued by DPW, excluding delays provided for in this Agreement. 5. TIME OF THE ESSENCE SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).doex/rev.05/2016 D -4of54 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 work of other contractors, subcontractors and CITY forces and, in general, all matters concerning the timely and orderly conduct of the work of CONTRACTOR on the premises. 6. CHANGES CONTRACTOR shall adhere strictly to the plans and specifications set forth in the Contract Documents unless a change therefrom is authorized in writing by DPW. CONTRACTOR agrees to make any and all changes, furnish materials and perform all work necessary within the scope of the PROJECT as DPW may require in writing. Under no condition shall CONTRACTOR make any changes without the prior written order or acceptance of DPW, and CITY shall not pay any extra charges made by CONTRACTOR that have not been agreed upon in writing by DPW. When directed to change the work, CONTRACTOR shall submit immediately to DPW a written cost proposal reflecting the effect of the change. Should DPW not agree to such SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx/rev.05/2016 D- 5of54 cost proposal, the work shall be performed according to the changes ordered in writing by DPW and the proper cost thereof shall be negotiated by the parties upon cost and pricing data submitted by CONTRACTOR; thereupon, CITY will promptly issue an adjusted change order to CONTRACTOR and the Agreement price will be adjusted upward or downward accordingly. 7. NOTICE TO PROCEED No work, services, material, or equipment shall be performed or furnished under this Agreement unless and until a Notice to Proceed has been given to CONTRACTOR by CITY. CITY does not warrant that the work will be available on the date the Notice to Proceed is issued. In the event of a delay in commencement of the work due to unavailability of the job site, for any reason, relief to CONTRACTOR shall be limited to a time extension equal to the delay due to such unavailability. 8. BONDS Only bonds issued by California admitted sureties will be accepted. CONTRACTOR shall, prior to its performance of this Agreement, furnish the following two (2) bonds approved by the City Attorney: One in the amount of one hundred percent (100%) of the Agreement price to guarantee the CONTRACTOR's faithful performance of the work, and one in the amount of one hundred percent of the Agreement price to guarantee payment of all claims for labor and materials furnished. In addition, CONTRACTOR shall submit to CITY a bond in the amount of one hundred percent (100%) of the final Agreement price, including all change orders, to warrant such perfonnance for a period of one (1) year after CITY's acceptance thereof within ten (10) days of filing of the Notice of Completion. SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx/rev. 05/2016 D -6of54 9. WARRANTIES CONTRACTOR unconditionally guarantees all work done under this Agreement including, but not limited to, any workmanship, installation, fabrication, material or structural facilities constructed. CONTRACTOR, within ten (10) days after.notice by CITY of any defect in the work, shall have the option to make appropriate repairs or replace the defective item or items. Upon expiration of such ten- (10) day period, CITY may then make appropriate repair or replacement at CONTRACTOR's risk and own cost and expense. 10. INDEPENDENT CONTRACTOR It is understood and agreed that CONTRACTOR is, and shall be, acting at all times hereunder as an independent contractor and not an employee of CITY. CONTRACTOR shall secure at its own cost and expense, and be responsible for any and all payment of all taxes, social security, state disability insurance compensation, unemployment compensation and other payroll deductions for CONTRACTOR and its officers, agents and employees and all business licenses, if any, in connection with the PROJECT and/or the services performed hereunder. 11. LIQUIDATED DAMAGES/DELAYS It is agreed by the parties hereto that in case the total work called for hereunder is not in all parts and requirements finished or completed within the number of calendar days as set forth herein, damage will be sustained by CITY; and that it is, and would be, impractical and extremely difficult to ascertain and determine the actual damage which CITY would sustain in the event of and by reason of such delay. It is, therefore, agreed that CONTRACTOR will pay to CITY, as liquidated damages and not as a penalty, the sum of seven hundred Dollars ($700.00) per each calendar day's delay in completing the work in excess of the number of working/calendar days set forth herein, which represents a reasonable endeavor by the parties SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx/rev.05/2016 D - 7of54 hereto to estimate a fair compensation for the foreseeable damages CITY would sustain in the event of and by reason of such delay; and CONTRACTOR agrees to pay these damages herein provided, and further agrees that CITY may deduct the amount thereof from any monies due or that may become due to CONTRACTOR hereunder. For projects on the National Highway System (NHS), the local formula for liquidated damages will be provided. CONTRACTOR will be granted an extension of time and will not be assessed damages for any portion of the delay in the completion of the work due to unforeseeable causes beyond the control and without the fault or negligence of CONTRACTOR, including, but not limited to, acts of God or of the public enemy, fire, floods, epidemics, quarantine restrictions, strikes, unsuitable weather, or delays of subcontractors due to such causes. CONTRACTOR shall, within fifteen (15) days from the beginning of any such delay (unless DPW shall grant a further period of time), notify DPW in writing of the cause of the delay and CITY shall extend the time for completing the work if, in its judgment, the findings of fact thereon justify the delay; and the decision of DPW shall be conclusive on the parties hereto. Should CONTRACTOR be delayed in the prosecution or completion of the work by the act, neglect or default of CITY, or should CONTRACTOR be delayed by waiting for materials required by this Agreement to be furnished by CITY, or by damage caused by fire or other casualty at the job site for which CONTRACTOR is not responsible, or by the combined action of the workers, in no way caused by or resulting from default or collusion on the part of CONTRACTOR, or in the event of a lockout by CITY, then the time herein fixed for the completion of the work shall be extended by the number of days CONTRACTOR has thus been SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).doex/rev. 05/2016 D-8of54 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 titne for completion shall be the sole remedy of CONTRACTOR. 12. DEMANDS FOR ADDITIONAL TIME OR MONEY A. Definitions. (1) "Change Order"means a document signed by the CONTRACTOR and CITY which authorizes an addition, deletion or revision in the work, or an adjustment in the Compensation under Section 3, or the Completion Time specified at Section 4. (2) "Demand"means a written demand for a Change Order by the CONTRACTOR for any of the following: (a) A time extension; (b) Payment of money or damages arising from work done by, or on behalf of, the CONTRACTOR pursuant to this Agreement and payinent of which is not expressly permitted pursuant to Section 3 of this Agreement; (c) Payment of an amount the CITY disputes; (d) Any disputes and other matters relating to the acceptability of the work performed or the interpretation of the Contract Documents; (e) A request for a time extension or additional payment based upon differing site conditions, such as subsurface or latent physical conditions at the job site differing materially from those indicated in this Agreement or the Contract Documents, or unknown SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx/rev. 05/2016 D - 9of54 physical conditions at the job site, of an unusual nature, differing materially from those ordinarily encountered and generally recognized as inherent to work of the PROJECT; or (0 A request for a time extension or additional payment based upon acts of neglect by CITY or due to fires, floods, labor disputes, epidemics, abnormal weather conditions or acts of God. B. A Demand for a time extension or payment of money or damages may only be granted by a Change Order. C. No Change Order may be granted except where the Contractor has submitted a Demand to the DPW (or his or her written designee). All Demands shall be submitted promptly, but in no event later than thirty (30) days after the occurrence of the event giving rise to the Demand. The Demand shall be in writing and include all documents necessary to substantiate the Demand. The DPW shall act on the Demand within fifteen(15) days after receipt, including by requesting additional information from the CONTRACTOR to detennine whether to approve the Change Order the Demand seeks. The DPW shall act on the Demand within fifteen(15) days after receipt of the additional information or within a period of time no greater than the time the CONTRACTOR took to produce the additional information requested, whichever is greater. D. Notwithstanding the thirty (30) days to submit a Demand under Subparagraph C, in the case of differing or unknown site conditions, immediately upon encountering the conditions, CONTRACTOR shall notify the DPW in writing of the conditions, so that the CITY may promptly investigate the conditions. E. If the CONTRACTOR disputes the DPW's written response on the Demand, or the CITY fails to respond within the time prescribed, the CONTRACTOR may so SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx/rev.05/2016 D- 10of54 notify the City Engineer, in writing, either within fifteen (15) days of receipt of the City Engineer's response or within fifteen(15) days of the DPW's failure to respond within the time prescribed, respectively, and request an informal conference to meet and confer for settlement of the Demand. Upon the CONTRACTOWs request, the DPW shall schedule a meet and confer conference within thirty (30) days to seek to resolve. F. CITY and CONTRACTOR shall execute appropriate Change Orders covering changes to the time or price by executing the Change Order by mutual agreement. If the CITY and CONTRACTOR are unable to reach a mutual agreement, then the City Engineer shall issue a written decision on the claim within a reasonable time. G. Following the meet and confer conference, if the Demand remains in dispute, the CONTRACTOR may file a claim with the City as provided in Chapter 1 (commencing with Section 900) and Chapter 2 (commencing with Section 910) of Part 3 of Division 3.6 of Title I of the Government Code. For purposes of those provisions, the running of the period of time within which a claim must be filed shall be tolled from the time the time the CONTRACTOR submits his or her Demand until the Demand is denied as a result of the meet and confer process, including any period of time utilized by the meet and confer process. 13. VARIATIONS IN ESTIMATED QUANTITIES The quantities listed in the bid schedule will not govern final payment. Payment to CONTRACTOR will be made only for the actual quantities of Agreement items used in construction of the PROJECT, in accordance with the plans and specifications. Upon completion of the PROJECT, if the actual quantities used are either more than or less than the quantities listed in the bid schedule, the bid price shall prevail subject to the provisions of this Section. DPW may, at its sole discretion, when warranted by the facts and circumstances, order SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx/rev. 05/2016 D - 11of54 an equitable adjustment, upwards or downwards, in payment to CONTRACTOR where the actual quantities used in construction of the PROJECT are in variation to the quantities listed in the bid schedule. No claim by CONTRACTOR for an equitable adjustment in price or time for completion shall be allowed if asserted after final payment under this Agreement. If the quantity variation is such as to cause an increase in the time necessary for completion, DPW shall ascertain the facts and circumstances and make such adjustment for extending the completion date as in its sole judgment the findings warrant. 14. PROGRESS PAYMENTS Each month DPW will make an estimate in writing of the work performed by CONTRACTOR and the value thereof. From each progress estimate, five percent (5%) will be deducted and retained by CITY and the remainder of the progress estimate, less the amount of all previous payments since commencement of the work, will be paid to CONTRACTOR. When CONTRACTOR has, in the judgment of DPW, faithfully executed fifty percent (50%) or more of the value of the work as determined from the bid schedule, and if DPW finds that satisfactory progress has been and is being made, CONTRACTOR may be paid such sum as will bring the payments of each month up to one hundred percent (100%) of the value of the work completed since the commencement of the PROJECT, as determined in its sole discretion by DPW, less all previous payments and less all previous retained amounts. CITY's final payment to CONTRACTOR, if unencumbered, or any part thereof' unencumbered, shall be made thirty (30) days after the acceptance of the work and the filing of a Notice of Completion by CITY. Provided, however, that in the event of a dispute between CITY and CONTRACTOR, CITY may withhold from the final payment an amount not to exceed 150 percent of the value of any disputed amount of work. Payments shall be made on demands SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).doex/rev. 05/2016 D - 12of54 drawn in the manner required by law, each payment to be accompanied by a certificate signed by DPW, affirming that the work for which payment is demanded has been performed in accordance with the terms of the Agreement and that the amount stated in the certificate is due under the terms of the Agreement. Partial payments on the contract price shall not be considered as an acceptance of any part of the work. 15. WITHHELD CONTRACT FUNDS SUBSTITUTION OF SECURITIES At the request and at the sole cost and expense of CONTRACTOR, who shall retain beneficial ownership and receive interest, if any thereon, CITY shall permit the substitution and deposit therewith of securities equivalent to the amount of any monies witl-licld by CITY to ensure performance under the terms of this Agreement. 16. AFFIDAVITS OF SATISFACTION OF CLAIMS After the completion of the work contemplated by this Agreement, CONTRACTOR shall file with DPW its affidavit stating that all workers and persons employed, all firms supplying materials and all subcontractors working upon the PROJECT have been paid in full and that there are no claims outstanding against the PROJECT for either labor or material, except certain items, if any, to be set forth in CONTRACTOR's affidavit covering disputed claims, or items in connection with Notices to Withhold, which have been filed under the provisions of the statutes of the State of California. 17. WAIVER OF CLAIMS The acceptance by CONTRACTOR of the payment of the final certificate shall constitute a waiver of all claims against CITY under or arising out of this Agreement. SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx/rev. 05/2016 D- 13of54 18. INDEMNIFICATION DEFENSE HOLD HARMLESS CONTRACTOR hereby agrees to protect, defend, indemnify and hold harmless CITY, its officers, elected or appointed officials, employees, agents, and volunteers from and against any and all claims, damages, losses, expenses, judgments, demands, defense costs, and consequential damage or liability of any kind or nature, however caused, including those resulting from death or injury to CONTRACTOR's employees and damage to CONTRACTOR's property, arising directly or indirectly out of the obligations or operations herein undertaken by CONTRACTOR, caused in whole or in part by any negligent act or omission of the CONTRACTOR, any subcontractors, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, including but not limited to concurrent active or passive negligence, except where caused by the active negligence, sole negligence, or willful misconduct of the CITY, Its officers, elected or appointed officials, employees, agents, and volunteers. CONTRACTOR will conduct all defense at its sole cost and expense and CITY shall approve selection of CONTRACTOR's counsel. This indetmiity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by CONTRACTOR. 19. WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY INSURANCE Pursuant to California Labor Code Section 1861, CONTRACTOR acknowledges awareness of Section 3700 et seq. of this Code, which requires every employer to be insured against liability for workers' compensation; CONTRACTOR covenants that it will comply with such provisions prior to commencing performance of the work hereunder. SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx/rev. 05/2016 D - 14of54 CONTRACTOR shall maintain workers' compensation and employer's liability insurance in an amount of not less than the State statutory limits. CONTRACTOR shall require all subcontractors to provide such workers' compensation and employer's liability insurance for all of the subcontractors' employees. CONTRACTOR shall furnish to CITY a certificate of waiver of subrogation under the terms of the workers' compensation and employer's liability insurance and CONTRACTOR shall similarly require all subcontractors to waive subrogation. 20. INSURANCE In addition to the workers' compensation and employer's liability insurance and CONTRACTOR's covenant to defend, hold harmless and indemnify CITY, CONTRACTOR shall obtain and furnish to CITY, a policy of general public liability insurance, including motor vehicle coverage covering the PROJECT. This policy shall indemnify CONTRACTOR, its officers, employees and agents while acting within the scope of their duties, against any and all claims arising out or in connection with the PROJECT, and shall provide coverage in not less than the following amount: combined single limit bodily injury and property damage, including products/completed operations liability and blanket contractual liability, of One Million Dollars ($1,000,000) per occurrence. If coverage is provided under a forth which includes a designated general aggregate limit, the aggregate limit must be no less than One Million Dollars ($1,000,000) for this PROJECT. This policy shall name CITY, its officers, elected or appointed officials, employees, agents, and volunteers as (the "Additionally Insured Parties") as Additional Insureds, and shall specifically provide that any other insurance coverage which may be applicable to the PROJECT shall be deemed excess coverage and that CONTRACTOR's insurance shall be primary and non-contributory with any other valid and collectible insurance or SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).doex/rev.05/2016 D - 15of54 self-insurance available to the Additionally Insured Parties. Any available insurance proceeds in excess of the minimum coverage amount specified herein shall be available to the Additionally Insured Parties. All coverage available to CONTRACTOR shall also be available to the Additionally Insured Parties. Under no circumstances shall said above-mentioned insurance contain a self-insured retention without the express written consent of CITY; however, an insurance policy "deductible" of$5,000.00 is permitted. 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 o1'the work hereunder, CONTRACTOR shall furnish to CITY certificates of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverages as required by this Agreement; the certificates shall: 1. provide the name and policy number of each carrier and policy; 2. state that the policy is currently in force; and 3. promise to provide that such policies will not be canceled or modified without thirty (30) days' prior written notice of CITY. CONTRACTOR shall maintain the foregoing insurance coverages in force until the work under this Agreement is fully completed and accepted by CITY. The requirement for carrying the foregoing insurance coverages shall not derogate from the provisions for indemnification of CITY by CONTRACTOR under the Agreement. CITY or its representative shall at all times have the right to demand the original or a copy of all SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).doex/rev. 05/2016 D - 16of54 the policies of insurance. CONTRACTOR shall pay, in a prompt and timely manner, the premiums on all insurance hereinabove required. CONTRACTOR shall provide a separate copy of the additional insured endorsement to each of CONTRACTOR's insurance policies, naming CITY, its officers, elected and appointed officials, employees, agents and volunteers as Additional Insureds, to the City Attorney for approval prior to any payment hereunder. 22. CALIFORNIA PREVAILING WAGE LAW A. The CITY has ascertained from the Director of Industrial Relations of the State of California the general prevailing rate of per diem wages and the general prevailing rate for legal holiday and overtime work in the locality in which the work is to be performed for each craft or type of work needed to execute this Agreement, and the same has been set forth by resolution on file in the office of the City Clerk of CITY. CONTRACTOR and any subcontractor under it shall pay not less than said prevailing wage rates to all workers employed on this public works Agreement, as required by California Labor Code Sections 1771 and 1774. In accordance with the provisions of Section 3700 of the California Labor Code, CONTRACTOR agrees to secure payment of compensation to every employee. B. Pursuant to this Agreement and in accordance with Section 1774 and 1775 of the California Labor Code, CONTRACTOR shall, as penalty to CITY, forfeit twenty-five dollars ($25) for each calendar day or portion thereof for each worker paid (either by CONTRACTOR or any of its subcontractors) less than the prevailing wage rate established fbr that particular craft or type of work. SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx/rev. 05/2016 D- 17of54 23. CALIFORNIA EIGHT-HOUR LAW A. California Labor Code, Sections 1810 et seg, shall apply to the performance of this Agreement; thereunder, not more than eight (8) hours shall constitute one day's work and CONTRACTOR and each subcontractor employed by its hereunder, shall not require more than eight (8) hours of labor per day or forty (40) hours per week from any one person employed by it hereunder, except as stipulated in California Labor Code Section 1815. CONTRACTOR and each subcontractor employed by it hereunder shall, in accordance with California Labor Code Section 1812, keep an accurate record, open to inspection at all reasonable hours, showing the name and actual hours worked each calendar day and each calendar week by each worker employed in connection with the PROJECT. B. Pursuant to this Agreement and in accordance with California Labor Code Section 1813, CONTRACTOR shall, as a penalty to CITY, forfeit twenty-five dollars ($25) for each worker employed hereunder by CONTRACTOR or any subcontractor for each calendar day during which such worker is required or permitted to work more than eight (8) hours in any one (1) calendar day or forty (40) hours in any one (1) calendar week in violation of California Labor Code Section 1815. 24. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE Section 1773.8 of the California Labor Code, regarding the payment of travel and subsistence allowance is applicable to this PROJECT. 25. EMPLOYMENT OF APPRENTICES Section 1777.5 of the California Labor Code, regarding the employment of apprentices is applicable to this PROJECT. SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).doex/rev.05/2016 D- 18of54 26. PAYROLL RECORDS CONTRACTOR agrees to keep accurate payroll record showing the name, address, social security number, work classification, straight time and overtime hours worked each day and week. and the actual per diem wages paid to each journeyman, apprentice or worker employed by it in connection with the PROJECT and agrees to require each of its subcontractors to do the same. CONTRACTOR further agrees that its payroll records and those of its subcontractors, if any, shall be available at all reasonable times to the CITY, and the employee or his representative, and the Division of Labor Standards Enforcement and the Division of Apprenticeship Standards, and to comply with all of the provisions of California Labor Code Section 1776, in general. 27. 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 perfonmance of this agreement within ten (10) days of receipt of such claim or claims. 28. DEFAULT AND TERMINATION If CONTRACTOR fails or refuses to prosecute the work hereunder with diligence, or fails to complete the work within the time specified, or is adjudged bankrupt or makes an assignment for the benefit of creditors or becomes insolvent, or violates any provision of this Agreement or the Contract Documents, CITY may give CONTRACTOR notice in writing of its intention to terminate this Agreement. Unless the violation is cured within ten (10) days after such Notice of Intention has been served on CONTRACTOR, CITY may, without prejudice to any other remedy it may have, terminate this Agreement upon the expiration of that time. SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx/rev.05/2016 D- 19of54 Upon such default by CONTRACTOR, CITY may elect not to tenninate 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 tennination of this Agreement under this Section was wrongful, such termination shall be converted to a termination for convenience under Section 29 and any damages shall be assessed as set forth in Section 29. 29. 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 tennination, under this Section CITY shall pay CONTRACTOR for value of work in place on the PROJECT through the termination period less all such payments already made. In case of such termination for convenience, the CONTRACTOR shall be entitled to receive payment for work executed, and costs incurred by reason of such termination. In no event shall CONTRACTOR be entitled to recover overhead, profit or CONTRACTOR's fee on work not performed. Such payment by CITY shall be CONTRACTOR's sole and exclusive remedy for termination by CITY for its convenience and CITY shall have no further obligation to CONTRACTOR. 30. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS CONTRACTOR agrees that upon completion of the work to be performed hereunder, or upon expiration or earlier tennination of this Agreement, all original plans, specifications, drawings, reports, calculations, maps and other documents pertaining to this Agreement shall be delivered to CITY and become its sole property at no further cost. SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx/rev.05/2016 D - 20of54 31. 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. 32. CITY EMPLOYEES AND OFFICIALS CONTRACTOR shall employ no CITY official nor any regular CITY employee in the work performed pursuant to this Agreement. No officer or employee of CITY shall have any financial interest in this Agreement in violation of the California Government Code. 33. STOP NOTICES; RECOVERY OF ADMINISTRATIVE COSTS CITY shall be entitled to all reasonable administrative costs and necessary disbursements arising out of the processing of Stop Notices, Notices to Withhold, or any similar legal document. This obligation shall be provided for in the labor and materials payment bond required of CONTRACTOR. CITY may charge an administrative fee of One Hundred Dollars ($100) for every Stop Notice filed in excess of two (2), regardless of whether or not CITY is named in an action to enforce such stop notices. CITY may set off any unreimbursed cost or expense so incurred against any sum or sums owed by CITY to CONTRACTOR under this Agreement. 34. NOTICES Any notices, certificates, or other conununications hereunder shall be given either by personal delivery to CONTRACTOR's agent (as designated in Section 1 hereinabove) or to CITY as the situation shall warrant, or by enclosing the same in a sealed envelope, postage prepaid, and depositing the same in the United States Postal Service, to the addresses specified below; provided that CITY and CONTRACTOR, by notice given hereunder, may designate SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).doex/rev.05/2016 D - 21of54 different addresses to which subsequent notices, certificates or other communications will be sent: TO CITY: TO CONTRACTOR: City of Huntington Beach R J Noble Company ATTN: John Griffin Kori Porter 2000 Main Street 15505 E. Lincoln Ave. Huntington Beach, CA 92648 Orange CA 92865 35. SECTION HEADINGS The titles, captions, section, paragraph, and subject headings, and descriptive phrases at the beginning of the various sections in this Agreement are merely descriptive and are included solely for convenience of reference only and are not representative of maters included or excluded from such provisions, and do not interpret, define, limit or describe, or construe the intent of the parties or affect the construction or interpretation of any provision of this Agreement. 36. IMMIGRATION CONTRACTOR shall be responsible for full compliance with the immigration and naturalization laws of the United States and shall, in particular, comply with the provisions of the Immigration Reform and Control Act of 1978 (8 USC Section 1324a) regarding employment verification. 37. LEGAL SERVICES SUBCONTRACTING PROHIBITED CONTRACTOR and CITY agree that CITY is not liable for payment of any subcontractor work involving legal services, and that such legal services are expressly outside the scope of services contemplated hereunder. CONTRACTOR understands that pursuant to SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).doex/rev.05/2016 D- 22of54 Huntington Beach City Charter Section 309, the City Attorney is the exclusive legal counsel for CITY; and CITY shall not be liable for payment of any legal services expenses incurred by CONTRACTOR. 38. ATTORNEY'S FEES In the event suit is brought by either party to construe, interpret and/or enforce the terms and/or provisions of this Agreement or to secure the performance hereof, each party shall bear its own attorney's fees and the prevailing party shall not be entitled to recover its attorney's fees from the nonprevailing party. 39. INTERPRETATION OF THIS AGREEMENT The language of all parts of this Agreement shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any of the parties. If any provision of this Agreement is held by an arbitrator or court of competent jurisdiction to be unenforceable, void, illegal or invalid, such holding shall not invalidate or affect the remaining covenants and provisions of this Agreement. No covenant or provision shall be deemed dependent upon any other unless so expressly provided here. As used in this Agreement, the masculine or neuter gender and singular or plural number shall be deemed to include the other whenever the context so indicates or requires. Nothing contained herein shall be construed so as to require the commission of any act contrary to law, and wherever there is any conflict between any provision contained herein and any present or future statute, law, ordinance or regulation contrary to which the parties have no right to contract, then the latter shall prevail, and the provision of this Agreement which is hereby affected shall be curtailed and limited only to the extent necessary to bring it within the requirements of the law. SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx/rev. 05/2016 D - 23ofS4 40. GOVERNING LAW This Agreement shall be governed and construed in accordance with the laws of the State of California. 41. DUPLICATE ORIGINAL The original of this Agreement and one or more copies hereto have been prepared and signed in counterparts as duplicate originals, each of which so executed shall, irrespective of the date of its execution and delivery, be deemed an original. Each duplicate original shall be deemed an original instrument as against any party who has signed it. 42. 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. 43. CALIFORNIA FAIR EMPLOYMENT AND HOUSING ACT CONTRACTOR agrees to comply with all requirements and utilize fair employment practices in accordance with California Government Code Sections 12900 et seq. 44. SIGNATORIES Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify CITY fully for any injuries or damages to CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx/rev. 05/2016 D-24of54 45. ENTIRETY The foregoing, and Exhibits "A" and "B" attached hereto, set forth the entire Agreement between the parties. No waiver or modification of this Agreement shall be valid unless in writing duly executed by both parties. The parties acknowledge and agree that they are entering into this Agreement freely and voluntarily following extensive arm's length negotiations, and that each has had the opportunity to consult with legal counsel prior to executing this Agreement. The parties also acknowledge and agree that no representations, inducements, promises, agreements or warranties, oral or otherwise, have been made by that party or anyone acting on that party's behalf, which are not embodied in this Agreement, and that that party has not executed this Agreement in reliance on any representation, inducement, promise, agreement, warranty, fact or circumstance not expressly set forth in this Agreement. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized officers on / 7 , 20/7. SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx/rev. 05/2016 D - 25of54 R.J.NOBLE COMPANY CONTRACTOR CITY OF HUNTINGTON BEACH, a municipal corporation of the State of California 0TU 'b By. X 61%J& CRAIG PORTER,V,1,96 PRESIDENT ayor print name n ITS: (circle one)Chairman/PresidentNice President L(/ w C4 Clerk AND INITIATED AND APPROVED: By: X //�/ ?�-- STEVE-MEND02A,SE(tRETARY print name Director of ubl' Works ITS: (circle one)Secretary/Chief Financial Officer/Asst. Secretary-Treasurer REVI IY D APPROVED: vif�Manager APPROVED AS F City Attorney SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx/rev. 05/2016 D - 26of54 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 02/09/2017 before me, J. DE IONGH, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared CRAIG PORTER Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(* whose names}is/are- subscribed to the within instrument and acknowledged to me that he/she/they-executed the same in his/her/t7heir authorized capacity(ies,and that by hisAw/their signature(*on the instrument the person(s); or the entity upon behalf of which the person(s)acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. - J. DE IONGH ' Commission #2128504 Notary Public - California z z " z. Signature Orange County - My Comm. Expires Oct 28,2019 J Signa otary Public J. DE IONGH Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: 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 [1 General I-1 Individual I I Attorney in Fact ❑ Individual ❑Attorney in Fact ❑Trustee ❑ Guardian or Conservator ❑Trustee ❑Guardian cr Conservator ❑Other: ❑ Other: Signer Is Representing: Signer Is Representing: 02014 National Notary Association •www.Nationa]Notary.org - 1-800-US NOTARY(1-800-876-6827) Item#5907 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 02/09/2017 before me, J. DE IONGH, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared STEVE MENDOZA Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the persons} whose name(s)- Ware- subscribed to the within instrument and acknowledged to me that he/she/they-executed the same in his/her/their authorized capacity(ies,,and that by his/her/their signature(oon 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 J. DE IONGH' is true and correct. Commission # 2128504 � WITNESS my hand and official seal a -�m Notary Public - California z Z ' Orange County n My Comm. Expires Oct 28,2019 Signature _ Signature Notary Public J. DE IONGH Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: 0 Corporate Officer — Title(s): n Corporate Officer — Title(s): - ❑ Partner — ❑i 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 EXHIBIT A (Contractor's Proposal) SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx/rev. 05/2016 D- 27of54 r SECTION C PROPOSAL for the construction of EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET AND WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 151b FEDERAL AID PROJECT STPL-5181(189) in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealedg3ids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 65 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts..and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid,find 10%BIDDER'S BOND in the amount of ----------------- which said amount is not less than 10%of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids,payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond for_% ", as the case may be) Any standard Surety Bid Bond form is acceptable. Bidder shall signify receipt of all Addenda here, if any: Addenda No. Dale Received Bidder's �re #1 12/12/16 - X STEVE MENDOZA,SE RETARY #2 12/20/2016 x // �// STEVE MEr OZA,SEO TARY C-2 SECTION C PROJECT BID SCHEDULE EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET AND WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 FEDERAL AID PROJECT STPL-5181(189) in the PROJECT BASE BID: Basis of Award EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET. . . . . . . . .. . .. . . . . .. . . . . . . . . . . . . . . .. ...C-2.2 to C-2.7 WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET. . . . . . .. . . . .... . . .. . .. .. . ... . . . .. . . .. . . . C-2.8 TO C2.12 1. EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET $ BID IN FIGURES 2. WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET $ �b� � o0 BID IN FIGURES BASE BID TOTAL AMOUNT LUMP SUM BID IN FIGURES: (TOTAL FOR��I�TEE1MS 1 AND 2) $ \_``� � LYC[) 5Q BASIS OF AWARD C-2.1 SECTION C PROJECT BID SCHEDULE EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET AND WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 FEDERAL AID PROJECT STPL-5181(189) EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET CC NO. 1516 C 2.2 Addendum 1, CC-1516 Replacement Page C-2.3 EDINGER (GRAHAM-SPRINGDALE) PROJECT BID SHEET Bid Const Contract Unit ( Extended No. No. Description Quantity Unit Price Amount 1 -- MOBILIZATION 1 LS $ �,��p�� $ �� 00 2 -- TRAFFIC CONTROL PLAN 1 LS $ 1,900.00 $ 1,900.00 S CON FUISH RO PROJECT TRAFFIC 1 LS $ 19,500.00 $ 19,500.00 4 __ FURNISH AND INSTALL SIGNING AND STRIPING 1 LS 5 -- PROJECT SPECIFIC SWPPP 1 LS $ 4,200.00 $ 4,200.00 REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB,AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). (INCLUDES ALL 6 1 APPURTENANCES, CURB 3 EA $ 4,400.00 $ 13,200.00 GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) CONSTRUCT 0.17'ASPHALT ��•°O S4�ow 00 7 3 RUBBER HOT MIX(ARHM)WET 1►4 PROCESS OVERLAY. 2,200 TN $ � $ �Iq 8 4 ADJUST SEWER MANHOLE TO GRADE. 6 EA 810.00 4,860.00 9 INTENTIONALLY LEFT BLANK REPLACE WATER VALVE BOX 10 6 ASSEMBLY AND ADJUST TO 11 EA $ 860.00 $ 91460'00 GRADE PER HB STD PLAN 612. 11 INTENTIONALLY LEFT BLANK C-2.3 CC-1516, Addendum 1 EDINGER (GRAHAM-SPRINGDALE) PROJECT BID SHEET Bid Const Contract Unit ExbmxW No. No. Description.Descilptiod.i entity Unit Prim Amount COLD MILL EXISTING A.C. 12 7 PAVEMENT TO A DEPTH OF 0.34' 0.20 = 31,640.00 FROM NEW FINISHED SURFACE 158,200 SF $ PER PLANS. COLD MILL EXISTING AC. 13 8 PAVEMENT TO A DEPTH OF 0.6T o.zo FROM NEW FINISHED SURFACE 8,800 SF $ $ 1,760.00 PER PLANS. CONSTRUCT NEW 0.17'AND 0.50'B-PG-70-10-RAP A.C. BASE 14 7 8 el COURSE OVER 95% 60.00 COMPACTED SUBGRADE PRIOR 2,400 TN Z = 144,000.00 TO 0.1T ARHM OVERLAY PER PLANS. 15 INTENTIONALLY LEFT BLANK SET SURVEY MONUMENTATION 16 9 D PREPARE CORNER RECORD(PRE-AND/OR POST- 2 EA $ 385.00 $ 770.00 CONSTRUCTION). REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202(CF--n.(INCLUDES 17 10 SLOT PAVEMENT,AGGREGATE 46.50 BASE,LOT DRAINS,AND ALL 1,580 LF $ $ 73,470.00 ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE) C-2.4 EDINGER (GRAHAM-SPRINGDALE) PROJECT BID SHEET Bid const Contract Unit extended No. No. Quantity Unit Price Amount REMOVE AND RECONSTRUCT SIDEWALK PER HB STD.PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE-GRAD FROM WALK TO EXISTING 18 11 SLOPE, RELOCATING 6,600 SF $ 7.00 $ 46,200.00 IRRIGATION TO BACK OF NEW WALK,RETURNING LANDSCAPING TO PRE- CONSTRUCTION CONDITION D ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT COMMERCIAL/RESIDENTIAL DRIVEWAY('W'AND TYPE 19 12 SHOWN ON PLAN)PER STD 1,3W SF $ 15.55 $ 20,681.50 PLAN 209 OR 211.MATCH EXISTING IMPROVEMENTS TO GRADE. 20 INTENTIONALLY LEFT BLANK 21 INTENTIONALLY LEFT BLANK INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC 22 13 SIGNALS AND LIGHTING 24 EA $ 210.00 $ 5,040.00 SYSTEMS,2006 EDITION. SPLICE LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE"D". REMOVE EXISTING TREE AND ROOTS;GRIND TREE STUMP 23 14 AND ROOTS TO 24"BELOW TOP 20 EA $ 460.00 s,2oo.00 OF SIDEWALK/GRADE WITHIN 3 PROPOSEDIMPROVEMENT G2.S EDINGER (GRAHA"PRINGDALE) PROJECT BID SHEET Bid Conat No: Descri n- Contract .Unit Extended No: Quantity Unit Price Amount: FURNISH LABOR,EQUIPMENT, GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED 24 15 BY AGENCY.(INCLUDES ALL ITEMS NECESSARY TO 2,500 SF $ 0.42 $ 1,050.00 COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C.AND OVER EXCAVATION BID PAY ITEMS.) 1161�DENTIFIED 26VER EXCAVATIONN WHEN BY CONTRACTOR 90 CY $ 52.00 $ 4,680.00 AND VERIFIED BY AGENCY. JUST EDISON VAULT/MANHOLE TO GRADE BY 26 17 EDISON.CONTRACTOR TO 4 EA NOTA CONTRACTOR BID ITEM COORDINATE WITH ERICK OEN T(714)895-0242. L2727INTENTIONALLY LEFT BLANK ADJUST OCSD MANHOLE TO GRADE PER OCSD STD. PLAN S. 18 05 S-054 AND S-055. CONTRACTOR TO COORDINATE 9 EA $ 8�0.00 $ �,2so.00 WITH MIKE BOLSTER AT(714) 593-7645. 129 INTENTIONALLY LEFT BLANK C-2.6 t EDINGER (GRAHAMSPRINGDALE) PROJECT BID SHEET Bid Const Contract Unit No. No Extended : 1 D cli n.: Quan ty Unit Price:! Amount FURNISH AND PLANT NEW 240 BOX EASTERN REDBUD TREE PER HB STD. PLANS 714,715, 716,718&719 AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF EYJSTING LANDSCAPING, 30 19 BUSHES OR GROUND COVER 20 EA D IRRIGATION TO A DEPTH OF 24"BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY PROVED EQUAL AT BASE OF NEW TREE). FURNISH AND INSTALL ZEBRON, SANCON OR CITY APPROVED 31 -- EQUAL COATING ON THE NEW 3 EA $ i,55o.00 $ 4,650.00 CONCRETE INSIDE OF AGENCY SEWER MANHOLE RING. otsl Amount Bid in Figures: $ 1p � \' jD Total Amount Bid in Word& C L7 SECTION C PROJECT BID SCHEDULE EDINGER AVENUE REHABMffATION FROM GRAHAM STREET TO SPRINGDALE STREET AND WARNER AVENUE REHABELITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 FEDERAL AID PROJECT STPL-5181(189) WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 G2.8 Addendum 1, CC-1516 Replacement Page C-2.9 WARNER (BEACH BLVD. TO NEWLAND) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount 1 -- MOBILIZATION 1 LS $ $ /7 Ij 2 -- TRAFFIC CONTROL PLAN 1 LS $ 1,900.00 $ 1,900.00 3 FURNISH PROJECT TRAFFIC CONTROL 1 LS $19,500.00 $ 19,500.00 4 __ FURNISH AND INSTALL SIGNING y� AND STRIPING 1 LS $ �C� m• $ Moo. 5 -- PROJECT SPECIFIC SWPPP 1 LS $ 4,125.00 $ 4,125.00 REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB, AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). 6 1 (INCLUDES ALL 4,260.00 APPURTENANCES, CURB 9 EA $ $ 3a,3ao.00 GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT,AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) CONSTRUCT 0.1 T ASPHALT 7 3 RUBBER HOT MIX(ARHM)WET 3,000 TN $ 77.00 $ 231,000.00 PROCESS OVERLAY. 8 4 ADJUST SEWER MANHOLE TO GRADE. 9 EA $ 810.00 $ 7,290.00 9 5 ADJUST STORM DRAIN MANHOLE TO GRADE. 2 EA $ 810.00 $ 1,620.00 REPLACE WATER VALVE BOX 10 6 ASSEMBLY AND ADJUST TO 49 EA $ 860.00 $ 42,140.00 GRADE PER HB STD PLAN 612. COLD MILL EXISTING A.C. 11 7 PAVEMENT TO A DEPTH OF 0.17' 15,370.00 $ FROM NEW FINISHED SURFACE 53,000 SF $ 0 29 PER PLANS. COLD MILL EXISTING A.C. 12 g PAVEMENT TO A DEPTH OF 0.34' 0.22 FROM NEW FINISHED SURFACE 157,000 SF $ $ 34,540.00 PER PLANS. C-2.9 CC-1516, Addendum 1 WARNER (BEACH BLVD. TO NEWLAND) PROJECT BID SHEET Bid Const Contract Unit E�atsnded No.: No. n Quantity: Unit Price Amount COLD MILL EXISTING A.C. 13 9 PAVEMENT TO A DEPTH OF 0.g7' 0 22 FROM NEW FINISHED SURFACE 20,100 SF 4,422.00 PER PLANS. CONSTRUCT NEW 0.17'JWD 0.50'B-PG-70-1 CRAP A.C. BASE COURSE OVER 95% 14 g 6 9 COMPACTED SUBGRADE PRIOR 2,8W TN S 55.50 S 158,175.00 O 0.1T ARHM OVERLAY PER PLANS. RAISE SURVEY WELL MONUMENT TO GRADE AND 15 10 PREPARE COMER RECORD 2 EA 1,250.00 $ 2,500.00 (PRE-AND/OR POST CONSTRUCTION). SET SURVEY MONUMENTATION 1g 11 D PREPARE CORNER 385.00 RECORD(PRE-AND/OR POST- 8 EA 3 3,oso.00 CONSTRUCTION). REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202(CFI. (INCLUDES 17 12 SLOT PAVEMENT,AGGREGATE BASE, LOT DRAINS,AND ALL 200 LF 52.50 10,500.00 ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND REC T SIDEWALK PER HS STD, PLAN 207 AND AS MODIFIED ON PLANS.(INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE,RE-GRAD FROM WALK TO EXISTING 18 13 SLOPE,RELOCATING 3,750 SF 7.10 $ 26,625.00 IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE- CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE. C 2.10 WARNER (BEACH BLVD. TO NEWLAND) PROJECT BID SHEET FB,Imd Const Contract UnitExtended : No. Descri o Qugnft Unit PNce Amount REMOVE AND RECONSTRUCT COMMERCIAL/RESIDENTIAL DRIVEWAY('11V"AND TYPE 19 14 SHOWN ON PLAN)PER STD 1,600 SF : 17.00 5 27,200.00 PLAN 209 OR 211.MATCH EXISTING IMPROVEMENTS TO GRADE. REMOVE AND RECONSTRUCT CONCRETE CURB AND CROSS GUTTER PER HB STD.PLAN 205. 20 15 (ITEM INCLUDES SLOT 3,6W SF $ 19.00 s 66,500.00 PAVEMENT,AGGREGATE BASE AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE) REMOVE AND RECONSTRUCT MEDIAN CURB AND GUTTER PER HB STD PLAN 201 (CF=8"). (INCLUDES SLOT PAVEMENT, 66.00 7,260.00 21 16 AGGREGATE BASE,LOT 110 LF $ $ DRAINS,AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC 22 17 SIGNALS AND LIGHTING 58 EA $ 210.00 $ 12,180.00 SYSTEMS,2005 EDITION. SPLICE LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE"W. REMOVE EXISTING TREE AND ROOTS;GRIND TREE STUMP 23 18 AND ROOTS TO 24"BELOW TOP 4 EA $ 700.00 s 2,800.00 OF SIDEWALK/GRADE WITHIN PROPOSEDIMPROVEMENT AREA C-2.11 WARNER (BEACH BLVD. TO NEWLAND) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Quanft Unit Price Amount FURNISH LABOR, EQUIPMENT, ND GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED 24 19 BY AGENCY.(INCLUDES ALL 2,500 $ 0.42 g �,050.00 ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE,EXCEPT BASE COURSE A.C.AND OVER EXCAVATION BID PAY ITEMS.) OVER EXCAVATION WHEN 26 20 IDENTIFIED BY CONTRACTOR 90 CY 52.00 $ 4,680.00 D VERIFIED BY AGENCY. ADJUST EDISON VAULTIMANHOLE TO GRADE BY 26 21 EDISON.CONTRACTOR TO 1 EA NOT CONTRACTOR BID ITEM COORDINATE WITH ERICK OEN AT 14 895-0242. ADJUST VERIZON VAULT/MANHOLE TO GRADE BY 27 22 VERIZON. CONTRACTOR TO 1 EA NOT CONTRACTOR BID ITEM COORDINATE WITH RAY ROUNDTREE AT(714)375-6760. ADJUST OCSD MANHOLE TO GRADE PER OCSD STD.PLAN S- 28 23 053,S-064 AND S-056. 1 EA s 810.00 $ 810.00 CONTRACTOR TO COORDINATE WITH MIKE BOLSTER AT(714) 593-760. 29 24 ADJUST MONITORING WELL 5 EA 860.00 $ 4,300.00 COVER TO GRADE. 30 INTENTIONALLY LEFT BLANK FURNISH AND INSTALL ZEBRON, SANCON OR CITY APPROVED 31 -- EQUAL COATING ON THE NEW 4 EA 1,560.00 6,240.00 CONCRETE INSIDE OF AGENCY SEINER MANHOLE RING. Total Amount Bid in Figures: $ t." 00 Total Amount Bid in Words: C-2.12 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater,and the portion of the work to be done by such subcontractor. Bld Name And Ad*=-of Stale -Class '; .DIR Dollar", s6 0l *M(s) Sub&woadw ..License. Number Amount, Contrail Nreniber 1-16 CASE LAND SURVEYING 2-15 614 N. ECKHOFF STREET 5411 LS 1000001533 4,540.00 0.32% 2-16 ORANGE,CA 92868 1-22 SMITHSON ELECTRIC 2-22 1938 E.KATELLA AVE 614518 C-10 1000001610 16,400.00 1.15% ORANGE,CA 92867 1-4 SUPERIOR PAVEMENT MARKINGS 2-4 14658 INDUSTRY CIRCLE 776306 C-31 1000001476 29 785.00 2.09% LA MI RADA,CA 90638 C-32 1-23 TREESMITH INC. �w 2-23 1551 N. MILLER ST 802705 C-27 1000001838 g0.80 d'w 1-30 ANAHEIM,CA 92806 o RUBBERIZED CRACKFILLER SEALANT 2 7 800 E.WALNUT AVE 484758 C-32dl°!� FULLERTON,CA 92831 1000010726 00 1-6 EBS GENERAL ENG p 1-17-19 1320 E.SIXTH STREET SUITE 100 720016 A 1000005295 301,992.50 21.22% 2-6 CORONA,CA 92879 2-17-21 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 SUBNHTTED 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 12/20/16 ' at ORANGE CA Date City State STEVE MENDOZA being first duly sworn, deposes and says that he)erxshe is SECRETARY of R.J.NOBLE COMPANY the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation,partnership, company association,organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. R J.NOBLE COMPANY Name of Bidder x jzjl&z?� Signature of✓Biddet' STEVE MENDOZA,SECRETARY 15505 E.LINCOLN AVENUE,ORANGE,CA 92865 Address of Bidder C4 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 - — — -,�r•.e.cecc�,�,cr-.4r,�.rahcrcr<c:5'.i A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness, accuracy,or validity of that document. State of California County of ORANGE On 12/20/2016 before me, J. DE IONGH, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared STEVE MENDOZA 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/t-heir 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. J. DE IONGH WITNESS my hand and offi ial s al. Commission #2128504 z:"m Notary Public -California n Z orange County My Comm. Expires oct 28,2019 Signature Signature o ary Public J. DE IONGH Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: 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 — u 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 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 Edinger Avenue Rehabilitation from Graham Street to Springdale Street and Warner Avenue Rehabilitation Beach Boulevard to Newland Street,Project CC No. 1516,(1)(we)(it)will employ and utilize only qualified persons, as hereinafter defined,to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8,California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved." The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal-OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. R.J.NOBLE COMPANY Contractor By STEVE MENDOZA,SECRETARY Title Date: 12/20/2016 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. N/A Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 op 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. R.J.NOBLE COMPANY Contractor X By STEVE MENDOZA,SECRETARY Title Daft: 12/20/2016 C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: R.J.NOBLE COMPANY Bidder Name 15505 E.LINCOLN AVENUE Business Address ORANGE CA 92665 City, State Zip r 714 637-1550 Telephone Number �- 762906 CLASS A&C-12 State Contractor's License No. and Class AUGUST2000 Original Date Issued AUGUST 31,2018 Expiration Date The work site was inspected by STEVE MENDOZA of our office on DECEMBER 15 '201&. The following are persons,firms,and corporations having a principal interest in this proposal: R.J.NOBLE COMPANY A CALIFORNIA CORPORATION MICHAEL J.CARVER,PRESIDENT CRAIG PORTER,VICE PRESIDENT STEVE MENDOZA,SECRETARY JAMES N.DUCOTE,TREASURER KASONDRA CARVER,ASSISTANT SECRETARY AUSTIN CARVER,ASSISTANT SECRETARY The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. R.J.NOBLE COMPANY Company Name x Signature or ts, r STEVE MENDOZA,SECRETARY Printed or Typed Signature J. DE IONGH Subscribed and sworn to before me this 20TH day Of DECEMBER 201� Commission #2128504 ' z �,I Notary Public-California z z ram," Orange County D My Comm. Expires Oct 28,20191 NOTARY PUBLIC x J.DE IONGH NOTARY SEAL C-8 s E 2 16 Tit F� � a O c o U C, NaW a O �m � �I V2� UA W Z o� Q L a. p-J O W V UQ1 W a0 O t Z _N U ch r• � ¢ o Bidder's Project History For the purposes of this project, the bidder shall provide project history of similar work, specifically referencing the construction of(Describe specific work and experience necessary for project. For example, "Sanitary-sewer line installation of at least of 1,000 of 8-inch and greater in public right-of-way. Sanitary sewer lift stations of similar size, nroiect work within Public streets, an area containing high round water and pipeline construction in high ground water regions with trench depths of 8-feet to the invert."). Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: 1. WALT DISNEY IMAGINEERING-1401 FLOWER STREET, GLENDALE, CA 91221-5020 Name and Address of Public Agency Name and Telephone No. of Project Manager: IENNETH DENSKI 714-284-6342 4.1 MILLION GRADING, PAVING, STORM DRAINAGE AUGUST 2010 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: WALK DISNEY IMAGINEERING-SP-9 PARKING FACILITY-GRADING AND PAVING PARKING LOT RECONSTRUCTION WITH UNDERGROUND STORM DRAINAGE SYSTEM INSTALLED 2. CITY OF TUSTIN, 300 CENTENNIAL WAY,TUSTIN,CA 92780 Name and Address of Public Agency Name and Telephone No. of Project Manager: BENNY TEN KEAN 714-573-3161 22 MILLION ROAD RECONSTRUCTION WITH STORM DRAIN IMPTS DECEMBER 2013 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: RECONSTRUCTION OF TUSTIN RANCH ROAD WITH STORM DRAIN IMPROVEMENTS 3. CITY OF TUSTIN, 300 CENTENNIAL WAY,TUSTIN, CA 92780 Name and Address of Public Agency Name and Telephone No. of Project Manager: BENNY TENKEAN 714-573-3161 15.1 MILLION ROAD RECONSTRUCTION WITH STORM DRAIN IMPTS APRIL 2014 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: BARRANCA ROAD RECONSTURCTION,ASPHALT PAVING, SIGNAGE&STRIPING, ELECTRICAL AND LANDSCAPING C-9 Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager, and Superintendent. For each of these critical positions,please list at least three projects for which the critical staff has performed similar work within the last five years. These projects do not have to be under the employment of the bidder of this project.Bidders are encouraged submit supplemental relevant project history in addition to the projects listed herein. 1, KORI PORTER Name of proposed Project Manager Telephone No. of proposed Project Manager: 714-637-1550 PAVEMENT REHABILITATION, CITY OF MISSION VIEJO, $1.5 MILLION CLASS A AUGUST 2013 Project Name&Contract Amount Type of Work Date Completed JAMBOREE ROAD, CITY OF ORANGE $1.6 MILLION ASPHALT PAVING CLASS A MARCH 2O14 Project Name&Contract Amount Type of Work Date Completed ARGOSY,YORKTOWN &6TH, CITY OF HUNTINGTON BEACH $3.3 MILLION CLASS A DECEMBER 2014 Project Name&Contract Amount Type of Work Date Completed 2. CHUCK SPIERS Name of proposed Superintendent Telephone No. of proposed Superintendent~ 714-637-1550 PAVEMENT REHAB OF VISTA ROAD, CITY OF TEMECULA, $1.4 MILLION CLASS A SEPTEMBER 2013 Project Name& Contract Amount Type of Work Date Completed LA PALMA AVE STREET IMPTS, CITY OF BUENA PARK, $1.5 MILLION CLASS A NOVEMBER 2013 Project Name&Contract Amount Type of Work Date Completed 3 ARTERIAL STREETS, CITY OF GARDEN GROVE, $2.4 MILLION CLASS A JULY 2014 Project Name&Contract Amount Type of Work Date Completed C-10 CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771.1(a)),passed by the California State Senate on June 20, 2014, established a new public works Contractor Registration Program, which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July 1 through June 30 state fiscal year) with the California Department of Industrial Relations (DIR). Currently the annual non-refundable registration fee for Contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 http://www.dir.ca.gov/DLSE/PublieWorks/SB854FactSheet 6.30.14.pdf DIR's Contractor Registration Link—Call(844) 522-6734 https:fefiling.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. R.J.NOBLE COMPANY Contractor x By l/ STEVE MENDOZA,SECRETARY Title Date: 12/20/2016 DIR#: 1000004235 C-11 �"—. a MM OPublic Works Contractor(PWC)Registration Search ..+vao.�w...e».oc+o.x++m..:xnww�i..�.ow��xm:..•ar...n nmwnuw.�u.: cwwwarcox.maw.am..m.woumw.w.mr.a:ewxae.. [ RhYY4nYxr: Cumn P...vw MIMI v OIEC M.IYn.11wIW: ..xP')L56)B9] CYxx�IpYMw: e!M[E CpNM1Y (mn.C>:%.nu.:. . IlrnxMu:Wn I.x'W�3].SB Ce , nenmll..W pw:.y.n[aM[nb:n 1 nn.lM..x •Rn.xx: CnM R 4YM.n: 6Am IYa1 G. Cn +• ..i.:.nie<o...x. l00000.m awaE oumse aa�aro[e wxvrov BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AN 4ENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations,Part 135* Economic Opportunities for Low and Very Low-Income Persons The bidder, under penalty of perjury, certifies that except as noted below,any person associated therewith in the capacity of owner,partner, director, officer,or manager(initial the applicable selections): Will ensure that 10%of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1961, or Will hire no new employees in conjunction with this project. Will award 10%of its sub-contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub-contracts related to this project. Contractor: R.J.NOBLE COMPANY Contact Person: STEVE MENDOZA,SECRETARY Contact Phone: 714-637-1550 Signed: x Date: 12/20/2016 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub-contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification C-12 RELIABLE CONTRACTOR DECLARATION(page 1 of 2) CalRecycle 168(Revised 9/16) This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalRecycle) prior to authorizing a contractor(s) to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of funds to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Reliable Contractor Declaration (formerly Unreliable List) requirement of their Terms and Conditions. The Reliable Contractor Declaration (formerly Unreliable List) provision requires the following: Prior to authorizing a contractor(s) to commence work under the Grant, the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractors) stating that within the preceding three (3) years, none of the events listed in Section 177050 of Title 14, Califomia Code of Regulations, Natural Resources, Division 7, has occurred with respect to the contractor(s). Please see the reverse of this page, or refer to the California Code of Regulations (www.calregs.com). If any of the events listed in Section 17050 have.occurred, disclosure is required but will not necessarily result in CalRecycle refusing to approve the contractor. A signed statement explaining the facts and circumstances of the events must be attached i and submitted with this form. Contractor: Complete the form and send original to the Grantee. Grantee: Scan the form and upload it to the grant in CalRecycle's Grant Management System. For further instruction about logging into the Grant Management System and uploading this form, reference the Procedures and Requirements. Retain the original form in your grant file. GRANTEE INFORMATION . GRANTEE NAME: GRANT NUMBER: CITY OF HUNTINGTON BEACH CC NO,1516 PRIMARY CONTACT NAME: JAMES WAGNER CONTRACTOR INFORMATION CONTRACTOR NAME: R.J NOBLE COMPANY AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: STEVE MENDOZA,SECRETARY MAILING ADDRESS: P.0 BOX 620,ORANGE,CA 92856 As the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor. Alternatively, as the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, if any of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor, I have disclosed all such occurrences in an attached signed statement that explains the facts and circumstances of the listed events. Signature Date X 12/20/2016 STEVE ME /OZA,SE TARY C-13 RELIABLE CONTRACTOR DECLARATION(page 2 of 2) Title 14 CCR,Division 7, Chapter 1 CalRecyde 168(Revised 9/16) Article 5. Unreliable Contractors,Subcontractors, Borrowers and Grantees Section 17050.Grounds for Placement on Unreliable List The following are grounds for a finding that a contractor,any subcontractor that provides services for a CalRecycle agreement, grantee or borrower is unreliable and should be placed on the CalRecycle Unreliable Contractor, Subcontractor, Grantee or Borrower List {"Unreliable List'). The presence of one of these grounds shall not automatically result in placement on the Unreliable List. A finding must be made by the Executive Director in accordance with section 17054, and there must be a final decision on any appeal that may be filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s)to CalRecycle due to fraudulent claims or reporting;or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act, Government Code section 12650 et.seq;or (c) Default on a CalRecycle loan,as evidenced by written notice from'Cal Recycle staff provided to the borrower of the default;or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycle;or (a) Filing voluntary or involuntary bankruptcy,where there is a finding based on substantial evidence, that the bankruptcy interfered with the CalRecycle contract,subcontract,grant or loan;or (tj Breach of the terms and conditions of a previous CalRecycle contract,any subcontract for a CalRecycle agreement,grant,or loan,resulting in termination of the CalRecycle contract,subcontract,grant or loan by the CalRecycle or prime contractor,or (g) Placement on the CalRecycle's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility;or (h) The person, or any partner, member, officer, director, responsible managing officer, or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion, conspiracy, or any act in violation of any state or federal antitrust law in connection with the bidding upon, award of, or performance under any CalRecycle contract, subcontract,grant or loan;or () The person or entity is on the list of unreliable persons or entities,or similar list,of any other federal or California state agency;or The person or entity has violated an Order issued in accordance with section 18304;or, (k) The person or entity has directed or transported to, has or accepted waste tires at,a site where the operator is required to have but does not have a waste fire facility permit or, (Ij The person or entity has transported waste tires without a waste fire hauler registration;or, (m) The person or entity has had a solid waste facility or waste fire permit or a waste fire hauler registration denied, suspended or revoked;or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRecycle to remediate,clean,or abate a nuisance at the site;or (o) The following are additional grounds for a finding that,a person or entity described below should be placed on the Unreliable List: (1) The person or entity owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director,manager,partner,trustee,or any other management position with significant control(Principal Manager)in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person who owns 20%or more of the entity,if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted In its placement on the Unreliable List (5) The entity has another entity which owns 20%or more of the entity,if that other entity: 1. Is on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (6) Subsection(o)is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-14 Local Assistance Procedures Manual Exhibit 12-H Sample Bid (THE BIDDER'S EXECU770N ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONS77TUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICA17ONS WHICHARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder R.J NOBLE COMPANY ,proposed subcontractor ,hereby certifies that he has " has not ,participated in a previous contract or subcontract subject to the equal opportunity clauses,as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity,all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b)(1)),and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director,Office of Federal Contract Compliance,U.S.Department of Labor. Page 1 of 8 C-15 June11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376,Stats. 1985),the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has_,has not X been convicted within the preceding three years of any offenses referred to in that section,including any charge of fraud,bribery,collusion, conspiracy,or any other act in violation of any state or Federal antitrust law in connection with the bidding upon,award of, or performance of,any public works contract,as defined in Public Contract Code Section 1101,with any public entity,as defined in Public Contract Code Section 1100,including the Regents of the University of California or the Trustees of the California State University. The term"bidder"is understood to include any partner,member,officer,director,responsible managing officer,or responsible managing employee thereof as referred to in Section 10295.1. Note: The bidder must place a checkmark after"has"or"has not"in one of the blank spaces provided.The above tu Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also consti te signature of this Statement.Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162,the,Bidder shall complete,under penalty of perjury,the following questionnaire: Has the bidder,any officer of the bidder,or any employee of the bidder who has a proprietary interest in the bidder,ever been disqualified,removed,or otherwise prevented from bidding on,or completing a federal,state,or local government project because of a violation of law or a safety regulation? Yes No " If the answer is yes,explain the circumstances in the following space. Page 2 of 8 C-16 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232,the Contractor,hereby states under penalty of perjury,that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that maldng a false certification may subject the certifier to criminal prosecution. Page 3 of C-17 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY/COUNTY of HUNTINGTON BEACH/ORANGE DEPARTMENT OF PUBLIC WORKS. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of,or on behalf of,any undisclosed person,partnership, company,association,organization,or corporation;that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded,conspired,connived,or agreed with any bidder or anyone else to put in a sham bid,or that anyone shall refrain from bidding;that the bidder has not in any manner,directly or indirectly,sought by agreement,communication,or conference with anyone to fix the bid price of the bidder or any other bidder,or to fix any overhead,profit,or cost element of the bid price,or of that of any other bidder,or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true;and,further,that the bidder has not,directly or indirectly,submitted his or her bid price or any breakdown thereof,or the contents thereof, or divulged information or data relative thereto,or paid,and will not pay,any fee to any corporation, partnership,company association,organization,bid depository,or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 4 of 8 C-18 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS,PART 29 The bidder,under penalty of perjury,certifies that,except as noted below,he/she or any other person associated therewith in the capacity of owner,partner,director,officer,manager: • is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any Federal agency; • has not been suspended,debarred,voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending;and • has not been indicted,convicted,or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification,insert the exceptions in the following space. NONE Exceptions will not necessarily result in denial of award,but will be considered in determining bidder responsibility. For any exception noted above,indicate below to whom it applies,initiating agency,and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 5 of 8 C-19 June 11,2014 Loyal Assistance Procedures Manual Exhibit 12-H Sample Bid NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies,by signing and submitting this bid or proposal,to the best of his or her knowledge and belief;that: (1} No Federal appropriated funds have been paid or will be paid,by or on behalf of the undersigned,to any person for influencing or attempting to influence an officer or employee of any Federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal,amendment,or modification of any Federal contract,grant,loan,or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with this Federal contract,grant, loan,or cooperative agreement,the undersigned shall complete and submit Standard Form-LLL "Disclosure of Lobbying Activities,"in conformance with its instructions. ' This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352,Title 31,U.S.Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts,which exceed$100,000 and that all such subrecipients shall certify and disclose accordingly. Page 6of8 C'20 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 r 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: J a. contract a. bid/offer/application a. initial / b. grant b. initial award b. material change c. cooperative agreement c. post-award d. loan For Material Change O e. loan guarantee year quarter f. loan insurance date last of report 4. Name and Address of Reporting Entity S. If Reporting Entity in No.4 is Sub aw rdee, Enter Name and Address of Prime- Prime � Subawardee Tier ,if known Congressional District,if known Congressional District,' own 6. Federal Department/Agency: 7. Federal Program Na escription: CFDA Number, ' applicable 8. Federal Action Number,if known: 9. Award Amou if known: 10. a. Name and Address of Lobby Entity b. Ind uals Performing Services (including (If individual,last name,first name,MI) ss if different from No. 1 Oa) ast name,first name,MI) (attach Continuati Sbeet(s)if necessary) 11. Amount of Payment(check all that apply) 13. Type of Payment(check all that apply) S actual P d a. retainer b. one-time fee 12. Form of Payment(check all that a ly): c. commission Ba. cash d. contingent fee b. in-kind, specify: n e deferred ' value f. other,specify 14. Brief Description of Se ces Performed or to be performed and Date(s)of Service,including offrcer(s),employees,or member(s)contacted,for Payment Indicated in Item 11: (attach Continuation Sheet(s)if necessary) 15. Continua' n Sheets)attached: Yes No 16. Informatio equestcd through this form is authorized by Title 31 .S.C.Section 1352. This disclosure of lobbying Signature: x� relim was placed by the tier above when his transaction was a or entered into. This disclosure is required STEVE t61ENDOZA to 31 U.S.C.1352. This information will be Print Name: r rted to Congress semiannually and will be available for ublic inspection. Any person who fails to file the required Title:_ SECRETARY disclosure shall be subject to a civil penalty of not less than S 10,000 and not more than$100,000 for each such failure. Telephone No.: 714-637-1550 Date: 12/20/16 Authorized for Local Reproduction Federal Use Only: Standard Form-LLL Standard Form LLL Rev.09-12-97 Page 7 of 8 C-21 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient,at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C.section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. l. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which the change occurred. Enter the date of the last, Previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name,address,city,state and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks"Subawardee"then enter the full name,address,city,state and zip code of the prime Federal recipient. Include Congressional District,if known. 6. Enter the name of the Federal agency making the award or loan commitment Include at least one organization level below agency name,if known. For example,Department of Transportation,United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action(item 1). If known,enter the full Catalog of Federal Domestic Assistance(CFDA)number for grants,cooperative agreements,loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item I (e.g., Request for Proposal(RFP)number,Invitation for Bid(IFB)number,grant announcement number,the contract grant or loan award number,the application/proposal control number assigned by the Federal agency). Include prefixes,e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency,enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a)Enter the full name,address,city,state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b)Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last Name,First Name and Middle Initial(Ml). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4)to the lobbying entity(item 10). Indicate whether the payment has been made(actual)or will be made(planned). Check all boxes that apply. If this is a material change report,enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box. Check all boxes that apply. If payment is made through an in-kind contribution,specify the nature and value of the in-kind payment. 13. Check the appropriate box. Check all boxes that apply. If other,specify nature. 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal of or employee(s)contacted or the officer(s)employee(s)or Membcr(s) Of Congress that were contacted. 15. Check whether or not a continuation sheet(s)is attached. 16. The certifying official shall sign and date the form,print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response,including time for reviewing instruction,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project (0348-0046),Washington,D.C.20503. sF-LLL-1"rLV im R".060/-9OaENDIF» Page 8 of 8 C"22 June 11,2014 wl O fj C4 O am cw L. 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(714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For EDINGER AVENUE REHABILITATION AND WARNER AVENUE REHABILITATION CC No. 1516 Federal Aid Project STPL-5181(189) in the CITY OF HUNTINGTON BEACH December 12, 2016 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) PROJECT BID SCHEDULE—Section C Specification Book (2 Sheets) Replace"Project Bid Schedule—C-2.3" with "Project Bid Schedule—C-2.3 Addendum 1" (1 sheet). Bid items 1, 2, 3 and 4 descriptions were shortened. Replace "Project Bid Schedule—C-2.9" with "Project Bid Schedule—C-2.9 Addendum 1" (1 sheet). Bid items 1, 2, 3 and 4 descriptions were shortened. 2) APPENDIX H —Appendix H Part 2 Specification Book (27 Sheets) Replace Cover Sheet(1 sheet) and "General Decision Number CA160035 10/28/2016" with "General Decision Number CA 160035 11/11/2016" (26 sheets). Federal Construction Wage Rates were updated on 11/11/2016. This is to acknowledge receipt and review of Addendum Number One, dated December 12, 2016. R.J NOBLE COMPANY X (jQ�Jkel0 Company Name By STEV•[E YENDOZkSECRETARY 12/12/16 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call James Wagner at (714) 536-5467 within 24 hours of posting. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER TWO For EDINGER AVENUE REHABILITATION AND WARNER AVENUE REHABILITATION CC No. 1516 Federal Aid Project STPL-5181(189) in the CITY OF HUNTINGTON BEACH December 20, 2016 Notice To All Bidders.- Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) BID OPENING POSTPONED REVISED BID DUE DATE ON COVER AND ON PAGE A-1 FROM "DECEMBER 20, 2016" to "DECEMBER 29. 2016." 2) ASPHALT CONCRETE CLARIFICATION REVISED SHEET E-23 and E-24 IN SPECIFICATION BOOK—203 BITUMINOUS MATERIALS (2 Sheets) Replace E-23 with "E-23 CC-1516, Addendum 2" (1 sheet) And Replace Page E-24 with "E-24 CC-1516, Addendum 2" (1 sheet) This is to acknowledge receipt and review of Addendum Number Two, dated December 20, 2016. R.J. NOBLE COMPANY X Company Name By STEVfMEN66ZA, SECRETARY 12/20/2016 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call James Wagner at(714) 536-5467 within 24 hours of posting. Local Assistance Procedures Manual EXHIBIT 15-G Local Agency Bidder DBE Commitment(Construction Contracts) EXHIBIT 15-G LOCAL AGENCY BIDDER DBE COMMITMENT(CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY: CITY OF HUNTINGTON BEACH LOCATION. HUNTINGTON BEACH PROJECT DESCRIPTION: EDINGER AVE&WARNER AVENUE REHABILITATION TOTAL CONTRACT AMOUNT:S 1,416,29850 BID DATE: 1 vzo/zo1 s BIDDERS NAME: R J NOBLE COMPANY CONTRACT DBE GOAL: 4 CONTRACT TEM OF WORK AND DESCRIPTION DBE(ART NO. NAME OF EACH DBE DOLLARAMOUNT ITEM NO. R SERVICES TO BE EXPIRATION (Must be certified on the date bids BE UBCONTRACTED OR MATERIALS DATE are opened-include DBE address BE PROVIDED(or contracted if the and phone number) idder is a DBE) Schedule 1,#23&30 TREE REMOVAL 35817 TREESMITH,714-996-6037 $34,740.00 I Schedule 2,#23 TREE PLANTING 07/2017 1551 N.MILLER STREET ANAHEIM,CA 92806 Schedule 1,#7&14 Supply Portion of Asphalt Oil 38327 LMS TRANSPORT 951-616-3828 $37,000 00 X 60 05/2017 2751 AVALON STREET =$22,200.00 JURUPA VALLEY,CA 92509 For Local Agency to Complete: J S/ Total Claimed DBE $ 5694000 Local Agency Contract Number. C Participation Federal-aid Project Number S 7 i L—sl g/ L/8 9) 4 Federal Share: S�c7O O Contract award Date: X Local Agency certifies that all DBE certifications have been verified and SW,-attire of Bidd!!�/ infortmtion is complete and accurate. G 12/20/2016 714-637-1550 Date (Area Code)Tel.No. Print rintNa Nam IgneIIae Date STEVE MENDOZA,SECRETARY Local Agency Representative ,,JJPerson to Contact (Please Type or Print) rea(A Code)Telephone Number.7(T- 534-6q(0,7 Local Aamcy Bidder DBE Commitmeat(Coneovctioo Conhaets) (Rev 6/26/09) Distribution: (1)Copy—Fax or scan a copy to the Caltrans District Local Assistance Engineer(DLAE)within 30 days of contract execution.Failure to send a copy to the DLAE within 30 days of contract execution may result in de-obligation of fiords for this project. (2)Copy—Include in award package to Caltrans District Local Assistance (3)Original—Local agency files Page 15-1 OR 12-04 C-23 June 29,2012 From:Treesmith Enterprise.-Fax: To: RJ Noble Fax: (714)637-6321 Page 1 of 2 12292018 12:46 PM PROPOSAL Treesmith Enterprises,Inc. Proposal submitted to: Job Name/Location: Estimator of Project Edinger Ave Rehabilitation From Graham St to Springdale St and Warner Ave Rehabilitation From REMISED QUOTE Beach Blvd to Newland St CC No. CC-1516 City of Huntington Beach Performed according to ANSI A300 industry standards for tree care, unless otherwise noted. Edinger Avenue Rehabilitation From Graham Street to Springdale Street Bid Item#23—Remove existing tree and roots; grind tree stump and roots to 24" below top of sidewalk/grade within proposed improvement area. Qty 20 (n, $432.00 = $8,640.00 Bid Item#30—Furnish and plant new 24" box Eastern Redbud tree per HB Std.Plans 714, 715, 716, 718 & 719 as shown on plans. Includes 90-day maintenance period+ additional 365 day maintenance(Tree Planting Only) Qty 20(a, $1,175.00= $23,500.00 Warner Avenue Rehabilitation From Beach Boulevard to Newland Street Bid Item#18—Remove existing tree and roots;grind tree stump and roots to 24"below top of sidewalk/grade within proposed improvement area. Qty 4 (a, $650.00= $2,600.00 *Proposal must be accepted in its entirety unless authorization from Treesmith Enterprises,Inc. *Contact Treesmith Enterprises,Inc, if this proposal is accepted and used for contract *UNION COMPANY *Traffic control,posting or notifications not included *Price includes prevailing wages *Compensation will be added for jobs that require special safety training requirements and security clearance *All retention monies due to Treesmith will be paid in full within ninety(90)calendar days of completion of contract work *Treesmith is not liable for any unforeseen damage to underground utilities,wiring, gas, water, irrigation lines,etc. *Excludes all backfills,permits,and property owner notifications *Excludes removal of bushes, shrubs, and ground cover material *Excludes non-accessible stumps or stubs *Excludes installation of replacement grass,vegetation and irrigation *Excludes removal of irrigation, rocks,trash,debris,and other non-plant material *Excludes dust control and soil erosion control *Excludes night work *Treesmith is a SBE-37366 Exp 07-31-17,DBE&UDBE-35817,DIR#1000001838 Exp 06-30-17 See back for definitions, terms, and conditions. Total :( S34,740.00) Treesmith Representative: �-V�-�-�T------_-----V-- Date: 12129/2016 Dale Gee WE-9697A This proposal maybe withdrawn by us if not accepted in 90 days Work authorization: All prices, specifications, and terms of this proposal are satisfactory, understood, and hereby accepted. Signature: Date: _ 1.551 N.Miller St. Anaheim, CA 92806 •(714)996-6037_Fax (71.4)996-6057 _ cnc T £ ►�y�Yj California State Contractors License 802705 - 1 LlA - R' : www.treesmith.net Page 1 of 2 From:Treesmith EnterpHse!Fax: To:RJ Noble Fax: (714)637-6321 Page 2 of 2 12292016 12:46 PM Terms and Conditions It is agreed by and between Treesmith Enterprises,Inc.and the authorizing party(customer and/or customer's agent)that the following provisions are made as part of this contract: Insurance by Contractor:Treesmith Enterprises,Inc.warrants that it is insured for liability resulting from injury to person(s)or property and that all employees are covered by Workers'Compensation as required by law. Certificates of coverage are available upon request. Cancellation: Treesmith Enterprises,Inc.kindly requests that the authorizing party provide at least 24 hours advance notice of any full or partial work cancellation.Proposals which are not accepted in their entirety are subject to a rebidding process. If a crew has been dispatched to the job site,the customer will be assessed a mobilization fee of S 150.00 for incurred expenses. Completion of Contract: Treesmith Enterprises,Inc.agrees to do its best to meet any agreed upon performance dates,but shall not be liable in damages or otherwise for delays because of inclement weather,labor,or any other cause beyond its control;nor shall the customer be relieved of completion for delays. Tree Ownership: The authorizing party warrants that all trees listed are located on the customer's property,and,if not,that the authorizing party has received full permission from the owner to allow Treesmith Enterprises,Inc.to perform the specified work. Should any tree be mistakenly identified as to ownership,the customer agrees to indemnify Treesmith Enterprises,Inc. for any damages or costs incurred from the result thereof. Safe : Treesmith Enterprises,Inc.warrants that all arboricultural operations will follow the latest version of the ANSI Z133.1 industry safety standards. The authorizing party agrees to not enter the work area during arboricultural operations unless authorized by the crew leader on-site. ANSI A300 Tree Care Standard Definitions: The following definitions apply to specifications detailed in this proposal. clean: Selective pruning to remove one or more of the following parts:dead,diseased,and/or broken branches. Unless noted otherwise on this proposal,all cleaning will be of branches 1 inch diameter or greater throughout the entire crown. crown:The leaves and branches of a tree measured from the lowest branch on the trunk to the top of the tree. leader:A dominant or co-dominant,upright stem. raise:Selective pruning to provide vertical clearance. reduce: Selective pruning to decrease height and/or spread by removing specified branches. restore: Selective pruning to improve the structure,form,and appearance of trees that have been severely headed,vandalized,or damaged. thin: Selective pruning to reduce density of live branches,usually by removing entire branches. vista pruning:Selective pruning to allow a specific view,usually by creating view"windows"through the tree's crown. Stump Removal: Unless specified in the proposal,stump removal is not included in the price quoted. Grindings from stump removal are not hauled unless specified in this proposal. Surface and subsurface roots beyond the stump are not removed unless specified in this proposal. ConceaIed Contingencies Any additional work or equipment required to complete the work,caused by the authorizing party's failure to make known or caused by previously unknown foreign material in the trunk,the branches,underground,or any other condition not apparent in estimating the work specified,shall be paid for by the customer on a time and material basis. Treesmith Enterprises,Inc.is not responsible for damages to underground sprinklers,drain lines,invisible fences or underground cables unless the system(s)are adequately and accurately mapped by the authorizing party and a copy is presented before or at the time the work is performed. Clean-up: Clean-up shall include removing wood,brush,and clippings,and raking of the entire area affected by the specified work,unless noted otherwise on this proposal. Lawn Repair: Treesmith Enterprises,Inc.will attempt to minimize all disturbances to the customer's lawn. Lawn repairs are not included in the contract price,unless noted otherwise on this proposal. Terms of Payment:Unless otherwise noted in this proposal,the customer agrees to pay the account in full upon completion. Failure to remit full payment within the payment term will result in a finance charge of 2.00%per month. Returned Check Fee: There will be a$25.00 fee charged for all checks returned to our office for non-sufficient funds. Page 2 of 2 Contractor Initial OFFICE: 951-616-3828 FAX: 951-685-1862 Email:orders@Ims-transport.com or orders@lmncoldmilling.com LMS TRANWORT 2751 Avalon St,Jurupa Valley, Ca 92509 CA # 434396 0 eoo-698-saes UDBE#38327 1 SBE# 1770011 UDBE#40561 SBE# 1795213 COMPANY: RJ Noble ATTN: Estimating BID DATE: 12-29-16 PROJECT NAME: Edinger Rehab &Warner Rehab—Huntington Beach Below is LMS Transport's& LMN Incorporated's quote for the above referenced project. If this quote is accepted please send a signed copy to orders@Ims-transport.com or fax to 951-685-1862 Item#: Oil Supply Only(per ton): (1)315 of PG70-10 &315 of PG64-10 @$368 thru 3/31/17 (Non-Index). • Item#Freight Only(per ton): (1) $21 LTR to Orange. Item Numbers: See rental rates below for cold milling,dump trucks, equipment moves, &flatbeds. INCLUSIONS(PERTAINING TO OIL SUPPLYING/TRUCKING/COLD MILLING): 1. TERMS ARE NET 7(no sales taxes or environmental fees included). 2. A flat$12 Oil Spill Assessment Fee will be added to each load of oil. 3. LMS TRANSPORT MUST BE NOTIFIED WITHIN 30 DAYS OF BID DATE OR QUOTE WILL BE NULL&VOID. 4. EACH ADDITIONAL MOVE/MOBILIZATION IS BASED ON LMN STANDARD RATES(SEE PAGE 2). 5. ADDITIONAL SHIFTS TO BE CHARGED AT LMN STANDARD RATES(SEE PAGE 2). 6. BACK CHARGES NOT PERMITTED FOR TRUCKING OR MILLING WITHOUT SAME DAY APPROVAL. 7. ALL WORK TO BE PERFOMED UNDER THE CUSTOMERS SUPERVISION. EXCLUSIONS(PERTAINING TO OIL SUPPLYING/TRUCKING/COLD MILLING): 1. QCQA,ARHM,TESTING, ENGINEERING, PERMITS, BONDS, FEES, INSPECTION FEES, SWPPP, LAYOUT,SURVEY. 2. SKIP WORK,SWEEPING, DETAIL,MINI GRINDER UNLESS NOTATED UNDER INCLUSIONS. 3. HANDWORK/DETAIL WORK UNLESS NOTATED UNDER INCLUSIONS. 4. TRAFFIC CONTROL LABOR,TRAFFIC CONTROL PLANS,SIGNS&CMS BOARD UNLESS NOTATED UNDER INCLUSIONS. 5. IMPORT&EXPORT,SUBGRADE REMOVAL&COMPACTION,SUBGRADE PREP,GRADING, FINE GRADING, DEWATERING, PETRO-MAT, CLAY, MACADAM,AND ANY UNFORSEEN CIRCUMSTANES OR CONDITIONS. UNLESS NOTATED UNDER INCLUSIONS. 6. PROTECTION OF EXST. UTILITIES, UTILITY ADJUSTMENTS UNLESS NOTATED UNDER INCLUSIONS. 7. STRIPING AND SIGNAGE,SEAL COAT,SLURRY,PRIME COAT,WEEDKILL. UNLESS NOTATED UNDER INCLUSIONS. Customer Name I Signature I Date: LMS & LMN Name I Signature I Date: LMS Transport-CA#434396 1 LMN Incorporated"A Cold Milling Co."-CSLB#987495 EXHMIT 15-G Local Assistance Procedures Manual Local Agency Bidder DBE Commitment(Construction Contracts) INSTRUCTIONS-LOCAL AGENCY BIDDER DBE COMMITMENT(CONSTRUCTION CONTRACTS) ALL BIDDERS: PLEASE NOTE: This information may be submitted with your bid.If it is not,and you are the apparent low bidder or the second or third low bidder,it must submitted and received as specified in the Special Provisions.Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract:Local Agency,Location,Project Description,Total Contract Amount,Bid Date,Bidder's Name, and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs.Prime contractors shall indicate all work to be performed by DBEs including,if the prime is a DBE,work performed by its own forces,if a DBE.The DBE shall provide a certification number to the Contractor and expiration date. Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work(who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier.Names of the First-Tier DBE Subcontractors and their respective items)of work listed should be consistent,where applicable, with the names and items of work in the"List of Subcontractors"submitted with your bid. There is a column for the DBE participation dollar amount.Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 1000/0 of item is not to be performed or furnished by the DBE,describe exact portion of time to be performed or furnished by the DBE.)See Section "Disadvantaged Business Enterprise(DBE),"of the Special Provisions(construction contracts),to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated by the person bidding.Also list a phone number in the space provided and print the name of the person to contact. LOCAL agencies should complete the Local Agency Contract Award,Federal-aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. Page 15-2 June 29,2012 C-24 OB 12-04 GOAL HAS BEEN MET Local Assistance Procedures Manual Exhibit 15-H DBE Information-Good Faith Effort Exmmrr 15-H DBE INFORMATION—GOOD FArm EFFoRTs DBE INFoRMAnoN-GOOD FAITH EFFORTS Federal-aid Project No. STPL-1111(189) Bid Opening Date 12/20/2016 The City of Huntington Beach established a Disadvantaged Business Enterprise(DBE) goal of 4 %for this project. The information provided herein shows that a good faith effort was made. Lowest,second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts.Bidders should submit the following information even if the"Local Agency Bidder DBE Commitment"form indicates that the bidder has met the DBE goal.This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons,e.g.,a DBE firm was not certified at bid opening,or the bidder made a mathematical error. Submittal of only the"Local Agency Bidder DBE Commitment"form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled"Submission of DBE Commitment"of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder(please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement COMPLIANCE NEWS 12/15/16 B. The names and dates of written notices sent to certified DBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested(please attach copies of solicitations,telephone records, fax confirmations,etc.): Names of DBEs Solicited Date of Initial Follow Up Methods and Dates Solicitation PLEASE SEE THE ATTACHED CALL LOG&E-MAIL DISTRIBUTION LIST Page 1 OB 12-04 C-25 June 29,2012 Exhibit 15-H Local Assistance Procedures Manuel DBE Information-Good Faith Effort C. The items of work which the bidder made available to DBE firms including,where appropriate, any breaking down of the contract work items(including those items normally performed by the bidder with its own forces)into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items ($) Of - - ,(YN Contract TRAFFIC LOOPS NO CONCRETE NO COLD MILLING NO TRAFFIC CONTROL NO — SURVEYING NO LANDSCAPE NO D. The names,addresses and phone numbers of rejected DBE firms,the reasons for the bidder's rejection of the DBEs,the firms selected for that work(please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: Names, addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested DBEs in obtaining bonding,lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: We are an Equal Opportunity Employer Performance Bonds may be required We will assist with bonds,insurance,an cre i e wi a so assist subcontractors in obtaininq necessary equipment supplies and materials Plans&specs for this project are available for review at our office Page 2 June 29,2012 C-26 OB 12-04 Local Assistance Procedures Manual Exhibit 15-H DBE Information-Good Faith Effort F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies,materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: We are an Equal Opportunity Employer.Performance Bonds may be required.We wdl assist with bonds,insurance,and credit We wtll also assist subcontractors in obtaining necessary eau ioment suoolies and matenal� Plans&soecs for this oroiect are available for rewew at our office G. The names of agencies,organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms(please attach copies of requests to agencies and any responses received, i.e.,lists,Internet page download,etc.): Name of Agency/Organization Method/Date of Contact Results H. An additio nal i oral data to support a demonstration of good faith efforts (use additional sheets if necessary): NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. Page 3 OB 12-04 C-27 June 29,2012 — ----- — --- — - —......_. ODI Wester n Surety Company BID BOND (Percentage) Bond Number- N/A KNOW ALL PERSONS BY THESE PRESENTS, That we R. J. Noble Company of Orange, California hereinafter referred to as the Principal, and Western Surety Company as Surety, are held and firmly bound unto of Huntington Beach hereinafter referred to as the Obligee, in the sum of percent of the greatest amount bid, for the payment of which we bind ourselves, our legal representatives, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, Principal has submitted or is about to submit a proposal to Obligee on a contract for------ CC-1 516 Edinger Ave and Warner Ave Arterial Rehabilitation NOW, THEREFORE, if the said contract be awarded to Principal and Principal shall, within such time as may be specified, enter into the contract in writing and give such bond or bonds as may be specified in the bidding or contract documents with surety acceptable to Obligee; or if Principal shall fail to do so, pay to Obligee the damages which Obligee may suffer by reason of such failure not exceeding the penalty of this bond, then this obligation shall be void; otherwise to remain in full force and effect. SIGNED, SEALED AND DATED this ---13 day of December 2016 R. J. Noble Company (Principal) By (Seal) Steve Mend Sea t ary f Wester n Sur p u rety) By (Seal) J !0,tt0!r1E,'y-in-Fact Form F5876 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of Califomia ) County of ORANGE ) On 12/14/2016 before me, J. DE IONGH, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared STEVE MENDOZA Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the persons} whose names} is/are- subscribed to the within instrument and acknowledged to me that he/she/they-executed the same in his/her/their authorized capacity(ieo,, and that by his/her/their signature(oon 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 1 of the State of California that the foregoing paragraph 1 DE IONGi is true and correct. " ._ Commission #2128504 WITNESS m hand and ial < _� Notary Public- California D y z Orange County My Comm. Expires Oct 28,2019 Signature Sig6fuj Notary Public J. DE IONGH Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: 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): O Partner — O Limited O General ❑ Partner — ❑ Limited ❑General ❑ Individual ❑Attorney in Fact ❑Individual ❑Attorney in Fact O Trustee ❑Guardian or Conservator ❑Trustee O Guardian or Conservator ❑Other: O Other: Signer Is Representing: Signer Is Representing: 02014 National Notary Association -www.NationalNotary.org- 1-800-US NOTARY(1-800-876-6827) Item#5907 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange ) On December 13, 2016 before me, Lauren Emily Bierman, A Notary Public (insert name and title of the officer) personally appeared James Scott Salandi, Attorney-in-Fact who proved to me on the basis of satisfactory evidence to be the person(s) whose name(%) is/aRy subscribed to the within instrument and acknowledged to me that he/%he" executed the same in his/hax hak authorized capacity(ieo, and that by his/harAhak signature(%) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. ��« LAUREN EMILY BIERMAN N � COMM.4 2097240 NOTARY PUMIC-WORMA ORANGE COUNTY N /� I L MY COMM.EXP.JAN 1S,2018 Signature Al � �1, U 1 I (Seal) Western Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents,That WESTERN SURETY COMPANY,a South Dakota corporation,is a duly organized and existing corporation having its principal office in the City of Sioux Falls,and State of South Dakota,and that it does by virtue of the signature and seal herein affixed hereby make,constitute and appoint James Scott Salandi, Leonard Ziminsky,David Jacobson, Individually of Irvine,CA,its true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign,seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts - and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney,pursuant to the authority hereby given,are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By-Law printed on the reverse hereof,duly adopted,as indicated,by the shareholders of the corporation. In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 16th day of June,2016. WESTERN SURETY COMPANY i *j�sf AV;`p °MTh DPµ aul T.Bruflat,Vice President State of South Dakota 1 County of Minnehaha I ss On this 16th day of June,2016,before me personally came Paul T.Bruflat,to me known,who,being by me duly swom,did depose and say: that he resides in the City of Sioux Falls,State of South Dakota;that he is the Vice President of WESTERN SURETY COMPANY described in and which executed - _ the above instrument;that-he knows-the seal-of said corporation;that the seal affixed to the said instrument is such corporate seal;that it was so affixed------ pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority,and acknowledges same to be the act and deed of said corporation. My commission expires J.MOHR Noramauauc /III',/ / June 23,2021 eFr SOUTH DAKOTA� J.Mohr,Notary A. �J_ Public CERTIFICATE I,L.Nelson,Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force,and further certify that the By-Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this ki day of Vl ...��, WESTERN SURETY COMPANY %_W _�Y PpOggj e;t 9 F'n= 1 ,zz Ay'Pc �; .T�.ppµ''ti �V,NINNN 21 L.Nelson,Assistant Secretary Form F4280-7-2012 RIP Ns 5 ENE,,i b Ck� 00�,/ r L. Ld 00 UN co b �+ xi ' €, mpm. . U O M Z .., W �_",s CL Z ,O o3 NO z z p z U U �n U am, i w` / Z Q p Of /Vr�� W Z Q _x� �T W 2 m F Q 00 00 w Q J ^I � N 1 z c-1 u 0 V w W U O EXHIBIT B (Exhibit 12-G to Local Assistance Procedures Manual) SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx/rev. 05/2016 D- 28of54 Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language EXHIBIT B EXHIBIT 12-G REQUIRED FEDERAL-AID CONTRACT LANGUAGE (For Local Assistance Construction Projects) The following language must be incorporated into all Local Assistance Federal- aid construction contracts. The following language, with minor edits, was taken from the Code of Federal Regulations. 1. DISADVANTAGED BUSINESS ENTERPRISES(DBE).................................................................................29 A. DBE COMMITMENT SUBMITTAL........................................................................................................30 B. GOOD FAITH EFFORTS SUBMITTAL..................................................................................................30 C. EXHIBIT 15-G-LOCAL AGENCY BIDDER DBE INFORMATION(CONSTRUCTION CONTRACTS)........................................... D. SUBCONTRACTOR AND DISADVANTAGED BUSINESS ENTERPRISE RECORDS...................31 E. PERFORMANCE OF DISADVANTAGED BUSINESS ENTERPRISES.............................................32 2. BID OPENING......................................................................................................................................................33 3. BID RIGGING......................................................................................................................................... .......33 4. CONTRACT AWARD..........................................................................................................................................33 5. CONTRACTOR LICENSE..................................................................................................................................33 6. CHANGED CONDITIONS...................................................................................................................... .......34 A. DIFFERING SITE CONDITIONS...............................................ERROR! BOOKMARK NOT DEFINED. B. SUSPENSIONS OF WORK ORDERED BY THE ENGINEER.............................................................34 C. SIGNIFICANT CHANGES IN THE CHARACTER OF WORK...........................................................34 7. BEGINNING OF WORK,TIME OF COMPLETION AND LIQUIDATED DAMAGES............................35 8. BUY AMERICA....................................................................................................................................................35 9. QUALITY ASSURANCE.....................................................................................................................................36 10. PROMPT PAYMENT OF FUNDS WITHHELD TO SUBCONTRACTORS................................................36 11. FORM FHWA-1273 REQUIRED CONTRACT PROVISIONS FEDERAL-AID CONTRACTS................36 12. FEMALE AND MINORITY GOALS.................................................................................................................48 13. FEDERAL TRAINEE PROGRAM.....................................................................................................................50 14. TITLE VI ASSURANCES...................................................................................................... .........52 ..................... 15. USE OF UNITED STATE-FLAG VESSELS.....................................................................................................53 D - 28of53 May 2016 SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language 1. DISADVANTAGED BUSINESS ENTERPRISES(DBE) Under 49 CFR 26.13(b): The contractor, subrecipient or subcontractor shall not discriminate on the basis of race, color, national origin, or sex in the performance of this contract. The contractor shall carry out applicable requirements of 49 CFR part 26 in the award and administration of DOT-assisted contracts. Failure by the contractor to carry out these requirements is a material breach of this contract, which may result in the termination of this contract or such other remedy as the recipient deems appropriate. Take necessary and reasonable steps to ensure that DBEs have opportunity to participate in the contract (49 CFR 26). To ensure equal participation of DBEs provided in 49 CFR 26.5, the Agency shows a goal for DBEs. Make work available to DBEs and select work parts consistent with available DBE subcontractors and suppliers. Meet the DBE goal shown elsewhere in these special provisions or demonstrate that you made adequate good faith efforts to meet this goal. It is your responsibility to verify that the DBE firm is certified as DBE at date of bid opening. For a list of DBEs certified by the California Unified Certification Program, go to: http://wuv.dot.ca. og v/hq/bep/find certified htm. All DBE participation will count toward the California Department of Transportation's federally mandated statewide overall DBE goal. Credit for materials or supplies you purchase from DBEs counts towards the goal in the following manner: ® 100 percent counts if the materials or supplies are obtained from a DBE manufacturer. a 60 percent counts if the materials or supplies are obtained from a DBE regular dealer. O Only fees, commissions, and charges for assistance in the procurement and delivery of materials or supplies count if obtained from a DBE that is neither a manufacturer nor regular dealer. 49 CFR 26.55 defines "manufacturer" and "regular dealer." You receive credit towards the goal if you employ a DBE trucking company that performs a commercially useful function as defined in 49 CFR 26.55(d)(1) through (4)and (6). D - 29of53 May 2016 SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language a. DBE Commitment Submittal Submit the Exhibit 15-G Local Agency Bidder DBE Commitment (Construction ('Onlracts) form, included in the Bid book. If the form is not submitted with the bid, remove the form from the Bid book before submitting your bid. If the DBE Commitment form is not submitted with the bid, the apparent low bidder, the 2nd low bidder, and the 3rd low bidder must complete and submit the DBE Commitment form to the Agency. DBE Commitment form must be received by the Agency no later than 4:00 p.m. on the 4th business day after bid opening. Other bidders do not need to submit the DBE Commitment form unless the Agency requests it. If the Agency requests you to submit a DBE Commitment fonn, submit the completed form within 4 business days of the request. Submit written confirmation from each DBE stating that it is participating in the contract. Include confirnation with the DBE Commitment form. A copy of a DBE's quote will serve as written confirmation that the DBE is participating in the contract. If you do not submit the DBE Commitment form within the specified time, the Agency will find your bid nonresponsive. b. Good Faith Efforts Submittal If you have not met the DBE goal, complete and submit the DBE Infonnation- Good Faith Efforts, Exhibit 15-H, form with the bid showing that you made adequate good faith efforts to meet the goal. Only good faith efforts directed towards obtaining participation by DBEs will be considered. If good faith efforts documentation is not submitted with the bid, it must be received by the Agency no later than 4:00 p.m. on the 4th business day after bid opening. If your DBE Commitment form shows that you have met the DBE goal or if you are required to submit the DBE Commitment form, you must also submit good faith efforts documentation within the specified time to protect your eligibility for award of the contract in the event the Agency finds that the DBE goal has not been met. Good faith efforts documentation must include the following information and supporting documents, as necessary: 1. Items of work you have made available to DBE firms. Identify those items of work you might otherwise perform with your own forces and those items that have been broken down into economically feasible units to facilitate DBE participation. For each item listed, show the dollar value and percentage of the total contract. It is your responsibility to demonstrate that sufficient work to meet the goal was made available to DBE firms. 2. Names of certified DBEs and dates on which they were solicited to bid on the project. Include the items of work offered. Describe the methods used for following up initial solicitations to determine with certainty if the DBEs were interested, and the dates of the follow-up. Attach supporting documents such as copies of letters, memos, facsimiles sent, telephone logs,telephone billing statements, and other evidence of solicitation. You are reminded to solicit D - 30of53 May 2016 SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docX Local Assistance Procedures Manual Exhibit 12-C Required Federal-aid Contract Language certified DBEs through all reasonable and available means and provide sufficient time to allow DBEs to respond. 3. Name of selected firm and its status as a DBE for each item of work made available. Include name, address, and telephone number of each DBE that provided a quote and their price quote. If the firm selected for the item is not a DBE, provide the reasons for the selection. 4. Name and date of each publication in which you requested DBE participation for the project. Attach copies of the published advertisements. 5. Names of agencies and dates on which they were contacted to provide assistance in contacting, recruiting, and using DBE firms. If the agencies were contacted in writing, provide copies of supporting documents. 6. List of efforts made to provide interested DBEs with adequate information about the plans, specifications, and requirements of the contract to assist them in responding to a solicitation. If you have provided information, identify the name of the DBE assisted, the nature of the information provided, and date of contact. Provide copies of supporting documents, as appropriate. 7. List of efforts made to assist interested DBEs in obtaining bonding, lines of credit, insurance, necessary equipment, supplies, and materials, excluding supplies and equipment that the DBE subcontractor purchases or leases from the prime contractor or its affiliate. If such assistance is provided by you, identify the name of the DBE assisted,nature of the assistance offered, and date assistance was provided. Provide copies of supporting documents, as appropriate. 8. Any additional data to support demonstration of good faith efforts. The Agency may consider DBE commitments of the 2nd and 3rd bidders when determining whether the low bidder made good faith efforts to meet the DBE goal. c. E.rhibit 1 S-G-Local Agency Bidder DBE Liforrnution (Construction Contracts) Complete and sign Exhibit 15-G Local Agency Bidder DBE Commitment (C'onstruCtiOn Contracts) included in the contract documents regardless of whether DBE participation is reported. Provide written confirmation from each DBE that the DBE is participating in the Contract. A copy of a DBE's quote serves as written confirmation. If a DBE is participating as a joint venture partner, the Agency encourages you to submit a copy of the joint venture agreement.) d Subcontractor and Disadvantages!Business Enterprise Records Use each DBE subcontractor as listed on Exhibit 12-B Bidder's List of Subcontractors (DBE and Non-DBE) and Exhibit 15-G Local Agency Bidder DBE C0111111it111ent(COnStruction Contracts) form unless you receive authorization for a substitution. The Agency requests the Contractor to: 1. Notify the Engineer of any changes to its anticipated DBE participation D - 31of53 May 2016 SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language 2. Provide this notification before starting the affected work 3. Maintain records including: ® Name and business address of each I`-tier subcontractor • Name and business address of each DBE subcontractor, DBE vendor, and DBE trucking company, regardless of tier • Date of payment and total amount paid to each business If you are a DBE contractor, include the date of work performed by your own forces and the corresponding value of the work. Before the 15th of each month, submit a Monthly DBE Trucking Verification form. If a DBE is decertified before completing its work, the DBE must notify you in writing of the decertification date. if a business becomes a certified DBE before completing its work, the business must notify you in writing of the certification date. Submit the notifications. On work completion, complete a Disadvantaged Business Enterprises (DBE) Certification Status Change, Exhibit 17-0, form. Submit the form within 30 days of contract acceptance. Upon work completion, complete Exhibit 17-F Final Report— Utilization of Disadvantaged Business Enterprises (DBE), First-Tier.Subcontractors. Submit it within 90 days of contract acceptance. The Agency will withhold $10,000 until the form is submitted. The Agency releases the withhold upon submission of the completed form. e. Performance of Disadvantaged Business Enterprises DBEs must perform work or supply materials as listed in the Exhibit l 5-G Local Agency Bidder DBE Commitment (Construction Contracts) form, included in the Bid. Do not terminate or substitute a listed DBE for convenience and perforni the work with your own forces or obtain materials from other sources without authorization from the Agency. The Agency authorizes a request to use other forces or sources of materials if it shows any of' the following justifications: 1. Listed DBE fails or refuses to execute a written contract based oil plans and specifications for the project. 2. You stipulated that a bond is a condition of executing the subcontract and the listed DBE fails to meet your bond requirements. 3. Work requires a contractor's license and listed DBE does not have a valid license under Contractors License Law. 4. Listed DBE fails or refuses to perform the work or furnish the listed materials. 5. Listed DBE's work is unsatisfactory and not in compliance with the contract. 6. Listed DBE is ineligible to work on the project because of suspension or debarment. 7. Listed DBE becomes bankrupt or insolvent. 8. Listed DBE voluntarily withdraws with written notice from the Contract D-32of53 May 2016 SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language 9. Listed DBE is ineligible to receive credit for the type of work required. 10. Listed DBE owner dies or becomes disabled resulting in the inability to perform the work on the Contract. 11. Agency determines other documented good cause. Notify the original DBE of your intent to use other forces or material sources and provide the reasons. Provide the DBE with 5 days to respond to your notice and advise you and the Agency of the reasons why the use of other forces or sources of materials should not occur. Your request to use other forces or material sources must include: 1. One or more of the reasons listed in the preceding paragraph 2. Notices from you to the DBE regarding the request 3. Notices from the DBEs to you regarding the request If a listed DBE is terminated or substituted, you must make good faith efforts to find another DBE to substitute for the original DBE. The substitute DBE must perform at least the same amount of work as the original DBE under the contract to the extent needed to meet the DBE goal. The substitute DBE must be certified as a DBE at the time of request for substitution. Unless the Agency authorizes (1) a request to use other forces or sources of materials or (2) a good faith effort for a substitution of a terminated DBE, the Agency does not pay for work listed on the Exhibit 15-G Local Agency Bidder DBE Commitment (C'onsti•uction C'onfl,acts) form unless it is performed or supplied by the listed DBE or an authorized substitute. 2. BID OPENING The Agency publicly opens and reads bids at the time and place shown on the Notice to Bidders. 3. BID RIGGING The U.S. Department of Transportation (DOT) provides a toll-free hotline to report bid rigging activities. Use the hotline to report bid rigging, bidder collusion, and other fraudulent activities. The hotline number is (800) 424-9071. The service is available 24 hours 7 days a week and is confidential and anonymous. The hotline is part of the DOT's effort to identify and investigate highway construction contract fraud and abuse and is operated under the direction of the DOT Inspector General. 4. CONTRACT AWARD If the Agency awards the contract, the award is made to the lowest responsible bidder. 5. CONTRACTOR LICENSE The Contractor must be properly licensed as a contractor from contract award through Contract acceptance (Public Contract Code § 10164). D- 33of53 May 2016 SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language 6. CHANGED CONDITIONS a. [Deleted] b. Suspensions of Work Ordered by the Engineer 1. If the performance of all or any portion of the work is suspended or delayed by the engineer in writing for an unreasonable period of time(not originally anticipated, customary,or inherent to the construction industry)and the contractor believes that additional compensation and/or contract time is due as a result of such suspension or delay, the contractor shall submit to the engineer in writing a request for adjustment within 7 calendar days of receipt of the notice to resume work. The request shall set forth the reasons and support for such adjustment. 2. Upon receipt,the engineer will evaluate the contractor's request. If the engineer agrees that the cost and/or time required for the performance of the contract has increased as a result of such suspension and the suspension was caused by conditions beyond the control of and not the fault of the contractor, its suppliers, or subcontractors at any approved tier, and not caused by weather,the engineer will make an adjustment (excluding profit)and modify the contract in writing accordingly. The contractor will be notified of the engineer's determination whether or not an adjustment of the contract is warranted. 3. No contract adjustment will be allowed unless the contractor has submitted the request for adiustment within the time prescribed. 4. No contract adjustment will be allowed under this clause to the extent that performance would have been suspended or delayed by any other cause, or for which an adjustment is provided or excluded under any other tern or condition of this contract. e. Signifrcant Changes in the Character of Work I. The engineer reserves the right to make, in writing,at any time during the work, such changes in quantities and such alterations in the work as are necessary to satisfactorily complete the project. Such changes in quantities and alterations shall not invalidate the contract nor release the surety, and the contractor agrees to perform the work as altered. D -34of53 May 2016 SF:16-5234/Complete Spec Contract Sec D(6-2-16) (Z).docX Local Assistance Procedures Manual Exhibit 12-C Requircd Federal-aid Contract Language 2. If the alterations or changes in quantities significantly change the character of the work under the contract, whether such alterations or changes are in themselves significant changes to the character of the work or by affecting other work cause such other work to become significantly different in character, an adjustment, excluding anticipated profit, will be made to the contract. The basis for the adjustment shall be agreed upon prior to the performance of the work. If a basis cannot be agreed upon,then an adjustment will be made either for or against the contractor in such amount as the engineer may determine to be fair and equitable. 3. If the alterations or changes in quantities do not significantly change the character of the work to be performed under the contract, the altered work will be paid for as provided elsewhere in the contract. 4. The term "significant change"shall be construed to apply only to the following circumstances: ® When the character of the work as altered differs materially in kind or nature from that involved or included in the original proposed construction;Ol- e When a major item of work, as defined elsewhere in the contract, is increased in excess of 125 percent or decreased below 75 percent of the original contract quantity. Any allowance for an increase in quantity shall apply only to that portion in excess of 125 percent of original contract item quantity, or in case of a decrease below 75 percent,to the actual amount of work performed. 7. BEGINNING OF WORK,TIME OF COMPLETION AND LIQUIDATED DAMAGES See Section 4 ("Commencement of Project") and Section I I ("Liquidated Damages") of the Contract. 8. BUY AMERICA Furnish steel and iron materials to be incorporated into the work with certificates of compliance. Steel and iron materials must be produced in the U.S. except: I. Foreign pig iron and processed, pelletized, and reduced iron ore may be used in the domestic production of the steel and iron materials [60 Fed Reg 15478 (03/24/1995)]; 2. If the total combined cost of the materials does not exceed the greater of 0.1 percent of the total bid or$2,500,materials produced outside the U.S. may be used. D - 35of53 May 2016 SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language Production includes: 1. Processing steel and iron materials, including smelting or other processes that alter the physical form or shape (such as rolling, extruding, machining, bending, grinding, and drilling) or chemical composition; 2. Coating application, including epoxy coating, galvanizing, and painting, that protects or enhances the value of steel and iron materials. 9. QUALITY ASSURANCE The Agency uses a Quality Assurance Program (QAP)to ensure a material is produced to comply with the Contract. You may examine the records and reports of tests the Agency performs if they are available at the job site. Schedule work to allow time for QAP. 10. PROMPT PAYMENT OF FUNDS WITHHELD TO SUBCONTRACTORS Pursuant to Section 14 of the Construction Contract, the City shall hold retainage from the prime contractor and shall make prompt and regular incremental acceptances of portions, as determined by the City, of the contract work, and pay retainage to the prune contractor based on these acceptances. The prime contractor, or subcontractor, shall return all monies withheld in retention from a subcontractor within 30 days after receiving payment for work satisfactorily completed and accepted including incremental acceptances of portions of the contract work by the agency. Federal law(49CFR26.29) requires that any delay or postponement of payment over 30 days may take place only for good cause and with the agency's prior written approval. Any violation of this provision shall subject the violating prime contractor or subcontractor to the penalties, sanctions and other remedies specified in Section 7108.5 of the Business and Professions Code. These requirements shall not be construed to limit or impair any contractual, administrative, or judicial remedies otherwise available to the prime contractor or subcontractor in the event of a dispute involving late payment or nonpayment by the prime contractor,deficient subcontract performance, or noncompliance by a subcontractor. 11. FORM FHWA-1273 REQUIRED CONTRACT PROVISIONS FEDERAL-AID CONTRACTS [The following 10 pages of FHWA Form 1273 are incorporated into and made a part of the Construction Contract without modification.] D -36of53 May 2016 SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).doex Local Assistance Procedures Manual Exhibit 12-C Required Federal-aid Contract Language FHWA-1273-- Revised May 1,2012 REQUIRED CONTRACT PROVISIONS FEDERAL-AID CONSTRUCTION CONTRACTS I. General probation. The term Federal-aid highway does not include roadways II. Nondiscrimination functionally classified as local roads or rural minor collectors. III. Nonsegregated Facilities IV. Davis-Bacon and Related Act Provisions V. Contract Work Hours and Safety Standards Act Provisions II. NONDISCRIMINATION VI. Subletting or Assigning the Contract VII. Safety:Accident Prevention The provisions of this section related to 23 CFR Part 230 are applicable Vill. False Statements Concerning Highway Projects to all Federal-aid construction contracts and to all related construction IX. Implementation of Clean Air Act and Federal Water Pollution subcontracts of$10,000 or more. The provisions of 23 CFR Part 230 are Control Act not applicable to material supply,engineering,or architectural service X. Compliance with Governmentwide Suspension and Debarment contracts. Requirements XI. Certification Regarding Use of Contract Funds for Lobbying In addition,the contractor and all subcontractors must comply with the following policies:Executive Order 11246,41 CFR 60,29 CFR 1625- ATTACHMENTS 1627,Title 23 USC Section 140,the Rehabilitation Act of 1973,as amended(29 USC 794).Title VI of the Civil Rights Act of 1964,as A.Employment and Materials Preference for Appalachian Development amended,and related regulations including 49 CFR Parts 21,26 and 27; Highway System or Appalachian Local Access Road Contracts(included and 23 CFR Parts 200,230,and 633. in Appalachian contracts only) The contractor and all subcontractors must comply with: the requirements of the Equal Opportunity Clause in 41 CFR 60-1.4(b)and, I. GENERAL for all construction contracts exceeding$10,000,the Standard Federal Equal Employment Opportunity Construction Contract Specifications in 1. Form FHWA-1273 must be physically incorporated in each 41 CFR 60-4.3. construction contract funded under Title 23(excluding emergency contracts solely intended for debris removal). The contractor(or Note:The U.S.Department of Labor has exclusive authority to determine subcontractor)must insert this form in each subcontract and further compliance with Executive Order 11246 and the policies of the Secretary require its inclusion in all lower tier subcontracts(excluding purchase of Labor including 41 CFR 60,and 29 CFR 1625-1627. The contracting orders,rental agreements and other agreements for supplies or agency and the FHWA have the authority and the responsibility to services). ensure compliance with Title 23 USC Section 140,the Rehabilitation Act of 1973,as amended(29 USC 794),and Title VI of the Civil Rights Act of The applicable requirements of Form FHWA-1273 are incorporated by 1964,as amended,and related regulations including 49 CFR Parts 21, reference for work done under any purchase order,rental agreement or 26 and 27;and 23 CFR Parts 200,230,and 633. agreement for other services. The prime contractor shall be responsible for compliance by any subcontractor,lower-tier subcontractor or service The following provision is adopted from 23 CFR 230,Appendix A,with provider. appropriate revisions to conform to the U S.Department of Labor(US DOL)and FHWA requirements. Form FHWA-1273 must be included in all Federal-aid design-build contracts,in all subcontracts and in lower tier subcontracts(excluding 1.Equal Employment Opportunity:Equal employment opportunity subcontracts for design services,purchase orders,rental agreements (EEO)requirements not to discriminate and to take affirmative action to and other agreements for supplies or services). The design-builder shall assure equal opportunity as set forth under laws,executive orders,rules, be responsible for compliance by any subcontractor,lower-tier regulations(28 CFR 35,29 CFR 1630,29 CFR 1625-1627,41 CFR 60 subcontractor or service provider. and 49 CFR 27)and orders of the Secretary of Labor as modified by the provisions prescribed herein,and imposed pursuant to 23 U.S.C. 140 Contracting agencies may reference Form FHWA-1273 in bid proposal shall constitute the EEO and specific affirmative action standards for the or request for proposal documents,however,the Form FHWA-1273 must contractor's project activities under this contract.The provisions of the be physically incorporated(not referenced)in all contracts,subcontracts Americans with Disabilities Act of 1990(42 U.S.C.12101 et seq.)set and lower-tier subcontracts(excluding purchase orders,rental forth under 28 CFR 35 and 29 CFR 1630 are incorporated by reference agreements and other agreements for supplies or services related to a in this contract.In the execution of this contract,the contractor agrees to construction contract). comply with the following minimum specific requirement activities of EEO: 2. Subject to the applicability criteria noted in the following sections, these contract provisions shall apply to all work performed on the a.The contractor will work with the contracting agency and the Federal contract by the contractor's own organization and with the assistance of Government to ensure that it has made every good faith effort to provide workers under the contractor's immediate superintendence and to all equal opportunity with respect to all of its terms and conditions of work performed on the contract by piecework,station work,or by employment and in their review of activities under the contract. subcontract. b.The contractor will accept as its operating policy the following 3. A breach of any of the stipulations contained in these Required statement Contract Provisions may be sufficient grounds for withholding of progress payments,withholding of final payment,termination of the contract, "It is the policy of this Company to assure that applicants are suspension/debarment or any other action determined to be appropriate employed,and that employees are treated during employment,without by the contracting agency and FHWA. regard to their race,religion,sex,color,national origin,age or disability. Such action shall include:employment,upgrading, 4. Selection of Labor:During the performance of this contract,the demotion,or transfer;recruitment or recruitment advertising;layoff or contractor shall not use convict labor for any purpose within the limits of termination;rates of pay or other forms of compensation;and selection a construction project on a Federal-aid highway unless it is labor for training,including apprenticeship,pre-apprenticeship,and/or on- performed by convicts who are on parole,supervised release,or the-job training." D -37of53 May 2016 SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docX Local Assistance Procedures Manual Exhibit 12-C Required Federal-aid Contract Language 2. EEO Officer:The contractor will designate and make known to the contracting officers an EEO Officer who will have the responsibility for and must be capable of effectively administering and promoting an active EEO program and who must be assigned adequate authority and responsibility to do so D - 38of53 May 2016 SF:16-5234/Complete Spec Contract Sec D(6-2-16) (2).docx Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language 3. Dissemination of Policy:All members of the contractor's staff who are authorized to hire,supervise,promote,and discharge a. The contractor will conduct periodic inspections of project sites employees,or who recommend such action,or who are substantially to insure that working conditions and employee facilities do not involved in such action,will be made fully cognizant of,and will indicate discriminatory treatment of project site personnel. implement,the contractor's EEO policy and contractual responsibilities to provide EEO in each grade and classification of b. The contractor will periodically evaluate the spread of wages employment. To ensure that the above agreement will be met,the paid within each classification to determine any evidence of following actions will be taken as a minimum: discriminatory wage practices. a. Periodic meetings of supervisory and personnel office c. The contractor will periodically review selected personnel employees will be conducted before the start of work and then not actions in depth to determine whether there is evidence of less often than once every six months,at which time the contractor's discrimination. Where evidence is found,the contractor will EEO policy and its implementation will be reviewed and explained. promptly take corrective action. If the review indicates that the The meetings will be conducted by the EEO Officer. discrimination may extend beyond the actions reviewed, such corrective action shall include all affected persons. b. All new supervisory or personnel office employees will be given a thorough indoctrination by the EEO Officer,covering all major d. The contractor will promptly investigate all complaints of aspects of the contractor's EEO obligations within thirty days alleged discrimination made to the contractor in connection with its following their reporting for duty with the contractor. obligations under this contract,will attempt to resolve such complaints,and will take appropriate corrective action within a c. All personnel who are engaged in direct recruitment for the reasonable time. If the investigation indicates that the discrimination project will be instructed by the EEO Officer in the contractor's may affect persons other than the complainant,such corrective procedures for locating and hiring minorities and women. action shall include such other persons. Upon completion of each investigation,the contractor will inform every complainant of all of d. Notices and posters setting forth the contractors EEO policy their avenues of appeal. will be placed in areas readily accessible to employees,applicants for employment and potential employees. 6.Training and Promotion: e. The contractor's EEO policy and the procedures to implement a. The contractor will assist in locating,qualifying,and increasing such policy will be brought to the attention of employees by means the skills of minorities and women who are applicants for of meetings,employee handbooks,or other appropriate means. employment or current employees. Such efforts should be aimed at developing full journey level status employees in the type of trade or 4.Recruitment:When advertising for employees,the contractor will job classification involved. include in all advertisements for employees the notation:"An Equal Opportunity Employer." All such advertisements will be placed in b. Consistent with the contractors work force requirements and publications having a large circulation among minorities and women as permissible under Federal and State regulations,the contractor in the area from which the project work force would normally be shall make full use of training programs,i.e.,apprenticeship,and on- derived. the-job training programs for the geographical area of contract performance. In the event a special provision for training is provided a. The contractor will, unless precluded by a valid bargaining under this contract,this subparagraph will be superseded as agreement,conduct systematic and direct recruitment through public indicated in the special provision. The contracting agency may and private employee referral sources likely to yield qualified reserve training positions for persons who receive welfare minorities and women. To meet this requirement,the contractor will assistance in accordance with 23 U.S.C. 140(a). identify sources of potential minority group employees,and establish with such identified sources procedures whereby minority and c. The contractor will advise employees and applicants for women applicants may be referred to the contractor for employment employment of available training programs and entrance consideration. requirements for each. b. In the event the contractor has a valid bargaining agreement d. The contractor will periodically review the training and providing for exclusive hiring hall referrals,the contractor is promotion potential of employees who are minorities and women expected to observe the provisions of that agreement to the extent and will encourage eligible employees to apply for such training and that the system meets the contractor's compliance with EEO promotion. contract provisions. Where implementation of such an agreement has the effect of discriminating against minorities or women, or 7. Unions:If the contractor relies in whole or in part upon unions as obligates the contractor to do the same,such implementation a source of employees,the contractor will use good faith efforts to violates Federal nondiscrimination provisions. obtain the cooperation of such unions to increase opportunities for minorities and women. Actions by the contractor,either directly or c. The contractor will encourage its present employees to refer through a contractor's association acting as agent,will include the minorities and women as applicants for employment. Information procedures set forth below: and procedures with regard to referring such applicants will be discussed with employees. a. The contractor will use good faith efforts to develop,in cooperation with the unions,joint training programs aimed toward 5.Personnel Actions:Wages,working conditions,and employee qualifying more minorities and women for membership in the unions benefits shall be established and administered,and personnel and increasing the skills of minorities and women so that they may actions of every type,including hiring,upgrading, promotion, qualify for higher paying employment. transfer,demotion, layoff,and termination,shall be taken without regard to race,color,religion,sex, national origin,age or disability. b. The contractor will use good faith efforts to incorporate an EEO The following procedures shall be followed: clause into each union agreement to the end that such union will be Page 39 of 54 May 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language contractually bound to refer applicants without regard to their race, by authorized representatives of the contracting agency and the color,religion,sex, national origin,age or disability. FHWA. c. The contractor is to obtain information as to the referral a. The records kept by the contractor shall document the practices and policies of the labor union except that to the extent following: such information is within the exclusive possession of the labor union and such labor union refuses to furnish such information to the (1)The number and work hours of minority and non-minority contractor,the contractor shall so certify to the contracting agency group members and women employed in each work classification and shall set forth what efforts have been made to obtain such on the project; information. (2)The progress and efforts being made in cooperation with d. In the event the union is unable to provide the contractor with a unions,when applicable,to increase employment opportunities for reasonable flow of referrals within the time limit set forth in the minorities and women;and collective bargaining agreement,the contractor will,through independent recruitment efforts,fill the employment vacancies (3)The progress and efforts being made in locating, hiring, without regard to race,color,religion,sex,national origin,age or training,qualifying,and upgrading minorities and women; disability;making full efforts to obtain qualified and/or qualifiable minorities and women. The failure of a union to provide sufficient b. The contractors and subcontractors will submit an annual referrals(even though it is obligated to provide exclusive referrals report to the contracting agency each July for the duration of the under the terms of a collective bargaining agreement)does not project,indicating the number of minority,women,and non-minority relieve the contractor from the requirements of this paragraph. In group employees currently engaged in each work classification the event the union referral practice prevents the contractor from required by the contract work. This information is to be reported on meeting the obligations pursuant to Executive Order 11246,as Dorm 1-1-f WA-1391. The staffing data should represent the project amended,and these special provisions,such contractor shall work force on board in all or any part of the last payroll period immediately notify the contracting agency. preceding the end of July. If on-the-job training is being required by special provision,the contractor will be required to collect and report 8. Reasonable Accommodation for Applicants/Employees training data. The employment data should reflect the work force on with Disabilities: The contractor must be familiar with the board during all or any part of the last payroll period preceding the requirements for and comply with the Americans with Disabilities Act end of July. and all rules and regulations established there under. Employers must provide reasonable accommodation in all employment activities unless to do so would cause an undue hardship. III.NONSEGREGATED FACILITIES 9.Selection of Subcontractors,Procurement of Materials and This provision is applicable to all Federal-aid construction contracts Leasing of Equipment:The contractor shall not discriminate on the and to all related construction subcontracts of$10,000 or more. grounds of race,color, religion,sex,national origin,age or disability in the selection and retention of subcontractors, including The contractor must ensure that facilities provided for employees procurement of materials and leases of equipment. The contractor are provided in such a manner that segregation on the basis of race, shall take all necessary and reasonable steps to ensure color, religion,sex,or national origin cannot result. The contractor nondiscrimination in the administration of this contract. may neither require such segregated use by written or oral policies nor tolerate such use by employee custom. The contractor's a. The contractor shall notify all potential subcontractors and obligation extends further to ensure that its employees are not suppliers and lessors of their EEO obligations under this contract. assigned to perform their services at any location,under the contractor's control,where the facilities are segregated. The term b. The contractor will use good faith efforts to ensure "facilities"includes waiting rooms,work areas, restaurants and other subcontractor compliance with their EEO obligations. eating areas,time clocks, restrooms,washrooms, locker rooms, and other storage or dressing areas,parking lots,drinking fountains, recreation or entertainment areas,transportation,and housing 10. Assurance Required by 49 CFR 26.13(b): provided for employees. The contractor shall provide separate or single-user restrooms and necessary dressing or sleeping areas to a. The requirements of 49 CFR Part 26 and the State DOT's U.S. assure privacy between sexes. DOT-approved DBE program are incorporated by reference. b. The contractor or subcontractor shall not discriminate on the IV. DAVIS-BACON AND RELATED ACT PROVISIONS basis of race,color, national origin,or sex in the performance of this contract. The contractor shall carry out applicable requirements of 49 CFR Part 26 in the award and administration of DOT-assisted This section is applicable to all Federal-aid construction projects contracts. Failure by the contractor to carry out these requirements exceeding$2,000 and to all related subcontracts and lower-tier is a material breach of this contract,which may result in the subcontracts(regardless of subcontract size). The requirements termination of this contract or such other remedy as the contracting apply to all projects located within the right-of-way of a roadway that agency deems appropriate. is functionally classified as Federal-aid highway. This excludes roadways functionally classified as local roads or rural minor 11.Records and Reports:The contractor shall keep such records collectors,which are exempt. Contracting agencies may elect to as necessary to document compliance with the EEO requirements. apply these requirements to other projects. Such records shall be retained for a period of three years following the date of the final payment to the contractor for all contract work The following provisions are from the U.S. Department of Labor and shall be available at reasonable times and places for inspection regulations in 29 CFR 5.5"Contract provisions and related matters" Page 40 of 54 May 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language with minor revisions to conform to the FHWA-1273 format and appropriate),a report of the action taken shall be sent by the FHWA program requirements. contracting officer to the Administrator of the Wage and Hour Division,Employment Standards Administration, U.S. Department of Labor,Washington, DC 20210.The Administrator,or an authorized representative,will approve,modify,or disapprove every additional classification action within 30 days of receipt and 1. Minimum wages so advise the contracting officer or will notify the contracting officer within the 30-day period that additional time is necessary. a. All laborers and mechanics employed or working upon the site of the work,will be paid unconditionally and not less often than once (3)In the event the contractor,the laborers or mechanics to be a week,and without subsequent deduction or rebate on any account employed in the classification or their representatives,and the (except such payroll deductions as are permitted by regulations contracting officer do not agree on the proposed classification and issued by the Secretary of Labor under the Copeland Act(29 CFR wage rate(including the amount designated for fringe benefits, part 3)),the full amount of wages and bona fide fringe benefits(or where appropriate),the contracting officer shall refer the cash equivalents thereof)due at time of payment computed at rates questions,including the views of all interested parties and the not less than those contained in the wage determination of the recommendation of the contracting officer,to the Wage and Hour Secretary of Labor which is attached hereto and made a part hereof, Administrator for determination.The Wage and Hour regardless of any contractual relationship which may be alleged to Administrator,or an authorized representative,will issue a exist between the contractor and such laborers and mechanics. determination within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30- Contributions made or costs reasonably anticipated for bona fide day period that additional time is necessary. fringe benefits under section 1(b)(2)of the Davis-Bacon Act on behalf of laborers or mechanics are considered wages paid to such (4)The wage rate(including fringe benefits where appropriate) laborers or mechanics,subject to the provisions of paragraph 1.d.of determined pursuant to paragraphs 1.b.(2)or 1.b.(3)of this this section;also, regular contributions made or costs incurred for section,shall be paid to all workers performing work in the more than a weekly period(but not less often than quarterly)under classification under this contract from the first day on which work plans,funds,or programs which cover the particular weekly period, is performed in the classification. are deemed to be constructively made or incurred during such weekly period.Such laborers and mechanics shall be paid the c.Whenever the minimum wage rate prescribed in the contract for appropriate wage rate and fringe benefits on the wage determination a class of laborers or mechanics includes a fringe benefit which is for the classification of work actually performed,without regard to not expressed as an hourly rate,the contractor shall either pay the skill,except as provided in 29 CFR 5.5(a)(4). Laborers or mechanics benefit as stated in the wage determination or shall pay another performing work in more than one classification may be bona fide fringe benefit or an hourly cash equivalent thereof. compensated at the rate specified for each classification for the time actually worked therein:Provided,That the employer's payroll records accurately set forth the time spent in each classification in d. If the contractor does not make payments to a trustee or other which work is performed.The wage determination(including any third person,the contractor may consider as part of the wages of additional classification and wage rates conformed under paragraph any laborer or mechanic the amount of any costs reasonably 1.b.of this section)and the Davis-Bacon poster(WH-1321)shall be anticipated in providing bona fide fringe benefits under a plan or posted at all times by the contractor and its subcontractors at the program,Provided,That the Secretary of Labor has found, upon the site of the work in a prominent and accessible place where it can be written request of the contractor,that the applicable standards of the easily seen by the workers. Davis-Bacon Act have been met.The Secretary of Labor may require the contractor to set aside in a separate account assets for b. (1)The contracting officer shall require that any class of the meeting of obligations under the plan or program. laborers or mechanics,including helpers,which is not listed in the wage determination and which is to be employed under the contract 2. Withholding shall be classified in conformance with the wage determination.The contracting officer shall approve an additional classification and The contracting agency shall upon its own action or upon written wage rate and fringe benefits therefore only when the following criteria have been met: request of an authorized representative of the Department of Labor, withhold or cause to be withheld from the contractor under this contract,or any other Federal contract with the same prime (i)The work to be performed by the classification requested is contractor,or any other federally-assisted contract subject to Davis- not performed by a classification in the wage determination;and Bacon prevailing wage requirements,which is held by the same prime contractor,so much of the accrued payments or advances as (ii)The classification is utilized in the area by the construction may be considered necessary to pay laborers and mechanics, industry;and including apprentices,trainees,and helpers,employed by the contractor or any subcontractor the full amount of wages required by the contract. In the event of failure to pay any laborer or mechanic, (iii)The proposed wage rate,including any bona fide fringe including any apprentice,trainee,or helper,employed or working on benefits,bears a reasonable relationship to the wage rates the site of the work,all or part of the wages required by the contract, contained in the wage determination. the contracting agency may,after written notice to the contractor, take such action as may be necessary to cause the suspension of (2)If the contractor and the laborers and mechanics to be any further payment,advance,or guarantee of funds until such violations have ceased. employed in the classification(if known),or their representatives, and the contracting officer agree on the classification and wage rate(including the amount designated for fringe benefits where 3. Payrolls and basic records Page 41 of 54 May 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language a. Payrolls and basic records relating thereto shall be maintained full wages earned,other than permissible deductions as set forth by the contractor during the course of the work and preserved for a in Regulations,29 CFR part 3; period of three years thereafter for all laborers and mechanics working at the site of the work.Such records shall contain the name, address,and social security number of each such worker,his or her (iii)That each laborer or mechanic has been paid not less correct classification,hourly rates of wages paid(including rates of than the applicable wage rates and fringe benefits or cash contributions or costs anticipated for bona fide fringe benefits or equivalents for the classification of work performed,as specified cash equivalents thereof of the types described in section 1(b)(2)(B) in the applicable wage determination incorporated into the of the Davis-Bacon Act),daily and weekly number of hours worked, contract. deductions made and actual wages paid.Whenever the Secretary of Labor has found under 29 CFR 5.5(a)(1)(iv)that the wages of any (3)The weekly submission of a properly executed certification laborer or mechanic include the amount of any costs reasonably set forth on the reverse side of Optional Form WH-347 shall anticipated in providing benefits under a plan or program described satisfy the requirement for submission of the"Statement of in section 1(b)(2)(B)of the Davis-Bacon Act,the contractor shall Compliance"required by paragraph 3.b.(2)of this section. maintain records which show that the commitment to provide such benefits is enforceable,that the plan or program is financially responsible,and that the plan or program has been communicated (4)The falsification of any of the above certifications may in writing to the laborers or mechanics affected,and records which subject the contractor or subcontractor to civil or criminal show the costs anticipated or the actual cost incurred in providing prosecution under section 1001 of title 18 and section 231 of title such benefits.Contractors employing apprentices or trainees under 31 of the United States Code. approved programs shall maintain written evidence of the registration of apprenticeship programs and certification of trainee c.The contractor or subcontractor shall make the records required programs,the registration of the apprentices and trainees,and the under paragraph 3.a.of this section available for inspection, ratios and wage rates prescribed in the applicable programs. copying,or transcription by authorized representatives of the contracting agency,the State DOT,the FHWA, or the Department b. (1)The contractor shall submit weekly for each week in which of Labor,and shall permit such representatives to interview any contract work is performed a copy of all payrolls to the employees during working hours on the job. If the contractor or contracting agency. The payrolls submitted shall set out accurately subcontractor fails to submit the required records or to make them and completely all of the information required to be maintained available,the FHWA may,after written notice to the contractor,the under 29 CFR 5.5(a)(3)(i),except that full social security numbers contracting agency or the State DOT,take such action as may be and home addresses shall not be included on weekly transmittals. necessary to cause the suspension of any further payment, Instead the payrolls shall only need to include an individually advance,or guarantee of funds.Furthermore,failure to submit the identifying number for each employee(e.g. ,the last four digits of required records upon request or to make such records available the employee's social security number).The required weekly payroll may be grounds for debarment action pursuant to 29 CFR 5.12. information may be submitted in any form desired Optional Form WH-347 is available for this purpose from the Wage and Hour 4. Apprentices and trainees Division Web site at http://www.dol.govtesa/whd/forms/wh347instr.htm or its successor site.The prime contractor is responsible for the submission of a.Apprentices(programs of the USDOL). copies of payrolls by all subcontractors.Contractors and subcontractors shall maintain the full social security number and Apprentices will be permitted to work at less than the predetermined current address of each covered worker,and shall provide them rate for the work they performed when they are employed pursuant upon request to the contracting agency for transmission to the State to and individually registered in a bona fide apprenticeship program DOT,the FHWA or the Wage and Hour Division of the Department registered with the U.S.Department of Labor,Employment and of Labor for purposes of an investigation or audit of compliance with Training Administration,Office of Apprenticeship Training,Employer prevailing wage requirements.It is not a violation of this section for a and Labor Services,or with a State Apprenticeship Agency prime contractor to require a subcontractor to provide addresses recognized by the Office,or if a person is employed in his or her first and social security numbers to the prime contractor for its own 90 days of probationary employment as an apprentice in such an records,without weekly submission to the contracting agency.. apprenticeship program,who is not individually registered in the program,but who has been certified by the Office of Apprenticeship (2)Each payroll submitted shall be accompanied by a"Statement of Training,Employer and Labor Services or a State Apprenticeship Compliance,"signed by the contractor or subcontractor or his or her Agency(where appropriate)to be eligible for probationary agent who pays or supervises the payment of the persons employed employment as an apprentice. under the contract and shall certify the following: The allowable ratio of apprentices to journeymen on the job site in (i)That the payroll for the payroll period contains the any craft classification shall not be greater than the ratio permitted to information required to be provided under§5.5(a)(3)(ii)of the contractor as to the entire work force under the registered Regulations,29 CFR part 5,the appropriate information is being program.Any worker listed on a payroll at an apprentice wage rate, maintained under§5.5(a)(3)(i)of Regulations,29 CFR part 5, who is not registered or otherwise employed as stated above,shall and that such information is correct and complete, be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed. In addition,any apprentice performing work on the job site in excess of (ii)That each laborer or mechanic(including each helper, the ratio permitted under the registered program shall be paid not apprentice,and trainee)employed on the contract during the less than the applicable wage rate on the wage determination for the payroll period has been paid the full weekly wages earned, work actually performed.Where a contractor is performing without rebate,either directly or indirectly,and that no construction on a project in a locality other than that in which its deductions have been made either directly or indirectly from the program is registered,the ratios and wage rates(expressed in Page 42 of 54 May 2016 Local Assistance Procedures Manual Exhibit 12-C Required Federal-aid Contract Language percentages of the journeyman's hourly rate)specified in the the equal employment opportunity requirements of Executive Order contractor's or subcontractor's registered program shall be 11246,as amended,and 29 CFR part 30. observed. Every apprentice must be paid at not less than the rate specified in d. Apprentices and Trainees(programs of the U.S.DOT). the registered program for the apprentice's level of progress, Apprentices and trainees working under apprenticeship and skill expressed as a percentage of the journeymen hourly rate specified training programs which have been certified re the Secretary of in the applicable wage determination.Apprentices shall be paid Transportation as promoting EEO in connection with Federal-aid fringe benefits in accordance with the provisions of the apprenticeship program. If the apprenticeship program does not highway construction programs are not subject to the requirements specify fringe benefits,apprentices must be paid the full amount of of paragraph 4 of this Section IV.The straight time hourly wage rates for apprentices and trainees under such programs will be fringe benefits listed on the wage determination for the applicable established b the articular programs.The ratio of classification. If the Administrator determines that a different practice y p p g apprentices and prevails for the applicable apprentice classification,fringes shall be trainees to journeymen shall not be greater than permitted by the paid in accordance with that determination. terms of the particular program. In the event the Office of Apprenticeship Training,Employer and 5.Compliance with Copeland Act requirements. The contractor Labor Services,or a State Apprenticeship Agency recognized by the shall comply with the requirements of 29 CFR part 3,which are Office,withdraws approval of an apprenticeship program,the incorporated by reference in this contract. contractor will no longer be permitted to utilize apprentices at less than the applicable predetermined rate for the work performed until 6.Subcontracts. The contractor or subcontractor shall insert Form an acceptable program is approved. FHWA-1273 in any subcontracts and also require the subcontractors to include Form FHWA-1273 in any lower tier subcontracts. The b.Trainees(programs of the USDOL). prime contractor shall be responsible for the compliance by any subcontractor or lower tier subcontractor with all the contract clauses in 29 CFR 5.5. Except as provided in 29 CFR 5.16,trainees will not be permitted to work at less than the predetermined rate for the work performed 7.Contract termination:debarment. A breach of the contract unless they are employed pursuant to and individually registered in clauses in 29 CFR 5,5 may be grounds for termination of the a program which has received prior approval,evidenced by formal contract,and for debarment as a contractor and a subcontractor as certification by the U.S.Department of Labor,Employment and Training Administration. provided in 29 CFR 5.12. The ratio of trainees to journeymen on the job site shall not be 8.Compliance with Davis-Bacon and Related Act requirements. greater than permitted under the plan approved by the Employment All rulings and interpretations of the Davis-Bacon and Related Acts and Training Administration. contained in 29 CFR parts 1,3,and 5 are herein incorporated by reference in this contract. Every trainee must be paid at not less than the rate specified in the 9.Disputes concerning labor standards.Disputes arising out of approved program for the trainee's level of progress,expressed as a the labor standards provisions of this contract shall not be subject to percentage of the journeyman hourly rate specified in the applicable 1 wage determination.Trainees shall be paid fringe benefits in the general disputes clause of this contract.Such disputes shall be accordance with the provisions of the trainee program. If the trainee resolved in accordance with the procedures of the Department of program does not mention fringe benefits,trainees shall be paid the Labor set forth in 29 CFR parts 5,6,and 7.Disputes within the full amount of fringe benefits listed on the wage determination meaning of this clause include disputes between the contractor(or unless the Administrator of the Wage and Hour Division determines any of its subcontractors)and the contracting agency,the U.S. that there is an apprenticeship program associated with the Department of Labor, or the employees or their representatives. corresponding journeyman wage rate on the wage determination which provides for less than full fringe benefits for apprentices.Any 10.Certification of eligibility. employee listed on the payroll at a trainee rate who is not registered and participating in a training plan approved by the Employment and a.By entering into this contract,the contractor certifies that neither it Training Administration shall be paid not less than the applicable wage rate on the wage determination for the classification of work (nor he or she)nor any person or firm who has an interest in the actually performed.In addition,any trainee performing work on the contractor's firm is a person or firm ineligible to be awarded job site in excess of the ratio permitted under the registered program Government contracts by virtue of section 3(a)of the Davis-Bacon shall be paid not less than the applicable wage rate on the wage Act or 29 CFR 5.12(a)(1). determination for the work actually performed. b. No part of this contract shall be subcontracted to any person or In the event the Employment and Training Administration withdraws firm ineligible for award of a Government contract by virtue of approval of a training program,the contractor will no longer be section 3(a)of the Davis-Bacon Act or 29 CFR 5.12(a)(1). permitted to utilize trainees at less than the applicable predetermined rate for the work performed until an acceptable c.The penalty for making false statements is prescribed in the U.S. program is approved. Criminal Code, 18 U.S.C. 1001. c.Equal employment opportunity.The utilization of apprentices, trainees and journeymen under this part shall be in conformity with Page 43 of 54 May 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language 1.The contractor shall perform with its own organization contract work amounting to not less than 30 percent(or a greater percentage V. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT if specified elsewhere in the contract)of the total original contract price,excluding any specialty items designated by the contracting The following clauses apply to any Federal-aid construction contract agency. Specialty items may be performed by subcontract and the in an amount in excess of$100,000 and subject to the overtime amount of any such specialty items performed may be deducted provisions of the Contract Work Hours and Safety Standards Act. from the total original contract price before computing the amount of These clauses shall be inserted in addition to the clauses required work required to be performed by the contractor's own organization by 29 CFR 5.5(a)or 29 CFR 4.6. As used in this paragraph,the (23 CFR 635.116). terms laborers and mechanics include watchmen and guards. a. The term"perform work with its own organization"refers to workers employed or leased by the prime contractor,and equipment 1.Overtime requirements. No contractor or subcontractor owned or rented by the prime contractor,with or without operators. contracting for any part of the contract work which may require or Such term does not include employees or equipment of a involve the employment of laborers or mechanics shall require or subcontractor or lower tier subcontractor,agents of the prime permit any such laborer or mechanic in any workweek in which he or contractor,or any other assignees. The term may include payments she is employed on such work to work in excess of forty hours in for the costs of hiring leased employees from an employee leasing such workweek unless such laborer or mechanic receives firm meeting all relevant Federal and State regulatory requirements. compensation at a rate not less than one and one-half times the Leased employees may only be included in this term if the prime basic rate of pay for all hours worked in excess of forty hours in such contractor meets all of the following conditions: workweek. (1)the prime contractor maintains control over the supervision of 2.Violation; liability for unpaid wages;liquidated damages. In the day-to-day activities of the leased employees; the event of any violation of the clause set forth in paragraph(1.)of (2)the prime contractor remains responsible for the quality of the this section,the contractor and any subcontractor responsible work of the leased employees; therefor shall be liable for the unpaid wages. In addition,such (3)the prime contractor retains all power to accept or exclude contractor and subcontractor shall be liable to the United States(in individual employees from work on the project;and the case of work done under contract for the District of Columbia or (4)the prime contractor remains ultimately responsible for the a territory,to such District or to such territory),for liquidated payment of predetermined minimum wages,the submission of damages.Such liquidated damages shall be computed with respect payrolls,statements of compliance and all other Federal to each individual laborer or mechanic,including watchmen and regulatory requirements. guards,employed in violation of the clause set forth in paragraph b."Specialty Items"shall be construed to be limited to work that (1.)of this section,in the sum of$10 for each calendar day on which requires highly specialized knowledge,abilities, or equipment not such individual was required or permitted to work in excess of the ordinarily available in the type of contracting organizations qualified standard workweek of forty hours without payment of the overtime and expected to bid or propose on the contract as a whole and in wages required by the clause set forth in paragraph(1.)of this section. general are to be limited to minor components of the overall contract. 3.Withholding for unpaid wages and liquidated damages.The 2.The contract amount upon which the requirements set forth in FHWA or the contacting agency shall upon its own action or upon paragraph(1)of Section VI is computed includes the cost of material written request of an authorized representative of the Department of and manufactured products which are to be purchased or produced Labor withhold or cause to be withheld,from any moneys payable by the contractor under the contract provisions. on account of work performed by the contractor or subcontractor under any such contract or any other Federal contract with the same 3.The contractor shall furnish (a)a competent superintendent or prime contractor,or any other federally-assisted contract subject to supervisor who is employed by the firm, has full authority to direct the Contract Work Hours and Safety Standards Act,which is held by performance of the work in accordance with the contract the same prime contractor,such sums as may be determined to be requirements,and is in charge of all construction operations necessary to satisfy any liabilities of such contractor or (regardless of who performs the work)and(b)such other of its own subcontractor for unpaid wages and liquidated damages as provided organizational resources(supervision,management,and in the clause set forth in paragraph(2.)of this section. engineering services)as the contracting officer determines is necessary to assure the performance of the contract. 4.Subcontracts. The contractor or subcontractor shall insert in any 4. No portion of the contract shall be sublet, assigned or otherwise subcontracts the clauses set forth in paragraph (1.)through(4.)of disposed of except with the written consent of the contracting officer, this section and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts.The prime contractor or authorized representative,and such consent when given shall not shall be responsible for compliance by any subcontractor or lower be construed to relieve the contractor of any responsibility for the fulfillment of the contract. Written consent will be given only after tier subcontractor with the clauses set forth in paragraphs(1.) through(4.)of this section. the contracting agency has assured that each subcontract is evidenced in writing and that it contains all pertinent provisions and requirements of the prime contract. VI.SUBLETTING OR ASSIGNING THE CONTRACT 5.The 30%self-performance requirement of paragraph(1)is not applicable to design-build contracts;however,contracting agencies This provision is applicable to all Federal-aid construction contracts may establish their own self-performance requirements. on the National Highway System. Page 44 of 54 May 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language VII.SAFETY:ACCIDENT PREVENTION Whoever knowingly makes any false statement,false representation,false report or false claim with respect to the This provision is applicable to all Federal-aid construction contracts character,quality,quantity,or cost of any work performed or to be and to all related subcontracts. performed,or materials furnished or to be furnished,in connection with the construction of any highway or related project approved by 1. In the performance of this contract the contractor shall comply the Secretary of Transportation;or with all applicable Federal,State,and local laws governing safety, health,and sanitation(23 CFR 635).The contractor shall provide all Whoever knowingly makes any false statement or false safeguards,safety devices and protective equipment and take any representation as to material fact in any statement,certificate,or other needed actions as it determines,or as the contracting officer report submitted pursuant to provisions of the Federal-aid Roads Act may determine,to be reasonably necessary to protect the life and approved July 1, 1916,(39 Stat.355),as amended and health of employees on the job and the safety of the public and to supplemented; protect property in connection with the performance of the work covered by the contract. Shall be fined under this title or imprisoned not more than 5 years or both." 2. It is a condition of this contract,and shall be made a condition of each subcontract,which the contractor enters into pursuant to this contract,that the contractor and any subcontractor shall not permit IX.IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL any employee,in performance of the contract,to work in WATER POLLUTION CONTROL ACT surroundings or under conditions which are unsanitary, hazardous or dangerous to his/her health or safety,as determined under This provision is applicable to all Federal-aid construction contracts construction safety and health standards(29 CFR 1926) and to all related subcontracts. promulgated by the Secretary of Labor,in accordance with Section 107 of the Contract Work Hours and Safety Standards Act(40 By submission of this bid/proposal or the execution of this contract, U.S.C.3704). or subcontract,as appropriate,the bidder, proposer, Federal-aid construction contractor,or subcontractor,as appropriate,will be 3.Pursuant to 29 CFR 1926.3,it is a condition of this contract that deemed to have stipulated as follows: the Secretary of Labor or authorized representative thereof,shall have right of entry to any site of contract performance to inspect or 1.That any person who is or will be utilized in the performance of investigate the matter of compliance with the construction safety and this contract is not prohibited from receiving an award due to a health standards and to carry out the duties of the Secretary under violation of Section 508 of the Clean Water Act or Section 306 of the Section 107 of the Contract Work Hours and Safety Standards Act Clean Air Act. (40 U.S.C.3704). 2.That the contractor agrees to include or cause to be included the requirements of paragraph(1)of this Section X in every subcontract, and further agrees to take such action as the contracting agency VIII.FALSE STATEMENTS CONCERNING HIGHWAY PROJECTS may direct as a means of enforcing such requirements. This provision is applicable to all Federal-aid construction contracts and to all related subcontracts. X.CERTIFICATION REGARDING DEBARMENT,SUSPENSION, In order to assure high quality and durable construction in INELIGIBILITY AND VOLUNTARY EXCLUSION conformity with approved plans and specifications and a high degree This provision is applicable to all Federal-aid construction contracts, of reliability on statements and representations made by engineers, design-build contracts,subcontracts,lower-tier subcontracts, contractors,suppliers,and workers on Federal-aid highway projects, purchase orders, lease agreements,consultant contracts or any it is essential that all persons concerned with the project perform other covered transaction requiring FHWA approval or that is their functions as carefully,thoroughly,and honestly as possible. estimated to cost$25,000 or more— as defined in 2 CFR Parts 180 Willful falsification,distortion,or misrepresentation with respect to and 1200. any facts related to the project is a violation of Federal law. To prevent any misunderstanding regarding the seriousness of these and similar acts, Form FHWA-1022 shall be posted on each 1.Instructions for Certification—First Tier Participants: Federal-aid highway project(23 CFR 635)in one or more places where it is readily available to all persons concerned with the a. By signing and submitting this proposal,the prospective first project: tier participant is providing the certification set out below. b.The inability of a person to provide the certification set out 18 U.S.C. 1020 reads as follows: below will not necessarily result in denial of participation in this covered transaction.The prospective first tier participant shall "Whoever,being an officer,agent,or employee of the United submit an explanation of why it cannot provide the certification set States,or of any State or Territory,or whoever,whether a person, out below.The certification or explanation will be considered in association,firm,or corporation,knowingly makes any false connection with the department or agency's determination whether statement,false representation,or false report as to the character, to enter into this transaction.However,failure of the prospective first quality,quantity,or cost of the material used or to be used,or the tier participant to furnish a certification or an explanation shall quantity or quality of the work performed or to be performed,or the disqualify such a person from participation in this transaction. cost thereof in connection with the submission of plans,maps, specifications,contracts,or costs of construction on any highway or c.The certification in this clause is a material representation of related project submitted for approval to the Secretary of fact upon which reliance was placed when the contracting agency Transportation;or determined to enter into this transaction. If it is later determined that Page 45 of 54 May 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language the prospective participant knowingly rendered an erroneous available to the Federal Government,the department or agency may certification,in addition to other remedies available to the Federal terminate this transaction for cause or default. Government,the contracting agency may terminate this transaction for cause of default. d.The prospective first tier participant shall provide immediate 2. Certification Regarding Debarment,Suspension,Ineligibility written notice to the contracting agency to whom this proposal is and Voluntary Exclusion—First Tier Participants: submitted if any time the prospective first tier participant learns that its certification was erroneous when submitted or has become a. The prospective first tier participant certifies to the best of its erroneous by reason of changed circumstances. knowledge and belief,that it and its principals: e.The terms"covered transaction,""debarred,""suspended," (1) Are not presently debarred,suspended,proposed for "ineligible,""participant,""person," "principal,"and"voluntarily debarment,declared ineligible,or voluntarily excluded from excluded,"as used in this clause,are defined in 2 CFR Parts 180 participating in covered transactions by any Federal department or and 1200. "First Tier Covered Transactions"refers to any covered agency, transaction between a grantee or subgrantee of Federal funds and a participant(such as the prime or general contract). "Lower Tier (2) Have not within a three-year period preceding this proposal Covered Transactions"refers to any covered transaction under a been convicted of or had a civil judgment rendered against them for First Tier Covered Transaction(such as subcontracts). "First Tier commission of fraud or a criminal offense in connection with Participant"refers to the participant who has entered into a covered obtaining,attempting to obtain,or performing a public(Federal, transaction with a grantee or subgrantee of Federal funds(such as State or local)transaction or contract under a public transaction; the prime or general contractor). "Lower Tier Participant"refers any violation of Federal or State antitrust statutes or commission of participant who has entered into a covered transaction with a First embezzlement,theft,forgery,bribery,falsification or destruction of Tier Participant or other Lower Tier Participants(such as records,making false statements,or receiving stolen property; subcontractors and suppliers). (3) Are not presently indicted for or otherwise criminally or civilly f.The prospective first tier participant agrees by submitting this charged by a governmental entity(Federal,State or local)with proposal that,should the proposed covered transaction be entered commission of any of the offenses enumerated in paragraph(a)(2) into,it shall not knowingly enter into any lower tier covered of this certification;and transaction with a person who is debarred,suspended,declared ineligible,or voluntarily excluded from participation in this covered (4) Have not within a three-year period preceding this transaction,unless authorized by the department or agency entering application/proposal had one or more public transactions(Federal, into this transaction. State or local)terminated for cause or default. g.The prospective first tier participant further agrees by b. Where the prospective participant is unable to certify to any of submitting this proposal that it will include the clause titled the statements in this certification,such prospective participant shall "Certification Regarding Debarment,Suspension, Ineligibility and attach an explanation to this proposal. Voluntary Exclusion-Lower Tier Covered Transactions,"provided by the department or contracting agency,entering into this covered 2.Instructions for Certification-Lower Tier Participants: transaction,without modification,in all lower tier covered transactions and in all solicitations for lower tier covered (Applicable to all subcontracts, purchase orders and other lower tier transactions exceeding the$25,000 threshold. transactions requiring prior FHWA approval or estimated to cost $25,000 or more-2 CFR Parts 180 and 1200) h.A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered a.By signing and submitting this proposal,the prospective lower transaction that is not debarred,suspended, ineligible,or voluntarily tier is providing the certification set out below. excluded from the covered transaction,unless it knows that the certification is erroneous. A participant is responsible for ensuring b.The certification in this clause is a material representation of that its principals are not suspended, debarred,or otherwise fact upon which reliance was placed when this transaction was ineligible to participate in covered transactions. To verify the entered into. If it is later determined that the prospective lower tier eligibility of its principals,as well as the eligibility of any lower tier participant knowingly rendered an erroneous certification,in addition prospective participants,each participant may,but is not required to, to other remedies available to the Federal Government,the check the Excluded Parties List System website department,or agency with which this transaction originated may (hnps//mv%v.enls.eovn,which is compiled by the General Services pursue available remedies,including suspension and/or debarment. Administration. c.The prospective lower tier participant shall provide immediate i. Nothing contained in the foregoing shall be construed to require written notice to the person to which this proposal is submitted if at the establishment of a system of records in order to render in good any time the prospective lower tier participant learns that its faith the certification required by this clause.The knowledge and certification was erroneous by reason of changed circumstances. information of the prospective participant is not required to exceed that which is normally possessed by a prudent person in the d.The terms"covered transaction,""debarred,""suspended," ordinary course of business dealings. "ineligible,""participant,""person,""principal,"and"voluntarily excluded,"as used in this clause,are defined in 2 CFR Parts 180 j.Except for transactions authorized under paragraph(f)of these and 1200. You may contact the person to which this proposal is instructions,if a participant in a covered transaction knowingly submitted for assistance in obtaining a copy of those regulations. enters into a lower tier covered transaction with a person who is "First Tier Covered Transactions"refers to any covered transaction suspended,debarred,ineligible,or voluntarily excluded from between a grantee or subgrantee of Federal funds and a participant participation in this transaction,in addition to other remedies (such as the prime or general contract). "Lower Tier Covered Page 46 of 54 May 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language Transactions"refers to any covered transaction under a First Tier Covered Transaction(such as subcontracts). "First Tier Participant" ..... refers to the participant who has entered into a covered transaction with a grantee or subgrantee of Federal funds(such as the prime or XI.CERTIFICATION REGARDING USE OF CONTRACT FUNDS general contractor). "Lower Tier Participant"refers any participant FOR LOBBYING who has entered into a covered transaction with a First Tier Participant or other Lower Tier Participants(such as subcontractors This provision is applicable to all Federal-aid construction contracts and suppliers). and to all related subcontracts which exceed$100,000(49 CFR 20). e.The prospective lower tier participant agrees by submitting this 1.The prospective participant certifies, by signing and submitting proposal that,should the proposed covered transaction be entered this bid or proposal,to the best of his or her knowledge and belief, into,it shall not knowingly enter into any lower tier covered that: transaction with a person who is debarred,suspended,declared ineligible,or voluntarily excluded from participation in this covered a.No Federal appropriated funds have been paid or will be paid, transaction,unless authorized by the department or agency with by or on behalf of the undersigned,to any person for influencing or which this transaction originated. attempting to influence an officer or employee of any Federal agency,a Member of Congress,an officer or employee of Congress, f.The prospective lower tier participant further agrees by or an employee of a Member of Congress in connection with the submitting this proposal that it will include this clause titled awarding of any Federal contract,the making of any Federal grant, "Certification Regarding Debarment,Suspension,Ineligibility and the making of any Federal loan,the entering into of any cooperative Voluntary Exclusion-Lower Tier Covered Transaction,"without agreement,and the extension,continuation,renewal,amendment, modification,in all lower tier covered transactions and in all or modification of any Federal contract,grant, loan,or cooperative solicitations for lower tier covered transactions exceeding the agreement. $25,000 threshold. b.If any funds other than Federal appropriated funds have been g.A participant in a covered transaction may rely upon a paid or will be paid to any person for influencing or attempting to certification of a prospective participant in a lower tier covered influence an officer or employee of any Federal agency,a Member transaction that is not debarred,suspended,ineligible,or voluntarily of Congress,an officer or employee of Congress,or an employee of excluded from the covered transaction, unless it knows that the a Member of Congress in connection with this Federal contract, certification is erroneous.A participant is responsible for ensuring grant,loan,or cooperative agreement,the undersigned shall that its principals are not suspended,debarred,or otherwise complete and submit Standard Form-LLL,"Disclosure Form to ineligible to participate in covered transactions. To verify the Report Lobbying,"in accordance with its instructions. eligibility of its principals,as well as the eligibility of any lower tier prospective participants,each participant may,but is not required to, 2.This certification is a material representation of fact upon which check the Excluded Parties List System website reliance was placed when this transaction was made or entered into. 0ht1ps:/Av"w.enls Rov/),which is compiled by the General Services Submission of this certification is a prerequisite for making or Administration. entering into this transaction imposed by 31 U.S.C. 1352. Any person who fails to file the required certification shall be subject to a h. Nothing contained in the foregoing shall be construed to require civil penalty of not less than$10,000 and not more than$100,000 establishment of a system of records in order to render in good faith for each such failure. the certification required by this clause.The knowledge and information of participant is not required to exceed that which is 3.The prospective participant also agrees by submitting its bid or normally possessed by a prudent person in the ordinary course of proposal that the participant shall require that the language of this business dealings. certification be included in all lower tier subcontracts,which exceed $100,000 and that all such recipients shall certify and disclose i. Except for transactions authorized under paragraph a of these accordingly. instructions,if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended,debarred, ineligible, or voluntarily excluded from participation in this transaction,in addition to other remedies available to the Federal Government,the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. Certification Regarding Debarment,Suspension,Ineligibility and Voluntary Exclusion--Lower Tier Participants: 1.The prospective lower tier participant certifies,by submission of this proposal,that neither it nor its principals is presently debarred, suspended, proposed for debarment,declared ineligible,or voluntarily excluded from participating in covered transactions by any Federal department or agency. 2.Where the prospective lower tier participant is unable to certify to any of the statements in this certification,such prospective participant shall attach an explanation to this proposal. Page 47 of 54 May 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language 12. FEMALE AND MINORITY GOALS To comply with Section II, "Nondiscrimination," of"Required Contract Provisions Federal- Aid Construction Contracts," the following are goals for female and minority utilization goals for Federal-aid construction contracts and subcontracts that exceed $10,000: The nationwide goal for female utilization is 6.9 percent. The goals for minority utilization [45 Fed Reg 65984 (10/3/1980)] are as follows: MINORITY UTILIZATION GOALS Goal Economic Area (Percent Redding CA: 174 Non-SMSA (Standard Metropolitan Statistical Area) Counties: 6.8 CA Lassen; CA Modoc; CA Plumas; CA Shasta; CA Siskiyou; CA Tehama Eureka, CA 175 Non-SMSA Counties: 6.6 CA Del Norte; CA Humboldt; CA Trinity San Francisco-Oakland-San Jose, CA: SMSA Counties: 7120 Salinas-Seaside-Monterey, CA 28.9 CA Monterey 7360 San Francisco-Oakland 25.6 CA Alameda; CA Contra Costa; CA Marin; CA San Francisco; CA San Mateo 7400 San Jose, CA 176 CA Santa Clara, CA 19.6 7485 Santa Cruz, CA CA Santa Cruz 14.9 7500 Santa Rosa CA Sonoma 9.1 8720 Vallejo-Fairfield-Napa, CA CA Napa; CA Solano 17.1 Non-SMSA Counties: CA Lake; CA Mendocino; CA San Benito 23.2 Sacramento, CA: SMSA Counties: 6920 Sacramento, CA 16.1 177 CA Placer; CA Sacramento; CA Yolo Non-SMSA Counties 14.3 CA Butte; CA Colusa; CA El Dorado; CA Glenn; CA Nevada; CA Sierra; CA Sutter; CA Yuba Page 48 of 54 May 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language Stockton-Modesto, CA: SMSA Counties: 5170 Modesto, CA 12.3 CA Staiuslaus 178 8120 Stockton, CA 24.3 CA San Joaquin Non-SMSA Counties 19.8 CA Alpine; CA Amador; CA Calaveras; CA Mariposa; CA Merced; CA Tuolumne Fresno-Bakersfield, CA SMSA Counties: 0680 Bakersfield, CA 19.1 179 CA Kern 2840 Fresno, CA 26.1 CA Fresno Non-SMSA Counties: 23.6 CA Kings; CA Madera; CA Tulare Los Angeles, CA: SMSA Counties: 0360 Anaheim-Santa Ana-Garden Grove, CA 11.9 CA Orange 4480 Los Angeles-Long Beach, CA 28.3 CA Los Angeles 180 6000 Oxnard-Simi Valley-Ventura, CA 21.5 CA Ventura 6780 Riverside-San Bernardino-Ontario, CA 19.0 CA Riverside; CA San Bernardino 7480 Santa Barbara-Santa Maria-Lompoc, CA 19.7 CA Santa Barbara Non-SMSA Counties 24.6 CA Inyo; CA Mono; CA San Luis Obispo San Diego, CA: SMSA Counties 181 7320 San Diego, CA 16.9 CA San Diego Non-SMSA Counties 18.2 CA Imperial For each July during which work is performed under the contract, you and each non material- supplier subcontractor with a subcontract of$10,000 or more must complete Form FHWA PR-1391 (Appendix C to 23 CFR 230). Submit the forms by August 15. Page 49 of 54 May 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language 13. FEDERAL TRALNEE PROGRAM For the Federal training program, the number of trainees or apprentices is This section applies if a number of trainees or apprentices is specified in the special provisions. As part of your equal opportunity affirmative action program, provide on-the-job training to develop full journeymen in the types of trades or job classifications involved. You have primary responsibility for meeting this training requirement. If you subcontract a contract park, determine how many trainees or apprentices are to be trained by the subcontractor. Include these training requirements in your subcontract. Where feasible, 25 percent of apprentices or trainees in each occupation must be in their 1 st year of apprenticeship or training. Distribute the number of apprentices or trainees among the work classifications on the basis of your needs and the availability of journeymen in the various classifications within a reasonable recruitment area. Before starting work, submit to the City/County of 1. Number of apprentices or trainees to be trained for each classification 2. Training program to be used 3. Training starting date for each classification Obtain the City/County's of approval for this submitted inforination before you start work. The City/County of credits you for each apprentice or trainee you employ on the work who is currently enrolled or becomes enrolled in an approved program. The primary objective of this section is to train and upgrade minorities and women toward journeymen status. Make every effort to enroll minority and women apprentices or trainees, such as conducting systematic and direct recruitment through public and private sources likely to yield minority and women apprentices or trainees, to the extent they are available within a reasonable recruitment area. Show that you have made the efforts. In making these efforts, do not discriminate against any applicant for training. Do not employ as an apprentice or trainee an employee: 1. In any classification in which the employee has successfully completed a training course leading to journeyman status or in which the employee has been employed as a journeyman 2. Who is not registered in a program approved by the US Department of Labor, Bureau of Apprenticeship and Training Page 50 of 54 May 2016 Local Assistance Procedures Manual Exhibit 12-C Required Federal-aid Contract Language Ask the employee if the employee has successfully completed a training course leading to journeyman status or has been employed as a journeyman. Your records must show the employee's answers to the questions. In your training program, establish the minimum length and training type for each classification. The City/County of and FHWA approves a program if one of the following is met: 1. It is calculated to: ■ Meet the your equal employment opportunity responsibilities • Qualify the average apprentice or trainee for journeyman status in the classification involved by the end of the training period 2. It is registered with the U.S. Department of Labor, Bureau of Apprenticeship and Training, and it is administered in a way consistent with the equal employment responsibilities of Federal-aid highway construction contracts Obtain the State's approval for your training program before you start work involving the classification covered by the program. Provide training in the construction crafts, not in clerk-typist or secretarial-type positions. Training is allowed in lower level management positions such as office engineers, estimators, and timekeepers if the training is oriented toward construction applications. Training is allowed in the laborer classification if significant and meaningful training is provided and approved by the division office. Off-site training is allowed if the training is an integral part of an approved training program and does not make up a significant part of the overall training. The City/County of reimburses you 80 cents per hour of training given an employee on this contract under an approved training program: 1. For on-site training 2. For off-site training if the apprentice or trainee is currently employed on a Federal-aid project and you do at least one of the following: • Contribute to the cost of the training • Provide the instruction to the apprentice or trainee • Pay the apprentice's or trainee's wages during the off-site training period 3. If you comply this section. Each apprentice or trainee must: 1. Begin training on the project as soon as feasible after the start of work involving the apprentice's or trainee's skill 2. Remain on the project as long as training opportunities exist in the apprentice's or trainee's work classification or until the apprentice or trainee has completed the training program Furnish the apprentice or trainee: 1. Copy of the program you will comply within providing the training Page 51 of 54 May 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language 2. Certification showing the type and length of training satisfactorily completed 14. TITLE VI ASSURANCES During the performance of this Agreement, the contractor, for itself, its assignees and successors in interest(hereinafter collectively referred to as CONTRACTOR) agrees as follows: (1) Compliance with Regulations: CONTRACTOR shall comply with the regulations relative to nondiscrimination in federally assisted programs of the Department of Transportation, Title 49,Code of Federal Regulations,Part 21, as they may be amended from time to time, (hereinafter referred to as the REGULATIONS),which are herein incorporated by reference and made a part of this agreement. (2) Nondiscrimination: CONTRACTOR, with regard to the work performed by it during the AGREEMENT, shall not discriminate on the grounds of race, color, sex, national origin, religion,age, or disability in the selection and retention of sub-applicants, including procurements of materials and leases of equipment. CONTRACTOR shall not participate either directly or indirectly in the discrimination prohibited by Section 21.5 of the Regulations, including employment practices when the agreement covers a program set forth in Appendix B of the Regulations. (3) Solicitations for Sub-agreements Including Procurements of Materials and Equipment: In all solicitations either by competitive bidding or negotiation made by CONTRACTOR for work to be performed under a Sub-agreement, including procurements of materials or leases of equipment,each potential sub-applicant or supplier shall be notified by CONTRACTOR of the CONTRACTOR'S obligations under this Agreement and the Regulations relative to nondiscrimination on the grounds of race, color, or national origin. (4) Information and Reports: CONTRACTOR shall provide all infonnation and reports required by the Regulations, or directives issued pursuant thereto, and shall permit access to its books, records,accounts, other sources of infonnation, and its facilities as may be detennined by the California Department of Transportation or FHWA to be pertinent to ascertain compliance with such Regulations or directives. Where any information required of CONTRACTOR is in the exclusive possession of another who fails or refuses to furnish this information, CONTRACTOR shall so certify to the California Department of Transportation or the FHWA as appropriate,and shall set forth what efforts CONTRACTOR has made to obtain the information. (5) Sanctions for Noncompliance: In the event of CONTRACTOR's noncompliance with the nondiscrimination provisions of this agreement, the California Department of Transportation shall impose such agreement sanctions as it or the FI WA may determine to be appropriate, including, but not limited to: (a) withholding of payments to CONTRACTOR under the Agreement within a reasonable period of time,not to exceed 90 days; and/or (b) cancellation, termination or suspension of the Agreement, in whole or in part. (6) Incorporation of Provisions: CONTRACTOR shall include the provisions of paragraphs(1) through(6) in every sub-agreement, including procurements of materials and leases of equipment, unless exempt by the Regulations, or directives issued pursuant thereto. Page 52 of 54 May 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal-aid Contract Language CONTRACTOR shall take such action with respect to any sub-agreement or procurement as the California Department of Transportation or FHWA may direct as a means of enforcing such provisions including sanctions for noncompliance, provided, however,that, in the event CONTRACTOR becomes urvolved in, or is threatened with, litigation with a sub-applicant or supplier as a result of such direction,CONTRACTOR may request the California Department of Transportation enter into such litigation to protect the interests of the State, and, in addition, CONTRACTOR may request the United States to enter into such litigation to protect the interests of the United States. 15. USE OF UNITED STATE-FLAG VESSELS The CONTRACTOR agrees- 1. To utilize privately owned United States-flag commercial vcssels to ship at least 50 percent of the gross tonnage(computed separately for dry bulk carries, dry cargo liners, and tankers) involved, whenever shipping any equipment, material, or commodities pursuant to this contract, to the extent such vessels are available at fair and reasonable rates for United States- flag commercial vessels. 2. To Furnish within 20 days following the date of loading for shipments originating within the United State or within 30 working days following the date of loading for shipments originating outside the United States, a legible copy of a ratcd"on-board" commercial ocean bill-of-lading in English for each shipment of cargo described in paragraph (1) of this section to both the Contracting Officer(through the prime contractor in the case of subcontractor bills-of-lading) and to the Division of National Cargo, Office of Market Development, Maritime Administration, Washington,DC 20590. 3. To insert the substance of the provisions of this clause in all subcontracts issued pursuant to this contract. MAINTAIN RECORDS AND SUBMIT REPORTS DOCUMENTING YOUR PERFORMANCE UNDER THIS SECTION Page 53 of 54 May 2016 CONTRACTOR'S SWORN STATEMENT AND WARRANTY REGARDING CONTINUING INSURANCE OBLIGATIONS FROM: R.J.NOBLE COMPANY PROJECT: CC-1516 EDINGER AVE&WARNER AVE (Contractor Name) 15505 E. LINCOLN AVENUE (Street Address) ORANGE,CA 92865 (City,State and Zip) TO: CITY OF HUNTINGTON BEACH DECLARATION Attached hereto is a true and correct copy of the current Certificate of Insurance and Additional Insured Endorsement CG 2010 1185, which Certificate complies with the insurance requirements of the Contract by and between the City of Huntington Beach("City' and the above-named Contractor("Contractor')for the above-described project( Project'?. I declare under penalty of perjury under the laws of the State of California that the above statement is true and correct. Signed on?�9_ 2017 at_15505 E. LINCOLN AVENUE ORANGE CA 92865 _ (Date) (City,State) X ��� dd��dd/WW STEVE MSi na�T SEBCRE ARYho is Making Declaration) WARRANTY Contractor hereby warrants and agrees to maintain Products and Completed Operations Insurance in compliance with the Insurance requirements of the Contract for the Project. Said insurance shall be maintained through and until the expiration of all Warranties provided by Contractor. Said insurance Shall contain Additional Insured Endorsement CG 2010 1165,naming City as an additional insured. Contractor shall supply to City,on at least an annual basis,a Certificate of Insurance and the aforementioned Endorsement evidencing continued coverage which meets the Contract requirements. Signed on 2/9 _ 2017 at 15505 E. LINCOLN AVENUE,ORANGE,CA 92865 (Date) (City,State) CONTRACTOR: Name: R.J. NOBLE COMPANY Name: STEVE STEVE MENDOZA // Title; SECRETARY/ 277621.2 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYWY) 2/14/20 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.ITHIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Patriot Risk& Insurance Services CONTACT 100 Spectrum Center Drive, Suite#400 PHONE Irvine, CA 92618 c No Ext: 949 486-7900 FAX No): 949 486-7950 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# www.patrisk.com OK07568 INSURED INSURER A: ZUfICh American Insurance COm an 16535 R. J. Noble Company, Inc. INSURERB: 15505 Lincoln Avenue INSURERC: P.O. Box 620 INSURER D: Orange CA 92856-9020 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 34226366 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 ADDL SUBR LTR TYPE OF INSURANCE POLICY EFF POLICY EXP POLICY NUMBER MM/DD/YYYY MM/ LIMITS DD/YYYY A ✓ COMMERCIAL GENERAL LIABILITY ✓ ✓ GLOO17436602 7/1/2016 7/1/2017 EACH OCCURRENCETO $ 1,000,000 CLAIMS-MADE �/ OCCUR DAMAGE TO RENTED APPROVED AS TO FO PREMISES Ea occurrence $ 300,000 ✓ Contractual Liability MED EXP(Any one person) $ 5,000 GEN'L AGGREGATE LIMIT APPLIES PER: B� .7 �7 PERSONAL&ADV INJURY $ 1,000,000 POLICY Z PRO- LOC ICHAEL E. GATES GENERAL AGGREGATE $ 2,000,000 JECTCITY ATTORNEY I PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: CITY OF HUNTINGTON BE CH $ A AUTOMOBILE LIABILITY ✓ ✓ BAP017436702 7/1/2016 7/1/2017 COMBINED SINGLE LIMIT ✓ ANY AUTO Ea accident $ 1,000,000 OWNED SCHEDULED BODILY INJURY(Per person) $ AUTOS ONLY AUTOS HIR BODILY INJURY(Per accident) $ ED NON-OWNED ✓ AUTOS ONLY ✓ AUTOS ONLY PROPERTY DAMAGE $ Per accident A UMBRELLA LIAB $ ✓ OCCUR AUC017437202 7/1/2016 7/1/2017 EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE Policy Follows Form Over $ 10,000,000 DED RETENTION$ Underlying General Liab. AGGREGATE $ 10,000,000 A WORKERS COMPENSATION ✓ WC01 7436302 7/1/2016 7/1/2017 0111_ $ AND EMPLOYERS'LIABILITY TA ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N No Deductible for Workers �/ S TUTE ER OFFICER/MEMBER EXCLUDED? ❑ N/A Compensation E L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Re:RJN#91580/Edinger Avenue and Warner Avenue,Project#CC-1516 City of Huntington Beach,its officers,elected or appointed officials,employees,agents and volunteers are named as Additional Insured, includes Primary&Non-contributory as respects to General Liability&Auto Liability per endorsement attached where required by written contract. Waiver of subrogation applies to GL,Auto and Work and in favor of the additional insureds per attached endorsement 30 days notice of cancellation, 10 days for non-payment of premium. CERTIFICATE HOLDER CANCELLATION Cityy of Huntington Beach SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2000 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Huntington Beach CA 92648 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Leonard E.Ziminsky '� � `'" r..J ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 34226366 1 16/17 - GL/AU/EXC/WC I Annette Romero 1 2/14/2017 10:19:06 AM (PUT) I Page 1 of 6 This certificate cancels and supersedes ALL previously issued certificates. Additional Insured — Owners, Lessees Or Contractors — ZURICH� Scheduled Person Or Organization EGLO0174E366O2 Eff. Date of Pol. Exp. Date of Pol. Eff.Date of End. Producer No. AddIT Prem Return Prem. �7/1/2016 7/1/2017 7/1/2016 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured:R.J. Noble Company, Inc. Address(including ZIP Code): 15505 Lincoln Avenue Orange CA 92856-9020 This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Covered Operations ity of Huntington Beach,its officers,employees and agents and Volunteer e:RJN#91580 A. Section II — Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule above, whom you are required to add as an additional insured on this policy under a written contract or written agreement. However, if you have entered into a construction contract.or construction agreement with an additional insured person or organization shown in the Schedule of this endorsement, the insurance afforded to such additional insured only applies to the extent permitted by law. B. The insurance provided to the additional insured person or organization applies only to "bodily injury", "property damage" or "personal and advertising injury" covered under Section i —Coverage A— Bodily injury And Property Damage Liability and Section I—Coverage B—Personal And Advertising Injury Liability, but only with respect to liability for"bodily injury", 'property damage"or"personal and advertising injury"caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf, and resulting directly from your ongoing operations or"your work" as included in the 'products-completed operations hazard", which is the subject of the written contract or written agreement at the Location designated and described in the Schedule above. C. However, regardless of the provisions of Paragraphs A.and B. above: 1. We will not extend any insurance coverage to any additional insured person or organization: U-GL-1 -E CW(04/12) This certificate icate - GL/AU/nd /WCsup edesAnne in�dmConvdgM�matee�ehAlnserange�e�vices office,Inc.,with its permission. Page 1 of 2 This certificate cancels and supersedes ALL previously issued certificates. a. That is not provided to you in this policy; or b. That is any broader coverage than you are required to provide to the additional insured person or organization in the written contract or written agreement; and 2. We will not provide Limits of Insurance to any additional insured person or organization that exceed the lower of: a. The Limits of Insurance provided to you in this policy; or b. The Limits of Insurance you are required to provide in the written contract or written agreement. D. The insurance provided to the additional insured person or organization does not apply to: "Bodily injury", "property damage" or"personal and advertising injury" arising out of the rendering or failure to render any professional architectural, engineering or surveying services including: 1. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. Supervisory, inspection, architectural or engineering activities. E. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV— Commercial General Liability Conditions: The additional insured must see to it that: I. We are notified as soon as practicable of an"occurrence"or offense that may result in a claim; 2. We receive written notice of a claim or"suit"as soon as practicable; and 3. A request for defense and indemnity of the claim or "suit" will promptly be brought against an y policy ssued by another insurer under which the additional insured may be an insured in any capacity. This provision ldoes not apply to insurance on which the additional insured is a Named Insured, if the written contract or written agreement requires that this coverage be primary and non-contributory. F. For the coverage provided by this endorsement: 1. The following paragraph is added to Paragraph 4.a. of the Other Insurance Condition of Section IV—Commercial General Liability Conditions: This insurance is primary insurance as respects our coverage to the additional insured person or organization, where the written contract or written agreement requires that this insurance be primary and non-contributory with respect to any other policy upon which the additional insured is a Named Insured. In that event, we will not seek contribution from any other such insurance policy available to the additional insured on which the additional insured person or organization is a Named Insured. 2. The following paragraph is added to Paragraph 4.b.of the Other Insurance Condition of Section IV—Commercial General Liability Conditions: This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same"occurrence", offense, claim or"suit'. This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on a primary and non- contributory basis. All other terms and conditions of this policy remain unchanged. U-GL-1177-E CW(04/12) Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 2 of 2 34226366 1 16/17 - GL/AU/EXC/WC Annette Romero 1 2/14/2017 10:19:06 AM (PDT) I Page 3 of 6 This certificate cancels and supersedes ALL Previously issued certificates. R. J. Noble Company, Inc. POLICY NUMBER:GLO017436602 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of Huntington Beach,its officers,employees and agents and Volunteers Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV— Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 ©Insurance Services Office, Inc., 2008 34226366 1 16/17 - GL/AU/EXC/WC I Annette Romero 1 2/14/2017 10:19:06 AM (PDT) I Page 4 of 6 Page 1 Of 1 ❑ This certificate cancels and supersedes ALL previously issued certificates. POLICY NUMBER:BAPo17436702 COMMERCIAL AUTO CA 20 48 1013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVE RED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s)who are"insureds"for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date Is indicated below. Named Insured:R.J. Noble Company, Inc. Endorsement Effective Date:7/1/2016 SCHEDULE Name Of Person(s)Or Organization(s): City of Huntington Beach,its officers,employees and agents and Volunteers Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an"insured"for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.I. of Section 11 — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 ®Insurance Services Office, Inc., 2011 Page 1 o f 1 34226366 I 16/17 - GL/AU/EXC/WC I Annette Romero I 2/14/2017 10:19:06 AM (PDT) I Page 5 of 6 Wolters Kluwer Financial Services I Uniform Fo S7m This certificate cancels and supersedes ALL previously issued certificates. WORKERS'COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 04 03 06(Ed.4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT- CALIFORNIA This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following"attaching clause"need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 7/1/2016 (GATE) at 12:01 A.M. standard time,forms a part of Policy No. WC017436302 Endorsement No. of the Zurich American Insurance Company (NAME OF INSURANCE COMPANY) issued t0 R.J.Noble Company, Inc. yF Premium (if any)$ /} Authorized Representative We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be % of the California workers' compensation pre- mium otherwise due on such remuneration. Schedule Person or Organization Job Description City of Huntington Beach,its officers,employees and agents and Volunteers Re:RJN#91580 WC 252(4-84) WC 04 03 06(Ed.4-84) Page 1 of 1 34226366 16/17 - GL/AU/EXC/WC I Annette Romero 12/14/2017 10:19:06 AM (PDT) I Page 6 of 6 This certificate cancels and supersedes ALL previously issued certificates. RECEIVED BY: CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office (Name) after signing/dating (Date) B CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: City Treasurer FROM: City Clerk 2 DATE: � � 34 . �� SUBJECT: Bond Acceptance I have received the bonds for (Company Name) CAPITAL PROJECTS (Includes CC's and MSC's) /1 Performance Bond No. ��i�0ba. /f 1 Payment Bond (Labor and Materials) Bond No. 3-00'o 3- 6 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 -;-O/�L / (Council Approval Date) CC No. �� Agenda Item No. MSC No. City Clerk Vault No. no 0 IS-0- Other No. SIRE System ID No. O9 g:/forms/bond transmittal to treasurer Bond No. 30003631 PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS: WHEREAS,City of Huntington Beach(hereafter referred to as"City")has, by written agreement dated Z i 1 ,20A entered into a contract with R.J.NOBLE COMPANY 15505 E. LINCOLN AVENUE,ORANGE,CA 92865 (name and address of Contractor) (hereinafter referred to as"Principal"),for performance of the work described as follows. EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET& WARNER AVENUE REHABILITATION FROM BEACH BLVD TO NEWLAND STREET CC NO. 1516 ; (Project Title) _�_---- — - WHEREAS, said contract, and all documents referenced therein (hereinafter collectively 'Contract"), are Incorporated herein by this reference made a part hereof as though set forth herein in full;and Said Principal is required under the terms of the Contract to furnish a bond guaranteeing the prompt,full and faithful performance of said Contract, by a duly admitted surety insurer under the laws of the State of California(hereinafter referred to as"Surety");and Surety is certified and listed in the U.S. Department of the Treasury Circular 570, and has provided proof of sufficient bonding limitations as shown in said circular to provide bonds in the amount required by said Contract;and Surety has provided financial strength ratings from reputable companies,such as from AM,Best,Moody's, or Standard&Poor's,to validate that Surety has positive ratings of being secure or Stable;and Surety is registered and listed with the California Department of Insurance, NOW,THEREFORE,we,the undersigned,as Principal,and Western Surety Company, 915 Wilshire Blvd., Suite 1650, Los Angeles CA 90017 (name and address of Surety) as Surety,are held and firmly bound unto City in the penal sum of one million four hundred sixteen thousand two hundred ninety eight&50/100 Dollars($1 416,298.50 ),this amount being not less than one hundred percent of the price set forth in the Contract,in lawful money of the United States,for the payment of which sum,well and truly to be made, we bind ourselves,our heirs,executors,administrators and successors,jointly and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION 1S SUCH THAT if the Principal shall promptly,fully and faithfully perform each and all of the covenants,obligations and things to be done and performed by the Principal In strict accordance with the terms of the Contract as said contract may be altered,amended or modified from time to time;and if the Principal shall Indemnify and save harmless City and all of City's officers,agents and employees(hereinafter collectively referred to as"Obligees")fromany and all losses,liability and damages, claims,judgments,stop notices,fees and costs of every description,whether imposed by law or in equity, which may be incurred by the Obligees by reason of the failure or default on the part of the Principal in the performance of any or all of the terms or the obligations of the Contract,including all alterations,amendments and modifications thereto,and any warranties or guarantees required thereunder,then this obligation shall be void;otherwise,it shall be and shall remain in full force and effect. Surety stipulates and agrees,for value received,that no adjustment of the time or price in the Contract or any alteration,change, deletion,addition or other modification to the Contract,or the work to be performed thereunder,shall in any way affect,limit, restrict,impair or release the obligations of the Surety under this Bond. Surety waives notice of any adjustment of contract or contract price,and any other alteration,change, deletion,addition or other modification to the Contract,or the work to be performed thereunder,and agrees 1 5-45 84/1 1 7 1 74 Bond No. 30003631 to automatically adjust the penal sum of this Bond to reflect such adjustments,alterations,changes, deletions,additions or other modifications. Surety agrees to provide written confirmation of such adjustments in the penal sum to City on not less than a quarterly basis. Surety also waives the provisions of Civil Code§§2845 and 2849, The obligations of this Bond shall survive the completion of the work described in the Contract as to all obligations and liabilities of the Principal which survive completion of the work. IN WITNESS WHEREOF,each party represents and warrants that this instrument has been duly executed by Principal and Surety,on the date set forth below,that the name of each corporate party being affixed hereto is such party's proper legal name and that the individuals signing this instrument have been duly authorized pursuant to the authority of its governing body. Surety, by execution of this bond,waives any defense which Surety has or may have by reason of any failure of the Principal to execute or properly execute this bond. Dated: February 14 2017 AT TEST R.J.NOBLE COMPANY (Corporate Seal) (Principal Name) By: X �-f Name: STEVE MEND9L Title-,SECRETARY ATTEST Western Surety Company (Corporate Seal) (Surety N�rne) By-� N me:Lbonard Ziminsk� //(Signature of Attorney-in-Fact for Su (Attac;+Attorney-iri-Fact Certificate) 866-404-7926 (Area Code&Telephone Number for Surety) APPROVED AS TO FLaF + By: Michael E.Gates,City Attorney �o����� t Atote: This bond must be executed in duplicate and dated,all signatures must be notartzecd and evidence of the authority of any person signing as aftomey--in-fact must be attached, PERFORMANCE BOND Page 2 of 2 I545941117174 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 02/15/2017 before me J. DE IONGH, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared STEVE MENDOZA Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the persons} whose names}is/are- subscribed to the within instrument and acknowledged to me that he/she/they-executed the same in his/her/heir authorized capacity(ie*, and that by his/her/their 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. WITNESS my hand and ial a J. DE IONGH Commission #2128504 a _m Z Signature Z : Notary Public - California z Z - orange County ' Signature Notary Public My Comm.Expires Oct 28,2019 tJ. DE IONGH Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: 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: 02014 National Notary Association •www.NationaiNotary.org - 1-800-US NOTARY(1-800-876-6827) Item#5907 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange ) On February 14, 2017 before me, Lauren Emily Bierman, A Notary Public (insert name and title of the officer) personally appeared Leonard Ziminsky, Attorney-in-Fact who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/aRX subscribed to the within instrument and acknowledged to me that he/&O" executed the same in his/hayA ak authorized capacity(ie*, and that by his/harAhek signature(g.) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. 4� �E. LAURENEMILYBIERMAN N a'p COMM.0 2097240 7 : ® NOTARY PURX-CAUFORNIA ORANGE COUNTY N (� f jj-1 MY COMM.EXP.JAN 15,2019 Signature !t �Vl�o�u��� '�A� (Seal) J Bond No. 30003631 PAYMENT BOND (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS: WHEREAS,City of Huntington Beach(hereafter referred to as"City")has awarded to R.J.NOBLE COMPANY 15505 E.LINCOLN AVENUE,ORANGE,CA 92865 (name and address of Contractor) hereinafter referred to as"Principal")) a contract(("Contract"))for the worts described as follows: hereinafter AVENUE REHABILITATICSIJ FROM GRAHAM STREET TO SPRINGDALE STREET& WARNER AVENUE REHABILITATION FROM BEACH BLVD TO NC-WLAND STREET (Project Title) WHEREAS, Principal Is required under the terms of the Contract and the California Civil Code to furnish a bond to secure the payment of claims of laborers,mechanics,materialmen,and other persons as provided by law, by a duly admitted surety insurer under the laws of the State of California (hereinafter referred to as "Surety");and Surety is certified and listed in the U.S. Department of the Treasury Circular 570, and has provided proof of sufficient bonding limitation, as shown In said circular to provide bonds in the amount required by said Contract;and Surety has provided financial strength ratings from reputable companies,such as from A.M.Best,Moody's or Standard&Poor's,to validate that Surety has positive ratings of being secure or stable;and Surety is registered and listed with the California Department of Insurance. NOW THEREFORE,we,the undersigned Principal,and Western Surety Company, 915 Wilshire Blvd., Suite 1650, Los Angeles, CA 90017 (name and address of Surety) as Surety,are held and firmly bound unto City in the-penal sum of one million four hundred sixteen thousand two hundred ninety eight&50/100 dollars 1,416,298.50 ),this amount being not less than one hundred percent(100%)of the total price set forth in the Contract,in lawful money of the United States of America,for the payment of which sum,well and truly to be made,we bind ourselves,and each of our heirs, executors,administrators,successors,and assigns,jointly and severally,firmly by these presents, THE CONDITION OF THIS OBLIGATION IS SUCH THAT,if the Principal,his,her,or its heirs,executors, administrators,successors or assigns,or subcontractors shall fail to pay any of the persons named in Section 3181 of the California Civil Code("Claimants")for all labor,materials or services used or reasonably required for use in performance of the work described in the Contract,or any amounts due under the Unemployment Insurance Code with respect to work or labor performed by any such Claimant,or prevailing wages due and penalties incurred pursuant to Sections 1774, 1775, 1813 or 1815 of the Labor Code,or any amounts required to be deducted,withheld and paid over to the Employment Development Department from the wages of employees of the Principal and Subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to the work or labor performed under the Contract,Surety will pay for the same, in an amount not exceeding the penal sum specified in this bond;otherwise,this obligation shall be null and void, This bond shall inure to the benefit of any of the persons named in Section 3181 of the California Civil Code so as to give a right of action to such persons or their assigns. In case any action is brought upon this bond, Surety further agrees to pay all court costs and a reasonable attorney's fee in an amount fixed by the court. PAYMENT BOND Page 1 of 2 t 5-45W117357 Surety stipulates and agrees,for value received,that no change,extension of time,alteration, addition or modification to the terms of the Contract,or any contract document or any work to be performed thereunder,whether made after notice or not, shall in any way affect,impair or release the obligations of Surety under this bond. Surety hereby waives notice of any such change, extension of time,alteration,addition,or modification to the terms of the Contract,the contract documents or the work thereunder. Surety also waives the provisions of California Civil Code§§ 2845 and 2849. IN WITNESS WHEREOF,each party represents and warrants that this instrument has been duly executed by Principal and Surety,on the date set forth below,that the name of each corporate party being affixed hereto is such 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: February 14, 2017 ATTEST R.J.NOBLE COMPANY (Corporate Seal) (Princi__al Name) Name: STEVE MENDO v Title: SECRETARY ATTEST Western Surety Company (Corporate Seal) (Surety Name) N e:Xeonard Ziminsk Signature of Attof in-Fact for Sur ty) (Attach Attorney-in-Fact Certificate) 866-404-7926 (Area Code&'telephone Number for Surety) 1-7 APPROVED AS T g''F,ORM: By: Itillichael E.Gates, ity Attorney Note: This bond must be executed in duplicate and dated,ail signatures must be notarized,and evidence of the authority of any person signing as attorney-in-fact must be attached. PAYMENT BOND Page 2 of 2 1 5-45 8 4/11 735 7 2/28/2017 Company Profile +s CALIFORNIA 'r COMPANY PROFILE Company Profile Company Search Company Information Company Search Results WESTERN SURETY COMPANY Company 333 S. WABASH AVEMIE Information CHICAGO, IL 60604 Old Company Names Agent for Service Old Company Names Effective Date Reference Information Agent For Service NAIC Group List Vivian Imperial Lines of Business 818 WEST SEVENTH STREET Workers' SUITE 930 Compensation LOS ANGELES CA 90017 Complaint and Request for Action/Appeals Reference Information Contact Information Financial Statements NAIC #: 13188 PDF's Annual Statements California Company ID #; 0761-7 Quarterly Date Authorized in California: 07/29/1930 Statements Company Complaint License Status: UNLIMITED-NORMAL Company Company Type: Property &Casualty Performance & Comparison Data State of Domicile: SOUTH DAKOTA�:=j Company Enforcement Action Composite back to top Complaints Studies Additional Info NAIC Group List Find A Company Representative In Your Area NAIC Group #: 0218 CNA INS GRP View Financial Disclaimer Lines Of Business The company is authorized to transact business within these lines of insurance. For an explanation of any of these terms, please refer to the glossary. LIABILITY SURETY back to top © 2008 California Department of Insurance https:/fi nteractive.web.i nsurance.ca.gov/com panyprofi letcom panyprofi le?event=com panyProfii le&doFunction=getCom panyProfi le&eid=2977 1/1 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 02/15/2017 before me, J. DE IONGH, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared STEVE MENDOZA Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s} whose name(s)-is/aw subscribed to the within instrument and acknowledged to me that he/she/they-executed the same in his/her/their authorized capacity(iesy,and that by his/lier/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 J. DE IONGH is true and correct. ' Commission #2128504 z = Notary Public California Z WITNESS my hand and o icia seal. q Orange County n 41 My Comm. Expires Oct 28, 201 Signature Signat of 4ary Public J. DE IONGH Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: 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: 02014 National Notary Association• www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 f ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange ) On February 14, 2017 before me, Lauren Emily Bierman, A Notary Public (insert name and title of the officer) personally appeared Leonard Ziminsky, Attorney-in-Fact who proved to me on the basis of satisfactory evidence to be the person(s) whose name(A) is/aRX subscribed to the within instrument and acknowledged to me that he/ghe" executed the same in his/herftek authorized capacity(ie*, and that by his/herAhek signature(%) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. 4OF* �, LAURENEMILYBIERMAN COMM.M 2097240 X g NOTARY FLeUC•CALIFORMIA ORANGE COUNTY N Signature Seal MY COMM.EV AN 15,209 Western Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents,That WESTERN SURETY COMPANY,a South Dakota corporation,is a duly organized and existing corporation having its principal office in the City of Sioux Falls,and State of South Dakota,and that it does by virtue of the signature and seal herein affixed hereby make,constitute and appoint James Scott Salandi, Leonard Ziminsky, David Jacobson, Individually of Irvine,CA,its true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign,seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts - and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney,pursuant to the authority hereby given,are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By-Law printed on the reverse hereof,duly adopted,as indicated,by the shareholders of the corporation. In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 21 st day of October,2016. „xs�aer"; WESTERN SURETY COMPANY a�"fpP?DAgl.le�i �Ws4 l�l a� r�\Sf AV. wAPaul T.Bruflat,Vice President State of South Dakota ss County of Minnehaha On this 21st day of October,2016,before me personally came Paul T.Bruflat,to me known,who,being by me duly sworn,did depose and say: that he resides in the City of Sioux Falls, State of South Dakota;that he is the Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument;that he knows the seal of said corporation;that the seal affixed to the said instrument is such corporate seal;that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation. My commission expires J.MOHR June 23,2021 Iss CAKaTA Y /] J.Mohr,Notary Public CERTIFICATE I, L.Nelson,Assistant Secretary of WESTERN SURRETY"COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force,and further certify that the By-Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this 1 day of ' a r v ,�/�....., WESTERN SURETY COMPANY JV CAN' :Pa 4 �?M DPI L.Nelson,Assistant Secretary Form F4280-7-2012 CITY OF HUNTINGTON BEACH PROJECT NAME: Edinger Avenue and Warner Avenue CC#: CC-1516 BID OPENING DATE: 12/29/2016 TIME & LOCATION: 2:00 PM Council Chambers ENGINEER'S ESTIMATE: $1,480,000.00 BIDS SUBMITTED (AS READ AT OPENING) BIDDER'S NAME FINAL APPARENT BID RANK AMOUNT All American,Asphalt 7Corona ;a. EBS General.Engineering, Inc-Corona Excel Paving.,L ong Beach ° ",�; Griffith Company- Santa Fe Springs Hardy& Harper, Inc.- Santa Ana Minco"Construction-Gardena R.J. Noble Col'-Orange Sequel Contractors, Inc- Santa'Fe Springs , SULLY MILLER- Brea a, r PTS 07282015 Version 15 CC1516 City of Huntington Beach r Rt 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachea.gov :ffe. PoF : Office of the City Clerk J7,1909, Robin Estanislau, City Clerk March 6, 2017 R J Noble Company ATTN: Kori Porter 15505 E. Lincoln Ave. Orange, CA 92865 Re: Edinger&Warner Avenues Rehab Project— CC-1516 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 protect is completed but prior to the release of retention funds. In addition, the following item must also be on file, with this office before the City can release any retention funds: A warranty bond guaranteeing the final amount of work and materials for one year. If your performance bond does not include specific wording for a one-year warranty, then a rider or separate bond must be submitted. Should you have any questions or concerns regarding the enclosures or items that must be on file in this office prior to release of retention funds, please call the Public Works Department at 536-5517. Sincerely, Q- 4q4ov liG1 4vdjle4d Robin Estanislau, CIVIC City Clerk RE:pe Enclosures: Copy of Contract including Proposal Copies of insurance/bonds Bid Bond (original) Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand RECEIVED'BY: CITY CLERK RECEIPT COPY -� Return DUPLICATE to City Clerk's Office (Name) after signing/dating (Date) >It� CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION LD TO: City Treasurer FROM: City Clerk DATE: /j 1 C���F A0I4 SUBJECT: Bond Acceptance I have received the bonds for bf -� I 68l j (Company Name) CAPITAL PROJECTS (Includes CC's and MSC's) ``-- Performance Bond No. Payment Bond (Labor and Materials) Bond No. 00 0 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. !. ka Agenda Item No. MSC No. City Clerk Vault No. Other No. SIRE System ID No. �:�1 ' ? o g:/forms/bond transmittal to treasurer \%//1;1? 111) Dept.ID PW17-001 Page 1 of 3 Meeting Date:1/17/2017 CITY OF HUNTINGTON BEACH REQUEST FOR, CITY COUNCIL ACTION MEETING DATE: 1/17/2017 SUBMITTED TO: Honorable Mayor and City Council Members SUBMITTED BY: Fred A.Wilson, City Manager PREPARED BY: Travis K. Hopkins, PE, Director of Public Works SUBJECT: Accept the lowest responsive and responsible bid and authorize execution of a construction contract with the R.J. Noble Company in the amount of $1,416,298.50 for the Edinger Avenue Rehabilitation and Warner Avenue Rehabilitation Project, CC-1516; and, authorize an amendment to move last years CIP Arterial Rehabilitation Projects CC-1516 and the forthcoming project CC-1502 Adams Avenue and Atlanta Avenue, into this year's FY 16-17 CIP Statement of Issue: On December 29, 2016, bids were publically opened for the Edinger Avenue Rehabilitation and Warner Avenue Rehabilitation Project. City Council action is requested to award the construction contract to the R.J. Noble Company, the lowest responsive and responsible bidder. Financial Impact: Funding for the project in the amount of$1,650,000 is included in the FY 16-17 budget in Measure M Account No. 21385201.69300 ($75,387) and in the FY15-16 CIP Carry Forward presented as part of tonight's agenda in Measure M Account No. 21390025.82300 ($1,074,613) and OCTA Grant Fund Account No. 87390009.82300 ($500,000). In order to utilize the 16-17 funds, City Council will need to authorize an amendment to the 16-17 Capital Improvement Program (CIP) to include arterial rehabilitation projects from the 15-16 CIP. This expenditure will be absorbed in the Measure M fund. Recommended Action: A) Accept the lowest responsive and responsible base bid submitted by the R.J. Noble Company in the amount of$1,416,298.50. B) Authorize the Mayor and City Clerk to execute a construction contract in a form approved by the City Attorney. C)Authorize an amendment to the Arterial Rehabilitation project included in the FY 16-17 CIP to include the following street segments: Edinger Avenue (Graham to Springdale), Warner Avenue (Beach to Newland), Adams Avenue (Beach to Newland) and Atlanta Avenue (Beach to Newland). Alternative Action(s): Reject all bids, or provide staff with alternative action. Item 5. - 1 HB -32- Dept.ID PW17-001 Page 2 of 3 Meeting Date: 1/17/2017 Analysis: The project will rehabilitate Edinger Avenue (Graham Street to Springdale Street) and Warner Avenue (Beach Blvd. to Newland Street). The segments of Edinger Avenue and Warner Avenue were last rehabilitated in 1981 and 1999 respectively. Rehabilitation methods include grinding out and replacing failed asphalt concrete as well as standard overlay. Sewer manholes and water meter boxes and valves will be adjusted to grade. Areas of raised or settled curb, gutter and sidewalk will be replaced as necessary. The project is using a sustainable paving material which utilizes rubberized asphalt concrete (RAC) which contains crumb rubber derived from 100% California waste tire rubber. A two inch layer of RAC uses over 2,000 waste tires per lane mile. The project will divert more than 7,000 waste tires that would otherwise end up in a landfill. Including this project, the use of RAC in the rehabilitation of the City's arterial streets has resulted in the diversion of over 290,000 waste tires. BIDDER'S NAME BID AMOUNT TOTAL CONTRACT AMOUNT (Amount Read at Bid Opening and Basis of Award) The R. J. Noble Company $1,416,298.50 $1,416,298.50 All American Asphalt $1,463,769.00 $1,463,769.00 Hardy & Harper, Inc. $1,477,000.00 $1,477,000.00 Sequel Contractors, Inc. $1,539,175.00 $1,539,175.00 Excel Paving $1,578,868.00 $1,578,868.00 The engineer's estimate for the project is $1,507,457.00. Staff recommends awarding a contract to the R.J. Noble Company in the amount of$1,416,298.50. The R.J. Noble Company has provided acceptable street rehabilitation construction in the past including the Talbert Avenue (Gothard St. to Newland St.) rehabilitation that was finished last month. The total project cost is estimated to be $1,650,000.00, which includes the construction contract, project management, construction contingency, and supplementals (soils and materials testing, construction support services by outside firms, in-house inspection services and additional engineering support). In addition to the grant funding of $500,000 from the OCTA Arterial Pavement Management (APM) program, reimbursement from the California Department of Resources Recycling and Recovery Targeted Rubberized Asphalt Concrete Incentive Grant in the amount of$29,000 is anticipated. Also included is a request to authorize an amendment for last year's Arterial Rehabilitation Program projects to be in the FY16/17 Arterial Rehabilitation Program which are projects CC-1516: Edinger Avenue (Graham to Springdale) and Warner Avenue (Beach to Newland), and forthcoming project CC-1502: Adams Avenue (Beach Blvd. to Newland Street) and Atlanta Avenue (Beach Blvd. to Newland Street). Public Works Commission Action: The Public Works Commission reviewed and approved CC-1516 on March 16, 2016, with a vote of 6-0-1 (Capps-absent). Environmental Status: The project is categorically exempt pursuant to Class 1, section 15031 c of the California Environmental Quality Act. HB -33- Item 5. - 2 Dept.ID PW17-001 Page 3 of 3 Meeting Date: 1/17/2017 Strategic Plan Goal: Enhance and maintain infrastructure Attachment(§): 1. Project Location Map CC-1516 Item 5. - 3 HB -34- �P U) U U) BOLSA AVE AFC O NTS a U) U Mc FADDEN AVE. U z U) can EDINGIER J z 0 J 0 OHEILM Q z AVE. 2 > 0 U U) w o Q WAR ER � Q z m AVE. w o � J SLATERw 00 AVE. 405 0 c� TALBERT AVE. PACIFIC ,o 9 b ELLIS AVE. GARFIELD AVE. o � \ U) U) U) U YORKTOWQN AVE. 3 U) ADAMS g AVE. Y w �'F g INDIANAPO IS AVE. PROJECT LOCATION �� o U)w TLAN A LE.=< cn = O1 Edinger Ave (Graham St to Springdale St) m Q Y m O Warner Ave (Beach Blvd to Newland St) HAMILTON AVE. � < m a BANNING OCEAN AVE. LEGEND ARTERIAL STREET LOCATIONS REV 12/14/16 ARTERIAL PAVEMENT MANAGEMENT PROGRAM PROJECT LOCATION MAP FOR CC-1516 'A• rt CITY OF HUNTINGTON BEACH to DEPARTMENT OF PUBLIC WORKS 1 ^c- H -35- Item 5. - 4 CITY OF HUNTINGTON BEACH PROJECT NAME: Edinger Avenue and Warner Avenue CC#: CC-1516 BID OPENING DATE: 12/29/2016 TIME & LOCATION: 2:00 PM Council Chambers ENGINEER'S ESTIMATE: $1,480,000.00 BIDS SUBMITTED (AS READ AT OPENING) BIDDER'S NAME -FINAL APPARENT BID RANK AMOUNT All American Asphalt-Corona , , -- EBS General Engineering, Inc-Corona Excel Paving- Long Beach Griffith Company- Santa Fe Springs Hardy& Harper, Inc.-Santa Ana Llr� Minco Construction-Gardena R.J. Noble Co-Orange Sequel Contractors, Inc-Santa Fe Springs -- SULLY MILLER- Brea PTS 07282015 Version 15 CC1516 UNSUCCESSFUL BIDS CC- 1516 Edinger Avenue Rehabilitation City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov Office of the City Clerk 77,1999 Robin Estanislau, City Clerk April 6, 2017 All American Asphalt P. O. Box 2229 Corona, CA 92878-2229 Re: Edinger Avenue Rehabilitation — CC-1516 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 protect is completed but prior to the release of retention funds. In addition, the following item must also be on file, with this office before the City can release any retention funds: A warranty bond guaranteeing the final amount of work and materials for one year. If your performance bond does not include specific wording for a one-year warranty, then a rider or separate bond must be submitted. Should you have any questions or concerns regarding the enclosures or items that must be on file in this office prior to release of retention funds, please call the Public Works Department at 536-5517. Sincerely, Robin Estanislau, CIVIC City Clerk RE:pe Enclosures: Copy of Contract including Proposal Copies of insurance/bonds Bid Bond (original) Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand 6 (� 4k � v � I f F g N � ON N 00 00 ui 1 � L U W O V I w - � _ w cr- Z N w T; H -4- O U h a o O Q � U r W � O � x O U W Q City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER TWO For EDINGER AVENUE REHABILITATION AND WARNER AVENUE REHABILITATION CC No. 1516 Federal Aid Project STPL-5181(189) in the CITY OF HUNTINGTON BEACH December 20, 2016 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) BID OPENING POSTPONED REVISED BID DUE DATE ON COVER AND ON PAGE A-1 FROM "DECEMBER 20, 2016" to "DECEMBER 29. 2016." 2) ASPHALT CONCRETE CLARIFICATION REVISED SHEET E-23 and E-24 IN SPECIFICATION BOOK—203 BITUMINOUS MATERIALS (2 Sheets) Replace E-23 with "E-23 CC-1516, Addendum 2" (1 sheet) And Replace Page E-24 with "E-24 CC-1516, Addendum 2" (1 sheet) This is to acknowledge receipt and review of Addendum Number Two, dated December 20, 2016. Company Name 1 '2 . 2 ( I � Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call James Wagner at (714) 536-5467 within 24 hours of posting. City of Huntington Beach r Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For EDINGER AVENUE REHABILITATION AND WARNER AVENUE REHABILITATION CC No. 1516 Federal Aid Project STPL-5181(189) in the CITY OF HUNTINGTON BEACH December 12, 2016 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) PROJECT BID SCHEDULE—Section C Specification Book(2 Sheets) Replace "Project Bid Schedule—C-2.3" with "Project Bid Schedule—C-2.3 Addendum 1" (1 sheet). Bid items 1, 2, 3 and 4 descriptions were shortened. Replace "Project Bid Schedule—C-2.9"with "Project Bid Schedule—C-2.9 Addendum 1" (1 sheet). Bid items 1,2, 3 and 4 descriptions were shortened. 2) APPENDIX H —Appendix H Part 2 Specification Book(27 Sheets) Replace Cover Sheet(1 sheet) and "General Decision Number CA160035 10/28/2016" with "General Decision Number CA 160035 11/11/2016" (26 sheets). Federal Construction Wage Rates were updated on 11/11/2016. This is to acknowledge receipt and review of Addendum Number One, dated December 12, 2016. Company Name By d ;1� vz -1 � b Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call James Wagner at(714) 536-5467 within 24 hours of posting. SECTION C PROPOSAL for the construction of EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET AND WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 FEDERAL AID PROJECT STPL-5181(189) in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 65 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid,unit prices shall govern over extended amounts,and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find ... a1 Cl Rolad M, __in the amount Of_ 1 O t 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 Bidde ' Si nature C-z SECTION C PROJECT BID SCHEDULE EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET AND WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 FEDERAL AID PROJECT STPL-5181(189) in the PROJECT BASE BID: Basis of Award EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET. . . . . . . . .. . .. . . . . .. . . . . . . . . . . . . . . .... .C-2.2 to C-2.7 WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET. . . .. .. . . .... . . . . . . . . . . .. . . . . . . . . . . . . . C-2.8 TO C2.12 1.EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET r —' BID IN FIGURES 2. WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET $ 0 BID IN FIGURES BASE BID TOTAL AMOUNT LUMP SUM BID IN FIGURES: (TOTAL FOR ITEMS 1 AND 2) $ 1 4Co3 .-T l-9 , o u ASIS OF AWARD C-2.1 SECTION C PROJECT BID SCHEDULE EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET AND WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 FEDERAL AID PROJECT STPL-5181(189) EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET CC NO. 1516 C-2.2 Addendum 1, CC-1516 Replacement Page C-2.3 EDINGER (GRAHAM-SPRINGDALE) PROJECT BID SHEET Bid Const Contract ! Unit Extended No. No. Description Quantity Unit Price Amount 1 -- MOBILIZATION 1 LS $ . $ J� 1L�' 2 -- TRAFFIC CONTROL PLAN 1 LS $ $ `CY S - FURNISH PROJECT TRAFFIC 1 LS $ �' $ ; CONTROL 4 - FURNISH AND INSTALL SIGNING 1 LS $ �� i1 $ �; C AND STRIPING 5 -- PROJECT SPECIFIC SWPPP 1 LS $ REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB, AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). (INCLUDES ALL 6 1 APPURTENANCES, CURB 3 EA $ $ yC L GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) CONSTRUCT 0.17' ASPHALT 7 3 RUBBER HOT MIX (ARHM) WET 2,200 TN $ $ I l lJ Z7 PROCESS OVERLAY, ADJUST SEWER MANHOLE TO 8 4 GRADE. 6 EA t61 0 f 2.2� 9 INTENTIONALLY LEFT BLANK REPLACE WATER VALVE BOX 10 6 ASSEMBLY AND ADJUST TO 11 EA $ �� i GRADE PER HB STD PLAN 612. 11 INTENTIONALLY LEFT BLANK C-2.3 CC-1516, Addendum 1 EDINGER (GRAHAM-SPRINGDALE) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount COLD MILL EXISTING A.C. 12 7 PAVEMENT TO A DEPTH OF 0.34' 158,200 SF $(� �, �� $ Cj`j cl FROM NEW FINISHED SURFACE PER PLANS. COLD MILL EXISTING A.C. 13 8 PAVEMENT TO A DEPTH OF 0.67' 8,800 SF $ c3 $ C FROM NEW FINISHED SURFACE PER PLANS. CONSTRUCT NEW OAT AND 0.50' B-PG-70-10-RAP A.C. BASE 14 7& 8 COURSE OVER 95% 2,400 TN $ $ ``{j` 2cu COMPACTED SUBGRADE PRIOR TO 0.17'ARHM OVERLAY PER PLANS, 15 INTENTIONALLY LEFT BLANK SET SURVEY MONUMENTATION 16 9 AND PREPARE CORNER 2 EA $ ?)'b l $ 1 1 RECORD(PRE-AND/OR POST- CONSTRUCTION). REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202 (CF=8"). (INCLUDES 17 10 SLOT PAVEMENT,AGGREGATE 1,580 LF $ 5� $ e BASE, LOT DRAINS,AND ALL Cc ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) C-z.4 EDINGER (GRAHAM-SPRINGDALE) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE-GRAD FROM WALK TO EXISTING 18 11 SLOPE, RELOCATING 6,600 SF $ ' $ S 2 oc IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE- CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN P LACE.) REMOVE AND RECONSTRUCT COMMERCIAL/RESIDENTIAL DRIVEWAY("W"AND TYPE 19 12 SHOWN ON PLAN) PER STD 1,330 SF $ y $ _ PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO GRADE. 20 INTENTIONALLY LEFT BLANK 21 INTENTIONALLY LEFT BLANK INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC 22 13 SIGNALS AND LIGHTING 24 EA $ 2 $ Li Ci L SYSTEMS, 2005 EDITION. SPLICE LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE"D" REMOVE EXISTING TREE AND ROOTS; GRIND TREE STUMP 23 14 AND ROOTS TO 24"BELOW TOP 20 EA $ L15 C' $ 0 U OF SIDEWALK/GRADE WITHIN PROPOSEDIMPROVEMENT AREA. C-2.5 EDINGER (GRAHAM-SPRINGDALE) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity._Unit Price` Amount FURNISH LABOR, EQUIPMENT, AND GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED 24 15 BY AGENCY. (INCLUDES ALL 2,500 SF $_ 2 ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C.AND OVER EXCAVATION BID PAY ITEMS.) OVER EXCAVATION WHEN 25 16 IDENTIFIED BY CONTRACTOR 90 CY AND VERIFIED BY AGENCY. ADJUST EDISON VAULT/MANHOLE TO GRADE BY 26 17 EDISON. CONTRACTOR TO 4 EA NOT A CONTRACTOR BID ITEM COORDINATE WITH ERICK OEN AT(714) 895-0242. 27 INTENTIONALLY LEFT BLANK ADJUST OCSD MANHOLE TO GRADE PER OCSD STD. PLAN S- 28 18 053, S-054 AND S-055. 9 EA $ CONTRACTOR TO COORDINATE —�— WITH MIKE BOLSTER AT(714) 593-7645. 29 INTENTIONALLY LEFT BLANK C-2.6 EDINGER (GRAHAM-SPRINGDALE) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount FURNISH AND PLANT NEW 24" BOX EASTERN REDBUD TREE PER HB STD. PLANS 714, 715, 716, 718&719 AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF EXISTING LANDSCAPING, 30 19 BUSHES OR GROUND COVER 20 EA $ $ u _ AND IRRIGATION TO A DEPTH OF 24"BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). FURNISH AND INSTALL ZEBRON, SANCON OR CITY APPROVED 31 -- EQUAL COATING ON THE NEW 3 EA $ $ L' CONCRETE INSIDE OF AGENCY SEWER MANHOLE RING. Total Amount Bid in Figures: $ L-1 Total Amount Bid in Words: i _. ............._._...._.-..._..__....._......_._..._.,,.-,_.....................: .�..,_,.._�_..h.. .., z ,_ ' .,_, : ......._............_.,......... ���;�c�I�d J��`�-� Y�U►�lt;ltf� �I�'�'l TUV� d��tU�S qn 2ecL ce�'t� C-2.7 SECTION C PROJECT BID SCHEDULE EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET AND WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 FEDERAL AID PROJECT STPL-5181(189) WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 C-2.8 Addendum 1, CC-1516 Replacement Page C-2.9 R WARNER (BEACH BLVD. TO NEWLAND) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount 1 -- MOBILIZATION 1 LS $ ��,©Z'C� $ ,CG U, 2 -- TRAFFIC CONTROL PLAN 1 LS $ 2 r u l`.b $ on i U( 3 - FURNISH PROJECT TRAFFIC 1 LS $ 2((?, U(.fi b $ ��� GV 0 CONTROL _ FURNISH AND INSTALL SIGNING 1 C— 4 AND STRIPING 1 LS $ $ 5 -- PROJECT SPECIFIC SWPPP 1 LS $ L $ v� REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB, AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). (INCLUDES ALL 6 1 9 EA $ U� $��� APPURTENANCES, CURB -T GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) CONSTRUCT 0.17'ASPHALT 7 3 RUBBER HOT MIX (ARHM)WET 3,000 TN $ $ j PROCESS OVERLAY. ADJUST$ 4 GRADE. SEWER MANHOLE TO 9 EA $ Ct•. �, $ �j (� ^jo 9 5 ADJUST STORM DRAIN 2 EA $ } L $ Ll o MANHOLE TO GRADE. REPLACE WATER VALVE BOX 10 6 ASSEMBLY AND ADJUST TO 49 EA $ $ '� l GRADE PER HB STD PLAN 612. COLD MILL EXISTING A.C. 11 7 PAVEMENT TO A DEPTH OF 0.17' 53,000 SF $ i $ L( FROM NEW FINISHED SURFACE PER PLANS. COLD MILL EXISTING A.C. 12 8 PAVEMENT TO A DEPTH OF 0.34' 157,000 SF $�,, $ C Z O FROM NEW FINISHED SURFACE PER PLANS. C-2.9 CC-1516, Addendum 1 WARNER (BEACH BLVD. TO NEWLAND) PROJECT BID SHEET Bid Const Contract Unit i Extended No. No. Description Quantity Unit Price Amount COLD MILL EXISTING A.C. 13 g PAVEMENT TO A DEPTH OF 0.67' $ c 20,100 SF 1 FROM NEW FINISHED SURFACE $ PER PLANS. CONSTRUCT NEW 0,17',AND 0.50'B-PG-70-10-RAP A.C. BASE 14 8&9 COURSE OVER 95% 2,850 TN $ $ . �. COMPACTED SUBGRADE PRIOR TO 0.17'ARHM OVERLAY PER PLANS. RAISE SURVEY WELL MONUMENT TO GRADE AND 15 10 PREPARE CORNER RECORD 2 EA $ _2 t� $ �� (PRE-AND/OR POST- CONSTRUCTION). SET SURVEY MONUMENTATION AND PREPARE CORNER 16 11 RECORD(PRE-AND/OR POST- 8 $ $ CONSTRUCTION). REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202 (CF=8"). (INCLUDES 17 12 SLOT PAVEMENT,AGGREGATE 200 LF $ v � BASE, LOT DRAINS, AND ALL — , ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE-GRAD FROM WALK TO EXISTING 18 13 SLOPE, RELOCATING 3,750 SF t 215C> IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE- CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE. C-2.10 WARNER (BEACH BLVD. TO NEWLAND) PROJECT BID SHEET Bid Const Contract Unit Extended No:: No. Description'` Quantity Unit Price Amount REMOVE AND RECONSTRUCT COMMERCIAL/RESIDENTIAL DRIVEWAY("W"AND TYPE 19 14 SHOWN ON PLAN) PER STD 1,600 SF $ $� (LI GNU PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO GRADE. REMOVE AND RECONSTRUCT CONCRETE CURB AND CROSS GUTTER PER HB STD. PLAN 205. { 20 15 (ITEM INCLUDES SLOT 3,500 SF $ PAVEMENT,AGGREGATE BASE AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT MEDIAN CURB AND GUTTER PER HB STD PLAN 201 (CF=8"). 21 16 (INCLUDES SLOT PAVEMENT, 110 LF $ AGGREGATE BASE, LOT —� DRAINS,AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC 22 17 SIGNALS AND LIGHTING 58 EA $ 2 05 $ n SYSTEMS, 2005 EDITION. SPLICE — LOOPS TO DLC IN PULLBOX_ BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE"D" REMOVE EXISTING TREE AND ROOTS; GRIND TREE STUMP f 23 18 AND ROOTS TO 24"BELOW TOP 4 EA $ 1 Li $ I OF SIDEWALK/GRADE WITHIN PROPOSEDIMPROVEMENT AREA. C-2.11 WARNER (BEACH BLVD. TO NEWLAND) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount FURNISH LABOR, EQUIPMENT, AND GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED 24 19 BY AGENCY. (INCLUDES ALL 2,500 SF $ �� ITEMS NECESSARY TO T— COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C. AND OVER EXCAVATION BID PAY ITEMS.) OVER EXCAVATION WHEN 25 20 IDENTIFIED BY CONTRACTOR 90 CY $ (j! j $ �6 AND VERIFIED BY AGENCY. ADJUST EDISON VAULT/MANHOLE TO GRADE BY 26 21 EDISON. CONTRACTOR TO 1 EA NOT CONTRACTOR BID ITEM COORDINATE WITH ERICK OEN AT(714) 895-0242. ADJUST VERIZON VAULT/MANHOLE TO GRADE BY 27 22 VERIZON. CONTRACTOR TO 1 EA NOT CONTRACTOR BID ITEM COORDINATE WITH RAY ROUNDTREE AT(714) 375-6760. ADJUST OCSD MANHOLE TO GRADE PER OCSD STD. PLAN S- 053, S-054 AND S-055. 28 23 1 EA $ CONTRACTOR TO COORDINATE $ WITH MIKE BOLSTER AT(714) 593-7645. 29 24 ADJUST MONITORING WELL 5 EA $ J-I $ ';Ls C COVER TO GRADE. 30 INTENTIONALLY LEFT BLANK FURNISH AND INSTALL ZEBRON, SANCON OR CITY APPROVED 31 -- EQUAL COATING ON THE NEW 4 EA $_ ,z $� CONCRETE INSIDE OF AGENCY SEWER MANHOLE RING. Total Amount Bid in Figures: $ Cl )0 Total Amount Bid In Wo.......: fie,- .:�1.,..,- U.,G..�G1,.,...�..L �h...�._.._.. . ��......,.:�,.,.4,.,...d ........................... . �y4r 1f�T1'G ( ' 1 C t• C-2.12 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Bid Name andAddress of ,State Class DIR Dollar. % of Items) Subcontractor License Number Amount Contract. Number y .1PP.r11 n_^C P014tme tActrWru (-cs5, Ca, �1�30 laocacwn�, aLq,7165 22 Sf1ir3�i�r pccflr c {n, . o��ry e l cr l�b {aoeac,�a�o { ILAc� 1� 15 CL 5 c3;t11 L5 lb c 3 By submission of this proposal,the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 w 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 �2� 1i-)b, at Caron�1 ,_CA Date City State being first duly sworn, deposes and says that he or she is of Akkthe 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. _A1 ( Alfh nro hoI Name of Bidder Signature of B' der Edu'a -V, quo C-- 4- Cwona t A ! 2 3 -1 Ci Address of Bidder C-4 CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT CIVIL CODE § 1189 A,notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached.and not the truthfulness.accuracv.or validity of that document. State of California County of Riverside On 12/19/2016 before me, Rebecca Angela Parra,NotM Public Date Here Insert name and Title of the Officer personally appeared Edward J. Carlson Name(s)of Signer(s) f who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/afe subscribed to the within instrument and acknowledged to me that he/sheAhey executed the same in his(he#their authorized capacity(ies), and that by his/her heir signature(s) on the instrument the person(s), or the entity upon behalf �6 ;-- C REBECA ANGELA PARRA < ,• of which the person(s)acted,executed the instrument. J t Commission # 2024944 Z Notary Public - Cali`ornia zl certify under PENALTY OF PERJURY under the laws of the State of z '':' Riverside County v California that the forgoing paragraph is true and correct. My Comm. Expires May 17,2017 WITNESS my hand rcial seal. Signature Place Notary Seal Above Signature otary Public OPTIONAL Though the information below is not required by law,it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document Non Collusion Affidavit Document Date: 12/19/2016 Number of Pages: One (1) Signer(s)Other Than Named Above: None Capacity(ies)Claimed by Signer(s) Signer's Name: Edward J. Carlson Signers Name: ❑ Individual ❑ Individual X Corporate Officer—Title(s): Vice President ❑Corporate Officer—Title(s): ❑ Partner❑ ❑Limited ❑ General RIGHT THUMBPRINT ❑Partner❑ ❑ Limited❑General RIGHT ❑Attorney in Fact OF SIGNER ❑Attorney in Fact OF ❑Trustee Top of thumb here ❑Trustee Top of thumb here ❑Other: ❑Other: Signer is Representing: Signer is Representing: All American Asphalt 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 Edinger Avenue Rehabilitation from Graham Street to Springdale Street and Warner Avenue Rehabilitation Beach Boulevard to Newland Street,Project CC No. 1516,(l)(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. A A(11ePl fresh Contractor By Cl >wrd 5, G"-rl inn — Title Date: 16 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? O Yes d No If the answer is yes,explain the circumstances in the space provided. VIV IL 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. Contractor BY _ -r CL S Cc v Title Date: 12 11 16 C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: 1 Y A Bidder Name Business Address � S� City, State Zip -5i ) T36-76ar� Telephone Number Q Cep, -- State Contractor's License No. and Class Original Date Issued Ii31 � Z�� Expiration Date The work site was inspected by�Yi w\jMC ,4)ee, of our office on Qet�d.bee if�201 . The following are persons,firms, and corporations having a principal interest in this proposal: C P ��� �rd 36 c rc--4a 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 spec'fications set forth. Company Nam Signature&Bidder Printed or Typed Signature Ason Tr Subscribed and sworn to before me this I_l day of Dc-c- , 2014 . NOTARY PUBLIC eA�J NOTARY SEAL C-8 CALIFORNIA JURAT GOV CODE § 8202 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of Riverside Subscribed and sworn to (or affirmed) before me on this 19th day of December, 2016, Date Month By (1) Edward J. Carlson Name of Signer Proved to me on the basis of satisfactory evidence be the person who appeared before me REBECCA ANGELA PARRAA Commission # 2024944 L � Notary Public California z Z z Riverside County r (2) My Comm.Expires May 17,2017 Name of Signer be the peFsen who appeared befe Fe me.) Signature Place Notary Seal Above Signature of Yotary Public OPTIONAL Though the information below is not required by law,it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Further Description of Any Attached Document RIGHT THUMBPRINT RIGHT THUMBPRINT OF SIGNER OF SIGNER Title or Type of Document Bidder's Information Top of thumb here Top of thumb here Document Date: None Number of Pages: 1 Signer(s)Other Than Named Above: None Bidder's Project History For the purposes of this project; the bidder shall provide project history of similar work, specifically referencing the construction of{Describe specific work and experience necessary for project. For example, "Sanitary sewer line installation of at least of 1,000 of 8-inch and greater in public right-of-way. Sanitary sewer lift stations of similar size, project work within public streets, an area containing high ground water and pipeline construction in high _ground water regions with trench depths of 8-feet to the invert."?. Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: 1. 0 IlO..0 : LMr_Ae, 4142: WV, i(,7) 5�'r. _ qD2 JED Name and Address of Public Agency Name and Telephone No. of Project Manager: �6,0_4,,J yjocm Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 2. &AC'I)es--c Ind 3r-�f'�t26f.1,.,,l�A gb3c, Name and Addre of Public Agency Name and Telephone No. of Project Manager: LL1 l P �1 C�l1 2-0 Contract kmount Type of Work Date Completed Provide additional project description to show similar work: 3. :j;cil, '34t7D (~l0.i f1.`a if"gk� tJL�sa `T(� �2'2 iD Nam and Address of Public Agency Name and Telephone No. of Project Manager: 5ktyc.N"M J j9s1) J12 6- �-Io D �6,L)0 Contact Amo nt Type of Work Date Completed Provide additional project description to show similar work: C-9 , Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager, and Superintendent. For each of these critical positions,please list at least three projects for which the critical staff has performed similar work within the last five years. These projects do not have to be under the employment of the bidder of this project.Bidders are encouraged submit supplemental relevant project history in addition to the projects listed herein. 1. Name of proposed Project Manager Telephone No. of proposed Project Manager: _Q 5 I -736- 7c, O Project Name &Contract Amount Type o Work Date Completed Project Name &Contract Amount Type of Work Date Completed s / 5t on 6�9q5 ?,5 12 /2yI,`-� Project Name &Contract Amount Type of Work Date Completed 2. ; C 1 i�2 Name of proposed Supe intendent Telephone No. of proposed Superintendent:_( 51 -7 3(?-7 boo Project Name& Contract Amount Type of Work Date Completed 2 r SI r 5 Project Name& Contract Amount 17ype of Woti Date Completed Project Name&Contr Amount Typd of Work Date Completed C-10 'CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771.1(a)),passed by the California State Senate on June 20, 2014, established a new public works Contractor Registration Program, which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July 1 through June 30 state fiscal year) with the California Department of Industrial Relations (DIR)_ Currently the annual non-refundable registration fee for Contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 http://www.dir.ca.gov/DLSE/PublicWorks/SB854FactSheet 6.30,14.pdf DIR's Contractor Registration Link—Call(844) 522-6734 https://efiling.dir.ca.gov/PWCR/ActionServlet?action--displayP WCRegistrationForm 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. Contractor By Title Date: C-11 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations,Part 135* Economic Opportunities for Low and Very Low-Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner,partner, director, officer,or manager(initial the applicable selections): Will ensure that 10%of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968;or Will hire no new employees in conjunction with this project. Will award 10%of its sub-contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub-contracts related to this project. Contractor: Arry r l GC'i.11 A f }- Contact Person: ��tZn:� --rL Contact Phone: — 3G -7 OC- Signed: Date: 2 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub-contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification C-12 RELIABLE CONTRACTOR DECLARATION(page 1 of 2) CalRecycle 168(Revised 9/16) This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalRecycle) prior to authorizing a contractor(s) to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of funds to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Reliable Contractor Declaration (formerly Unreliable List) requirement of their Terms and Conditions. The Reliable Contractor Declaration (formerly Unreliable List) provision requires the following: Prior to authorizing a contractor(s) to commence work under the Grant, the Grantee shall submit to CalRecycle a declaration signed under penal%y of perjury by the contractors) stating that within the preceding three (3) years, none of the events listed in Section 1 050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the contractor(s). Please see the reverse of this page, or refer to the California Code of Regulations (www.calregs.com). If any of the events listed in Section 17050 have occurred, disclosure is required but will not necessarily result in CalRecycle refusing to approve the contractor. A signed statement explaining the facts and circumstances of the events must be attached to and submitted with this form. Contractor: Complete the form and send original to the Grantee. Grantee: Scan the form and upload it to the grant in CalRecycle's Grant Management System. For further instruction about logging into the Grant Management System and uploading this form, reference the Procedures and Requirements. Retain the original form in your grant file. GRANTEE INFORMATION GRANTEE NAME: GRANT NUMBER: PRIMARY CONTACT NAME: CONTRACTOR INFORMATION CONTRACTOR NAME: f` c� s AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: C r. S - L6 ?res' d MAILING ADDRESS: As the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor. Alternatively, as the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of California that within the preceding three (3)years, if any of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor, I have disclosed all such occurrences in an attached signed statement that explains the facts and circumstances of the listed events. Signature Date CC, (9ceiiDe'l C-13 RELIABLE CONTRACTOR DECLARATION (page 2 of 2) CalRecycle 168(Revised 9116) Title 14 CCR, Division 7, Chapter 1 Article 5. Unreliable Contractors,Subcontractors, Borrowers and Grantees Section 17050.Grounds for Placement on Unreliable List The following are grounds for a finding that a contractor,any subcontractor that provides services for a CalRecycle agreement, grantee or borrower is unreliable and should be placed on the CalRecycle Unreliable Contractor, Subcontractor, Grantee or Borrower List ("Unreliable List'). The presence of one of these grounds shall not automatically result in placement on the Unreliable List. A finding must be made by the Executive Director in accordance with section 17054,and there must be a final decision on any appeal that may be filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s)to CalRecycle due to fraudulent claims or reporting;or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act, Government Code section 12650 et.seq;or (c) Default on a CalRecycle loan,as evidenced by written notice from'CalRecycle staff provided to the borrower of the default;or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycle;or (e) Filing voluntary or involuntary bankruptcy,where there is a finding based on substantial evidence, that the bankruptcy interfered with the CalRecycle contract,subcontract,grantor loan;or (f) Breach of the terms and conditions of a previous CalRecycle contract,any subcontract for a CalRecycle agreement,grant,or loan,resulting in termination of the CalRecycle contract,subcontract,grant or loan by the CalRecycle or prime contractor;or (g) Placement on the CalRecycle's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility;or (h) The person, or any partner, member, officer, director, responsible managing officer, or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion,conspiracy, or any act in violation of any state or federal antitrust law in connection with the bidding upon, award of, or performance under any CalRecycle contract, subcontract,grantor loan;or (i) The person or entity is on the list of unreliable persons or entities,or similar list,of any other federal or California state agency;or (j) The person or entity has violated an Order issued in accordance with section 18304;or, (k) The person or entity has directed or transported to,has or accepted waste tires at,a site where the operator is required to have but does not have a waste fire facility permit;or, (1) The person or entity has transported waste tires without a waste tire hauler registration;or, (m) The person or entity has had a solid waste facility or waste tire permit or a waste tire hauler registration denied, suspended or revoked;or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRecycle to remediate,clean,or abate a nuisance at the site;or (o) The following are additional grounds for a finding that,a person or entity described below should be placed on the Unreliable List: (1) The person or entity owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director,manager,partner,trustee,or any other management position with significant control(Principal Manager)in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person who owns 20%or more of the entity,if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (5) The entity has another entity which owns 20%or more of the entity,if that other entity: 1. Is on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (6) Subsection(o)is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-14 + e Local Assistance Procedures Manual Exhibit 12-H Sample Bid (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH AREA PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder I Ame_ri C c�r t A,,�o►ck /,proposed subcontractor h 1(Q�S rYl t '1 (1 tS�S ', ereby certifies that he has V, has not participated in a previous contract or subcontract subject to the equal opportunity clauses,as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity,all reports due under the applicable filling requirementg. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b)(1)),and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not fled the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director,Office of Federal Contract Compliance,U.S.Department of Labor. Page 1 of 8 C-15 June ll,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CER77FICATIONS WHICH AREA PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION CCThe bidder ;�' 1 Jt�('o C on ' j(I �} ,proposed subcontractor i yO(t i Q�c �G y E i1Y�ti Fyn V�lq(1 ,hereby certifies that he has has not participated in a previous contract or subcontract subject to the equal opportunity clauses,as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity,all reports due under the applicable filling requirementg. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b)(1)),and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director,Office of Federal Contract Compliance,U.S.Department of Labor. Page 1 of 8 C-15 June 11,2014 • Local Assistance Procedures Manual Exhibit 12-H Sample Bid (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHAREA PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder AmM r I U10 t Z16VICA �f ,proposed subcontractor Sm I�h1 ,O-x kc-kr I L ,hereby certifies that he has , has not—,participated in a previous contract or subcontract subject to the equal opportunity clauses,as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity,all reports due under the applicable filling requirementg. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b)(1)),and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director,Office of Federal Contract Compliance,U.S.Department of Labor. Page 1 of 8 C-15 June 11,2014 • Local Assistance Procedures Manual Exhibit 12-H Sample Bid (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH AREA PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder 1 A m e n co o Asp h CA if ,proposed subcontractor �C C L 4yl ,hereby certifies that he has, , has not participated in a previous contrA or Abcontract subject to the equal opportunity clauses,as required by Executive Orders 10925,11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity,all reports due under the applicable filling requirementg. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b)(1)),and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director,Office of Federal Contract Compliance,U.S.Department of Labor. Page 1 of 8 C-15 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHAREA PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder ,proposed subcontractor hereby certifies that he has has not_,participated in a previous contract or subcontract subject to the equal opportunity clauses,as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity,all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b)(1)),and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director,Office of Federal Contract Compliance,U.S.Department of Labor. Page 1 of 8 C-15 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376,Stats. 1985),the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has_,has not-�Lbeen convicted within the preceding three years of any offenses referred to in that section,including any charge of fraud,bribery,collusion, conspiracy,or any other act in violation of any state or Federal antitrust law in connection with the bidding upon,award of, or performance of,any public works contract,as defined in Public Contract Code Section 1101,with any public entity,as defined in Public Contract Code Section 1100,including the Regents of the University of California or the Trustees of the California State University. The term"bidder"is understood to include any partner,member,officer,director,responsible managing officer,or responsible managing employee thereof,as referred to in Section 10285.1. Note: The bidder must place a checkmark after"has"or"has not"in one of the blank spaces provided.The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement.Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162,the,Bidder shall complete,under penalty of perjury,the following questionnaire: Has the bidder,any officer of the bidder,or any employee of the bidder who has a proprietary interest in the bidder,ever been disqualified,removed,or otherwise prevented from bidding on,or completing a federal,state,or local government project because of a violation of law or a safety regulation? Yes No ✓ If the answer is yes,explain the circumstances in the following space. Page 2 of 8 C-16 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232,the Contractor,hereby states under penalty of pedury,that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 3 of 8 C-17 June 11,2014 ► Local Assistance Procedures Manual Exhibit 12-H Sample Bid Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY/COUNTY of Nxn,' DEPARTMENT OF PUBLIC ORKS. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of,or on behalf of,any undisclosed person,partnership, company,association,organization,or corporation;that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded,conspired,connived,or agreed with any bidder or anyone else to put in a sham bid,or that anyone shall refrain from bidding;that the bidder has not in any manner,directly or indirectly,sought by agreement,communication,or conference with anyone to fix the bid price of the bidder or any other bidder,or to fix any overhead,profit,or cost element of the bid price,or of that of any other bidder,or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true;and,further,that the bidder has not,directly or indirectly,submitted his or her bid price or any breakdown thereof,or the contents thereof, or divulged information or data relative thereto,or paid,and will not pay,any fee to any corporation, partnership,company association,organization,bid depository,or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 4 of 8 C-18 June 11,2014 Local Assistance Procedures Manual Exhibit 12-R Sample Bid DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS,PART 29 The bidder,under penalty of perjury,certifies that,except as noted below,he/she or any other person associated therewith in the capacity of owner,partner,director,officer,manager: • is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any Federal agency; • has not been suspended,debarred,voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending;and • has not been indicted,convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years, If there are any exceptions to this certification,insert the exceptions in the following space. Exceptions will not necessarily result in denial of award,but will be considered in determining bidder responsibility. For any exception noted above,indicate below to whom it applies,initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 5 of S C-19 ,Tune 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies,by signing and submitting this bid or proposal,to the best of his or her knowledge and belief,that: (1) No Federal appropriated funds have been paid or will be paid,by or on behalf of the undersigned,to any person for influencing or attempting to influence an officer or employee of any Federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal,amendment,or modification of any Federal contract,grant,loan,or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with this Federal contract,grant, loan,or cooperative agreement,the undersigned shall complete and submit Standard Form-LLL,"Disclosure of Lobbying Activities,"in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352,Title 31,U.S.Code. Any person who fails to file the required certification shall be subject to a civil penalty of not Iess than$10,000 and not more than$100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts,which exceed$100,000 and that all such subrecipients shall certify and disclose accordingly. Page 6 of 8 C-20 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT'TO 31 U.S.C.1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract a. bid/offer/application =a. initial b. grant b. initial award b. material change c. cooperative agreement c. post-award d. loan For Material Change Only: e. loan guarantee year quarter f. loan insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No.4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier ,if known Congressional District,if known Congressional Distr' t,if known 6. Federal Department/Agency: 7. Federal Progra ame/Description: CFDA N her,if applicable 8. Federal Action Number,if known: 9. Awar Amount,if known: 10. a. Name and Address of Lobby Entity Individuals Performing Services (including (If individual,last name,first name,MI) nI address if different from No. 10a) (last name,first name,W) (attach Co nuation Sheets)ifnecessary) 11. Amount of Payment(check all that a ly) 13. Type of Payment(check all that apply) $ actual planned a. retainer b. one-time fee 8 12. Form of Payment(check all t t apply): c. commission a. cash d. contingent fee b. in-kind; specif, nature a deferred / value £ other,specify 14. Brief Description of ervices Performed or to be performed and Date(s)of Service,including offrcer(s),employ (s),or member(s)contacted,for Payment Indicated in Item 11: / (attach Continuation Sheet(s)if necessary) 15. Conti action Sheets)attached: Yes No 16. Info 'on requested through this form is authorized by Title I U.S.C.Section 1352. This disclosure of lobbying Signature: ✓js r _ rel' ce was placed by the tier above when his transaction made or entered into, This disclosure is required Print Name: C i_06 r t, � UA t�Son pursuant to 31 U.S.C.1352. This information will be reported to Congress semiannually and will be available for n public inspection. Any person who fails to file the required Title: i(i(� 1' (�t°i$ 1 G e) disclosure shall be subject to a civil penalty of not less than $10,000 and not more than$100,000 for each such failure. Telephone No.: J��7 3(�7{d t� Date: 2 —tq- 6 Authorized for Local Reproduction Federal Use Only: Standard Form-LLL Standard Form LLL Rev,09-12-97 Page 7of8 C-21 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient,at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C.section 1352, The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. I. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which-the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name,address,city,state and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks"Subawardee"then enter the full name,address,city,state and zip code of the prime Federal recipient. Include Congressional District,if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name,if known. For example,Department of Transportation,United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action(item 1). If known,enter the full Catalog of Federal Domestic Assistance(CFDA)number for grants,cooperative agreements,loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item I (e.g., Request for Proposal(RFP)number,Invitation for Bid(IFB)number,grant announcement number,the contract grant.or loan award number,the application/proposal control number assigned by the Federal agency). Include prefixes,e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency,enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a)Enter the full name,address,city,state and zipcode of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b)Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last Name,First Name and Middle Initial(MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4)to the lobbying entity(item 10). Indicate whether the payment has been made(actual)or will be made(planned). Check all boxes that apply. If this is a material change report,enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box. Check all boxes that apply. If payment is made through an in-kind contribution,specify the nature and value of the in-kind payment. 13. Check the appropriate box. Check all boxes that apply. If other,specify nature. 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s)or employee(s)contacted or the officer(s)employee(s)or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s)is attached. 16. The certifying official shall sign and date the form,print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response,including time for reviewing instruction,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project (0348-0046),Washington,D.C.20503. sr-UL-Insirmriom Rev.0e-04-90aEND1F» Page 8 of 8 C-22 June 11,2014 � •n v � VVIfItC � 4 *._�` �. 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C-4 0 t3 41 el- C--3 tu el- rA Q a3 t3 0 "13 Local Assistance Procedures Manual EXHIBIT 15-G Local Agency Bidder DBE Commitment(Construction Contracts) EXHIBIT 15-G LOCAL AGENCY BIDDER DBE COMMITMENT(CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY: � c tom- rlk A LOCATION: t/1 o+Z('Ie—oi c- PROJECT DESCRIPTION: �`- t U +�J 1 81 G 11J 0 TOTAL CONTRACT AMOUNT:$ 1 Ak 3-7 16 9 , aQ BID DATE: 12/z /1 BIDDER'S NAME: All A m,,,_,f t i n A b L�1�lA1 CONTRACT DBE GOAL: CONTRACT ITEM OF WORK AND DESCRIPTION DBECERTNO. NAME OF EACH DBE DOLLAR AMOUNT ITEM NO. OR SERVICES TO BE AND EXPIRATION (Must be certified on the date bids DBE SUBCONTRACTED OR MATERIALS DATE are opened-include DBE address O BE PROVIDED(or contracted if the and phone number) bidder is a DBE) D IS 16JAr SU _ 15 • r L�� pbrwflol Z (1 IY J&H 17 7' - It'fq CA O G,c�; I t -7 _ �1 Ift ^r3 h For Local Agency to Complete: Total Claimed DBE Local Agency Contract Number: Participation Federal-aid Project Number: '4 % Federal Share: Contract Award Date: Local Agency certifies that all DBE certifications have been verified and SiAalure of Bidder information is complete and accurate. i z It t 14 q5 I -736 •76W Date (Area Code)Tel.No. Print Name Signature Date Ot LA)(A,f-A yy_(r3�' I7 Local Agency Representative P- errson to Contact (Please Type or Print) w l ce. Pre-,I de,+- (Area Code)Telephone Number: Local Agency Bidder DBE Commitment(Construction Contracts) (Rev 6/26/09) Distribution: (1)Copy-Fax or scan a copy to the Caltrans District Local Assistance Engineer(DLAE)within 30 days of contract execution.Failure to send a copy to the DLAE within 30 days of contract execution may result in de-obligation of funds for this project. (2)Copy-Include in award package to Caltrans District Local Assistance (3)Original-Local agency files Page 15-1 OB 12-04 C-23 June 29,201 EXHIBIT 15-G Local Assistance Procedures Manual Local Agency Bidder DBE Commitment(Construction Contracts) INSTRUCTIONS-LOCAL AGENCY BIDDER DBE COMMITMENT(CONSTRUCTION CONTRACTS) ALL BIDDERS: PLEASE NOTE: This information may be submitted with your bid. If it is not,and you are the apparent low bidder or the second or third low bidder,it must submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency,Location,Project Description,Total Contract Amount,Bid Date,Bidder's Name,and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs.Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE,work performed by its own forces,if a DBE.The DBE shall provide a certification number to the Contractor and expiration date.Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work(who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier.Names of the First-Tier DBE Subcontractors and their respective item(s)of work listed should be consistent,where applicable, with the names and items of work in the"List of Subcontractors"submitted with your bid. There is a column for the DBE participation dollar amount.Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions.(If 100%of item is not to be performed or furnished by the DBE,describe exact portion of time to be performed or furnished by the DBE.)See Section "Disadvantaged Business Enterprise(DBE),"of the Special Provisions(construction contracts),to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated by the person bidding.Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award,Federal-aid Project Number, Federal Share,Contract Award Date fields and verify that all information is complete and accurate before signing and filing. Page 15-2 June 29,2012 C-24 OB 12-04 Local Assistance Procedures Manual Exhibit 15-H DBE Information-Good Faith Effort EXHIBIT 15-H DBE INFORMATION—GOOD FAITH EFFORTS I DBE INFORMATION-GOOD FAITH EFFORTS Federal-aid Project No. S PL- 5 91 L� �) Bid Opening Date �2C7� The City of Huntington Beach established a Disadvantaged Business Enterprise(DBE) goal of 4 %for this project.The information provided herein shows that a good faith effort was made. Lowest,second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts.Bidders should submit the following information even if the"Local Agency Bidder DBE Commitment"form indicates that the bidder has met the DBE goal.This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons,e.g.,a DBE firm was not certified at bid opening,or the bidder made a mathematical error. Submittal of only the"Local Agency Bidder DBE Commitment"form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled"Submission of DBE Commitment"of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder(please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement l,vvJw..Cchj;torn►, 9"Kba, I2✓BIIti L,6�L,-4, L�A- 3►Fi--o_&A.15 .C.a rn B. The names and dates of written notices sent to certified DBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested(please attach copies of solicitations,telephone records,fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods and Dates n Solicitation c. f.. . l 9� L i2 r V4, Page I OB 12-04 C-25 June 29,2012 Exhibit 15-H Local Assistance Procedures Manual DBE Tntormation-Good Faith Effort C. The items of work which the bidder made available to DBE firms including,where appropriate, any breaking down of the contract work items(including those items normally performed by the bidder with its own forces)into economically feasible units to facilitate DBE participation.It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items M Of (1'/N) Contract SAl D. The names, addresses and phone numbers of rejected DBE firms,the reasons for the bidder's rejection of the DBEs,the firms selected for that work(please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: Names, addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: itn�d�o All blCSkAz n - i � .. Page 2 June 29,2012 C-26 OB 12-04 Local Assistance Procedures Manual Exhibit 15-H • DBE Information-Good Faith Effort F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies,materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: ;/,,�- l� G. The names of agencies,organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms(please attach copies of requests to agencies and any responses received, i.e., lists,Internet page download,etc.): Name of Agency/Organization Method/Date of Contact Results LJ H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): e e fAr44,hc--,d- NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. Page 3 OB 12-04 C-27 June 29,2012 All American Asphalt Sub-contracting & Vendor Opportunities Phone(951)736-7600 Public Works Fax(951)736-7646 Project: Edinger Avenue ans Warner Avenue Rehabilitation Federal Aid Project STPL-5181(189) Owner: County of Huntington Beach Estimator: JIM MCGEE Bid Date&Time: 12/20/16(&2 PM (Bid should be(az'd to the above number at least t hr.priorto Bid Time) Subcontracting Opportunities in the following areas; Underground Miscellaneous Water Improvements Landscaping&Irrigation-Street Trees X Sewer Improvements Fencing and/or Railing GUARD RAIL Storm Drain Improvements Mass Grading/Earthwork Underground Linings and/or Coatings Pulverizing and/or Cement Treat,Lime Treat Adjust Utilities to Grade/Install Monuments Crack Filling/Joint Sealing Cast-In-Place Structures&V-Ditches Heater Re-Mix and/or Cold Recycling E/c ric/ Tree Removals and/or Root Pruning&Root Ball X Traffic Detector Loops X Irrigation Hookup Traffic Signal Improvements Street and/or Parking Lot Lighting Engineering/Testing Dry Utilities Testing and/or Inspection Relocate Pull Boxes Survey X Concrete Traffic Control Devices and/or Plans Masonry Wall(Grouted River Rock) Specialty Wall Finishes Stamped Concrete Striping&Markings&Removals Specialty Concrete/Monument Wall Monument Signs Steel Placement Slurry Seal Grinding/Grooving Painting and/or Finishes ROCK COBBLE BLANKET Chip Seal CMB All American Asphalt is an Equal Opportunity Employer and encourages the participation of Certified DBE/MBE/WBE/DVBE Subcontractors and/or Vendors. Subcontractors may be required to submit Payment&Performance Bond equal to 100%of their bid at a maximum additional cost of 1 1/2%of total bid amount.Subcontractor will be required to fully execute All American Asphalt standard subcontract. PLANS & SPECS ARE AVAILABLE FOR REVIEW AT THE OFFICE OF ALL AMERICAN ASPHALT AT 400 E. SIXTH ST., CORONA, CA. 92879 TELE: 951-736-7600 ALL AMERICAN ASPHALT `% , ALL AMERICAN AGGREGATES T 951-736-7600 E 951-739-4671 ALL AMERICAN P.O. BOX 2229,CORONA,CA 92878-2229 ASPHALT DIR CONTRACTORS LICENSE 21000001051 AN EQUAL OPPORTUNITY EMPLOYER December 8, 2016 California Professional Engineering 929 Otterbein Ave, Unit E La Puenta, CA 91761 ATTN: Estimating We will be bidding a City of Huntington Beach project called "EDINGER AVENUE REHABILITATION FROM GRAM STREET TO SPRINGDALE STREET ANS WARNER AVENUE REHABILITATION FROM BEACH BLVD TO NEWLAND STREET FEDERAL AID PROJECT STPL- 5181(189)" This project bids Tuesday, December 20t" 2016. We are requesting bids from DBE Businesses for the following items of work: Landscaping Survey Tree Removals Electrical We have Plans and Specifications for review in our office. If you have any questions please contact Jim Mcgee at (951) 736-7600. Sincerely, Kelley Cima Project Administrator 12/8/2016 FedEx Ship Manager-Print Your Label(s) 0 CO gPo No Oho ZD or;r.'_7 o N R10 n�rz C3. C D o� W I_ CDC 0 T M. �ZDZ� - - m 0� O U)� =Am -_ m CO D m� Z _ - — D p O -J O � 91 � = A� m m CD Cn � r= m O �v- = Z — � IT! D Xr W c�ncn O T - Z r- 0 z gam- < � .=_ m m D O = ITI Zornm v � 2 Cn rn n Z <0 _;Cl CDr � Z CDDIM = o Xoo cn � D MM � d162616161261uv ® 544J1/D42F/14E8 After printing this label: 1. Use the'Print'button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3.Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. Warning:Use only the printed original label for shipping.Using a photocopy of this label for shipping purposes is fraudulent and could result in additional billing charges,along with the cancellation of your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide,available on fedex.com.FedEx will not be responsible for any claim in excess of$100 per package,whether the result of loss,damage,delay,non-delivery,misdelivery,or misinformation, unless you declare a higher value,pay an additional charge,document your actual loss and file a timely claim.Limitations found in the current FedEx Service Guide apply.Your right to recover from FedEx for any loss,including intrinsic value of the package,loss of sales,income interest,profit, attorney's fees,costs,and other forms of damage whether direct,incidental,consequential,or special is limited to the greater of$100 or the authorized declared value.Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is$1,000,e.g.jewelry, precious metals,negotiable instruments and other items listed in our ServiceGuide.Written claims must be filed within strict time limits,see current FedEx Service Guide. https://www.fedex.com/shipping/shipAction.handle?method=doContinue 1/1 ALL AMERICAN ASPHALT / � ALL AMERICAN AGGREGATES T 951-736-7600 E 951-739-4671 ALL AMERICAN P.O. Box 2229,CORONA,CA 92878-2229 ASPHALT DIR CONTRACTORS LICENSE 21000001051 AN EQUAL OPPORTUNITY EMPLOYER December 8, 2016 High Light Electric 6942 Ed Perkic St, Suite A Riverside, CA 92504 ATTN: Estimating We will be bidding a City of Huntington Beach project called "EDINGER AVENUE REHABILITATION FROM GRAM STREET TO SPRINGDALE STREET ANS WARNER AVENUE REHABILITATION FROM BEACH BLVD TO NEWLAND STREET FEDERAL AID PROJECT STPL- 5181(189)" This project bids Tuesday, December 20th 2016. We are requesting bids from DBE Businesses for the following items of work: Landscaping Survey Tree Removals Electrical We have Plans and Specifications for review in our office. If you have any questions please contact Jim Mcgee at (951)736-7600. Sincerely, Kelley Cima Project Administrator 12/8/2016 FedEx Ship Manager-Print Your Label(s) O CC7 o�T.O o O�a� CD �= orr-A = Mo m o m m r— m� n 0 cn� xn n c - - - _ v M _ C� A= crr x _ = m m m> _ o _ - n m n �-' Z =W N r mCI) W po 0 o D _ _ Igj M z m c� M W 0)>(n Q v . _ C)O—m < O m moo CO D O 'p Mm m c C Co M n co z rn ncm+tuunw ° 544J1ID42FI14E8 After printing this label: 1.Use the'Print'button on this page to print your label to your laser or inkjet printer. 2.Fold the printed page along the horizontal line. 3.Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. Warning:Use only the printed original label for shipping.Using a photocopy of this label for shipping purposes is fraudulent and could result in additional billing charges,along with the cancellation of your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide,available on fedex.com.FedEx will not be responsible for any claim in excess of$100 per package,whether the result of loss,damage,delay,non-delivery,misdelivery,or misinformation, unless you declare a higher value,pay an additional charge,document your actual loss and file a timely claim.Limitations found in the current FedEx Service Guide apply.Your right to recover from FedEx for any loss,including intrinsic value of the package,loss of sales,income interest,profit, attorney's fees,costs,and other forms of damage whether direct,incidental,consequential,or special is limited to the greater of$100 or the authorized declared value.Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is$1,000,e.g.jewelry, precious metals,negotiable instruments and other items listed in our ServiceGuide.Written claims must be filed within strict time limits,see current FedEx Service Guide. https://www.fedex.com/shipping/shipAction.handle?method=doContinue 1/1 ALL AMERICAN ASPHALT `0 ALL AMERICAN AGGREGATES T 951-736-7600 F 951-739-4671 AtTL AMERICAN P.O. Box 2229,CORONA,CA 92878-2229 ASPHALT CONTRACTORS LICENDIR#1000001051 AN EQUAL OPPORTUNITY EMPLOYER December 8, 2016 High Light Electric 6942 Ed Perkic St, Suite A Riverside, CA 92504 ATTN: Estimating We will be bidding a City of Huntington Beach project called "EDINGER AVENUE REHABILITATION FROM GRAM STREET TO SPRINGDALE STREET ANS WARNER AVENUE REHABILITATION FROM BEACH BLVD TO NEWLAND STREET FEDERAL AID PROJECT STPL- 5181(189)" This project bids Tuesday, December 201h 2016. We are requesting bids from DBE Businesses for the following items of work: Landscaping Survey Tree Removals Electrical We have Plans and Specifications for review in our office. If you have any questions please contact Jim Mcgee at (951) 736-7600. Sincerely, Kelley Cima Project Administrator ALL AMERICAN ASPHALT ALL AMERICAN AGGREGATES T 951-736-7600 E 951-739-4671 ALL AME RICAN P.O. BOX 2229,CORONA,CA 92878-2229 ASPHALT CONTRACTORS LICENSE DIR#1000001051 AN EQUAL OPPORTUNITY EMPLOYER December 8, 2016 MSL Electric Co. 4938 East La Palma Ave Anaheim, CA 92807 ATTN: Estimating We will be bidding a City of Huntington Beach project called "EDINGER AVENUE REHABILITATION FROM GRAM STREET TO SPRINGDALE STREET ANS WARNER AVENUE REHABILITATION FROM BEACH BLVD TO NEWLAND STREET FEDERAL AID PROJECT STPL- 5181(189)" This project bids Tuesday, December 20th 2016. We are requesting bids from DBE Businesses for the following items of work: Landscaping Survey Tree Removals Electrical We have Plans and Specifications for review in our office. If you have any questions please contact Jim Mcgee at(951) 736-7600. Sincerely, Kelley Cima Project Administrator 12/8/2016 FedEx Ship Manager-Print Your Label(s) 0 CO o o�oD �' � mo MrG) mz ~ o Z W � oq wm� = oo r r �'qc) -)--o m m m I,,-- �Z�o -``~ = o m r r r W =n - — - - D n n 0 0 C a a r to = CP W c Dz �, D n to � � o m o � m C/) � O 70 2 z &G)� _ rn CO m CDA moo ZWT c M Cn M n o rN Z o G) oo w � J v J162016101:0luv a 544JI/D42F/14E8 After printing this label: 1. Use the'Print'button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. Warning:Use only the printed original label for shipping. Using a photocopy of this label for shipping purposes is fraudulent and could result in additional billing charges,along with the cancellation of your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide,available on fedex.com.FedEx will not be responsible for any claim in excess of$100 per package,whether the result of loss,damage,delay,non-delivery,misdelivery,or misinformation, unless you declare a higher value,pay an additional charge,document your actual loss and file a timely claim.Limitations found in the current FedEx Service Guide apply.Your right to recover from FedEx for any loss,including intrinsic value of the package,loss of sales, income interest,profit, attorney's fees,costs,and other forms of damage whether direct,incidental,consequential,or special is limited to the greater of$100 or the authorized declared value.Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is$1,000,e.g.jewelry, precious metals,negotiable instruments and other items listed in our ServiceGuide.Written claims must be filed within strict time limits,see current FedEx Service Guide. https://www.fedex.com/shipping/shipAction.handle?method=doContinue 1/1 ALL AMERICAN ASPHALT ALL AMERICAN AGGREGATES T 951-736-7600 F 951-739-4671 1 LL 11MERICA P.O. Box 2229,CORONA,CA 92878-2229 ASPHALT CONTRACTORS LICENSE DIR#1000001051 AN KLUAL OPPORTUNITY EMPLOYER December 8, 2016 Smithson Electric 1938 East Katella Ave Orange, CA 92867 ATTN: Estimating We will be bidding a City of Huntington Beach project called "EDINGER AVENUE REHABILITATION FROM GRAM STREETTO SPRINGDALE STREET ANS WARNER AVENUE REHABILITATION FROM BEACH BLVD TO NEWLAND STREET FEDERAL AID PROJECT STPL- 5181(189)" This project bids Tuesday, December 20th 2016. We are requesting bids from DBE Businesses for the following items of work: Landscaping Survey Tree Removals Electrical We have Plans and Specifications for review in our office. If you have any questions please contact Jim Mcgee at (951) 736-7600. Sincerely, Kelley Cima Project Administrator 12/8/2016 FedEx Ship Manager-Print Your Label(s) zp 8rmA ors omo N WP �cnmA j 00 c oZ m = DAZo Z � — 0 --I Z Z tn<o m� r _ 0No IT! IT! 0 0 W o m n n _ o C>I = m .D IT o"�5 — Z M--I�; m mom A �g5 coo n 0 Zr M �W N TM n rn N j o G) � FmI w 00 .4 - a J1 6 2 0161012 01uv ® 5441lID42FI14EB After printing this label: 1. Use the'Print'button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. Warning:Use only the printed original label for shipping.Using a photocopy of this label for shipping purposes is fraudulent and could result in additional billing charges,along with the cancellation of your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide,available on fedex.com.FedEx will not be responsible for any claim in excess of$100 per package,whether the result of loss,damage,delay,non-delivery,misdelivery,or misinformation, unless you declare a higher value,pay an additional charge,document your actual loss and file a timely claim.Limitations found in the current FedEx Service Guide apply.Your right to recover from FedEx for any loss,including intrinsic value of the package,loss of sales,income interest,profit, attorney's fees,costs,and other forms of damage whether direct,incidental,consequential,or special is limited to the greater of$100 or the authorized declared value. Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is$1,000,e.g.jewelry, precious metals,negotiable instruments and other items listed in our ServiceGuide.Written claims must be filed within strict time limits,see current FedEx Service Guide. https://www.fedex.com/shipping/shipAction.handle?method=doContinue 1/1 ALL AMERICAN ASPHALT ALL AMERICAN AGGREGATES T 951-736-7600 F 951-739-4671 ALL AMERICAN P.O. BOX 2229.CORONA,CA 92878-2229 ASPHALT CONTRACTORS LICENSE DIP,1000001051 AN EQUAL OPPORTUNITY EMPLOYER December 8, 2016 Diversified Landscape 21730 Bundy Canyon Road Wildomar, CA 92806 ATTN: Estimating We will be bidding a City of Huntington Beach project called "EDINGER AVENUE REHABILITATION FROM GRAM STREET TO SPRINGDALE STREET ANS WARNER AVENUE REHABILITATION FROM BEACH BLVD TO NEWLAND STREET FEDERAL AID PROJECT STPL- 5181(189)" This project bids Tuesday, December 20t" 2016. We are requesting bids from DBE Businesses for the following items of work: Landscaping Survey Tree Removals Electrical We have Plans and Specifications for review in our office. If you have any questions please contact Jim Mcgee at (951) 736-7600. Sincerely, Kelley Cima Project Administrator 12/8/2016 FedEx Ship Manager-Print Your Label(s) o � � q<o IV �0CD o��� _ _ v v V �� m�Z m m �A�o y -- .0 C CO CI) CI) y(D Sn q CD m m m Cr) N Z 5 v v > N = m 0 0 Cn 0 Z > > OMM m D n 0 -1 0 0 _ r gn2 O -n 35 0 , — - 'oo Zo 00 q 0 cc — �W m C y IT! m 1 O � Z 0 0 Z = o M J162016101361uv ® 544J1/D42FI14E8 After printing this label: 1.Use the'Print'button on this page to print your label to your laser or inkjet printer. 2.Fold the printed page along the horizontal line. 3.Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. Warning:Use only the printed original label for shipping. Using a photocopy of this label for shipping purposes is fraudulent and could result in additional billing charges,along with the cancellation of your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide,available on fedex.com.FedEx will not be responsible for any claim in excess of$100 per package,whether the result of loss,damage,delay,non-delivery,misdelivery,or misinformation, unless you declare a higher value,pay an additional charge,document your actual loss and file a timely claim.Limitations found in the current FedEx Service Guide apply.Your right to recover from FedEx for any loss,including intrinsic value of the package,loss of sales,income interest,profit, attorney's fees,costs,and other forms of damage whether direct,incidental,consequential,or special is limited to the greater of$100 or the authorized declared value. Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is$1,000,e.g.jewelry, precious metals,negotiable instruments and other items listed in our ServiceGuide.Written claims must be filed within strict time limits,see current FedEx Service Guide. hftps://www.fedex.com/shipping/shipAction.handle?method=doContinue 1/1 ALL AMERICAN ASPHALT `�/ � ALL AMERICAN AGGREGATES T 951-736-7600 F 951-739-4671 ALL 1` ME RICA P.O. BOX 2229,CORONA,CA 92878-2229 ASP HALT CONTRACTORS LICENDIR 1000001051 AN EQUAL OPPORTUNITY EMPLOYER December 8, 2016 Treesmith Enterprises 1551 North Miller St Anaheim, CA 92806 ATTN: Estimating We will be bidding a City of Huntington Beach project called "EDINGER AVENUE REHABILITATION FROM GRAM STREET TO SPRINGDALE STREET ANS WARNER AVENUE REHABILITATION FROM BEACH BLVD TO NEWLAND STREET FEDERAL AID PROJECT STPL- 5181(189)" This project bids Tuesday, December 20th 2016. We are requesting bids from DBE Businesses for the following items of work: Landscaping Survey Tree Removals Electrical We have Plans and Specifications for review in our office. If you have any questions please contact Jim Mcgee at (951) 736-7600. Sincerely, Kelley Cima Project Administrator 12/8/2016 FedEx Ship Manager-Print Your Label(s) o x o<o zo o�mA �'k o D � — o z m m " �m�Z y -.c'c-F= CD= m m n0 � o �_-- —4 = o m Z Cf) V) moo z cCO W( n mn , D m 4 m m M� '-- oo _ _ - N Z Z t= � � � � 00 — o —I m m CTr rn 70 X o Cn Cn mm = � CI) CI) W O>m� X m V) mob.. CD - A moo CO D Ip Eqm m COM co � o r Z 00 o G) °O x a162616101201.v ° 544J1/D42F114E8 After printing this label: 1.Use the'Print'button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. Warning: Use only the printed original label for shipping.Using a photocopy of this label for shipping purposes is fraudulent and could result in additional billing charges,along with the cancellation of your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide,available on fedex.com.FedEx will not be responsible for any claim in excess of$100 per package,whether the result of loss,damage,delay,non-de livery,mis delivery,or misinformation, unless you declare a higher value, pay an additional charge,document your actual loss and file a timely claim.Limitations found in the current FedEx Service Guide apply.Your right to recover from FedEx for any loss,including intrinsic value of the package,loss of sales,income interest,profit, attorney's fees,costs,and other forms of damage whether direct,incidental,consequential,or special is limited to the greater of$100 or the authorized declared value.Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is$1,000,e.g.jewelry, precious metals,negotiable instruments and other items listed in our ServiceGuide.Written claims must be filed within strict time limits,see current FedEx Service Guide. https://www.fedex.com/shipping/shipAction.handle?method=doContinue 1/1 ALL AMERICAN ASPHALT `4; ALL AMERICAN AGGREGATES "®1 T 951-736-7600 F 951-739-4671 ALTL AME RIC . ,w T P.O. BOX 2229,CORONA,CA 92878-2229 CONTRACTORS LICENSE 2 ASPHALT DI R 1000001051 AN EQUAL OPPORTUNITY EMPLOYER December 8, 2016 Caseland Surveying and Mapping 614 North Eckhoff Street Orange, CA 92868 ATTN: Estimating We will be bidding a City of Huntington Beach project called "EDINGER AVENUE REHABILITATION FROM GRAM STREET TO SPRINGDALE STREET ANS WARNER AVENUE REHABILITATION FROM BEACH BLVD TO NEWLAND STREET FEDERAL AID PROJECT STPL- 5181(189)" This project bids Tuesday, December 20th 2016. We are requesting bids from DBE Businesses for the following items of work: Landscaping Survey Tree Removals Electrical We have Plans and Specifications for review in our office. If you have any questions please contact Jim Mcgee at (951) 736-7600. Sincerely, Kelley Cima Project Administrator 12/8/2016 FedEx Ship Manager-Print Your Label(s) CO AATO Oho O ZO or�A - _ = oo Q - Ap n mmz T > > MOR w -<Z —4 Cn CA -; 05 M r r Ds = n xis —- — ITI n D D c, U)Cnn _ -- C _ 00 -n C C W Oo - M CA < < CD — °° M M o ■_ M — m - _ W 0�_ r /2 Z &6)D — rn D m < � D O p miM c < -� IT! 0 ZCn G o ZCc w rnD > o n J162016101201uv ° 544J1/D42F/14E8 After printing this label: 1. Use the'Print'button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. Warning:Use only the printed original label for shipping.Using a photocopy of this label for shipping purposes is fraudulent and could result in additional billing charges,along with the cancellation of your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide,available on fedex.com.FedEx will not be responsible for any claim in excess of$100 per package,whether the result of loss,damage,delay,non-delivery,misdelivery,or misinformation, unless you declare a higher value,pay an additional charge,document your actual loss and file a timely claim.Limitations found in the current FedEx Service Guide apply.Your right to recover from FedEx for any loss,including intrinsic value of the package,loss of sales,income interest,profit, attorney's fees,costs,and other forms of damage whether direct,incidental,consequential,or special is limited to the greater of$100 or the authorized declared value.Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is$1,000,e.g.jewelry, precious metals,negotiable instruments and other items listed in our ServiceGuide.Written claims must be filed within strict time limits,see current FedEx Service Guide. https://www.fedex.com/shipping/shipAction.handle?method=doContinue 1/1 12/8/2016 Seeking DBE Subs-Classified Ad hip-r97109 we Hello, Kim Bird not you? Your stuff Help Post an ad(free�Log out Search for... SEARCH in CommunityAnnouncements Search for... Huntington SEARCH Beach, CA Community: Announcements Huntington Beach, CA • All Cate og Ties • Jobs • Vehicles • Items for Sale • Pets • Real Estate • For Rent • Services • Personals • Community • All Community • Announcements • Carpool • Churches • Free Stuff • Garage Sales • General Entertainment • Items Wanted • Lost & Found • Musicians & Bands • Volunteers • Zip or city • More locations Your ad has been posted. Post another ad Edit this ad Help page Your stuff Share your ad for more visibility! Seeking DBE Subs https://www.classifiedads.com/announcements/859xc6n9pd9d 1/4 12/8/2016 Seeking DBE Subs-Classified Ad Share & Like Share this G+1 0 Ad #227720249 Created: December 8, 2016 Updated: December 8, 2016 Expires: December 22, 2016 Viewed: 0 times Avoid scams Signs of fraud: wire transfer, money orders, cashier checks, shipping, escrow, "transaction protection", "guarantee". Be safe by dealing locally. Read more Report this ad Overview Respond to this Ad Ad number:#22 7 720249 Contact:Kim Bird Phone:951-736-7600 City:Corona Zip:92879 Posted in: Orange County Announcements Description Respond to this Ad Sub Bids Requested From Certified DBE Sub Contractors Suppliers for the Following Project: City of Huntington Beach Edinger Ave and Warner Ave Federal AID Project STPL-5181(189) Bid Date: December 20 @ 2pm Quotes are requested for(but not limited to)the following services &Suppliers: Tree Removals https://www.classifiedads.com/announcements/859xc6n9pd9d 2/4 12/8/2016 Seeking DBE Subs-Classified Ad Survey Electrical Land Scalping ALL AMERICAN ASPHALT (Equal Opportunity Employer) P.O. Box 2229 Corona, CA 92878-2229 (951)736-7600 Fax; (951)736-7646 Information and/or assistance regarding or obtaining plans and Specifications are available upon request. - Respond to this Ad Your name Your email Message Send Message Report this ad Type of problem: Harassment Spam �«s Scam or fraud -. Wrong category Violation of terms Other (please comment) Your email (optional) publicworks@allamericanasphalt.com I would like a response https://www.classifiedads.com/announcements/859xc6n9pd9d 3/4 12/8/2016 Seeking DBE Subs-Classified Ad URL (optional) Comment(optional) r; Send report Sending... Sending... Ads related to announcements 50% Off Announcements View our Stunning 2016 Collection. Get Free Shipping on orders $49+ www.Shutterfly.com t 50% Off Photo Cards 50% Off Photo Cards at Walgreens. 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Seeking DBE Subs Edit Description : Sub Bids Requested From Certified DBE Sub Contractors Suppliers for the Following Project: City of Huntington Beach Edinger Ave and Warner Ave Federal AID Project STPL-5181(189) Bid Date: December 20 @ 2pm Quotes are requested for (but not limited to) the following services & Suppliers: Tree Removals Survey Electrical Land Scaping ALL AMERICAN ASPHALT (Equal Opportunity Employer) P.O. Box 2229 Corona, CA 92878-2229 (951)736-7600 Fax; (951) 736-7646 Information and/or assistance regarding or obtaining plans and Specifications are available upon request. - Category : MBE/DBE/WBE/VBE/LBE Expiration date: 12/20/2016 Publisher Information Name: All American Asphalt Posted:12/08/2016 04:26 pm Last updated:12/08/2016 04:26 pm Post an Ad My Ads Search Ads Ads by Category Cars & Trucks Const. Equip. Const. Materials Employment MBE/DBE/WBE/VBE/LBE Misc. Items Services Available Services Needed Business News NASA Awards Restore-L Spacecraft Bus and Support Services Contract Coronal Energy to Acquire More Solar Projects California American Water to Acquire Meadowbrook Water Company The Mobile Majority Acquires Gimbal SF Low Income Communities Receive $45M To Support Business Construction OSI Systems Contracted By a Major European Union International Airport Caltrans, SANDAG Kick Off Construction on North Coast Corridor Program Village 605 Gets Green Light from the Los Alamitos Planning Commission NV5 Annouces Acquisition of The Hanna Group U.S. Based Vasari Energy Seeks Chinese Investors for Up to 500 MW Solar Projects December Issue of Trillions Now Available Los Angeles Superior Court Upholds California's Ban on Ivory and Rhino Horn Trade West Contra Costa Unified School District Goes Solar with SunPower Sutter Health Awarded Grant To Advance Precision Medicine Trump Adrninistration Now Accepting Employment Applications BAE Systems Wins $192 Million U.S. Navy Contract NAPC Launches NativeBiz.link Hyatt Place Hotel Opens in Emeryville, California Digital Science Invests in Transcriptic Miller Law Firm Reached $7.3M Settlement for Barker Block Homeowners Association Sharp Chula Vista Building $244 Million Hospital Tower Green Charge, REC Solar Plan Solar-Plus-Energy Storage Project in California PG&E Partners to Restore Wetland, Giving Community Clean Surface Water OC 405 Partners Wins OCTA's $1.2 Billion Contract for 1-405 Project Porsche Opens New Headquarters in Los Angeles MBDA Awards Technology Integration Group 'Minority Technology Firm of the Year' Fulcrum BioEnergy Announces Major Strategic Partnership with BP Straub Wins MCON Design-Bid-Build Project P-378 in California Contract for Richmond-San Rafael Bridge Improvement Project Awarded San Diego's Historic Swimming Pool, 'The Plunge,' Gets New Home NEXTracker and Biosar Agreed for Solar Projects in Brazil ZGIobal Completes 33MVA Battery Storage System Project UCLA Building Mo Ostin Basketball Practice Facility Niner Wine Estates Completes New Landscaping Project NBA's Sacramento Kings Arena Gets Rooftop Solar Provided by SPI Energy Monterey's New Water Supply Pipeline Project Is Underway $100M in California College Readiness Grants Available California's Transportation Infrastructure System to Receive $244M in New Funding Panasonic to Supply New Inflight Entertainment and WiFi for China Eastern Airlines Orange County Consider Additional Ways to Address Homelessness Take the Contractor Planning Survey - Chance to Win $50 Amazon Gift Card UC Merced Broke Ground On $1.3 Billion Expansion Project Former DuPont Property in Oakley Sold to Industrial Park Developer SF Secures $11 M in Federal Funding for Innovative Congestion Management Programs Landmark Master Plan To Expand Groundwater Supplies Approved Skanska to Build Light Rail in San Diego for USD 307M Sony's Columbia Pictures to Develop CG Film Based on Beatrix Potter Books AECOM Signs Framework Agreement With Shell for Infrastructure Support Sunpreme Deployed 12.8 MW of Solar Panels for Large Scale Utility Project ACCO Engineered Systems Team Up with All Area Plumbing o Fidelity and Deposit Company of Maryland Home Office:P.O.Box 1227.Baltimore. MD 2I203-1227 BID BOND KNOW ALL MEN BY THESE PRESENTS: That we, ALL AMERICAN ASPHALT BOND NO.085 97 423 as Principal, (hereinafter called the"Principal'), and FIDELITY AND DEPOSIT COMPANY OF MARYLAND P.O. Box 1227, Baltimore, Maryland 21203, a corporation duly organized under the laws of the State of Maryland, as Surety,(hereinafter called the"Surety"),are held and firmly bound unto City of Huntington Beach as Obligee,(hereinafter called the"Obligee"),in the sum of TEN PERCENT OF THE TOTAL BID PRICE IN-------- Dollars($ 10%OF TOTAL BID PRICE ),for the payment of which sum well and truly to be made,the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS,the Principal has submitted a bid for Edinger Avenue Rehabilitation from Graham Street to Springdale Street and Warner Rehabilitation from Beach Boulevard to Newland Street CCNO. 1516 Federal Aid Project STPL(189) Bid Date:December 20,2016 NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a contract with the Obligee in accordance with the terms of such bid and give such bond or bonds as may be specified in the bidding or contract documents with good and sufficient surety for the faithful performance of such contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter into such contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another 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 sea ed this 6th day of December A D 2016 ALL AMERICAN ASPHALT (SEAL) Z",Y PH al /Qe�ecir ea P4KA�/yrJ �GKI/( Il�itness /� �/� FIDELITY AND DEPOSIT COMPANY OF MARYLAND Surety (SEAL) Rebecca Haas-Bates Attornev-in-Faci Printed in cooperation with the American Institute of Architects(Al A)by Fidelity and Deposit Company of Maryland. Fidelity and Deposit Company of Maryland vouches that the language in the document conforms exactly to the language used in AIA Document A-310,February 1970 Edition. BID70000770701f 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 12/06/2016 before me, R. Paramo,Notary Public Date Here Insert Name and Title of the Officer personally appeared Rebecca Haas-Bates NameN,of Signer(* who proved to me on the basis of satisfactory evidence to be the persons} whose name(5$ is/a-re subscribed to the within instrument and acknowledged to me that he/she/b-my executed the same in his/her/their authorized capacity(i*, and that by his(her/Their signature4on the instrument the person(t), or the entity upon behalf of which the person(s),acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the-Sta a of a i a that the foregoing paragraph is rrec . R.PARAMO ITNESS and and offi 'a Commisfion#t 203,5890 Notary Puilic=California Orange County M Comm..Expires Aug5,2017 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: Bid Bond Document Date: 12/06/2016 Number of Pages: One 1 Signer(s) Other Than Named Above: All American Asphalt Capacity(ies) Claimed by Signer(s) Signer's Name: Rebecca Haas-Bates Signer's Name: ❑Corporate Officer — Title(s): ❑Corporate Officer — Title(s): Partner — ❑ Limited ❑General ❑ Partner — ❑Limited ❑General ❑Individual WAttorney in Fact ❑ Individual ❑Attorney in Fact ❑Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other: ❑ Other: Signer Is Representing: Signer Is Representing: Fidelity and Deposit Company of Maryland ©2014 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V,Section 8,Attorneys-in-Fact. The Chief Executive Officer,the President,or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys-in-fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attomey-in-fact to affix the corporate seal thereto;and may with or without cause modify of revoke any such appointment or authority at any time. CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate;and I do further certify that Article V,Section 8,of the By-Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney...Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the loth day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice-President, Secretary,or Assistant Secretary of the Company,whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company,shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIM NY WHEREOF,I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this h!!!day of 20-1-6. CA f io? 33 t►« 0" SEAL y b., 1998 ar7 ,{7 Michael Bond,Vice President CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached.and not the truthfulness.accuracv.or validitv of that document. State of California County of Riverside On 12/19/2016 before me, Rebecca Angela Parra, Notary Public Date Here Insert name and Title of the Officer personally appeared Edward J. Carlson Name(s)of Signer(s) f who proved to me on the basis of satisfactory evidence to be the �— REBECCA ANGELA PA RRA person(s) whose name(s) is/are subscribed to the within instrument Commission # 2024944 and acknowledged to me that he/she/they executed the same in Notary Public -California z his/her#heir authorized capacity(ies), and that by his/befAheir z ' ' Riverside County ' signature(s) on the instrument the person(s), or the entity upon behalf My Comm.Expires May 17,2017 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 forgoing paragraph is true and correct. WITNESS my hand cial seal. AV Signature Place Notary Seal Above Signature o otary Public OPTIONAL Though the information below is not required by law, it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document Bid Bond Document Date: 12/06/2016 Number of Pages: One (1) Signer(s)Other Than Named Above: Fidelity and Deposit Company of Maryland Capacity(ies)Claimed by Signer(s) Signer's Name: Edward J. Carlson Signer's Name: ❑ Individual ❑ Individual X Corporate Officer—Title(s): Vice President ❑Corporate Officer—Title(s): ❑ Partner❑ ❑ Limited ❑General RIGHT ❑ Partner❑ ❑ Limited❑ General _ IGHTTHUMBPRINT ❑Attorney in Fact OF SIGNER ❑Attorney in Fact OF ❑Trustee Top of thumb here ❑Trustee Tap of thumb here ❑Other: ❑Other: Signer is Representing: Signer is Representing: All American Asphalt City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov FB : Office of the City Clerk •17,1909, Robin Estanislau, City Clerk April 6, 2017 Excel Paving Company 2230 Lemon Ave. Long Beach, CA 90806 Re: Edinger Avenue Rehabilitation —CC-1516 The City Council awarded the bid to your company for the above referenced project. Enclosed is a copy of the executed contract with the City of Huntington Beach. A Certification of Compliance with Title VII of the Civil Rights Act, Certification of Compliance with Prevailing Wage Laws and Contractor's Certificate form must be returned to this office after the project is completed but prior to the release of retention funds. In addition, the following item must also be on file, with this office before the City can release any retention funds: A warranty bond guaranteeing the final amount of work and materials for one year. If your performance bond does not include specific wording for a one-year warranty, then a rider or separate bond must be submitted. Should you have any questions or concerns regarding the enclosures or items that must be on file in this office prior to release of retention funds, please call the Public Works Department at 536-5517. Sincerely, 4441U e&�� Robin Estanislau, CIVIC City Clerk RE:pe Enclosures: Copy of Contract including Proposal Copies of insurance/bonds Bid Bond (original) Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand iti �,�pL 'C�71 LLS j City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For EDINGER AVENUE REHABILITATION AND WARNER AVENUE REHABILITATION CC No. 1516 Federal Aid Project STPL-5181(189) in the CITY OF HUNTINGTON BEACH December 12, 2016 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) PROJECT BID SCHEDULE—Section C Specification Book (2 Sheets) Replace "Project Bid Schedule—C-2.3"with "Project Bid Schedule—C-2.3 Addendum 1" (1 sheet). Bid items 1,2,3 and 4 descriptions were shortened. Replace "Project Bid Schedule—C-2.9" with "Project Bid Schedule—C-2.9 Addendum 1" (1 sheet). Bid items 1,2,3 and 4 descriptions were shortened. 2) APPENDIX H—Appendix H Part 2 Specification Book(27 Sheets) Replace Cover Sheet(1 sheet)and "General Decision Number CA160035 10/28/2016"with "General Decision Number CA 160035 11/11/2016" (26 sheets). Federal Construction Wage Rates were updated on 11/11/2016. This is to acknowledge receipt and review of Addendum Number One, dated December 12,2016. .W.Du Company Name By C.P. NOWN,PRE91DENT Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call James Wagner at(714) 536-5467 within 24 hours of posting. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER TWO For EDINGER AVENUE REHABILITATION AND WARNER AVENUE REHABILITATION CC No. 1516 Federal Aid Project STPL-5181(189) in the CITY OF HUNTINGTON BEACH December 20, 2016 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) BID OPENING POSTPONED REVISED BID DUE DATE ON COVER AND ON PAGE A-1 FROM "DECEMBER 20, 2016" to "DECEMBER 29, 2016." 2) ASPHALT CONCRETE CLARIFICATION REVISED SHEET E-23 and E-24 IN SPECIFICATION BOOK—203 BITUMINOUS MATERIALS (2 Sheets) Replace E-23 with "E-23 CC-1516, Addendum 2" (1 sheet) And Replace Page E-24 with "E-24 CC-1516, Addendum 2" (1 sheet) This is to acknowledge receipt and review of Addendum Number Two, dated December 20, 2016. PAUX XU MR PAVING C"AW C Company Name By Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call James Wagner at(714) 536-5467 within 24 hours of posting. SECTION 203 - BITUMINOUS MATERIALS 203-6 ASPHALT CONCRETE. 203-6.1 General. [Add the following:]. Asphalt concrete Base course shall be B 3/4" PG 70-10 RAP and shall conform to the requirements of Section 400-4. The asphalt binder shall comply with the Performance Grade specifications of Section 203-1. 203-11 ASPHALT RUBBER HOT MIX(ARHM) 203-11.3 Composition and Grading. [Replace the first paragraph with the following:]. Asphalt-rubber hot-mix gap graded surface course shall be ARHM-GG-C 1%"PG 64-16 and shall conform to the requirements of this section, Table 203-11.3(A),and Section 302-9. The asphalt binder to be mixed with the mineral aggregate shall be paving asphalt conforming to the Performance Grade specifications of Section 203-1. The grading of the combined aggregates for rubberized asphalt concrete shall conform to the requirements of Section 203-11.3. Asphalt Rubber Hot Mix shall contain one hundred percent (100%)California-generated waste tires in the rubber portion of the Rubber Hot Mix and the rubberized binder shall contain a minimum of 300 pounds(equivalent to 15%by weight)of tire-derived crumb rubber per ton of rubberized binder. E-23 CC-1516,ADDENDUM 2 SECTION 212 —LANDSCAPE AND IRRIGATION MATERIALS 212-1 LANDSCAPE MATERIALS. [Add the following:]. Items may be modified or substituted as indicated on the Plans and Specifications. 212-2 IRRIGATION SYSTEM MATERIALS. [Add the following:]. Items may be modified or substituted as indicated on the Plans and Specifications. 212-3 ELECTRICAL MATERIALS. [Add the following:]. Items may be modified or substituted as indicated on the Plans and Specifications. SECTION 213 - ENGINEERING FABRICS 213-2 GEOSYNTHETICS. 213-2.1 General. [Replace entire subsection with the following:]. The exposed subgrade should be inspected during excavation and prior to placement of structural section. When time constraints do not permit suitable drying or where perimeter conditions include uncontrollable water sources, additional measures may be necessary. Where conditions are not firm and unyielding,use of a geogrid shall be considered. The excavation shall extend 4"greater than the currently planned structural section unless rut exceeds 4". Geogrids shall then be placed over the prepared grade. The geogrid shall be type S2, and the width of overlap shall be 1 to 3 feet depending on conditions encountered at the time of construction. Aggregate base shall be end dumped and spread in minimum 12" lifts. No equipment shall be permitted to operate on the exposed geogrid or on top of the aggregate base E-24 CC-1516,ADDENDUM 2 SECTION C PROPOSAL for the construction of EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET AND WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 FEDERAL AID PROJECT STPL-5181(189) in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids,the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 65 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY-ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts,and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. e is proposal of bid,find 2i 1 QDeds fJO�I) in the amount TEi!l��ICE"'o'f 9� jhich 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: Addbidallo. ' Date Recefved Bidder's S' afore:::.`::' C.P. ®RiOWN PRESIDENT ti C-2 SECTION C PROJECT BID SCHEDULE EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET AND WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 FEDERAL AID PROJECT STPL-5181(189) in the PROJECT BASE BID: Basis of Award EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET. . . . . . . . .. . .. . .. . .. . . . . . . . ............C-2.2 to C-2.7 WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET. .... .... ........ . . . ... . .. .. . .. . ... ... C-2.8 TO C2.12 1. EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET BID IN FIGURES 2. WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET $ BID IN FIGURES BASE BID TOTAL AMOUNT LUMP SUM BID IN FIGURES: (TOTAL FOR ITEMS 1 AND 2) BASIS OF AWARD C-2.1 SECTION C PROJECT BID SCHEDULE EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET AND WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 FEDERAL AID PROJECT STPL-5181(189) EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET CC NO. 1516 C-2.2 Addendum 1, CC-1516 Replacement Page C-2.3 EDINGER (GRAHAM-SPRINGDALE) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity Unit ,�Price Amount 1 -- MOBILIZATION 1 LS $ al $ 1 BWV--- 2 -- TRAFFIC CONTROL PLAN 1 LS $ 3NO / $ 30P3 3 -- FURNISH PROJECT TRAFFIC 1 LS $ CONTROL 4 - FURNISH AND INSTALL SIGNING 1 LS $ AND STRIPING 5 -- PROJECT SPECIFIC SWPPP 1 LS $ `I�L�— $ LAW- REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB,AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). (INCLUDES ALL 6 1 APPURTENANCES, CURB 3 EA $ !uw' $ �r ow GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) CONSTRUCT 0.1T ASPHALT 7 3 RUBBER HOT MIX(ARHM)WET 2,200 TN $ / $ PROCESS OVERLAY. 8 4 ADJUST SEWER MANHOLE TO GRADE. 6 EA -1, 0 — 9 INTENTIONALLY LEFT BLANK REPLACE WATER VALVE BOX �1 10 6 ASSEMBLY AND ADJUST TO 11 EA $ / . $ ;?6' GRADE PER HB STD PLAN 612. 11 INTENTIONALLY LEFT BLANK C-2.3 CC-1516,Addendum 1 EDINGER (GRAHAM-SPRINGDALE) PROJECT BID SHEET Bid Const Contract Unit Extended No.. No. Description'_: Quantity Unit Price Amount COLD MILL EXISTING A.C. 12 7 PAVEMENT TO A DEPTH OF 0.34' 158,200 SF $ �. Z� $ 2 FROM NEW FINISHED SURFACE PER PLANS. COLD MILL EXISTING A.C. n 13 g PAVEMENT TO A DEPTH OF 0.67' 8 800 SF $ v• � FROM NEW FINISHED SURFACE PER PLANS. CONSTRUCT NEW 0.17'AND 0.50'B-PG-70-10-RAP A.C. BASE ``AA 14 7&8 COURSE OVER 2,400 TN $ $ 400 COMPACTED SUBGRADE PRIOR To 0.1T ARHM OVERLAY PER PLANS. 15 INTENTIONALLY LEFT BLANK SET SURVEY MONUMENTATION AND PREPARE CORNER 16 9 RECORD(PRE-AND/OR POST- 2 EA $ $ CONSTRUCTION). REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202(CF=8"). (INCLUDES 17 10 SLOT PAVEMENT,AGGREGATE 1,580 LF $ BASE, LOT DRAINS,AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) C-2.4 EDINGER (GRAHAM-SPRINGDALE) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity. Unit Price Amount REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE-GRAD FROM WALK TO EXISTING 18 11 SLOPE, RELOCATING 6,600 SF IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE- CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT COMMERCIAL/RESIDENTIALDRIVEWAY("W"AND TYPE 2 19 12 SHOWN ON PLAN)PER STD 1,330 SF $� PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO GRADE. 20 INTENTIONALLY LEFT BLANK 21 INTENTIONALLY LEFT BLANK INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC 22 13 SIGNALS AND LIGHTING 24 EA $ 23 Q $ 26 SYSTEMS,2005 EDITION. SPLICE LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE"D" REMOVE EXISTING TREE AND ROOTS;GRIND TREE STUMP 23 14 AND ROOTS TO 24"BELOW TOP 20 EA $ U $ Gl OF SIDEWALK/GRADE WITHIN PROPOSEDIMPROVEMENT AREA. C-2.5 EDINGER (GRAHAM-SPRINGDALE) PROJECT BID SHEET Bid Const Contract Unit Extended No: NO. Description - Quantity, Unit Price'. Amount FURNISH LABOR, EQUIPMENT, AND GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED 24 15 BY AGENCY. (INCLUDES ALL 2,500 SF $ $ ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C.AND OVER EXCAVATION BID PAY ITEMS.) OVER EXCAVATION WHEN ., 25 16 IDENTIFIED BY CONTRACTOR 90 CY $ i $ AND VERIFIED BY AGENCY. ADJUST EDISON VAULT/MANHOLE TO GRADE BY 26 17 EDISON. CONTRACTOR TO 4 EA NOT A CONTRACTOR BID ITEM COORDINATE WITH ERICK OEN AT(714) 895-0242. 27 INTENTIONALLY LEFT BLANK ADJUST OCSD MANHOLE TO GRADE PER OCSD STD. PLAN S- 9 $ 053, 5-054 AND S-055. // $ n` 28 18 CONTRACTOR TO COORDINATE WITH MIKE BOLSTER AT(714) 593-7645. 29 INTENTIONALLY LEFT BLANK C-2.b EDINGER (G RAHAM-SP RING DALE) PROJECT BID SHEET Bid Const Contract: Unit Extended No.. No. Description Quantity,: Unit Price: Amount FURNISH AND PLANT NEW 24" BOX EASTERN REDBUD TREE PER HB STD.PLANS 714,715, 716,718&719 AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF EXISTING LANDSCAPING, 30 19 BUSHES OR GROUND COVER 20 EA $ SOO ` $ 2-00.)o AND IRRIGATION TO A DEPTH OF 24"BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). FURNISH AND INSTALL ZEBRON, SANCON OR CITY APPROVED 31 _- EQUAL COATING ON THE NEW 3 EA $ $ CONCRETE INSIDE OF AGENCY SEWER MANHOLE RING. Total Amount Bid in Figures: $ ZZ 1 Total Amount Bid in Words: �e&.Cb � T1Gt C-2.7 SECTION C PROJECT BID SCHEDULE EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET AND WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 FEDERAL AID PROJECT STPL-5181(189) WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 C-2.8 Addendum 1, CC-1516 Replacement Page C-2.9 WARNER (BEACH BLVD. TO NEWLAND) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount 1 -- MOBILIZATION 1 LS $ $ 2 -- TRAFFIC CONTROL PLAN 1 LS $ $ 3( , 3 - FURNISH PROJECT TRAFFIC 1 LS $ S $ I UUu' CONTROL 4 - FURNISH AND INSTALL SIGNING 1 LS $ 'LO 01)IJ3 ' $ 24 0)7) AND STRIPING 5 -- PROJECT SPECIFIC SWPPP 1 LS $ $ q00-0' REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB,AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). /y,,,,11ryry 6 1 (INCLUDES ALL g EA $ qox $ ®/ APPURTENANCES, CURB GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT,AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) CONSTRUCT 0.1 T ASPHALT 7 3 RUBBER HOT MIX(ARHM)WET 3,000 TN $ PROCESS OVERLAY. 8 4 ADJUST SEWER MANHOLE TO g EA $ $ GRADE. 9 5 ADJUST STORM DRAIN 2 EA $ $ QCJb MANHOLE TO GRADE, REPLACE WATER VALVE BOX �/"_ 10 6 ASSEMBLY AND ADJUST TO 49 EA $ to $ �GI goo GRADE PER HB STD PLAN 612. COLD MILL EXISTING A.C. �r 11 7 PAVEMENT TO A DEPTH OF 0.17' 53,000 SF $ $ 7grV- FROM NEW FINISHED SURFACE PER PLANS. COLD MILL EXISTING A.C. 12 8 PAVEMENT TO A DEPTH OF 0.34' 157,000 SF $ $ Z FROM NEW FINISHED SURFACE PER PLANS. C-2.9 CC-1516, Addendum 1 WARNER (BEACH BLVD. TO NEWLAND) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity: Unit Price Amount COLD MILL EXISTING A.C. 13 9 PAVEMENT TO A DEPTH OF 0.67' 20,100 SF $ $ 10 FROM NEW FINISHED SURFACE PER PLANS. CONSTRUCT NEW 0.17',AND 0.50'B-PG-70-10-RAP A.C. BASE rn 14 8&9 COURSE OVER 95% 21850 TN $ $ in e, V COMPACTED SUBGRADE PRIOR TO 0.1 T ARHM OVERLAY PER PLANS. RAISE SURVEY WELL MONUMENT TO GRADE AND 15 10 PREPARE CORNER RECORD 2 EA $ IJO $ Z (PRE-AND/OR POST- CONSTRUCTION). SET SURVEY MONUMENTATION AND PREPARE CORNER` 16 11 RECORD(PRE-AND/OR POST- 8 $ $- CONSTRUCTION). REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202(CF=8"). (INCLUDES 17 12 SLOT PAVEMENT,AGGREGATE 200 LF $ ` — BASE, LOT DRAINS,AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE-GRAD FROM WALK TO EXISTING 18 13 SLOPE, RELOCATING 3,750 SF $ �. $ U0 Iry- IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE- CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE. C-2.10 WARNER (BEACH BLVD. TO NEWLAND) PROJECT BID SHEET Bid Const Contract Unit Extended No No. Description Quantity Unit Price Amount. REMOVE AND RECONSTRUCT COMMERCIAL/RESIDENTIAL DRIVEWAY("W"AND TYPE 19 14 SHOWN ON PLAN)PER STD 1,600 SF PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO GRADE. REMOVE AND RECONSTRUCT CONCRETE CURB AND CROSS GUTTER PER HB STD. PLAN 205. 20 15 (ITEM INCLUDES SLOT 3,500 SF $ ?i $= PAVEMENT,AGGREGATE BASE AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT MEDIAN CURB AND GUTTER PER HB STD PLAN 201 (CF=8"). 21 16 (INCLUDES SLOT PAVEMENT, 110 LF AGGREGATE BASE, LOT DRAINS,AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC SIGNALS AND LIGHTING 22 17 58 EA SYSTEMS,2005 EDITION. SPLICE LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE"D" REMOVE EXISTING TREE AND ROOTS; GRIND TREE STUMP 23 18 AND ROOTS TO 24"BELOW TOP 4 EA $ -lop $ Z�C/o. OF SIDEWALK/GRADE WITHIN L PROPOSEDIMPROVEMENT AREA. C-2.11 WARNER (BEACH BLVD. T4 NEWLAND) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity. Unit Price Amount FURNISH LABOR, EQUIPMENT, AND GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED 24 19 BY AGENCY. (INCLUDES ALL 2,500 SF $ ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C.AND OVER EXCAVATION BID PAY ITEMS.) OVER EXCAVATION WHEN 25 20 IDENTIFIED BY CONTRACTOR 90 CY $_ $ 3 j AND VERIFIED BY AGENCY. ADJUST EDISON VAULT/MANHOLE TO GRADE BY 26 21 EDISON.CONTRACTOR TO 1 EA NOTA CONTRACTOR BID ITEM COORDINATE WITH ERICK OEN AT(714)895-0242. ADJUST VERIZON VAULT/MANHOLE TO GRADE BY 27 22 VERIZON. CONTRACTOR TO 1 EA NOT CONTRACTOR BID ITEM COORDINATE WITH RAY ROUNDTREE AT(714)375-6760. ADJUST OCSD MANHOLE TO GRADE PER OCSD STD. PLAN S- 053, S-054 AND S-055. 28 23 1 EA $CONTRACTOR TO COORDINATE UU� $ WITH MIKE BOLSTER AT(714) 593-7645. 29 24 ADJUST MONITORING WELL s 3 �� COVER TO GRADE. 5 EA $ $ 80 INTENTIONALLY LEFT BLANK FURNISH AND INSTALL ZEBRON, SANCON OR CITY APPROVED 31 -- EQUAL COATING ON THE NEW 4 EA $ _ $ 3 ZOn — CONCRETE INSIDE OF AGENCY SEWER MANHOLE RING. Total Amount Bid in Figures: $ Total Amount Bid in Words: yr/ �� l V�+' C-2.12 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Class.amegn-N- 4 .State b'L"nst UM Arr `Amount:::. r:NuinbL In 3q*l 7-3 1636 013 A 10000 to. qZ Up U*<rTCtti Loft LO03 2_q A31— r 3/ 90 Inreq Z. CO/too�2- Dov� AV,-, C4 0 II(q (:444W, bvm ('I,, CA UG Xf, SMIL k Ia)dJ Iron10,r;./ L'J I (;�MVCAA &VO4- (A By submission of this proposal,the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Name aidAddress of Stale `; Class DIR Dollar Items). Subcontrador License; Number, Amu Vy..Contrad Number. :. 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 i NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID 1 declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed On ,*t LONG BEACFt ,CALIPORMA Date City State C.P. 9FiiO4YN , being n, deposes and says that he or she is PRESIDENT of C1 61 1 the party making the foregoing bid that the bid is not made in ehalf 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. MA i.PAVMiG CO~ Name of Bidder Signature of Bidder C.P. MOWN,PREPBENT 2230 LEMON AVENUE LONG BEACH. CA 90808 Address of Bidder C4 ( CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. i State of California f [ County of Los Angeles On OR 2 0 1016 before me, C. Phillips, Notary Public Notary Public, (Here insert name and title of the officer) personally appeared C. P. Brown who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/,W subscribed to the within instrument and acknowledged to me that he/sJt/tOW executed the same in his/l*/ttWr authorized capacity(ies),and that by his/*/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. ,• �, C,PHILLIPS COMM,#217OV7 N WITNESS m hand and official seal Notary Public-California a:y � LOS ANGELES COUNTY LL My Comm.Expires Oct 29,2020 Signature of Notary Public (Notary Seal) t ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly as DESCRIPTION OF THE ATTACHED DOCUMENT appears above in the notary section or a separate acknowledgment form must be properly completed and attached to that document. The only exception is if a document is to be recorded outside of California.In such instances, any alternative { (Title or description of attached document) acknowledgment verbiage as may be printed on such a document so long as the k verbiage does not require the notary to do something that is illegal for a notary in k k California (i.e. certifying the authorized capacity of the signer). Please check the j (Title or description of attached document continued) document carefully for proper notarial wording and attach this form if required I I t Number of Pages Document Date • State and County information must be the State and County where the document g signer(s)personally appeared before the notary public for acknowledgment. f • Date of notarization must be the date that the signer(s)personally appeared which must also be the same date the acknowledgment is completed. (Additional information) • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title(notary public). • Print the name(s) of document signer(s)who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms(Le, ❑ Individual(s) Wshe/tfiey—is/are)or circling the correct forms.Failure to correctly indicate this information may lead to rejection of document recording. ❑ Corporate Officer • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines.If seal impression smudges,re-seal if a (Title) sufficient area permits,otherwise complete a different acknowledgment form. ❑ 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. I } ❑ Other Indicate title or type of attached document,number of pages and date. Indicate the capacity claimed by the signer.If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). • Securely attach this document to the signed document i s C 2004-2015 ProL nk Signing Service,Inc.—All Rights Reserved wwwMeProLink.com—Nationwide Notary Service UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH,CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract,known as the Edinger Avenue Rehabilitation from Graham Street to Springdale Street and Warner Avenue Rehabilitation Beach Boulevard to Newland Street,Project CC No. 1516,(1)(we)(it)will employ and utilize only qualified persons,as hereinafter defined,to work in proximity to any electrical secondary or transmission facilities. The term"Qualified Person" is defined in Title 8,California Administrative Code,Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved." The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal-OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. MM PAVING CONMW Contractor C By WNW.PRES094A Title DEC 2 0 2Q�6 Date: 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 U/No If the answer is yes,explain the circumstances in the space provided. 1v 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. WCDBA MEL PAVING COMPAW Contractor By C.Po BROWN,PREMENT Title Date: C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: W WC.DGA OM PAVM CWW Bidder Name 2M LEWM AVENUE LONG bEt 0,hJ1 IM Business Address City, State Zip jsG2)599-5841 Telephone Number STATE uc. 668659•A• State Contractor's License No.and Class I�►19�1 Original Date 4sued ll'�,QIg Expiration Date The work site was inspected by ,, d W�V 1L-kW of our office on 201 J. The following are persons,firms,and corporations having a principal interest in this proposal: •WA Cartls P.Brown President and Chief Executive Officer C Curtis P,Brown III Vice President and ChiefOperating icer PAMGompm waft F.Flatt Vice President and Chief Financial Officer Marcia S.Miller Secretary Miehale F ❑rakulich Assistant Secretary The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specification Company Name am I Signature of Bidder C.fa, WON Perm .., Printed or Typed Signature T Subscribed and sworn to before me this_day of "r ?016 ,201_. 0��'` •"°., G I�ItLtPS . .�. COMM.#2170177 w Notary Public-California jr LOS ANGELES COUNTY NOTARY PUBLIC W", My Comm.Expires Oct 29,2Cr2O"{ NOTARY SEAL C-8 Bidder's Project History For the purposes of this project; the bidder shall provide project history of similar work, specifically referencing the construction of{Describe specific work and experience necessary for project. For example, "Sanitary sewer line installation of at least of 1,000 of 8-inch and greater in public right-of-way. Sanitary sewer lift stations of similar size, project work within public streets, an area containing high ground water and pipeline construction in high ground water regions with trench depths of 8-feet to the invert. . Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: 1. 1 kAA ► � Name and Address of Public Agency t Name and Telephone No.of Project Manager: C L I �'7� 3VL 314- Contract Amount Type of Work Date Completed F�oviduadt!i al project description tq show 'milar work: Name and Address of Public Agency Name and Telephone No.of Project Manager: aGal. — 1 1uww �W *1 'dad Contract Amount Type of Work Date ompleted PrAvide addi 'oval project description o show similar work: 3. LJ� UL Name and Address of Public Agency Name and Telephone No.of Project Manager: (Q Contract Amount Type of Work Date dompleted Provide additional project descripti n to show si ilar work: �.1 d/1tMn��r1 �� G�lnt'AVL ( C-9 Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager,and Superintendent. For each of these critical positions,please list at least three projects for which the critical staff has performed similar work within the last five years. These projects do not have to be under the employment of the bidder of this project.Bidders are encouraged submit supplemental relevant project history in addition to the projects listed herein. 1. V 8J i n NJ k(JU�✓' Name of proposed Project Manager Telephone No.of proposed Project Manager: (.562)599-58 41 Project Name&Contract Amount Type of Work Date Completed M VUIII roj ect Name&Contract Amount Type of Work Date Completed %I f inn ► Z22q�Z "1 do I Project Nakhe&Contract Amount Type of Work Date Completed 2. LL S( ;ft()I3 L-V eV- Name of proposed Superintendent Telephone No. of proposed Superintendent: (552)599-5841 ewA�z 4,u ��uwr ; mpA 110 1� Project Name&Contract Amount Type of Work Date Completed ckp�V;roe.;�avetoa 2 8 3 rnnt Proj6d Name&Contract Amount Type of Work Date Completed �,edLbj,, A& -�04 Project N &Contract Amount Type of Work Date Completed C-10 CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771.1(a)),passed by the California State Senate on June 20, 2014, established a new public works Contractor Registration Program, which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July 1 through June 30 state fiscal year) with the California Department of Industrial Relations (DIR). Currently the annual non-refundable registration fee for Contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 http://www.dir.ca.gov/DLSE/PublicWorks/SB854FactSheet 6.30.14.pdf DIR's Contractor Registration Link—Call(844) 522-6734 https://e,filing.d ir.ca.gov/PWCR/ActionServlet?action=displayP WCRegistrationFonm DIR's Contractor Registration searchable database: https://efiling.dir.ca.gov/PWCR/Search.action I am aware and will comply with the provisions of Labor Code Section 1771.1(a)which states: "A contractor or subcontractor shall not be qualified to bid on,be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code,or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725.5. It is not a violation of this section for an unregistered contractor to submit a bid that is authorized _ by Section 7029.1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract Code,provided the contractor is registered to perform public work pursuant to Section 1725.5 at the time the contract is awarded." I furthermore will comply by providing proof of registration with DIR as the primary contractor, as well as for ALL subcontractors at the time of submitti�g,te�lei 1'qL .P�lis I.PAV#MG C Contractor By C.P. 6m".PRE$SEWT DEC 2 n 2W Title Date: DIR#: �p600�33�� C-11 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AM TENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations,Part 135* Economic Opportunities for Low and Very Low-Income Persons The bidder, under penalty of perjury,certifies that except as noted below, any person associated therewith in the capacity of owner,partner, director,officer,or manager(initial the applicable selections): Will ensure that 10%of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968;or G1' Will hire no new Jin con ees emP to junction with Y this project. Will award 10%of its sub-contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub-contracts related to this project. Contractor: EXM PAVING COMPAW Contact Person: bfiy o txQ,' ' Contact Phone: (562)599-5641 Signed: _ 1 -t .,o G.P.M ,laREMENT" Date: DEC 2 0 20 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub-contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992(HUD). Previous non-compliance with Section 3 could result in disqualification. C-12 RELIABLE CONTRACTOR DECLARATION(page 1 of 2) CalRecycle 168(Revised 9/16) This form must be completed and submitted to the Department of Resources Recycling and Recovery.(CalRecycle) prior to authorizing a contractor(s) to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of funds to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Reliable Contractor Declaration (formerly Unreliable List) requirement of their Terms and Conditions. The Reliable Contractor Declaration (formerly Unreliable List) provision requires the following: Prior to authorizing a contractor(s) to commence work under the Grant, the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractor(s) stating that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the contractor(s). Please see the reverse of this page, or refer to the California Code of Regulations (www.calregs.com). If any of the events listed in Section 17050 have occurred, disclosure is required but will not necessarily result in CalRecycle refusing to approve the contractor. A signed statement explaining the facts and circumstances of the events must be attached to and submitted with this form. Contractor: Complete the form and send original to the Grantee. Grantee: Scan the form and upload it to the grant in CalRecycle's Grant Management System. For further instruction about logging into the Grant Management System and uploading this form, reference the Procedures and Requirements. Retain the original form in your grant file. GRANTEE INFORMATION .• :�.,:.�,::: ::.::.::.::.....:.::. :: :• .- _ .. .. , GRANTEE NAME: GRANT NUMBER: PRIMARY CONTACT NAME: CONTRACTOR INFORMATION CONTRACTOR NAME: PALP MCJMA AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: PMESWENT MAILING ADDRESS: 2230 LEMON AVENUE LONG BEACH, CA 90806 As the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor. Alternatively, as the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of California that within the preceding three (3)years, if any of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor, 1 have disclosed all such occurrences in an attached signed statement that explains the facts and circumstances of the listed events. Signature Date 7 1 �� ,,� C( 2 0 Bib C.-F.DIEM,PRESIDENT C-13 RELIABLE CONTRACTOR DECLARATION(page 2 of 2) CalRecycle 168(Revised 9/16) Title 14 CCR,Division 7,Chapter 1 Article 5. Unreliable Contractors,Subcontractors,Borrowers and Grantees Section 17060,Grounds for Placement on Unreliable List The following are grounds for a finding that a contractor,any subcontractor that provides services for a CalRecycle agreement, grantee or borrower is unreliable and should be placed on the CalRecycle Unreliable Contractor, Subcontractor, Grantee or Borrower List ("Unreliable List"). The presence of one of these grounds shall not automatically result in placement on the Unreliable List. A finding must be made by the Executive Director in accordance with section 17054,and there must be a final decision on any appeal that may be filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s)to CalRecycle due to fraudulent claims or reporting;or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act, Government Code section 12650 at.seq;or (c) Default on a CalRecycle loan,as evidenced by written notice from'CalRecycle staff provided to the borrower of the default;or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycle;or (e) Filing voluntary or involuntary bankruptcy,where there is a finding based on substantial evidence, that the bankruptcy interfered with the CalRecycle contract,subcontract,grant or loan;or (f) Breach of the terms and conditions of a previous CalRecycle contract,any subcontract for a CalRecycle agreement,grant,or loan,resulting in termination of the CalRecycle contract,subcontract,grant or loan by the CalRecycle or prime contractor,or (g) Placement on the CafRecyde's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility;or (h) The person, or any partner, member, officer, director, responsible managing officer, or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion,conspiracy, or any act in violation of any state or federal antitrust law in connection with the bidding upon, award of, or performance under any CalRecycle contract, subcontract,grant or loan;or () The person or entity is on the list of unreliable persons or entities,or similar list,of any other federal or California state agency-or (j) The person or entity has violated an Order issued in accordance with section 18304;or, (k) The person or entity has directed or transported to,has or accepted waste tires at,a site where the operator is required to have but does not have a waste fire facility permit;or, (I) The person or entity has transported waste tires without a waste tire hauler registration;or, (m) The person or entity has had a solid waste facility or waste tire permit or a waste tire hauler registration denied, suspended or revoked;or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRecycle to remediate,clean,or abate a nuisance at the site;or (o) The following are additional grounds for a finding that,a person or entity described below should be placed on the Unreliable List: (1) The person or entity owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director,manager,partner,trustee,or any other management position with significant control(Principal Manager)in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person who owns 20%or more of the entity,if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (5) The entity has another entity which owns 20%or more of the entity,if that other entity: 1. is on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (6) Subsection(o)is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-14 Local Assistance Procedures Manual Exhibit 12-H Sample Bid (THE BIDDER'S EXECU770N ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTMITE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHAREA PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION Mp.WCMA The bidder ' � G CJ� oposed subcontractor hereby certifies that he has has not_,participated in a previous contract or subcontract subject to the equal opportunity clauses,as required by Executive Orders 10925,11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity,all reports due under the applicable filling requirement. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b)(1)),and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director,Office of Federal Contract Compliance,U.S.Department of Labor. Page 1 of 8 C-15 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285,1 (Chapter 376,Stats. 1985),the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has_,has not�i been convicted within the preceding three years of any offenses referred to in that section,including any charge of fraud,bribery,collusion, conspiracy,or any other act in violation of any state or Federal antitrust law in connection with the bidding upon,award of, or performance of,any public works contract,as defined in Public Contract Code Section 1101,with any public entity,as defined in Public Contract Code Section 1100,including the Regents of the University of California or the Trustees of the California State University. The term"bidder"is understood to include any partner,member,officer,director,responsible managing officer,or responsible managing employee thereof,as referred to in Section 10285.1. Note: The bidder must place a checkmark after"has"or"has not"in one of the blank spaces provided.The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement.Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162,the.Bidder shall complete,under penalty of perjury,the following questionnaire: Has the bidder,any officer of the bidder,or any employee of the bidder who has a proprietary interest in the bidder,ever been disqualified,removed,or otherwise prevented from bidding on,or completing a federal,state,or local government project because of a violation of law or a safety regulation? Yes No If the answer is yes,explain the circumstances in the following space. Page 2 of 8 C-16 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE 1.0232 STATEMENT in conformance with Public Contract Code Section 10232,the Contractor,hereby states under penalty of perjury,that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 3 of 8 C-17 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section.7106) To the CITY/COUNTY of Ow�� DEPARTMENT O UBLIC WORKS. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of or on behalf of,any undisclosed person,partnership, company,association,organization,or corporation;that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded,conspired,connived,or agreed with any bidder or anyone else to put in a sham bid,or that anyone shall refrain from bidding;that the bidder has not in any manner,directly or indirectly,sought by agreement,communication,or conference with anyone to fix the bid price of the bidder or any other bidder,or to fix any overhead,profit,or cost element of the bid price,or of that of any other bidder,or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract,that all statements contained in the bid are true;and,further,that the bidder has not,directly or indirectly,submitted his or her bid price or any breakdown thereof,or the contents thereof, or divulged information or data relative thereto,or paid,and will not pay,any fee to any corporation, partnership,company association,organization,bid depository,or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 4 of 8 C-18 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS,PART 29 The bidder,under penalty of perjury,certifies that,except as noted below,he/she or any other person associated therewith in the capacity of owner,partner,director,officer,manager: • is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any Federal agency; • has not been suspended,debarred,voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending;and • has not been indicted,convicted,or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification,insert the exceptions in the following space. V' Exceptions will not necessarily result in denial of award,but will be considered in determining bidder responsibility. For any exception noted above,indicate below to whom it applies,initiating agency,and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 5 of 8 C-19 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies,by signing and submitting this bid or proposal,to the best of his or her knowledge and belief,that: (1) No Federal appropriated funds have been paid or will be paid,by or on behalf of the undersigned,to any person for influencing or attempting to influence an officer or employee of any Federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal,amendment,or modification of any Federal contract,grant,loan,or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with this Federal contract,grant, loan,or cooperative agreement,the undersigned shall complete and submit Standard Form-LLL,"Disclosure of Lobbying Activities,"in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for malting or entering into this transaction imposed by Section 1352,Title 31,U.S.Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts,which exceed$100,000 and that all such subrecipients shall certify and disclose accordingly. Page 6 of 8 C-20 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C.1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: lr I a. contract ® a. bid/offer/application IZI a. initial b. grant b. initial award b. material change c. cooperative agreement c. post-award d. loan For Material Change Only: e. loan guarantee year quarter f. loan insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No.4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee ��jpp��®®1A'f► r1A♦ �A�p�r�f► Tier ,ifknown s AUP W.DGA PAMG CMPM LOW SFACH, L:A9M Congressional District,if known Congressional District,if known 6. Federal Department/Agency: 7, Federal Program Name/Description: CFDA Number,if applicable 8. Federal Action Number,if known: 9. Award Amount,if known: 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual,last name,first name,MI) address if different from No.I Oa) (last name,first name,MI) (attach Continuation Sheet(s)if necessary) 11. Amount of Payment(check all that apply) 13. Type of Payment(check all that apply) S actual planned a. retainer b. one-time fee 12. Form of Payment(check all that apply): c. commission 8 a. cash d. contingent fee b. in-kind; specify: nature e deferred P f1'� value f: other,specify 14. Brief Description of Services Performed or to be performed and Date(s)of Service,including officer(s),employee(s),or member(s)contacted,for Payment Indicated in Item 11: (attach Continuation Sheets)if necessary) 15. Continuation Sheet(s)attached: Yes No 16. Information requested through this form is authorized by (, Title 31 U.S.C.Section 1352. This disclosure of lobbying Signature: reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required print Name: C-P. WWN1 PRESIDENT pursuant to 31 U.S.C.1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required Title: disclosure shall be subject to a civil penalty of not less than i r) 599-584 t $10,000 and not more than$100,000 for each such failure. Telephone No.: Date: Authorized for Local Reproduction Federal Use Only: Standard I;orm-LLL Standard Form LLL Rev.09-12-97 Page 7of8 C-21 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING AC'FIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient,at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C.section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which-the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name,address,city,state and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to he a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks"Subawardee"then enter the full name,address,city,state and zip code of the prime Federal recipient. Include Congressional District,if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name,if known. For example,Department of Transportation,United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action(item 1). If known,enter the full Catalog of Federal Domestic Assistance(CFDA)number for grants,cooperative agreements,loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item I(e.g., Request for Proposal(RFP)number,Invitation for Bid(IFB)number,grant announcement number,the contract grant.or loan award number,the application/proposal control number assigned by the Federal agency), Include prefixes,e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency,enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a)Enter the full name,address,city,state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b)Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last Name,First Name and Middle Initial(MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4)to the lobbying entity(item 10). Indicate whether the payment has been made(actual)or will be made(planned). Check all boxes that apply. If this is a material change report,enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box. Check all boxes that apply. If payment is made through an in-kind contribution,specify the nature and value of the in-kind payment. 13. Check the appropriate box. Check all boxes that apply. If other,specify nature. 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officers)or employee(s)contacted or the officer(s)employee(s)or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s)is attached. 16. The certifying official shall sign and date the form,print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response,including time for reviewing instruction,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project (0348-0046),Washington,D.C.20503. SP-LLL-Inst—iam R�.ov-on-9oaaxng» Page 8 of 8 C-22 June 11,2014 EXHIBIT 15-G Local Assistance Procedures Manual Local Agency Bidder DBE Commitment(Construction Contracts) INSTRUCTIONS-LOCAL AGENCY BIDDER DBE COMMITMENT(CONSTRUCTION CONTRACTS) ALL BIDDERS: PLEASE NOTE: This information may be submitted with your bid.If it is not,and you are the apparent low bidder or the second or third low bidder,it must submitted and received as specified in the Special Provisions.Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract:Local Agency,Location,Project Description,Total Contract Amount,Bid Date,Bidder's Name,and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs.Prime contractors shall indicate all work to be performed by DBEs including,if the prime is a DBE,work performed by its own forces,if a DBE.The DBE shall provide a certification number to the Contractor and expiration date.Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work(who must be certified on the date bids are opened and include the DBE address and phone number). 11VIPORTANT: Identify all DBE firms participating in the project regardless of tier.Names of the First-Tier DBE Subcontractors and their respective item(s)of work listed should be consistent,where applicable, with the names and items of work in the"List of Subcontractors"submitted with your bid. There is a column for the DBE participation dollar amount.Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions.(If 100%of item is not to be performed or furnished by the DBE,describe exact portion of time to be performed or furnished by the DBE.)See Section "Disadvantaged Business Enterprise(DBE),"of the Special Provisions(construction contracts),to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated by the person bidding.Also list a phone number in the space provided and print the name of the person to contact. LOCaI agencies should complete the Local Agency Contract Award,Federal-aid Project Number, Federal Share,Contract Award Date fields and verify that all information is complete and accurate before signing and filing. Page 15-2 June 29,2012 C-24 OB 12-04 M�- JAI vs 1.3 An �20 LP '° o a o t f I I { { j I I j l i .f II Y 4. 00 .0 .0 g, r- =0 go r- 0 0 0 .0 g- 0 0 0 gs� Pw 0 u El E 5 .— .— .— = = po par F! E vi i C E kn. �o kn in C) IvnI w) C> kr, kn rv),Zoq v� os 6,1� 169 41) fA) fill) to Z,� 6 6 V".IV V V A IE1 EEII ED]El El NP F V V V A V V V A V V V V 'A 4 PR: br o 4) 2 ed 6 co r ts tl ?Z Er w Z, cc go fq cl .......... pq � z ~ � 3 li ! I ! ` ji � il ' lii A Az ID C7 a r- CA 0 0 0 z 0 0 0 r. r. 0 0 0 G Z- 0 0 0 .0 ..0 0 0 2 cul V E E 0 E E d) kn Inkn C> Wn W) cadtr) &9� 64 to , *;; , -; (,;; (;� Z; (;;Z;fe 6 6s�� f �69 Frs .0 .0 V V V A V v v V A r V V V V A = V V V V A r -1 El El D n DE]EIIIE]l El 0 El qq. Q. Q� cr 4) bo -6 — E < vj C'S 4 &4 Ld bo ID N o =�-- r � � --- a Y ti - � C m _ - L p i O f cX I ; if +� 111i Ij ° .� ... � : I � � , ; ► � I � i { � III W II I q o = ldPC o lu � G :A ; ! 1i } IiIII IiIII I ' �. z by N s t a O O u Or .F N t% Py u 0 O: C C G C C C C C Q C g C S U Lr. .e.. 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V V V A v v V A V V V A ETIODS111-Y 0 Ell ❑ cr 0 A4 ZZ, L4 iz %4 tw oj _3 Bond No. Bid Bond BID BOND The American Institute of Architects, AIA Document No.A310(February, 1970 Edition) KNOW ALL MEN BY THESE PRESENTS,that we PALP Inc.dba Excel Paving Company _ as Principal hereinafter called the Principal,and Federal Insurance Company a corporation duly organized under the laws of the state of Indiana as Surety, hereinafter called the Surety, are held and firmly bound unto City of Huntington Beach as Obligee,hereinafter called the Obligee,in the sum Of Ten percent of the total amount of the 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 Edinger Avenue Rehab(1516) NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material famished in the prosecution thereof, or in the event of the failure of the Principal to enter such 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 5th day of December 2016 �� C 1(Vdi i �1 A �_/ PALP Inc.dba Excel Paving Company ��ll Principal (Seal) Witness !1t=RF1:F F. DRAKULiCH, ASST_ SECRETARY By. C-PQ AW,PREP RENT Namerritle erallnsurance— Co p S ) Witness By- - mothy D.Rapp Attorney-in-Fact ORSC 21328(3/97) ACKNOWLEDGMENT State of California County of Orange ) On December 5, 2016 before me, Debra Swanson, Notary Public (insert name and title of the officer) personally appeared Timothy D. Rapp who proved to me on the basis of satisfactory evidence to be the person($)whose name($) isEefe subscribed to the within instrument and acknowledged to me that he/ehe*l"y executed the same in hisl4e4+he*authorized capacity(*&& , and that by hiss signature(of)on the instrument the person(8), or the entity upon behalf of which the person(o)acted, executed the instrument. certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. DEBRA'S ANSON N a COMM.#2170759 X w ; NOTARY PUBLIC•CAUFORNIA N ORANGE COUNTY N i °.,u MY COMM.EXP.NOV 10,2020 Signature (Seal) Chubb POWER Federal Insurance Company Attn: Surety Department OF Vigilant Insurance Company 15 Mountain View Road Surety ATTORNEY Pacific Indemnity Company Warren, NJ 07059 oHUBe Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and appoint Douglas A. Rapp and Timothy D. Rapp of Aliso Viejo, California---------------------------------------------------------- each as their true and lawful Attorney-in-Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or otherwise,bonds and undertakings and other writings obligatory in the nature thereof(other than bail bonds)given or executed in the course of business,and any instruments amending or altering the same,and consents to the modification or alteration of any instrument referred to in said bonds or obligations. In Witness Whereof,said FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and affixed their corporate seals on this 16th day of December,2011. Kenneth C-Wendel,Assistant Secretary .N�Vic-e, , nt STATE OF NEW JERSEY County of Somerset ss. On this 16th day of December, 2011 before me,a Notary Public of New Jersey,personally came Kenneth C.Wendel,to me known to be Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which executed the foregoing Power of Attorney, and the said Kenneth C. Wendel, being by me duly sworn, did depose and say that he is Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof, that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of the By-Laws of said Companies;and that he signed said Power of Attomey as Assistant Secretary of said Companies by like authority;and that he is acquainted with David B.Norris,Jr.,and knows him to be Vice President of said Companies;and that the signature of David B.Norris,Jr.,subscribed to said Power of Attorney is in the genuine handwriting of David B.Norris, Jr.,and was thereto subscribed by authority of said By- Laws and in deponent's presence. Notanal Seal KATHERINE J.ADELAAR�.ADc j��,, y9� NOTARY PUBLIC NEW JFkSFI aRY l N�,231116 5685 Cor"ittion Expires July 16,2014 PV �� Notary Public CERTIFICATION Extract from the By-Laws of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY: "All powers of attorney for and on behalf of the Company may and shall be executed in the name and on behalf of the Company,either by the Chairman or the President or a Vice President or an Assistant Vice President,jointly with the Secretary or an Assistant Secretary, under their respective designations. The signature of such officers may be engraved,printed or lithographed.The signature of each of the following officers:Chairman,President,any Vice President,any Assistant Vice President, any Secretary, any Assistant Secretary and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached." I,Kenneth C.Wendel,Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY (the"Companies")do hereby certify that (i) the foregoing extract of the By-Laws of the Companies is true and correct, (ii) the Companies are duly licensed and authorized to transact surety business in all 50 of the United States of America and the District of Columbia and are authorized by the U.S.Treasury Department;further,Federal and Vigilant are licensed in Puerto Rico and the U.S.Virgin Islands,and Federal is licensed in American Samoa,Guam,and each of the Provinces of Canada except Prince Edward Island;and (iii) the foregoing Power of Attorney is true,correct and in full force and effect. Given under my hand and seals of said Companies at Warren,NJ this 5th day of December,2016 P CC yp114 `��1r1e•NC�„ �'DIANP hr qfr' SEW Kenneth C.We el,Assistant Secretary IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM,VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER, PLEASE CONTACT US AT ADDRESS LISTED ABOVE,OR BY Telephone(908)903-3493 Fax(908)903-3656 e-mail: surety@chubb.com Form 15-10-0225B-U (Ed.5-03) CONSENT } CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California r Angeles Los An County of 9 On DEC' 2 U L016 before me, C. Phillips, Notary Public ,Notary Public, (Here insert name and title of the officer) personally appeared C. P. Brown and Michele E. Drakulich who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s)Kare subscribed to the within instrument and acknowledged to me that l C*Vthey executed the same in IA/b)4/their authorized capacity(ies), and that by IW/b)K/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. °.N. 0,PHILLIPS r' COMM,#2170177 y NoWry Publlo•Callfornla P" LOS ANnELES COUNTY U- S igriature of Notary Public (Notary Seal) •4NONM N My Comm,Ezplres Oct 29,2020 i ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly as DESCRIPTION OF THE ATTACHED DOCUMENT appears above in the notary section or a separate acknowledgment form must be properly completed and attached to that document. The only exception is if a document is to be recorded outside of California.In such instances,any alternative 1 acknowledgment verbiage as may be printed on such a document so long as the (Title or description of attached document) verbiage does not require the notary to do something that is illegal for a notary in California (i.e. certifying the authorized capacity of the signer). Please check the (Title or description of attached document continued) document carefully for proper notarial wording and attach this form if required. • State and County information must be the State and County where the document Number of Pages Document Date signer(s)personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s)personally appeared which must also be the same date the acknowledgment is completed. (Additional information) • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title(notary public). • Print the name(s) of document signer(s)who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms(i.e. ❑ Individual(s) he/she/they,is/are)or circling the correct forms.Failure to correctly indicate this information may lead to rejection of document recording. ❑ Corporate Officer 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 (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 ti 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). f • Securely attach this document to the signed document l l C 2004-2015 ProLink Signing Service,Inc.-All Rights Reserved www.TheProLinkcom-Nationwide Notary Service City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov Office of the City Clerk Robin Estanislau, City Clerk April 6, 2017 Hardy & Harper, Inc. 1312 E. Warner Ave. Santa Ana, CA 92705 Re: Edinger Avenue Rehabilitation —CC-1516 The City Council awarded the bid to your company for the above referenced project. Enclosed is a copy of the executed contract with the City of Huntington Beach. A Certification of Compliance with Title VII of the Civil Rights Act, Certification of Compliance with Prevailing Wage Laws and Contractor's Certificate form must be returned to this office after the project is completed but prior to the release of retention funds. In addition, the following item must also be on file, with this office before the City can release any retention funds: A warranty bond guaranteeing the final amount of work and materials for one year. If your performance bond does not include specific wording for a one-year warranty, then a rider or separate bond must be submitted. Should you have any questions or concerns regarding the enclosures or items that must be on file in this office prior to release of retention funds, please call the Public Works Department at 536-5517. Sincerely, Cs �&4vdjltu) Robin Estanislau, CIVIC City Clerk RE:pe Enclosures: Copy of Contract including Proposal Copies of insurance/bonds Bid Bond (original) Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand N � °4 F 00 V 'r _ :o ca N LO C) +� V > O U ro � v Cam U . . c u +• +j j r ,__• S m V p U p CV m 'iz bm . L a G v m o ro N Ul N rG m L C ro O O� 4- N N M ci O Qj t N (u ro > — t < m N i � N � ro Q � � � cz Z 0 ++ U U w U) Ln v m ro ro d C ai Z CD a O U) L City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For EDINGER AVENUE REHABILITATION AND WARNER AVENUE REHABILITATION CC No. 1516 Federal Aid Project STPL-5181(189) in the CITY OF HUNTINGTON BEACH December 12, 2016 Notice To All Bidders.- Please note the following clarification to the.Project Plans, Specifications, and Special Provisions: 1) PROJECT BID SCHEDULE—Section C Specification Book (2 Sheets) Replace "Project Bid Schedule—C-2.3" with "Project Bid Schedule—C-2.3 Addendum 1" (1 sheet). Bid items 1, 2, 3 and 4 descriptions were shortened. Replace "Project Bid Schedule—C-2.9" with "Project Bid Schedule—C-2.9 Addendum 1" (1 sheet). Bid items 1, 2, 3 and 4 descriptions were shortened. 2) APPENDIX H —Appendix H Part 2 Specification Book(27 Sheets) Replace Cover Sheet (1 sheet) and "General Decision Number CA160035 10/28/2016" with "General Decision Number CA 160035 11/11/2016" (26 sheets). Federal Construction Wage Rates were updated on 11/11/2016. This is to acknowledge receipt and review of Addendum N r e, dated December 12 2016. HQrdl i NarM Inc Company Naryie ny 1421t(o Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call James Wagner at(714) 536-5467 within 24 hours of posting. Dec 20 2016 12:35PM Huntington Beach PW 7145365204 page 1 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431 , Fax (714) 374-1573 ADDENDUM NUMBER TWO For EDINGER AVENUE REHABILITATION AND WARNER AVENUE REHABILITATION CC No. 1516 Federal Aid Project S7PL-5181(189) in the CITY OF HUNTINGTON BEACH December 20,2016 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) BID OPENING POSTPONED REVISED BID DUE DATE ON COVER AND ON PAGE A-1 FROM "DECEMBER 20,2016" to"DECEMBER 29, 2016." 2) ASPHALT CONCRETE CLARIFICATION REVISED SHEET E-23 and E-241N SPECIFICATION BOOK— 203 BITUMINOUS MATERIALS (2 Sheets) Replace E-23 with "E-23 CC-1516, Addendum 2" (1 sheet) And Replace Page E-24 with "E-24 CC-1616, Addendum 2" (1 sheet) This is to acknowledge receipt and review of Addendum Number T , dated December 20 2016. H ard� T' harper, m r" Company Name y ��P/`(P/ YSGI(1n�,t -VICE fflTn IZ'21J1W Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call James Wagner at(714) 536-5467 within 24 hours of posting. 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%of Amountwhich said amount is not less than 10%of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids,payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond forto% ", as the case may be) Any standard Surety Bid Bond forms is acceptable. Bidder shall signify receipt of all Addenda here, if any: Addenda No. bate Received. ,. '- Bid s i .:'afore . 12 %2- Ib 2 12 120/1 p C-2 SECTION C PROJECT BID SCHEDULE EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET AND WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 FEDERAL AID PROJECT STPL-5181(184) in the PROJECT BASE BID: Basis of Award EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET. . . . . . . . . . . .... . . .. .. . . . . . . . . . . . . ... ..C-2.2 to C-2.7 WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET. . . . . . . . . .. .. . .. . . . . . . . . .. ... .. .... . . . C-2.8 TO C2.12 1.EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET BID IN FIGURES 2. WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET � �1 � 1r� 000, 00 BID IN FIGURES BASE BID TOTAL AMOUNT LUMP SUM BID IN FIGURES: (TOTAL FOR ITEMS 1 AND 2) $ 9 4111060 - 80 BASIS OF AWARD C-21 SECTION C PROJECT BID SCHEDULE EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET AND WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 FEDERAL AID PROJECT STPL-5181(189) EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET CC NO. 1516 C-z.2 Addendum 1, CC-1516 Replacement Page C-2.3 EDINGER (GRAHAM-SPRINGDALE) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount 30,000� a0 1 -- MOBILIZATION 1 LS $^.0 000-00�r$K 2 -- TRAFFIC CONTROL PLAN 1 LS $ S,000.00 $ 5,.Q(l0.00 3 FURNISH PROJECT TRAFFIC 1 LS $ Z� ,000.01) $364 ;(Zd-Qd CONTROL 4 - FURNISH AND INSTALL SIGNING 1 LS $ ZI,600-00 $ 21; 000•00 AND STRIPING 5 - - PROJECT SPECIFIC SWPPP 1 LS $ I,23Lj.00 $ S j-L 4 OQ_ REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB, AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). (INCLUDES ALL 6 1 APPURTENANCES, CURB 3 EA $ Q i L00.0 0 $ I 00. 40 GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) CONSTRUCT 0.1 T ASPHALT 7 3 RUBBER HOT MIX (ARHM)WET 2,200 TN $(0 q • (0"I $ '53 31�.0 0 PROCESS OVERLAY. �- $ 4 JADJUST GRADE SEWER MANHOLE TO 6 EA $OQ.00 �{A Q U ,Q o 9 INTENTIONALLY LEFT BLANK REPLACE WATER VALVE BOX Q 10 6 ASSEMBLY AND ADJUST TO 11 EA $ 40Q• 00 $ $ 1000.U6 GRADE PER HB STD PLAN 612. 11 INTENTIONALLY LEFT BLANK C-2.3 CC-1516, Addendum 1 EDINGER (GRAHAM-SPRINGDALE) PROJECT BID SHEET Bid Const Contract ! Unit Extended No. No. Description Quantity Unit Price Amount i COLD MILL EXISTING A.C. 12 7 PAVEMENT TO A DEPTH OF 0.34' 158,200 SF $ `� �a�1 FROM NEW FINISHED SURFACE $ PER PLANS. COLD MILL EXISTING A.C. 13 g PAVEMENT TO A DEPTH OF 0.67' 8 800 SF FROM NEW FINISHED SURFACE PER PLANS. CONSTRUCT NEW OAT AND 0.50'B-PG-70-10-RAP A.C. BASE COURSE OVER 95% 14 7& 8 2,400 TN $ ��• $ 1�j�,l Z COMPACTED SUBGRADE PRIOR — - TO 0.17'ARHM OVERLAY PER PLANS. 15 INTENTIONALLY LEFT BLANK SET SURVEY MONUMENTATION 16 9 AND PREPARE CORNER 2 EA $ j.()QQ. RECORD (PRE-AND/OR POST- CONSTRUCTION)- REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202 (CF=8"). (INCLUDES 17 10 SLOT PAVEMENT,AGGREGATE 1,580 LF $ 5 3.3 0 $8 40. 00 BASE, LOT DRAINS,AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) C-2.4 EDINGER (GRAHAM-SPRI NG DALE) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE-GRAD FROM WALK TO EXISTING f 18 11 SLOPE, RELOCATING 6,600 SF $ $ �,�Sd IRRIGATION TO BACK OF NEW ° WALK, RETURNING LANDSCAPING TO PRE- CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT COMMERCIAL/RESIDENTIAL DRIVEWAY("W"AND TYPE 19 12 SHOWN ON PLAN)PER STD 1,330 SF $ ��' $ ®_ PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO GRADE. 20 INTENTIONALLY LEFT BLANK 21 INTENTIONALLY LEFT BLANK INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC ,,ll 22 13 SIGNALS AND LIGHTING 24 EA $ SYSTEMS, 2005 EDITION, SPLICE LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE"D". REMOVE EXISTING TREE AND ROOTS; GRIND TREE STUMP 23 14 AND ROOTS TO 24" BELOW TOP — 00 20 EA $ OF SIDEWALK l GRADE WITHIN PROPOSEDIMPROVEMENT AREA. C-2.5 EDINGER (GRAHAM-SP RING DALE) PROJECT BID SHEET Bid_Const Contract Unit f Extended No. No. Description Quantity Unit Price Amount FURNISH LABOR, EQUIPMENT, AND GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED 24 15 BY AGENCY. (INCLUDES ALL 2,500 SF $ 160 ® $ 3, 5®•613 ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C.AND OVER EXCAVATION BID PAY ITEMS.) OVER EXCAVATION WHEN 25 16 IDENTIFIED BY CONTRACTOR 90 CY $ 4•(7 0 $ e g y 0 AND VERIFIED BY AGENCY, ADJUST EDISON VAULT/MANHOLE TO GRADE BY 26 17 EDISON. CONTRACTOR TO 4 EA NOT A CONTRACTOR BID ITEM COORDINATE WITH ERICK OEN AT(714) 895-0242. 27 INTENTIONALLY LEFT BLANK ADJUST OCSD MANHOLE TO GRADE PER OCSD STD_ PLAN S- 28 18 053, S-054 AND S-055. 9 EA $ q00,60 $ —1 a10a 10 0 CONTRACTOR TO COORDINATE WITH MIKE BOLSTER AT(714) 593-7645. 29 INTENTIONALLY LEFT BLANK C-2.6 EDINGER (GRAHAM-SPRINGDALE) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount FURNISH AND PLANT NEW 24" BOX EASTERN REDBUD TREE PER HB STD. PLANS 714,715, 716, 718&719 AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF EXISTING LANDSCAPING, 30 19 BUSHES OR GROUND COVER 20 EA AND IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE,- REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). FURNISH AND INSTALL ZEBRON, SANCON OR CITY APPROVED 31 -- EQUAL COATING ON THE NEW 3 EA $ Z i5O O. O $ CONCRETE INSIDE OF AGENCY SEWER MANHOLE RING_ Total Amount Bid in Figures: $ ®, Total Amount Bid in Words: C-2.7 SECTION C PROJECT BID SCHEDULE EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET AND WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLANN.D STREET CC NO. 1516 FEDERAL AID PROJECT STPL-5181(189) WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 C-2.8 Addendum 1, CC-1516 Replacement Page C-2.9 WARNER (BEACH BLVD. TO NEWLAND) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount 1 -- MOBILIZATION 1 LS $ � 2 -- TRAFFIC CONTROL PLAN 1 LS $ nO O. d $S,n�D• DO 3 FURNISH PROJECT TRAFFIC 1 LS $ ?361 OD $�''�jG( ,OOP dD CONTROL 4 FURNISH AND INSTALL SIGNING 1 LS $ 31/, /)O fJ6 $ 3d 6t)O.6D AND STRIPING 5 -- PROJECT SPECIFIC SWPPP 1 LS $ (p q�. O0 $ 1Q�1(p Od REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB, AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). 6 1 (INCLUDES ALL 9 EA $ U.Z Ord [) $ -�.. •r�� _ APPURTENANCES, CURB GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) CONSTRUCT 0.17'ASPHALT 7 3 RUBBER HOT MIX (ARHM)WET 3,000 TN $ �Q�(•� $ Q.60 PROCESS OVERLAY. 8 4 ADJUST SEWER MANHOLE TO 9 EA $ GRADE. 9 5 ADJUST STORM DRAIN 2 EA $ OO.00 $1 U88 .60 MANHOLE TO GRADE. REPLACE WATER VALVE BOX 10 6 ASSEMBLY AND ADJUST TO 49 EA $ �bb.00 $ GRADE PER HB STD PLAN 612. COLD MILL EXISTING A.C. 'l 11 7 PAVEMENT TO A DEPTH OF 0.17' 53,000 SF $ $ �{ 'U� OC) FROM NEW FINISHED SURFACE PER PLANS. COLD MILL EXISTING A.C. 12 8 PAVEMENT TO A DEPTH OF 0.34' 157,000 SF $�. _ FROM NEW FINISHED SURFACE — PER PLANS. C-2.9 CC-1516, Addendum 1 WARNER (BEACH BLVD_ TO NEWLAND) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description: Quantity Unit Price Amount COLD MILL EXISTING A.C. �3 9 PAVEMENT TO A DEPTH OF 0.67' 20,100 SF $ d - $l�o L�Q O FROM NEW FINISHED SURFACE PER PLANS. CONSTRUCT NEW 0.17' ,AND 0.50'B-PG-70-10-RAP A.C. BASE 14 8 & 9 COURSE OVER 95% 2,850 TN $ _t�3 __ _ $ ®�' '� � Q �►� COMPACTED SUBGRADE PRIOR - TO 0.17'ARHM OVERLAY PER PLANS. J RAISE SURVEY WELL MONUMENT TO GRADE AND 15 10 PREPARE CORNER RECORD 2 EA $ $?`o(}Q®•®� (PRE-AND/OR POST- CONSTRUCTION). SET SURVEY MONUMENTATION 16 11 AND PREPARE CORNER 8 $ , RECORD(PRE-AND/OR POST- CONSTRUCTION). REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202 (CF=8"). (INCLUDES SLOT PAVEMENT,AGGREGATE 17 12 BASE, LOT DRAINS,AND ALL 200 LF $ ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE-GRAD FROM WALK TO EXISTING G 18 13 SLOPE, RELOCATING 3,750 SF IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE- CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE. C-2.10 WARNER (BEACH BLVD. TO NEWLAND) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount REMOVE AND RECONSTRUCT COMMERCIAL/RESIDENTIAL DRIVEWAY ("W"AND TYPE 19 14 SHOWN ON PLAN) PER STD 1,600 SF $ L PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO GRADE, REMOVE AND RECONSTRUCT CONCRETE CURB AND CROSS GUTTER PER HB STD. PLAN 205. 20 15 (ITEM INCLUDES SLOT 3,500 SF $ 45b PAVEMENT,AGGREGATE BASE AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT MEDIAN CURB AND GUTTER PER HB STD PLAN 201 (CF=8"). 21 16 (INCLUDES SLOT PAVEMENT, 110 LF AGGREGATE BASE, LOT DRAINS,AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC 22 17 SIGNALS AND LIGHTING 58 EA $�-����� $ SYSTEMS, 2005 EDITION. SPLICE LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE"D" REMOVE EXISTING TREE AND ROOTS;GRIND TREE STUMP 23 18 AND ROOTS TO 24"BELOW TOP 4 EA $ OF SIDEWALK/GRADE WITHIN PROPOSEDIMPROVEMENT AREA. C-2.11 WARNER (BEACH BLVD. TO NEWLAND) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount FURNISH LABOR, EQUIPMENT, AND GEOGRiD FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED BY AGENCY. (INCLUDES ALL 24 19 ITEMS NECESSARY TO 2,500 SF $ l ?� $ 3 s � �• COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C.AND OVER EXCAVATION BID PAY ITEMS.) OVER EXCAVATION WHEN 25 20 IDENTIFIED BY CONTRACTOR 90 CY AND VERIFIED BY AGENCY. ADJUST EDISON VAULT/MANHOLE TO GRADE BY 26 21 EDISON. CONTRACTOR TO 1 EA NOT A CONTRACTOR BID ITEM COORDINATE WITH ERICK OEN AT(714)895-0242. ADJUST VERIZON VAULT/MANHOLE TO GRADE BY 27 22 VERIZON. CONTRACTOR TO 1 EA NOTA CONTRACTOR BID ITEM COORDINATE WITH RAY ROUNDTREE AT(714) 375-6760. ADJUST OCSO MANHOLE TO GRADE PER OCSD STD. PLAN S- 2$ 23 053, S-054 AND S-055. 1 EA $ u' u� $ 2 DD CONTRACTOR TO COORDINATE WITH MIKE BOLSTER AT(714) 593-7645. 29 24 ADJUST MONITORING WELL 5 EA F $ , 60(��� COVER TO GRADE. �r 30 INTENTIONALLY LEFT BLANK FURNISH AND INSTALL ZEBRON, SANCON OR CITY APPROVED ,,�` 31 -- EQUAL COATING ON THE NEW 4 EA $1,i5 b0 ,®® $ 1b 06 CONCRETE INSIDE OF AGENCY SEWER MANHOLE RING. Total Amount Bid in Figures: $ ®(� Total Amount Bid in Words:_ C-2.12 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Bid. Nirnxe an,dAddress of State Class: DIR. Dollar °10 of Item(s) Subcontractor. License. Number Amount Contract Number LA (A IV6 ' (A 'f(ahQ ULCe, r v ��3u �.`►�=���tfA l r���F�,r� �.-1� i��G��i��u v,�luu,ua �%,^I,2. LV VRr -4 'all �3a4 tuuJai�j1 p_Liq L`), 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 12/9/16, at Santa Ana CA Date City State Steve Kirschner , being first duly sworn, deposes and says that he or she is Vice President of Hardy&Harper,Inc the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a share 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. Hardy&Harper,Inc Name o idder Signature of Bidder Steve Kirschner-Vice President 1312 E.Warner Ave.,Santa Ana,CA 92705 Address of Bidder C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract,known as the Edinger Avenue Rehabilitation from Graham Street to Springdale Street and Warner Avenue Rehabilitation Beach Boulevard to Newland Street,Project CC No. 1516,(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 S,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. Hardy&Harper,Inc Con tr r i By Steve Kirschner-Vice Presidient Title Date: 12/9/16 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. 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 l 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. Hardy&Harper,Inc Contrac r By Steve Kirschner-Vice President Title Date: 12/9/16 C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Hardy&Harper,Inc Bidder Name 1312 East Warner Ave. Business Address Santa Ana CA 92705 City, State Zip ( 714 ) 444-1851 Telephone Number 215952;A,C-8,C12 State Contractor's License No. and Class 3/13/63 Original Date Issued 12/31/17 Expiration Date The work site was inspected by Corey Kirschner of our office on December 8th 2016 . The following are persons, firms, and corporations having a principal interest in this proposal: Fred T.Maas,Jr-President,Treasurer Dan T.Maas-CEO Steve Kirschner-Vice President Kristen S.Paulino-Secretary The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. HardX&Harper,Inc o any Na Signature of Bidder Steve Kirschner-Vice President Printed or Typed Signature Subscribed and sworn to before me this_day of ,201_ NOTARY PUBLIC NOTARY SEAL C-8 CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE §8202 �����::Y'rif:�C�`c:S?t:�`�1tY'�:`.c�C'.s�C:xzs^�f��' 1s;C•�:5`r:-�c,t�'t�,,��s<:t�,�Y`,�t�cac`..czsx ?t C`s;(��Y,�'� ,,.c.r;2 ....,,'F ,,.,<':,, .. ❑See Attached Document (Notary to cross out lines 1-6 below) ❑See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) — - - - ---- — - ------ -Signature of of Document Signer No. 1 Signature of Document Signer No. 2(if any) A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy, or validity of that document. State of California Subscribed and sworn to (or affirmed) before me County of -, _ Orange on this i 9 _ day of_ December , 20-_ 16 by Date Month Year 7Notary ,E.. ,M1HAM�• 149384 N (and (2)_'~�'<. c-California '� COUNTY a Name(�Of Signer( M' s Apr 17,2020 proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. Signature ---- Signature of Notary Public Seal Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Bidder's Information - Document Date: December 9_20�i Number of Pages: � Signer(s)Other Than Named Above: None 02014 National Notary Association •www.NationaiNotary.org• 1-800-US NOTARY(1-800-876-6827) Item#5910 Bidder's Project History For the purposes of this project; the bidder shall provide project history of similar work, specifically referencing the construction of{Describe specific work and experience necessary for project. For example, "Sanitary sewer line installation of at least of 1,000 of 8-inch and greater in public right-of-way. Sanitary sewer lift stations of similar size, project work within public streets, an area containing! hil4h ground water and pipeline construction in high ground water regions with trench depths of 8-feet to the invert."}. Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: l• ��i SP,P/ Qtlt�(',h rl'1PXlt '��" Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 2. Name and Address of Public Agency Name and Telephone No.of Project Manager: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 3. Name and Address of Public Agency Name and Telephone No.of Project Manager: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: C-9 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. l Mike Amundson Name of proposed Project Manager Telephone No. of proposed Project Manager: 714-444-1851 Schleisman Rd Overlay $333,333.00 Road Overlay work 8/15 Project Name & Contract Amount Type of Work Date Completed Minor Street Maintenance Phase 1 $1,543,000.00 Street Maintenance _ 4/14 Project Name &Contract Amount Type of Work Date Completed Phase 3 Street Rehab$1,075,484.00 Street Rehabilitation 6/14 Project Name&Contract Amount Type of Work Date Completed Z, Dennis Beyle Name of proposed Superintendent Telephone No. of proposed Superintendent: 714-444-1851 Street Improvement&Main Street Bridge Rehab $1,188,570.00 Street Improve_men_t_ 1/15 Project Name&Contract Amount Type of Work Date Completed Foothill Blvd Pavement Rehabilitation S1 076 200 00 Pavement Rehabilitation 11/15 Project Name& Contract Amount Type of Work Date Completed Street Resurfacing Project $1,187,987.00 Resurfacing Project 12/14 Project Name &Contract Amount Type of Work Date Completed C-10 PUBLIC WORKS REFERENCES Attachment A 2015/2016 Owner/Agency Contact Project (Amount & Completion Date) City of Pasadena Richard Yee Preventitive Maintenance 100 N Garfield Ave (626) 744-4643 Street FEDERAL ID NO. Pasadena, CA 92570 STPL-5064(081) $1,518,231.24 8/15 City of Covina Natalie Avila Resurfacing of Streets at 125 E. College Street (626) 384-5400 Hollenbeck Ave, Cypress St. Covina, CA 91723-2199 RAvila covinaca.gov $624,297.95 8/15 City of Laguna Niguel Frank Borges St. Christopher Neighborhoods 30111 Crown Valley Parkway (949) 362-4325 & Via Vetti Pavement Rehab Laguna Niguel, CA 92677 FBorges(d).cityoflagunaniguel.org Improvement No. 15-02 $1,226,861.00 9/15 City of Norco Bill Thomas FY 2015-16 Annual Minor 2870 Clark Ave (951) 735-3900 Street Rehabilitation Phase I Norco, CA 92860 $777,000.00 10/15 City of Walnut Natalie Avila, P.E Area 1 & 2 Street 21201 La Puente Rd. (909) 594-9702, Ext. 315 Resurfacing Project Walnut, CA 91789 navila(a rkagroup.com $1,077,000.00 11/15 City of Rancho Cucamonga Romeo David Foothill Blvd Pavement 10500 Civic Center Drive (909)477-2740 Rehabilitation Rancho Cucamonga, CA 91730 Romeo.David a.citvofrc.us $1,076,200.00 11/15 City of Norco Bill Thomas FY 2015-16 Annual Minor 2870 Clark Ave (951) 735-3900 Street Rehabilitation Phase 11 Norco, CA 92860 $547,000.00 11/15 City of Simi Valley Fuad Shamout, P.E FY 2015-16 Annual Minor 2929 Tapo Canyon Road (805) 583-6788 Street Rehabilitation Simi Valley, CA 93063 FShamout a)simivalley.orq $1 ,213,960.50 11/15 PUBLIC WORKS REFERENCES Attachment A 2015/2016 Owner/Agency Contact Project's Info City of Redondo Beach Lauren Sablan, P.E Aviation Blvd Resurfacing 415 Diamond Street (310) 318-0661 Project Redondo Beach, CA 90277 Lauren.Sablan(apredondo.org $367,293.00 12/15 City of Palm Desert Bo Chen, P.E Portola Ave STP Rehabilitation 73-510 Fred Waring Drive (310) 370-5099 Project Palm Desert, CA 92260 bochen(a7cityofpalmdesert.org $639,204.74 2/16 City of Lake Elsinore Ken Rukavina FY 15-16 Citywide Pavement 130 South Main Street (951) 674-3124 Rehab Phase 5 Lake Elsinore, CA 92530 krukavinaplake-elsinore.org $560,736.74 2/16 City of Lake Elsinore Ken Rukavina FY 15-16 Citywide Pavement 130 South Main Street (951) 674-3124 Rehab Phase 4 Lake Elsinore, CA 92530 krukavina@lake-elsinore.org $895,665.91 3/16 City of Colton Jess Sotto FY 15-16 Asphalt Paving 650 N. La Cadena Drive (909) 370-5099 Project Colton, CA 92324 JSotto ,coltonca.gov $1,569,242.84 4/16 City of Pasadena Sean Singletary Preventitive Maintenance of 100 N. Garfield Ave (626) 744-4273 Streets 2015 Pasadena, CA91109 ssingleta a7cityofpasadena.net $1 ,182,829.46 4/6/16 City of Westminster Tuan Pham Citywide Street Improvement 8200 Westminster Blvd (714) 898-3311 For Various Residential Streets Westminster, CA 92683 tpham(c7westminster-ca.gov $679,108.61 5/16 City of Arcadia Jan Balanay Pavement Rehab Program 240 West Huntington Dr (626) 256-6582 Camino Real Ave & 6th Ave Arcadia, CA 91066 ibalanayCd).arcadiaca.gov Project # 33854016 $632,386.21 7/16 City of Fontana Ticha Loera Pavement Rehab of Slover Ave 8353 Sierra Ave (909) 350-6696 From Mulberry Ave to Cherry Fontana, CA 92335 tloera fontana.org Ave $1,313,161 .86 8/16 City of La Canada Flintridge Greg Kwolek 2016 Citywide Street 1327 Foothill Blvd (818) 790-8880 Resurfacing La Canada Flintridge, CA 91011 gkwolek(a7lcf.ca.gov $1,084,562.67 8/16 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/SB854FactShect 6.30.14.pdf DIR's Contractor Registration Link—Call(844) 522-6734 https:Hefiling.dir.ca.gov/PW CR/ActionSmlet?action--displayP W CRegistrationFon-n 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. Hardy&Harper,Inc Contrac r By Steve Kirschner-Vice President Title Date: 12/9/16 DIR#: 1000000076 C-11 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations,Part 135* Economic Opportunities for Low and Very Low-Income Persons The bidder,under penalty of perjury,certifies that except as noted below,any person associated therewith in the capacity of owner,partner, director, officer,or manager(initial the applicable selections): Will ensure that 10%of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10%of its sub-contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub-contracts related to this project. Contractor: Hardy&Harper,Inc Contact Person: Steve Kirschner Contact Phone: 4-I85, Signed: Zak Steve Kirschner- ice President Date: 12 L9/_16 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub-contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act,as amended in 1992(HUD). Previous non-compliance with Section 3 could result in disqualification. C-12 RELIABLE CONTRACTOR DECLARATION (page 1 of 2) CalRecycle 168(Revised W16) This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalRecycle) prior to authorizing a contractor(s) to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of funds to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Reliable Contractor Declaration (formerly Unreliable List) requirement of their Terms and Conditions. The Reliable Contractor Declaration (formerly Unreliable List) provision requires the following: Prior to authorizing a contractor(s) to commence work under the Grant, the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractor(s) stating that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the contractor(s). Please see the reverse of this page, or refer to the California Code of Regulations (www.calregs.com). If any of the events listed in Section 17050 have occurred, disclosure is required but will not necessarily result in CalRecycle refusing to approve the contractor. A signed statement explaining the facts and circumstances of the events must be attached to and submitted with this form. Contractor: Complete the form and send original to the Grantee. Grantee: Scan the form and upload it to the grant in CalRecycle's Grant Management System. For further instruction about logging Into the Grant Management System and uploading this form, reference the Procedures and Requirements. Retain the original form in your grant file. GRANTEE INFORMATION GRANTEE NAME: GRANT NUMBER: PRIMARY CONTACT NAME: CONTRACTOR INFORMATION CONTRACTOR NAME: Hardy&Harper,inc. AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: ^� Steve Kirschner MAILING ADDRESS: 1312 E.Warner Ave.,Santa Ana,CA 92705 As the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor. Alternatively, as the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, if any of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor, I have disclosed all such occurrences in an attached signed statement that explains the facts and circumstances of the listed events. Signature Date - !T tlgrd� t tar Per,tnc wt I► �covld� rnls rvrm 12/19/16 1111W out w w ro . C-13 RELIABLE CONTRACTOR DECLARATION(page 2 of 2) CalRecycle 168(Revised 9116) Title 14 CCR,Division 7,Chapter 1 Article 5. Unreliable Contractors,Subcontractors,Borrowers and Grantees Section 17050.Grounds for Placement on Unreliable List The following are grounds for a finding that a contractor,any subcontractor that provides services for a CalRecycle agreement, grantee or borrower is unreliable and should be placed on the CalRecycle Unreliable Contractor, Subcontractor, Grantee or Borrower List ("Unreliable List"). The presence of one of these grounds shall not automatically result in placement on the Unreliable List. A finding must be made by the Executive Director in accordance with section 17054, and there must be a final decision on any appeal that may be filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s)to CalRecycle due to fraudulent claims or reporting;or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act, Goverment Code section 12650 et.seq;or (c) Default on a CalRecycle loan,as evidenced by written notice from CalRecycle staff provided to the borrower of the default;or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycle;or (e) Filing voluntary or involuntary bankruptcy,where there is a finding based on substantial evidence, that the bankruptcy interfered with the CalRecycle contract,subcontract,grant or loan;or (f) Breach of the terms and conditions of a previous CalRecycle contract,any subcontract for a CalRecycle agreement,grant,or loan,resulting in termination of the CalRecycle contract,subcontract,grant or loan by the Cal Recycle or prime contractor;or (g) Placement on the CalRecycle's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility;or (h) The person, or any partner, member, officer, director, responsible managing officer, or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, co8usion,conspiracy, or any act in violation of any state or federal antitrust law in connection with the bidding upon, award of, or performance under any CalRecycle contract, subcontract,grant or loan;or (i) The person or entity is on the list of unreliable persons or entities,or similar list,of any other federal or California state agency;or (l) The person or entity has violated an Order issued in accordance with section 18304;or, (k) The person or entity has directed or transported to,has or accepted waste tires at,a site where the operator is required to have but does not have a waste tire facility permit;or, (� The person or entity has transported waste tires without a waste tire hauler registration;or, (m) The person or entity has had a solid waste facility or waste tire permit or a waste tire hauler registration denied, suspended or revoked;or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRecycle to remediate,clean,or abate a nuisance at the site;or (o) The following are additional grounds for a finding that, a person or entity described below should be placed on the Unreliable List: (1) The person or entity owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director,manager,partner,trustee,or any other management position with significant control(Principal Manager)in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person who owns 20%or more of the entity,if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (5) The entity has another entity which owns 20%or more of the entity,if that other entity; 1. Is on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (6) Subsection(o)is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-14 Local Assistance Procedures Manual Exhibit 12-H Sample Bid (THE BIDDER'S EXECUTION ON THE SIGA'ATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFIC47YONS WHICH AREA PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION 1fie bidder Hardy&Harper,Inc ,proposed subcontractor 5s U��`����5 ,hereby certifies that he has X has not_,participated in a previous contract or subcontract subject to the equal opportunity clauses,as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity,all reports due under the applicable filling requirements. Note. The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b)(1)),and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Cuirently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director,Office of Federal Contract Compliance,U.S.Department of Labor. Page 1 of 8 C-15 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTEAN ENDORSEMENT AND EXECUTION OF THOSE CERTIFIC.47"70NS N'HICHAREA PART OF Y HIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Hardy&Harper,Inc ,proposed subcontractor ( asp, hereby certifies that he has X has not_,participated in a previous contract or subcontract subject to the equal opportunity clauses,as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity,all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b)(1)),and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Cuirently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director,Office of Federal Contract Compliance,U.S.Department of Labor_ Page 1 of 8 C-15 June 11,2014 Local Assistance Procedures Manna] Exhibit 12-H Sample.Bid (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT'AND EXECUTION OF THOSE CERTIFICATIONS Wh7CHAREA PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION 'Fhe bidder Hardy&Harper,Inc ,proposed subcontractor hereby certifies that be has X , has not_,participated in a previous contract or subcontract subject to the equal opportunity clauses,as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee an Equal Employment Opportunity,all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b)(1)),and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director,Office of Federal Contract Compliance,U.S.Department of Labor. Page 1 of 8 C-15 dune ll,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid a=BIDDER'S EAECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFIC 4TIONS YYHICHAREA PART OF 7H1S PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Hardy&Harper,Inc ,proposed subcontractor hereby certifies that he has X , has not_,participated in a previous contract or subcontract subject to the equal opportunity clauses,as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity,all reports due under the applicable filling requirements. Note. The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b)(1)),and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director,Office of Federal Contract Compliance,U.S.Department of Labor. Page 1 of 8 C-15 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Sid (THE BIDDER'S EAECUTION ON THE SIGA:4TURE PORTION OF THIS PROPOSAL SHALL ALSO CONS77MTE AN ENDORSE—hIEArT AND EXECUTION OF THOSE CERTIFIC 417ONS Wh7CHARBA PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Hardy&Harper,Inc ,proposed subcontractor hereby certifies that he has X , has not_,participated in a previous contract or subcontract subject to the equal opportunity clauses,as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Govemment contracting or administering agency,or the former President's Committee on Equal Employment Opportunity,all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b)(1)),and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director,Office of Federal Contract Compliance,U.S.Department of Labor. Page I of 8 C-15 June li,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376,Stats. 1985),the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has.,,_,has not X been convicted within the preceding three years of any offenses referred to in that section,including any charge of fraud,bribery,collusion, conspiracy,or any other act in violation of any state or Federal antitrust law in connection with the bidding upon,award of, or performance of,any public works contract,as defined in Public Contract Code Section 1101,with any public entity,as defined in Public Contract Code Section 1100,including the Regents of the University of California or the Trustees of the California State University. The term"bidder"is understood to include any partner,member,officer,director,responsible managing officer,or responsible managing employee thereof,as referred to in Section 10285.1. Note: The bidder must place a checkmark after"has"or"has not"in one of the blank spaces provided.The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement.Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162,the,Bidder shall complete,under penalty of perjury,the following questionnaire: Has the bidder,any officer of the bidder,or any employee of the bidder who has a proprietary interest in the bidder,ever been disqualified,removed,or otherwise prevented from bidding on,or completing a federal,state,or local government project because of a violation of law or a safety regulation? Yes No X If the answer is yes,explain the circumstances in the following space. Page 2 of 8 C-16 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232,the Contractor,hereby states under penalty of perjury,that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 3 of 8 C-17 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY/COUNTY of o aafj DEPARTMENT OPPUBLIC WORKS. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of or on behalf of,any undisclosed person,partnership, company,association,organization,or corporation;that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded,conspired,connived,or agreed with any bidder or anyone else to put in a sham bid,or that anyone shall refrain from bidding;that the bidder has not in any manner,directly or indirectly,sought by agreement,communication,or conference with anyone to fix the bid price of the bidder or any other bidder,or to fix any overhead,profit,or cost element of the bid price,or of that of any other bidder,or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true;and,further,that the bidder has not,directly or indirectly,submitted his or her bid price or any breakdown thereof,or the contents thereof, or divulged information or data relative thereto,or paid,and will not pay,any fee to any corporation, partnership,company association,organization,bid depository,or to any member or agent thereof to effectuate a collusive or share bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 4 of 8 C-18 June ll,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DEBARMENT AND SUSPENSION CERTIFICATION TnLE 49,CODE OF FEDERAL REGULATIONS,PART 29 The bidder,under penalty of perjury,certifies that,except as noted below,he/she or any other person associated therewith in the capacity of owner,partner,director,officer,manager: • is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any Federal agency; • has not been suspended,debarred,voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending;and • has not been indicted,convicted,or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification,insert the exceptions in the following space. Exceptions will not necessarily result in denial of award,but will be considered in determining bidder responsibility. For any exception noted above,indicate below to whom it applies,initiating agency,and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 5 of S C-19 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Sid NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies,by signing and submitting this bid or proposal,to the best of his or her knowledge and belief,that: (1) No Federal appropriated fiends have been paid or will be paid,by or on behalf of the undersigned,to any person for influencing or attempting to influence an officer or employee of any Federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal,amendment,or modification of any Federal contract,grant,loan,or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with this Federal contract,grant, loan,or cooperative agreement,the undersigned shall complete and submit Standard Form-LLL,"Disclosure of Lobbying Activities,"in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352,Title 31,U.S.Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts,which exceed$100,000 and that all such subrecipients shall certify and disclose accordingly. Page 6 of 8 C-20 June 11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES COMPLETT TkIlS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ® a. contract a. bid/offer/application 0 a. initial b. grant b. initial award b. material change c, cooperative agreement c. post-award d. loan For Material Change Only: e. loan guarantee year quarter f. loan insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No.4 is Subawardee, Enter Name and Address of Prime: ® Prime Subawardee Tier ifknown N/A Congressional District,if known Congressional District,if known 6. Federal Department/Agency: 7. Federal Program Name/Description: N/A CFDA Number,if applicable 8. Federal Action Number,if known: 9. Award Amount,if known: N/A N/A 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual,last name,first name,MI) address if different from No.I Oa) (last name,fast name,lull) None None (attach Continuation Sheet(s)if necessary) 11. Amount of Payment(check all that apply) 13. Type of Payment(check all that apply) $ None actual planned a, retainer b. one-time fee 12. Form of Payment(check all that apply): c. commission ea. cash d. contingent fee b. in-kind, specify:i nature a deferred t value X f. other,specify 14. Brief Description of Services Performed or to be performed and Date(s)of Service,including offtcer(s),employee(s),or member(s)contacted,for Payment Indicated in Item II: Hardy&Harper,Inc has not paid any funds in regards to this project. (attach Continuation Sheet(s)if necessar 15. Continuation Sheet(s)attached: Yes No 16. Information requested through this form is authorized by Title 31 U.S.C.Section 1352. This disclosure of lobbying Signature: reliance was placed by the tier above when his transaction was made or entered into, This disclosure is required Print Name: Steve Kirschner pursuant to 31 U.S.c_1352. Thus information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required Title: Vice President disclosure shall be subject to a civil penalty of not less than 510,000 and not more than$100,000 for each such failure. Telephone No.: 714 444 1851 Date: 12/9/16 Authorized for Local Reproduction Federal Use Only: Standard Form-LLL Standard Form LLL Rev.09.12-97 Page 7 of 8 C-21 .Tune 1.1,2014 77, N t7 :a » o ;� .:'-A �_- �WS (ate.•' t l�W �.�; -F fWF-- !`J'+�., � .�W.� � a� N" �„' � ty Bit r Ed I ! ! I t40 ad ! I I h ti 4+ s a I i j j j I i � O eAi � � �p i '• tilli ! ! l � 11 jj i I I A a A u F s., . C C 0 0 0 C C 0 0 0 0 0 0 O O C I~ .0 ,0 0 � o Via+:. oV va ss b3 v3 ifi s4 rr4 64 69 6R 5q 65 .-. Fs� 64 i!f ss H?59 CA d ' V v v v n $` v v v v n r v v v v n v v v v n a p rn 0Lin x Q = d rY T qJ ri� r �- rl pk: s M M S S I- W A •-- -o O o � � u iG td pq :. w T y- ^�'., C� • 00 to N c, N. 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I � lfil iil lisl II ! i III .� =�U 0 A A . 0 0 0 0 0 q 0 0 0 { G 0 0 0 C t 0 0 0 �` Wn o n v� a �n n Cl kn W) v> de vj vj rfl-: w V V V V A V V V V A V V V V A V V V V !� ❑ ❑ : [�l❑❑❑❑ ❑❑❑❑❑ : DOME" p � U � ed o o� E 0 m m v m b Cz `t�T 41 4, W O.� 4) 3 7i � o uv' o 4) U ti CLI O o CS is w m � ai 65 12/29/2016 California Department of Industrial Relations-Contact DIR Public Works Public Works Contractor (PWC) Registration Scu,�:�rch This is a listing of current and active PWC registrations pursuant to Division 2,Part 7,Chapter 1(commencing with section 1720 of the California Labor Code.) Enteratleast one search criteria to display active registered public works contractor(s)matching your selections. Registration Year: Current Fiscal Year:2016/17 PWC Registration Number: %iVTIJ)10 12.3456769C, Contractor Legal Name: Hardy&Harper, Inc Contractor License.Lookup License Number: *xample:123456 County: Select County V ' i Export as: cei I Pi: Search Results One registered contractor found. 1 Details Legal Name Registration County City Registration Expiration Number Date Date View HARDY&HARPER,INC. 1000000076 ORANGE SANTA ANA 06/08/2016 06/30/2017 v2.20160101 Conlact MR Conditions of Use Privacy Policy Disclaimer Disability accommodation Site Help Copyright©2015 State of California https://efii I i ng.di r.ca.gov/PW C R/Search.action 1!1 12/29/2016 California Department of Industrial Relations-Contact DIR Public Works PUblic Works Contractor (PWC) Registration Se arch This is a listing of current and active PWC registrations pursuant to Division 2,Part 7,Chapter 1(commencing with section 1720 of the California Labor Code.) Enter at least one search criteria to display active registered public works contractors)matching your selections. Registration Year: Current Fiscal Year:2016/17 v PWC Registration Number: oxamps". 1234567890 Contractor Legal Name: Case Land Contractor License.Lookup License Number: County: Select County V Export as: Excel P Search Results One registered contractor found. 1 Details Legal Name Registration County City Registration Expiration Number Date Date View CASE LAND SURVEYING,INC. 1000001533 ORANGE ORANGE 06/21/2016 06/30/2017 v2.201601 01 r Who we are DIP Divisions,Boards&"Oninill—slons Contact DIR pu')Ilc iv: ;t DIP, Conditions of Use Privacy Policy Disclaimer Disability accommodation Site Help Copyright @ 2015 State of California https:HefiIing.dir.ca.gov/PWCR/Search.action 12/29/2016 California Department of Industrial Relations-Contact DIR Home Labor Law Cal/OSHA.Safety&Health Workers'Comp Se,'Insurance Aaarentzceship Public Works Public Works Contractor (PWC) Registration Search This is a listing of current and active PWC registrations pursuant to Division 2,Part 7,Chapter 1 (commencing with section 1720 of the California Labor Code.) Enter at least one search criteria to display active registered public works contractor(s)matching your selections. Registration Year: Current Fiscal Year:2016/17 • PWC Registration Number: example: 1234567890 ---------- ---------._.. Contractor Legal Name: Treesmith Contractor License Lookup License Number: oxample: 123456 County: Select County IF Export as: Excel I PDF Search Results One registered contractor found. 1 Details Legal Name Registration County City Registration Expiration Number Date Date View TREESMITH ENTERPRISES,INC. 1000001838 ORANGE ANAHEIM 06/09/2016 06/30/2017 v2.20160101 About DIR Work with Us �>rn, Who Uve are Licensir: ,;registrations,certifii:ations.t :};.rrr.i' S, Hap DIR Divisions,Boards&Commissions Notiflcatic,of activies Contact:DIR Pul:>Iic Records Act iota-%at:i7(Iz Conditions of Use Privacy Policy Disclaimer Disability accommodation Site Help Copyright©2015 State of California https://efiling.dir.ca.gov/PWCR/Search.action 1/1 12/29/2016 California Department of Industrial Relations-Contact DIR k Public Works Public Works Contractor (PWC) Registration Search This is a listing of current and active PWC registrations pursuant to Division 2,Part 7,Chapter 1(commencing with section 1720 of the California Labor Code.) Enter at least one search criteria to display active registered public works contractor(s)matching your selections. Registration Year: Current Fiscal Year: 2016/17 • PWC Registration Number: �xamPIO,: 1234567891G Contractor Legal Name: smithson electric Contractor License.Lookup License Number: r;xanple: 123456 County: Select County Export as: Fxc6�lI Search Results One registered contractor found. 1 Details Legal Name Registration County City Registration Expiration Number Date Date View SMITHSON ELECTRIC,INC 1000001610 ORANGE ORANGE 06/20/2016 06/30/2017 v2.20160101 b`dho we are Li e r s..ct,ra.li:trat 3 �_r2rt A_ r. .r',. iitis �p DIR Divisions,Boards&C:ornmis o,l,s NoU ca,'w, r;f act:..,,<.<_. Contact DiR Public.Rr r r ds Aca f� Conditions of Use Privacy Policy Disclaimer Disability accommodation Site Help Copyright©2015 State of California https://efiling.dir.ca.gov/PWCR/Search.action 12/29/2016 California Department of Industrial Relations-Contact DIR Public Works Public Works Contractor, (PWQ Registration Search This is a listing of current and active PWC registrations pursuant to Division 2,Part 7,Chapter 1 (commencing with section 1720 of the California Labor Code.) Enter atleast one search criteria to display active registered public works contractor(s)matching yourselections. Registration Year: Current Fiscal Year: 2016/17 • PWC Registration Number. `exa inplc: 1234567890 Contractor Legal Name: Superior Pavement Markings Contractor License Lookup License Number: oxzz!nple 123456 County: Select County i Export as: excel I pf7F: Search Results One registered contractor found. 1 Details Legal Name Registration County City Registration Expiration Number Date Date View SUPERIOR PAVEMENT MARKINGS 1000001476 ORANGE CYPRESS 06/07/2016 06/30/2017 v2.20160101 About DIR Cornact. DIR i'!1 i ? is Act Conditions of Use Privacy Policy Disclaimer Disability accommodation Site Help Copyright©2015 State of California https://efiling.dir.ca.gov/PWCR/Search.action 1/1 12/29/2016 California Department of Industrial Relations-Contact DIR Public Works Public Works Contractor (PWC) Registration Sear=._ This is a listing of current and active PWC registrations pursuant to Division 2,Part7,Chapter 1(commencing with section 1720 of the California Labor Code.) Enter at least one search criteria to display active registered public works contractor(s)matching your selections. Registration Year: Current Fiscal Year: 2016/17 • PWC Registration Number: example: 1234567890 Contractor Legal Name: EBS Utilities Adjusting, Inc Contractor License.Lockup License Number: example: 123456 County: Select County d i Export as: Pxcel I PD1 Search Results One registered contractor found. 1 Details Legal Name Registration County City Registration Expiration Number Date Date View EBS UTILITIES ADJUSTING,INC 1000004286 RIVERSIDE CORONA 06/03/2016 06/30/2017 v2.20160101 Conditions of Use Privacy Policy Disclaimer Disability accommodation Site Help Copyright©2015 State of California https:Hefii I i ng.di r.ca.gov/PW C R/Search.action 1/1 Bid Bond Bid Bond Number:CSBA-3772 CONTRACTOR: SURETY: (Name,legal status and address) (Name,legal status and principal place of business) Hardy&Harper,Inc. Fidelity and Deposit Company of Maryland 1312 E.Warner Avenue 777 South Figueroa Street,Suite 3900 Santa Ana,CA 92705 Los Angeles,CA 90017 OWNER: This document has important legal (Name,legal status and address) consequences.Consultation with City of Huntington Beach An attorney is encouraged with respect 2000 Main Street its completion or modification. Huntington Beach,CA 92648 Any singular reference to Contractor,Surety,Owner-or other party shall be considered Plural where applicable. BOND AMOUNT: Ten Percent(10%)of Amount Bid PROJECT:Edinger Avenue Rehabilitation from Graham Street to Springdale Street&Warner Ave.Rehabilitation from Beach Blvd. to Newland Street CC No. 1516 STPL-5181(189) Project Number,if any: The Contractor and Surety are bound to the Owner in the amount set forth above,for the payment of which the Contractor and Surety bind themselves,their heirs,executors,administrators,successors and assigns,jointly and severally,as provided herein.The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents,or within such time period as may be agreed to by the Owner and Contractor,and the Contractor either(1)enters into a contract with the Owner in accordance with the terms of such bid,and gives such bond or bonds as may be specified in the bidding or Contract Documents,with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Owner,for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof;or(2)pays to the Owner the difference,not to exceed the amount of this Bond,between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid,then this obligation shall be null and void,otherwise to remain in full force and effect.The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid.Waiver of notice by the Surety shall not apply to any extension exceeding sixty(60)days in the aggregate beyond the time for acceptance of bids specified in the bid documents,and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty(60)days. If this Bond is issued in connection with a subcontractor's bid to a Contractor,the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project,any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted here from and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein.When so famished,the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. Signed and sealed this 14th day of December,2016 Hardy&H=er,Inc. � (Principal) (Seal) (Witness) �rzt �11�chiler- vlCe �fESicl�►1fi Fidelity and Deposit Company of Maryland Vf/0 (Surely) (Seal) (Wlitness) (Title)Dwight Reilly,Attorney-in-Fact By arrangement with the American Institute of Architects, the National Association of Surety Bond Producers(NASBP) (www.nasbp.ora) makes this form document available to its members, affiliates, and ALL associates in Microsoft Word format for use in the regular course of surety business.NASBP vouches that c the original text of this document conforms exactly to the text in AIA Document A310-2010, Bid Bond. Subsequent modifications may be made to the original text of this document by users,so careful review of its wording and consultation with an attorney are encouraged before its completion, execution or acceptance. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 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 December 14. 2016 before me, Tina Pham, Notary Public Date Here Insert Name and Title of the Officer personally appeared Steve Kirschner Name(l)of Signer( who proved to me on the basis of satisfactory evidence to be the person(x) whose name(2s) is/aye subscribed to the within instrument and acknowledged to me that he/sXe/they executed the same in his/her/their authorized capacity(ii?t), and that by his/h)Rr/their signature(g)on the instrument the person(a), or the entity upon behalf of which the person(x) acted, executed the instrument. certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. TINA PRAM WITNESS my hand and official seal. f COMM.#2149384 M ' l^ Notary Public-California C v/ ORANGE COUNTY a My Cornm.Expires Apr 17,2020 Signature Sign ture of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Bid Bond Document Date: December 14, 2016 Number of Pages: 1 Signer(s) Other Than Named Above: Dwight Reilly Capacity(ies) Claimed by Signer(s) Signer's Name: Steve Kirschner Signer's Name: ❑✓ Corporate Officer — Title(s): Vice Prasirianr ❑ 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: Hardy&Harper, Inc 02014 National Notary Association • www.NationalNotary.org ' 1-800-US NOTARY (1-800-876-6827) Item#5907 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness, accuracy,or validity of that document. State of California County of Orange On 12/14/2016 before me, Karen L. Ritto , Notary Public personally appeared Dwight Reilly who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the state of California that the foregoing paragraph is true and correct. KAREN L.RITTO COMM.#2138527 N V , ` Notary Public-California WITNESS my hand and official seal. ORANGE COUNTY U. JA My Comm.Expires Dec 30,2019 Signature otary OPTIONAL Though the data below is not required by law,it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLA 3HD BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL Bid Bond ❑ CORPORATE OFFICER Title or Type of Document One ❑ PARTNER(S) Number of Pages ❑ MEMBER of LLC ® ATTORNEY-IN-FACT ❑ TRUSTEE(S) 12/14/2016 ❑ GUARDIAN/CONSERVATOR Date of Document OTHER: SIGNER IS REPRESENTING: Signer(s) other than named above NAME OF PERSON(S)OR ENTITY(IES) ZURICH AMERICAN INSURANCE COMPANY Bond No. CSBA-3772 COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That the ZURICH AMERICAN INSURANCE COMPANY,a corporation of the State of New York,the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY,a corporation of the State of Maryland,and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by MICHAEL BOND,Vice President,in pursuance of authority granted by Article V, Section 8, of the By-Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute,and appoint Daniel HUCKABAY,Dwight REILLY,Andrew WATERBURY,Arturo AYALA,Shaunna Rozelle OSTROM and Michael CASTANEDA,all of Orange,California, EACH its true and lawful agent and Attorney-in-Fact,to make,execute,seal and deliver,for, and on its behalf as surety,and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies,as fully and amply,to all intents and purposes,as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York,New York.,the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills,Maryland,,and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland.,in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V,Section 8,of the By-Laws of said Companies,and is now in force. IN WITNESS WHEREOF,the said Vice-President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND,this 5th day of December,A.D.2016. ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND ` � 'wa o..., ,G�r `, , SEAL = —+ i i �O B Secretary Vice President Eric D.Barnes Michael Bond State of Maryland County of Baltimore On this 5th day of December,A.D.2016,before the subscriber,a Notary Public of the State of Maryland,duly commissioned and qualified,MICHAEL BOND,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 swom,deposeth and saith,that heshe 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. \,p,tlnlpq. Constance A.Dunn,Notary Public My Commission Expires:July 9,2019 POA-F 012-0079B City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov Office of the City Clerk Robin Estanislau, City Clerk April 6, 2017 Sequel Contractors, Inc. 13546 Imperial Hwy. Santa Fe Springs, CA 90670 Re: Edinger Avenue Rehabilitation — CC-1516 The City Council awarded the bid to your company for the above referenced project. Enclosed is a copy of the executed contract with the City of Huntington Beach. A Certification of Compliance with Title VII of the Civil Rights Act, Certification of Compliance with Prevailing Wage Laws and Contractor's Certificate form must be returned to this office after the project is completed but prior to the release of retention funds. In addition, the following item must also be on file, with this office before the City can release any retention funds: A warranty bond guaranteeing the final amount of work and materials for one year. If your performance bond does not include specific wording for a one-year warranty, then a rider or separate bond must be submitted. Should you have any questions or concerns regarding the enclosures or items that must be on file in this office prior to release of retention funds, please call the Public Works Department at 536-5517. Sincerely, Q 44 1i61ht� Robin Estanislau, CIVIC City Clerk RE:pe Enclosures: Copy of Contract including Proposal Copies of insurance/bonds Bid Bond (original) Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand cv "- N Co 1- J .L v � � U L w 2 S Z� �to w (Y) U- � z 1 Dec 20 2016 03:15PM Huntington Beach PW 7145365204 page 1 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431 , Fax (714) 374-1573 ADDENDUM NUMBER TWO For EDINGER AVENUE REHABILITATION AND WARNER AVENUE REHABILITATION CC No.1516 Federal Aid Project STPL-5181(189) in the CITY OF HUNTINGTON BEACH December 20,2016 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) BID OPENING POSTPONED REVISED BID DUE DATE ON COVER AND ON PAGE A-1 FROM "DECEMBER 20, 2016" to "DECEMBER 29,2016." 2) ASPHALT CONCRETE CLARIFICATION REVISED SHEET E-23 and E-24 IN SPECIFICATION BOOK—203 BITUMINOUS MATERIALS (2 Sheets) Replace E-23 with "E-23 CC-1516, Addend urn 2" (1 sheet) And Replace Page E-24 with "E-24 CC-1516, Addendum ' (1�_S et) This is to acknowledge receipt and review of Addendum Number T ated Dec 0 2016. SEOM CM I M41 V , ., Company Name h0fr;tt3 � x president DEC 2 0 2016 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum,please call James Wagner at(714) 536-5467 within 24 hours of posting. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431 , Fax (714) 374-1573 ADDENDUM NUMBER _ For EDINGER AVENUE REHABILITATION AND WARNER AVENUE REHABILITATION CC No. 1516 Federal Aid Project STPL-5181(189) in the CITY OF HUNTINGTON BEACH December 12, 2016 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) PROJECT BID SCHEDULE—Section C Specification Book(2 Sheets) Replace "Project Bid Schedule—C-2.3"with "Project Bid Schedule—C-2.3 Addendum 1" (1 sheet). Bid items 1,2, 3 and 4 descriptions were shortened. Replace"Project Bid Schedule—C-2.9"with "Project Bid Schedule—C-2.9 Addendum 1" (1 sheet). Bid items 1,2, 3 and 4 descriptions were shortened. 2) APPENDIX H —Appendix H Part 2 Specification Book (27 Sheets) Replace Cover Sheet(1 sheet)and "General Decision Number CA160035 10/28/2016"with "General Decision Number CA 160035 11/11/2016"(26 sheets). Federal Construction Wage Rates were updated on 11/11/2016. This is to acknowledge receipt and review of Addendum Number One d d c e m b 2016. SEOM CMIMAMM, Company Name I hQfl . [jack 'President DEC 1 2 2016 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call James Wagner at(714) 536-5467 within 24 hours of posting. ,9EQ'JEL CbNTRACTORS, ING., SECTION C PROPOSAL for the construction of EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET AND WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 FEDERAL AID PROJECT STPL-5181(189) in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids,the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 65 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid,unit prices shall govern over extended amounts,and words shall govern over figures. C-1 9EQXJEL CONTRACTORS, iNG. 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 ts'oEsTv SO NO in the amount of 16°b 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 i er f ire Z /(o a � C-2 SEOUEL CONTRACTORS, ING. SECTION C PROJECT BID SCHEDULE EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET AND WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 FEDERAL AID PROJECT STPL-5181(189) in the PROJECT BASE BID: Basis of Award EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET. . .. . . . . .. ... . . . ... . . . . . ... . . . . . . .....C-2.2 to C-2.7 WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET. ........ .... . ... . . .... .. . .. . .. .. .. . . . C-2.8 TO C2.12 1.EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET DO BID IN FIGURES 2. WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET 00 BID IN FIGURES BASE BID TOTAL AMOUNT LUMP SUM BID IN FIGURES: (TOTAL FOR ITEMS 1 AND 2) G� 1 S "� q Ts-. - BASIS OF AWARD C-2.1 SAC UEL CONTRACTORS, W(,, SECTION C PROJECT BID SCHEDULE EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET AND WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 FEDERAL AID PROJECT STPL-5181(189) EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET CC NO. 1516 C-2.2 seov us- nrri4roaryowet, Addendum 1, CC-1516 Replacement Page C-2.3 EDINGER (GRAHAM-SPRINGDALE) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount 00 0 1 - - MOBILIZATION 1 LS $ If 00c) $ E, b00, a& a 2 -- TRAFFIC CONTROL PLAN 1 LS $ 4Z b 3 FURNISH PROJECT TRAFFIC 1 LS $ 20, 0� $ 20 CX�. CONTROL 4 FURNISH AND INSTALL SIGNING 1 LS $ 1 $ /SG�CJ AND STRIPING 5 -- PROJECT SPECIFIC SWPPP 1 LS $ /DOOM $ /aOOU REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB, AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). (INCLUDES ALL dip 6 1 APPURTENANCES, CURB 3 EA $ GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT,AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) CONSTRUCT 0.17'ASPHALT D0 io 7 3 RUBBER HOT MIX(ARHM)WET 2,200 TN $ W—17 $ 1 - / o9- PROCESS OVERLAY. — 8 4 ADJUST SEWER MANHOLE TO 6 EA 51 GRADE. 900, ,S YGv 9 INTENTIONALLY LEFT BLANK REPLACE WATER VALVE BOX tz a, 10 6 ASSEMBLY AND ADJUST TO 11 EA $ $ (,�1 " GRADE PER HB STD PLAN 612. 11 INTENTIONALLY LEFT BLANK C-2.3 CC-1516,Addendum 1 SEQUEL CONTRACTORS, IN6. EDINGER (GRAHAM-SPRINGDALE) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity I Unit Price Amount COLD MILL EXISTING A.G. 12 7 PAVEMENT TO A DEPTH OF 0.34' 158,200 SF $ 3� $ t y6� FROM NEW FINISHED SURFACE PER PLANS. COLD MILL EXISTING A.C. PAVEMENT TO A DEPTH OF 0.67' .?S 13 8 FROM NEW FINISHED SURFACE 8,800 SF $ — $ /OOI� PER PLANS. CONSTRUCT NEW OAT AND 0.50' B-PG-70-10-RAP A.C. BASE 14 7& 8 COURSE OVER 95% 2,400 TN $ coo COMPACTED SUBGRADE PRIOR TO 0.17'ARHM OVERLAY PER PLANS, 15 INTENTIONALLY LEFT BLANK SET SURVEY MONUMENTATION 16 9 AND PREPARE CORNER 2 EA -- RECORD(PRE-AND/OR POST- CONSTRUCTION)- REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202 (CF=8"). (INCLUDES SLOT PAVEMENT,AGGREGATE 17 10 BASE, LOT DRAINS,AND ALL 1,580 LF $ '�� $ /✓s� ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) C-14 SEQUEL CONTRACTORS, IN6. EDINGER (GRAHAM-SP RING DALE) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE-GRAD a FROM WALK TO EXISTING Gw 18 11 SLOPE, RELOCATING 6,600 SF $ a IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE- CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT COMMERCIAL/RESIDENTIAL DRIVEWAY("W"AND TYPE 19 12 SHOWN ON PLAN) PER STD 1,330 SF PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO GRADE. 20 INTENTIONALLY LEFT BLANK 21 INTENTIONALLY LEFT BLANK INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC 22 13 SIGNALS AND LIGHTING 24 EA S � SYSTEMS, 2005 EDITION, SPLICE LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE "D" REMOVE EXISTING TREE:AND ROOTS; GRIND TREE STUMP AND ROOTS TO 24"BELOW TOP 20 EA S �.!(� S 23 14 OF SIDEWALK/GRADE WITHIN PROPOSEDIMPROVEMENT AREA. C-2.s SEQUEL CONTRACTOM, It& EDINGER (G RAHAM-SPRI NG DALE) PROJECT BID SHEET Bid..Const Contract Unit Extended No. NO. Description: Quantity Unit Price Amount:.: FURNISH LABOR, EQUIPMENT, AND GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED oa BY AGENCY. (INCLUDES ALL 24 15 ITEMS NECESSARY TO 2,500 SF $ �r n $ �G COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C.AND OVER EXCAVATION BID PAY ITEMS.) OVER EXCAVATION WHEN 25 16 IDENTIFIED BY CONTRACTOR 90 CY $ $ 7Q AND VERIFIED BY AGENCY. ADJUST EDISON VAULT/MANHOLE TO GRADE BY 26 17 EDISON. CONTRACTOR TO 4 EA NOT A CONTRACTOR BID ITEM COORDINATE WITH ERICK OEN AT(714)895-0242. 27 INTENTIONALLY LEFT BLANK ADJUST OCSD MANHOLE TO GRADE PER OCSD STD. PLAN S- 053, S-054 AND S-055. 28 18 9 EA $ /�i� $ CONTRACTOR TO COORDINATE WITH MIKE BOLSTER AT(714) 593-7645. 29 INTENTIONALLY LEFT BLANK C-2.6 SEQUEL CdINTRAC TORS, INC, EDINGER (GRAHAM-SPRINGDALE) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. I Description Quantity Unit Price Amount FURNISH AND PLANT NEW 24" BOX EASTERN REDBUD TREE PER HB STD. PLANS 714, 715, 716, 718&719 AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF EXISTING LANDSCAPING, �rM ev 30 19 BUSHES OR GROUND COVER 20 EA S •7� AND IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). FURNISH AND INSTALL ZEBRON, 00 SANCON OR CITY APPROVED Z "7CO. 31 -- EQUAL COATING ON THE NEW 3 EA $ CONCRETE INSIDE OF AGENCY SEWER MANHOLE RING. Total Amount Bid in Figures: $ Total Amount Bid in Words: S�v�� 4 VpJt>R E0 I (,,r j THOQShNID EVE vtsbZtD �bzuh)?s /-NP 2C CEti 7s c2 SEOUEL CONTRACTORS, tir& SECTION C PROJECT BID SCHEDULE EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET AND WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 FEDERAL AID PROJECT STPL-5181(189) WARNER AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1516 C-2.8 Addendum 1.. CC-1516 Replacement Page C-2.9 WARNER (BEACH BLVD. TO NEWLAND) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount 1 -- MOBILIZATION 1 LS $ ' J� coo• $ 006 2 - - TRAFFIC CONTROL PLAN 1 LS $ yAOQ $ �OIXI O 3 FURNISH PROJECT TRAFFIC 1 LS $ 20, paD CONTROL $ ��� 4 FURNISH AND INSTALL SIGNING 1 LS $ GYI'.? $ p?Sj AND STRIPING 5 -- PROJECT SPECIFIC SWPPP 1 LS $ BOG ? $ /OLL'?.1 REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB, AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). Q, (INCLUDES ALL �0 6 1 APPURTENANCES, CURB 9 EA $ G $ a GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT,AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) CONSTRUCT 0.17'ASPHALT ,�,, 00 7 3 RUBBER HOT MIX(ARHM) WET 3,000 TN $ G-7. $ 2 O I OOD. PROCESS OVERLAY. 8 4 ADJUST SEWER MANHOLE TO GRADE. g EA 9 5 ADJUST STORM DRAIN 2 EA $ 9OCl $ /Sego MANHOLE TO GRADE. REPLACE WATER VALVE BOX a a 10 6 ASSEMBLY AND ADJUST TO 49 EA $ $ �9YO4 GRADE PER HB STD PLAN 612. COLD MILL EXISTING A.C. aio 11 7 PAVEMENT TO A DEPTH OF 0.17' 53,000 SF $ $ ���� ✓ FROM NEW FINISHED SURFACE PER PLANS. COLD MILL EXISTING A.C. r� eau 12 8 PAVEMENT TO A DEPTH OF 0.34' 157,000 SF 7$ •3a $ ilk FROM NEW FINISHED SURFACE PER PLANS. C-2.9 CC-1516,Addendum 1 SEGUE .CONTRACTORS, INN, WARNER (BEACH BLVD. TO NEWLAND) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity, Unit Price Amount COLD MILL EXISTING A.C. 13 9 PAVEMENT TO A DEPTH OF 0.67' 20,100 SF $ /•�S $ �S�af oa FROM NEW FINISHED SURFACE PER PLANS. CONSTRUCT NEW 0.17',AND 0.50'B-PG-70-10-RAP A.C. BASE o 14 8& 9 COURSE OVER 95% 2,850 TN $ (00 ' $ I 1 ��p COMPACTED SUBGRADE PRIOR TO 0.17'ARHM OVERLAY PER PLANS. RAISE SURVEY WELL MONUMENT TO GRADE AND a' 15 10 PREPARE CORNER RECORD 2 EA $ 02 5V (PRE-AND/OR POST- CONSTRUCTION). SET SURVEY MONUMENTATION a 16 11 AND PREPARE CORNER 8 EA $ RECORD (PRE-AND/OR POST- CONSTRUCTION), REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202 (CF=8"). (INCLUDES SLOT PAVEMENT,AGGREGATE 17 12 BASE, LOT DRAINS, AND ALL Z00 LF 7S $ $ I��L7 ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE-GRAD FROM WALK TO EXISTING GaU Op 18 13 SLOPE, RELOCATING 3,750 SF IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE- CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE. C-2.10 SEQUEL CONTRACTOM, Mo. WARNER (BEACH BLVD. TO NEWLAND) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount REMOVE AND RECONSTRUCT COMMERCIAL!RESIDENTIAL DRIVEWAY("W"AND TYPE 19 14 SHOWN ON PLAN) PER STD 1,600 SF $ �� $ PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO GRADE, REMOVE AND RECONSTRUCT CONCRETE CURB AND CROSS GUTTER PER HB STD. PLAN 205. e:t:;o 20 15 (ITEM INCLUDES SLOT 3,500 SF $ l� $ PAVEMENT,AGGREGATE BASE AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT MEDIAN CURB AND GUTTER PER HB STD PLAN 201 (CF=8"). / ap 21 16 (INCLUDES SLOT PAVEMENT, 110 LF $ AGGREGATE BASE, LOT ` DRAINS,AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC o0 22 17 SIGNALS AND LIGHTING 58 EA $ ap SYSTEMS, 2005 EDITION. SPLICE LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE"D" REMOVE EXISTING TREE AND ROOTS; GRIND TREE STUMP qG pp 23 18 AND ROOTS TO 24"BELOW TOP 4 EA OF SIDEWALK/GRADE WITHIN PROPOSEDIMPROVEMENT AREA. C-2.11 SEQUEL CONMACTCRS, INC. WARNER (BEACH BLVD. TO NEWLAND) PROJECT BID SHEET Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount FURNISH LABOR, EQUIPMENT, AND GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED 1010 a, 24 19 BY AGENCY. (INCLUDES ALL 2,500 SF $ ITEMS NECESSARY TO '— COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C.AND OVER EXCAVATION BID PAY ITEMS.) OVER EXCAVATION WHEN 25 20 IDENTIFIED BY CONTRACTOR 90 CY $ / $_l,.-V b AND VERIFIED BY AGENCY. ADJUST EDISON VAULTWANHOLE TO GRADE BY 26 21 EDISON. CONTRACTOR TO 1 EA NOTA CONTRACTOR BID ITEM COORDINATE WITH ERICK OEN AT(714) 895-0242. ADJUST VERIZON VAULT/MANHOLE TO GRADE BY 27 22 VERIZON. CONTRACTOR TO 1 EA NOT A CONTRACTOR BID ITEM COORDINATE WITH RAY ROUNDTREE AT(714) 375-6760. ADJUST OCSD MANHOLE TO GRADE PER OCSD STD. PLAN S- ev qp 28 23 053, S-054 AND S-055. 1 EA $ CONTRACTOR TO COORDINATE WITH MIKE BOLSTER AT(714) 593-7645. ADJUST MONITORING WELL a 29 24 COVER TO GRADE. 5 EA $ J $ 30 INTENTIONALLY LEFT BLANK FURNISH AND INSTALL ZEBRON, d SANCON OR CITY APPROVED 31 -- EQUAL COATING ON THE NEW 4 EA $ S CONCRETE INSIDE OF AGENCY SEWER MANHOLE RING. Total Amount Bits in Figures: $ 1�3 0 / �• Total Amount Bid in Words: C I UH � PVIJ�p6D % � bL - 2E�zo jjTS C-z.1z SEQUEL CONTRACTORS, ING, LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Bid Name and Address of'' State Class DIR Dollar. %of Item(s) Subcontractor License; Number ` Amount Contract Number` 0(1 S0P Erb to 5�12 c.IP�Fss ST• 3(o C32 197� 2g,Soo. I• Si C*gfsS C 4 C?O "3 0 !7'a/ Corr yek_?M- aNsc t+ 7/-76Z A/4lf 4.0 A00' q 100 doe) 3 d //OM/d✓•w �'/ PA /o e,t;. D ILy �J17 Go ��iy 61VLo<. g2�y3 4 � � o6dD0 b v 13 2 '• . -7 0(2- t-N(>E L ` 2 S 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 SEQUEL CONTRACTORS, INC." LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Brd Naine andAddress of : State Class DER Dgllar. %of Subcontractor License; Number.: Arno.unt . Contract Number l i f f 4 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 DEC 2 ,Oat 2016 Fe SpM90CALIFORNIA Date City State Thomas S. PacK , being first duly sworn, deposes and says that he or she is President of 4; arty making the foregoing bid that the bid is not made in the interest of, or on the beha f 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. SEMEL CR CTOM, IN(,, Name of Bid r S' o ' er Thomas S. PaCK_President 13546 IMPERIAL HWY. SANTA FE SPRINGS, CALIF. 90670 Address of Bidder C-4 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other o} cer completing this certikate veriPes only the identity of the individual who signed the document to which this certikate is attached,and not the truthfulness,accuracy,or validity of that document. State of California ) County of LOS ANG2F1 E2 ) On DEC 2 o 7016 before me, Darn°e'Custarrtante, ddNotar r Date Here Insert Name and Title of the Officer personally appeared Thomas 5. PaCk President Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person jar whose nameW is/W subscribed to the within instrument and acknowledged to me that he/Spe/ eq executed the same in his/he?/tl;e authorized capacity(ioel, and that by his/W/tbetr signaturej$)on the instrument the persono or the entity upon behalf of which the persort,W acted, executed the instrument. oo°ooacoo I certify under PENALTY OF PERJURY under the laws P"f°°"'0DANIE 'BUST of the State of California that the foregoing paragraph DANIEL BUSTArv4ANTt • is true and correct. o COMM. #200580" s WITNESS my hand and official seal. — NOTARY PUPLIC CAI. ;OIWA LOS AM1GELES CQU'vTY —+ Signature ,�'? !J�� • ,,a , My Cit3lh'�agl���rbrpu:IrlNeAH�7 .. �������• ����������e�������N������ �p�i�2 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): 0 Corporate Officer—Title(s): Partner— Limited 1 General ❑ Partner— ❑ Limited ❑ General Individual ❑Attorney in Fact ❑ Individual ❑Attorney in Fact Trustee Guardian or Conservator El Trustee El Guardian or Conservator Other: ❑ Other: Signer Is Representing: Signer Is Representing: ©2016 National Notary Association•www.NationaiNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH,CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract,known as the Edinger Avenue Rehabilitation from Graham Street to Springdale Street and Warner Avenue Rehabilitation Beach Boulevard to Newland Street,Project CC No. 1516,(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. SEQUEL 3TRA,7® , IN . Contracto Thomas Pace, President Title Date: It's C-5 WQvEL CbNTMCT'ORS, INN. 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. Contractor y 7�1 Thomas S. Pack President Title Date: DEC 2 0 2016 C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: EOUEL CbNTRACTORS, Mo.. Bidder Name 13546 IMPERIAL HWY, Business Address SANTA FE SPRINGS, CALIF. 90670 City, State Zip g562U 802-7997 Telephone Number Q I (0 _ A State Contractor's License No. d Class i 31 al Original Date Issued 31 � Expiration Date The work site was inspected by Thomas S. PacK of our office on 12 52011. The following are persons,firms, and corporations having a principal interest in this proposal: SEWEL CbNTRACTORS, [N(C . Thomas S. Pack President _ Abel Magallanes •�, The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the cont t for the proposed work and improvements in accordance with the plans and s ecification et orth. MEOUfL Co 0 , INC.. Com Si atur o d r Thomas S. Presiden Printed or Typed Signature Subscribed and sworn to before me this_day of ,201_. 9 NOTARY PUBLIC ZEE xvv AC; NOTARY SEAL C-8 1 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other of cer completing this certikate veriPes only the identity of the individual who signed the document to which this certiPcate is attached, and not the truthfulness, accuracy,or validity of that document. State of California ) County of LOS ANGELES ) On 'DEC 2 0 2016 before me, Date Here Insert Name and Title of the Officer personally appeared Thomas S. PacK President Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the personf*fwhose name(e is/W subscribed to the within instrument and acknowledged to me that he/fie/tj;,� executed the same in his/he?/tle authorized capacity(isel,and that by his/hef/t4etr signatures)on the instrument the person(& or the entity upon behalf of which the personal acted, executed the instrument. oeac♦o�aoc000000eoo♦e♦000♦o♦c♦♦♦eo♦♦♦o♦>coo I certify under PENALTY OF PERJURY under the laws : of the State of California that the foregoing paragraph DANIEL BUSTAh1ANTE is true and correct. C COMM. #2005801 NOTARY pu3 is cnu oF;NiA o WITNESS my hand and official seal. LOS ANGELES COUNTY —' Z My CCR'"��SSiOr ExpnCs.IAN„'Af4Y 3' �i /Signature /f/ 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— El Limited ❑ General Individual Attorney in Fact [I Individual ❑Attorney in Fact Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator Other: El Other: Signer Is Representing: Signer Is Representing: ©2016 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 SEQUEL CONTRACTORS, INC. ST.LIC#610600A 13546 IMPERIAL HWY SANTA FE SPRINGS, CA 90670 Fax (562) 802-7499 (562) 802-7227 Office ACTION BY UNANIMOUS WRITTEN CONSENT OF THE BOARD OF DIRECTORS OF SEQUEL CONTRACTORS, INC. The undersigned being all of the Directors of SEQUEL CONTRATORS, INC. a California Corporation,do hereby take the following action by this written consent at a meeting of the Board of Directors held on April 4, 2015 in accordance with the Bylaws of the Corporation and the California Corporation Code. WHEREAS, the Board of Directors deems it advisable to authorize the officers of the Corporation, Abel Magallanes, Thomas S. Pack and Michael A. Mahler, respectively, to execute bid bonds on behalf of the Corporation with any agency,person,company or municipality; RESOLVED FURTHER, that Abel Magallanes, Thomas S. Pack and Michael A. Mahler are authorized to execute labor, material, and faithful performance bonds in connection with contracts to be entered into with any agency, person, company or municipality; RESOLVED FURTHER, that Abel Magallanes, Thomas S. Pack and Michael A. Mahler are authorized and directed to execute and deliver street improvement contracts and related agreements with any agency, person, company or municipality on such terms conditions as they deem advisable in their sole discretion; RESOLVED FURTHER, that Abel Magallanes, Thomas S. Pack and Michael A. Mahler be, and they hereby are authorized by their sole signatures on any document to bind this corporation to contract,bids,bonds,etc.; RESOLVED FURTHER, that Abel Magallanes, Thomas S. Pack and Michael A. Mahler be, and they hereby are authorized and directed to take any and all such other actions and execute such other documents as may be necessary or appropriate to carry out the purposes of the foregoing authorizations. In witness thereof, the undersigned Directors have executed this unanimous written consent to indicate this adoption of the consent of the foregoing resolution and the action set forth therein. Dated: pri 4,2015 o as ac Abel Magallanes Director President Director,Vice President&Assistant Secretary Ile M' el ahler Director& Secretary SEQUEL CONTRACTORS, INC,. Bidder's Project History For the purposes of this project; the bidder shall provide project history of similar work, specifically referencing the construction of{Describe specific work and experience necessary for project. For example, "Sanitary sewer line installation of at least of 1,000 of 8-inch and ureater in public right-of-way. Sanitary sewer lift stations of similar size,_project work within public streets, an area containinz high ground water and pipeline construction in high ground water regions with trench depths of 8-feet to the invert"}. Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: 1. Name and Address of Public Agency Naive and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 2. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Provide additional project description fo show similar work: 3. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: C-9 SEQUEL CONTRACTORS, INC. ST.LIC#610600A 13546 IMPERIAL HWY SANTA FE SPRINGS, CA 90670 Fax (562) 802-7499 (562) 802-7227 Office STATEMENT OF EXPERIENCE 1. OWNER: CITY OF LA MIRADA ADDRESS: 15515 PHOEBE AVE. LA MIRADA,CA 90638 PHONE NO.: (562)902-2373 CONTACT: GARY SANUI PROJECT: RESIDENTIAL STREET REHAB PHASE 1 PROJECT AMOUNT: $4,668,969.75 COMPLETION DATE AUGUAT 2015 2. OWNER: CITY OF NGLEWOOD ADDRESS: ONE MANCHESTER BLVD NGLEWOOD,CA 90301 PHONE NO.: (310)412-5333 CONTACT: HUNTER NGUYEN PROJECT: STREET IMPROVEMENTS FY 2014-2015 PROJECT AMOUNT: $3,028,886.41 COMPLETION DATE SEPTEMBER 2015 6. OWNER: CITY OF WESTMNSTER ADDRESS: 8200 WESTMNSTER BLVD WESTMNSTER,CA 92683 PHONE NO.: (714)548-3464 CONTACT: THERESA TRAN PROJECT: CITY WIDE STREET IMPROVEMENTS PROJECT AMOUNT: $1,538,452.62 COMPLETION DATE AUGUST 2015 4. OWNER: CITY OF CERRITOS ADDRESS: 18125 BLOOMFIELD AVE CERRITOS,CA 90703 PHONE NO.: (562)916-1229 CONTACT: FREDY BONNILA PROJECT: RESIDENTIAL STREET REHAB PROJECT AMOUNT: $544,627.80 COMPLETION DATE DECEMBER 2015 5. OWNER: CITY OF LA MIRADA ADDRESS: 15515 PHOEBE AVE LA MIRADA,CA 90638 PHONE NO.: (562)902-2373 CONTACT: GARY SANUI PROJECT: FOSTER PARK AREA PHASE 4 PROJECT AMOUNT: $2,054,436.78 COMPLETION DATE OCTOBER 2015 SEQUEL CONTRACTORS, INC. ST.LIC#610600A 13546 IMPERIAL HWY SANTA FE SPRINGS, CA 90670 Fax (562) 802-7499 (562) 802-7227 Office STATEMENT OF EXPERIENCE 6. OWNER: CITY OF INGLEWOOD ADDRESS: ONE MANCHESTER BLVD INGLEWOOD, CA 90301 PHONE NO.: (310)412-5333 CONTACT: HUNTER NGUYEN PROJECT: STREET IMPROVEMENTS FY 2012-13 PROJECT AMOUNT: $1,823,814.00 COMPLETION DATE SEPTEMBER 2014 7. OWNER: CITY OF GARDENA ADDRESS: 170OW 162'STREET GARDENA,CA 90247 PHONE NO.: (310)217-9500 CONTACT: JOHN FELIX PROJECT: VERMONT AVE REHAB PROJECT AMOUNT: $1,548,818.00 COMPLETION DATE AUGUST 2014 8. OWNER: CITY OF HIGHLAND ADDRESS: 27215 BASE LINE HIGHLAND,CA 92346 PHONE NO.: (909)864-6861 CONTACT: CARLOS ZAMANO PROJECT: BASE LINE BEUTICICATION PROJECT AMOUNT: $2,725,182.63 COMPLETION DATE JANUARY 2014 9. OWNER: CITY OF NEWPORT BEACH ADDRESS: 100 CIVIC CENTER DR. NEWPORT BEACH, CA 92660 PHONE NO.: (949)644-3314 CONTACT: ALFRED CASTANEN PROJECT: RESIDENTIAL STREET EVER-LAY PROGRAM PROJECT AMOUNT: $1,280,124.99 COMPLETION DATE FEBRUARY 2015 10. OWNER: CITY OF SANTA FE SPRINGS ADDRESS: 11710 TELEGRAPH RD. SANT FE SPRINGS,CA 90670 PHONE NO.: (562)868-0511 CONTACT: NOE NEGRETE PROJECT: GRIDLEY RD.PAVEMENT REHAB. PROJECT AMOUNT: $236,904.78 COMPLETION DATE MAY 2014 SEQUEL CONTRACTORS, INC. ST.LIC#610600A 13546 IMPERIAL HWY SANTA FE SPRINGS, CA 90670 Fax (562) 802-7499 (562) 802-7227 Office STATEMENT OF EXPERIENCE 11. OWNER: CITY OF LA MIRADA ADDRESS: 15515 PHOEBE AVE. LA MIRADA,CA 90638 PHONE NO.: (562)943-0131 CONTACT: TONY MORENO PROJECT: FOSTER PARK STREET IMPROVEMENTS PHASE 3 PROJECT AMOUNT: $650,121.97 COMPLETION DATE OCTOBER 2013 12. OWNER: CITY OF TUSTIN ADDRESS: 300 CENTENNIAL WAY TUSTIN,CA 92780 PHONE NO.: (714)573-3157 CONTACT: EDDY JAN PROJECT: ANNUAL ROADWAY AND SIDEWALK REHAB PROJECT AMOUNT: $1,136,251.87 COMPLETION DATE NOVEMBER 2013 13. OWNER: CITY OF INGLEWOOD ADDRESS: ONE MANCHESTER BLVD INGLEWOOD,CA 90301 PHONE NO.: (310)412-5333 CONTACT: HUNTER NGUYEN PROJECT: STREET IMPROVEMENTS FY 2012-13 PROJECT AMOUNT: $1,294,140.16 COMPLETION DATE JULY 2013 14. OWNER: CITY OF LOS ALAMITOS ADDRESS: 3191 KATELLA AVE LOS ALAMITOS,CA 90720 PHONE NO.: (562)431-3538 CONTACT: DAVE HUNT PROJECT: COMMERCIAL STREET IMPROVEMENT PROJECT AMOUNT: $600,776.30 COMPLETION DATE SEPTEMBER 2013 15. OWNER: CITY OF CERRITOS ADDRESS: 18125 BLOOMFIELD AVE. CERRITOS,CA 90703 PHONE NO.: (562)916-1229 CONTACT: FREDY BONILLA PROJECT: 183'STREET IMPROVEMENTS PROJECT AMOUNT: $529,823.96 COMPLETION DATE APRIL 2013 QUEE .CbNMCTORS, INN. 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. Name of proposed Project Manager Telephone No. of proposed Project Manager:) $n2-7227 Project Name & Contract Amount Type rk Date Completed (, C SO Project Name &Contract Amount Type of Work Date Completed Project Name&Contract Amount Type of Work Date Completed 2. Thomas S. PacK President Name of proposed Superintendent Telephone No. of proposed Superintendent: (562) 802-7227 Project Name& Contract Amount Type ork Date Completed Project Name & Contract And nt Type of Work Date Completed Project Name & Contract Amount Type of Work Date Completed C-10 SEQUEL CONTRACTORS, INC. ST.LIC#610600A 13546 IMPERIAL HWY SANTA FE SPRINGS, CA 90670 Fax (562) 802-7499 (562) 802-7227 Office STATEMENT OF EXPERIENCE 1. OWNER: CITY OF LA MIRADA ADDRESS: 15515 PHOEBE AVE. LA MIRADA,CA 90638 PHONE NO.: (562)902-2373 CONTACT: GARY SANUI PROJECT: RESIDENTIAL STREET REHAB PHASE 1 PROJECT AMOUNT: $4,668,969.75 COMPLETION DATE AUGUAT 2015 2. OWNER: CITY OF INGLEWOOD ADDRESS: ONE MANCHESTER BLVD INGLEWOOD,CA 90301 PHONE NO.: (310)412-5333 CONTACT: HUNTER NGUYEN PROJECT: STREET IMPROVEMENTS FY 2014-2015 PROJECT AMOUNT: $3,028,886.41 COMPLETION DATE SEPTEMBER 2015 6. OWNER: CITY OF WESTMINSTER ADDRESS: 8200 WESTMINSTER BLVD WESTMINSTER,CA 92683 PHONE NO.: (714)548-3464 CONTACT: THERESA TRAN PROJECT: CITY WIDE STREET IMPROVEMENTS PROJECT AMOUNT: $1,538,452.62 COMPLETION DATE AUGUST 2015 4. OWNER: CITY OF CERRITOS ADDRESS: 18125 BLOOMFIELD AVE CERRITOS,CA 90703 PHONE NO.: (562)916-1229 CONTACT: FREDY BONNILA PROJECT: RESIDENTIAL STREET REHAB PROJECT AMOUNT: $544,627.80 COMPLETION DATE DECEMBER 2015 5. OWNER: CITY OF LA MIRADA ADDRESS: 15515 PHOEBE AVE LA MIRADA,CA 90638 PHONE NO.: (562)902-2373 CONTACT: GARY SANUI PROJECT: FOSTER PARK AREA PHASE 4 PROJECT AMOUNT: $2,054,436.78 COMPLETION DATE OCTOBER 2015 SEQUEL CONTRACTORS, INC. ST.LIC#610600A 13546 IMPERIAL HWY SANTA FE SPRINGS, CA 90670 Fax (562) 802-7499 (562) 802-7227 Office STATEMENT OF EXPERIENCE 6. OWNER: CITY OF INGLEWOOD ADDRESS: ONE MANCHESTER BLVD INGLEWOOD,CA 90301 PHONE NO.: (310)412-5333 CONTACT: HUNTER NGUYEN PROJECT: STREET IMPROVEMENTS FY 2012-13 PROJECT AMOUNT: $1,823,814.00 COMPLETION DATE SEPTEMBER 2014 7. OWNER: CITY OF GARDENA ADDRESS: 170OW 162°d STREET GARDENA, CA 90247 PHONE NO.: (310)217-9500 CONTACT: JOHN FELIX PROJECT: VERMONT AVE REHAB PROJECT AMOUNT: $1,548,818.00 COMPLETION DATE AUGUST 2014 8. OWNER: CITY OF HIGHLAND ADDRESS: 27215 BASE LINE HIGHLAND,CA 92346 PHONE NO.: (909)864-6861 CONTACT: CARLOS ZAMANO PROJECT: BASE LINE BEUTICICATION PROJECT AMOUNT: $2,725,182.63 COMPLETION DATE JANUARY 2014 9. OWNER: CITY OF NEWPORT BEACH ADDRESS: 100 CIVIC CENTER DR. NEWPORT BEACH,CA 92660 PHONE NO.: (949)644-3314 CONTACT: ALFRED CASTANEN PROJECT: RESIDENTIAL STREET EVERLAY PROGRAM PROJECT AMOUNT: $1,280,124.99 COMPLETION DATE FEBRUARY 2015 10. OWNER: CITY OF SANTA FE SPRINGS ADDRESS: 11710 TELEGRAPH RD. SANT FE SPRINGS,CA 90670 PHONE NO.: (562)868-0511 CONTACT: NOE NEGRETE PROJECT: GRIDLEY RD.PAVEMENT REHAB. PROJECT AMOUNT: $236,904.78 COMPLETION DATE MAY 2014 SEQUEL CONTRACTORS, INC. ST.LIC#610600A 13546 IMPERIAL HWY SANTA FE SPRINGS, CA 90670 Fax (562) 802-7499 (562) 802-7227 Office STATEMENT OF EXPERIENCE 11. OWNER: CITY OF LA MIRADA ADDRESS: 15515 PHOEBE AVE. LA MIRADA,CA 90638 PHONE NO.: (562)943-0131 CONTACT: TONY MORENO PROJECT: FOSTER PARK STREET IMPROVEMENTS PHASE 3 PROJECT AMOUNT: $650,121.97 COMPLETION DATE OCTOBER 2013 12. OWNER: CITY OF TUSTIN ADDRESS: 300 CENTENNIAL WAY TUSTIN,CA 92780 PHONE NO.: (714)573-3157 CONTACT: EDDY JAN PROJECT: ANNUAL ROADWAY AND SIDEWALK REHAB PROJECT AMOUNT: $1,136,251.87 COMPLETION DATE NOVEMBER 2013 13. OWNER: CITY OF INGLEWOOD ADDRESS: ONE MANCHESTER BLVD INGLEWOOD,CA 90301 PHONE NO.: (310)412-5333 CONTACT: HUNTER NGUYEN PROJECT: STREET IMPROVEMENTS FY 2012-13 PROJECT AMOUNT: $1,294,140.16 COMPLETION DATE JULY 2013 14. OWNER: CITY OF LOS ALAMITOS ADDRESS: 3191 KATELLA AVE LOS ALAMITOS,CA 90720 PHONE NO.: (562)431-3538 CONTACT: DAVE HUNT PROJECT: COMMERCIAL STREET IMPROVEMENT PROJECT AMOUNT: $600,776.30 COMPLETION DATE SEPTEMBER 2013 15. OWNER: CITY OF CERRITOS ADDRESS: 18125 BLOOMFIELD AVE. CERRITOS, CA 90703 PHONE NO.: (562)916-1229 CONTACT: FREDY BONILLA PROJECT: 183'STREET IMPROVEMENTS PROJECT AMOUNT: $529,823.96 COMPLETION DATE APRIL 2013 SEQUEL CONTRACTORS, INC. ST. LIC #610600A 13546 IMPERIAL HIGHWAY SANTA FE SPRINGS, CA 90670 FAX (562) 802-7499 (562) 802-7227 OFFICE RESUME FOR THOMAS S. PACK Sequel Contractors,Inc. President and Treasurer TRAINING: Thirty-three years in the industry with three years of experience in mechanical construction and engineering, twelve years of experience in private industry road building estimating both Public Works and Private Works and four years as an executive. Responsible for start up, management and completion of the final product. WORK EXPERIENCE: Sequel Contractors, Inc. 1995-Presently President&Treasurer Vice President & Secretary Executive and Project Manager Shawnan Corporation 1991-1995 Vice President & Secretary Chief Estimator and Project Manager for Public Works Boral Resources 1988-1991 Estimator for Public Works & Private Works Sully Miller Co. 1983-1988 Estimator for Public Works & Private Works Fluor Constructors 1980-1983 Warehouse Administrator resume.tsp SEQUEL CONTRACTORS, INC. ST.LIC#610600A 13546 IMPERIAL HWY SANTA FE SPRINGS, CA 90670 Fax (562) 802-7499 (562) 802-7227 Office RESUME FOR MICHAEL A. MAHLER Sequel Contractors, Inc. Secretary TRAINING: Twenty-Two years in estimating and project managing for both Public and Private Works General Engineer Construction with one year experiences in Building Construction. Earned a Bachelors of Science degree in 1996 from California State University at Long Beach in Engineering Construction Management. WORK EXPERIENCE: Sequel Contractors, Inc. 1996- Present Assistant Secretary, Chief Estimator& Scheduler. Senior Project Manager Responsible for Bid Review, Bidding Schedule and Overall Operations of the Estimating&Project Manager Department. Storm Water Pollution Prevention Manager Shawnan Corporation 1994-1996 Estimator for Public& Private Works Project Engineering for Port of L.A. Berth 300 Backland Improvements Project Management Contractors Labor Pool 1993-1994 Finished Carpenters Assistant General Laborer &Rough Carpentry "RESUMEMAM" CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771.1(a)), passed by the California State Senate on June 20, 2014, established a new public works Contractor Registration Program, which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July 1 through June 30 state fiscal year) with the California Department of Industrial Relations (DIR)_ Currently the annual non-refundable registration fee for Contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 http://www.dir.ca.gov/DLSE/PublicWorks/SB854FactSheet 6.30.14.pdf DIR's Contractor Registration Link—Call(844) 522-6734 https://efiling.dir.ca.gov/PWCRJActionS ervlet?action--displayPWCRegistrationForm DIR's Contractor Registration searchable database: https:Hefiling.dir.ca.gov/PWCR/Search.action I am aware and will comply with the provisions of Labor Code Section 1771.1(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.SEE UEL V CTORe S ING, Contractor F3 1 ho^",ias S PaCh JPresiden. Title Date: rDEC 2 0 2016 DIR Qooc) SZ C-11 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AlWkIENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations,Part 135* Economic Opportunities for Low and Very Low-Income Persons The bidder,under penalty of perjury, certifies that except as noted below,any person associated therewith in the capacity of owner,pa er, director, officer,or manager(initial the applicable selections): Will ensure that 10%of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968;or Will hire no new employees in conjunction with this project. Will award 10%of its sub-contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub-contracts related to this project. Contractor: SEQUEL CONTRACTORS, Ntl. Contact Person: Thomas S. a K Presi nt Contact Phone: t562 agk-f22_7,�Z, Signed- Thomas S. PaCK President Date: 'p C o tote *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub-contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act,as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in diisgualification. ec /rafiHlf's. .?OCR ar pw �,r�,��,,�. �i.ti�v/rr�f ��G ��c��v� f�S�cJ/✓ �rc �' 7 a ffgotitd C-12 l� Section 3 Resident Certification Employee Residing in Orange County Note: This form is for use in conjunction with the "Section 3 Business Certification Form"to(S)substantiate a certification as a Section 3 Business Concern; or (2) to substantiate a subcontracting written commitment only. This form MAY NOT be used for the purpose of qualifying a new hire as a Section 3 Resident.Only residents of Los Angeles County may qualify as Section 3 New Hires. � U S-T I NAME t SLI32 NEAR(_A-TE PVN lriylotj 13FAQ4 9)-( ��'J EI ADDRESS I hereby certify that I am a Section 3 resident;based on the following qualification(s): i i 1. ❑ I am a Public Housing Resident: j NAME Of PUBLIC HOUSINC S6E I ACCRESS OF PURR HOJSiNG SITE I 2. I am a low-income resident of the metropolitan area and: I 2016INCOME L1MUS My household My household's gross annual income from all sources is: Size is: 1 $20,500 or Less ❑ $20,501 to$34,150 Z $34,151 to$54,600 ❑ $54,601 or more ❑ 2 ❑ $23,400 or Less ❑❑ $23,401 to$39,090 ❑ $39,001 to$62,400 ❑ $62,401 or more i 3 ❑ S26,350 or Less ❑ $26,351 to$43,900 ❑ $43,901 to$70,200 ❑ $70,201 or more ❑ i 4 ❑ $29,250 or Less ❑ $29,251 to$48,750 ❑ $48,751tn V4000 ❑ $78,001 or more ❑ 5 ❑ $31,600 or Less ❑ $31,601 to$52,650 ❑ $52,651 to$84,2S0 ❑ $84,251 or more ❑ 6 ❑ $33,950 or Less ❑ $33,951 to$56,550 ❑ $56,551 to$90,500 ❑ $90,501 or more ❑ 7 ❑ $36,730 or Less ❑ I $36,731 to$60,430 ❑ $60,451 to$96,750 ❑ $96,751 or more ❑ i 8 ❑ $40,890 or Less ❑ $40,891 to$64,350 ❑ $64,351 to 103,000 ❑ $108,001 or more ❑ i According to Title I8, Section 1001 of the U.S. Code, it is a felony for any person to knowingly and willingly make false or fraudulent statements to any department of the United States Government 1, the undersigned hereby certifj that all statements contained herein, are true and correct to the best of my knowledge and belief. I understand the information 1 ; provide in this certification is subject to verification,and i agree to provide necessary documentation if requested. I U n5Vr the pe 'u ,I ce that the above information is true and correct. � 1 EM SIG ATURE I DATt II i i To be Completed by Employer: i The above-named person was hired previous to this certification on: ZD The above-named person is a new hire as of: The above-named person's Work Classification is: Company Name: liONTRACT RS, INC. Employer Name/Signature: MA9,1EN, SEWFI•MY I To Be Completed by Local Contracting Agency Preference Category: 0 Targeted Service Area 0 Youthbuild 0 McKinney Homeless 0 Other Section 1 3 k t3 LJ . X\A�t��V f Section 3 Resident Certification Employee Residing in Los Angeles County I (Vote: This form is for use in conjunction with the "Section 3 Business Certification Form"to (1)substantiate a certification as a Section 3 Business Concern;or (2) to substantiate a written commitment. It may also be used for the purposes of qualifying a new hire as a Section 3 Resident. Only residents of Los Angetes County may quality as Section 3 New Hires. i C�(5 NAME ADDRESS I hereby certify that I am a Section 3 resident;based on the following qualification(s): i i1. ❑ I am a Public Housing Resident: EI NAME OF PUKIC HOUANG SIT; I ADCRESS Or PU6LIC HCUSiNG 5,'TE I 2. ❑ I am a low-income resident of the metropolitan area and: If 2016 NCOME LIMITS My (t household My household's gross annual income from all sources is: Size is: 1 ❑ $18,250 or Less ❑ $18,251 to$30,400 ❑ $30,401 to$43,650 Q $48,651 or more ❑ I 2 ❑ $20,850 or Less ❑ $20,851 to$34,750 ❑ $34,751 to$55,600 ❑ $55,601 or more ❑ 3 $23,450 or Less ❑ $23,451 to$39,100 ❑ $39,101 to$62,550 $62,551 or more ❑ 4 ❑ $26,050 or Less ❑ $26,051 to$43,400 ❑ $43,401 to$69,450 ET $69,451 or more ❑ 5 ❑ $28,440 or Less ❑ S28,441 to$46,900 ❑ $46,901 to$75,050 ❑ $75,051 or more ❑ i 6 ❑ $32,580 or Less $32,581 to$50,350 ❑ ❑ ❑ $50,351 to$80,600 Q $80,601 or more i 7 ❑ $36,730 or Less ❑ $36,731 to$53,850 ❑ f $53,851 to$86,150 ❑ $86,151 or more ❑ 8 ❑ $40,890 or Less ❑ $40,891 t0$57,300 ❑ $57,301 to$91,700 ❑ $91,701 or more ❑ According to Title 18, Section 1001 of the U.S. Code, it is a felony for any person to knowingly and willingly make false or fraudulent statements to any deportment of the United States Government. 1, the undersigned, hereby certifl that all ! statements contained herein, are true and correct to the best of my knowledge and belief. 1 understand the information l provide in this certification is subject to verification,and 1 agree to provide necessary documentation if requested. U the enalty of perjury,I certify that the above information is true and correct. i c EMPLOYEE S19rrS DATE j(. I To be Completed by Employer. t The above-named person was hired previous to this certification on: l 13 - 04 I The above-named person is a new hire as of: / i The above-named person's Work Classification is: /�,��l�✓.�tv` Company Name: L CONTRACTORS IN61 Employer Name/Signature: WA,MAK ., SEGyjj`d To Be Completed by Local Contracting Agency Preference Category: 0 Targeted Service Area 0 Youthbuild 0 McKinney Homeless 0 Other Section 3 i y�\y t� Section 3 Resident Certification Employee Residing in Orange County Note: This form is for use in conjunction with the "Section 3 Business Certification Form"to(1)substantiate a certification as a Section 3 Business Concern; or (2) to substantiate a subcontracting written commitment only. This form MAY NOT be used for the purpose of qualifying anew hire as a Section 3 Resident. Only residents of Los Angeles Count r may qualify as Section 3 New Hires. j C_wI C 2Q�X NAME A (D 3;,;3 )A C�J &I C -]T-u ADDRESS I hereby certify that I am a Section 3 resident;based on the following qualifications): i 1. ❑ I am a Public Housing Resident: NA,M:OF RUBUC HOUSING ATE AOUBE55 OF PUBIC HOUSING STf 2. I am a low-income resident of the metropolitan area and: i i 2016INCOME LIMITS i My household My household's gross annual income from all sources is: Size is: 1 ❑ $20,500 or Less ❑ $20,501 to$34,150 ❑ $34,151 to$54,600 ❑ $54,601 or more ❑ i 2 $23,400 or Less ❑ $23.401 to$39,000 ® $39,001 to$62,400 ❑ $62,401 or more ❑ 3 ❑ $26,350 or Less ❑ $26,351 to$43,900 ❑ $43 901 to$70,200 ❑ $70,201 or more ❑ 4 ❑ $29,250 or Less ❑ $29,251 to$48,750 ❑ $48,751 to$78,000 ❑ $78,001 or more ❑ 5 ❑ $31,600 or Less ❑ $31,601 to$52,650 ❑ $52,651 to$84,2S0 ❑ $84,251 or more ❑ 6 ❑ $33,950 or Less ❑ $33,951 to$56,550 ❑ $56,551 to$90,500 ❑ $90,501 or more ❑ 7 ❑ $36,730 or Less $36,731 to$60,430 ❑ $60,4S1 to$96,750 ❑ $96,751 or more ❑ 8 El $40,890 or Less ❑ $40,891 to$64,350 ❑ $64,351 to 103,000 El $103,001 or more El According to Title 18, Section 1001 of the U.S. Code, it is a felony for any person to knowingly and willingly make false or { fraudulent statements to any department of the United States Government. !, the undersigned, hereby certify that all statements contained herein, are true and correct to the best of my knowledge and belief, l understand the information l provide in this certification is subject to verification,and l agree to provide necessary documentation if requested. i i Under the penalty of perjury,I ertify that the above information is true and correct. j EMPLOYEE SIGMA DATE ! I i To be Completed by Employer: The above-named person was hired previous to this certification on: The above-named person is a new hire as of: The above-named person's Work Classification is: �b y�'^v ! Lev, Company Name: riiAt ' A Employer Name/Signature: To Be Completed by Local Contracting Agency Preference Category: D Targeted Service Area G Youthbuild r McKinney Homeless ©Other Section 3 k- t3 i Section 3 Resident Certification Employee Residing in San Bernardino County J Riverside County Note: This form is for use in conjunction with the "Section 3 Business Certification Form"to (1)substantiate I a certification as a Section 3 Business Concern; or (2) to substantiate a subcontracting written �. commitment only. This form MAY NOT be used for the purpose of qualifying a new hire as a Section 3 4 Resident. Only residents of Los Angeles County may qualify as Section 3 New Hires. r c& NA1.:E � ehYeni�S ' s , C�- 12570 AOJ.i£55 � I 7 I hereby certify that I am a Section 3 resident:based on the following qualification(s): 1. ❑ I am a Public Housing Resident: NAME OE 7USUC HOUSING SrrE i I ACOR£SS OF PUBLIC HOUSING SII£ i 2. [� 1 am a low-income resident of the metropolitan area and: 2016INCOME LIMITS j My household My household's gross annual income from all sources is: Size is: 1 $13,450 or Less ❑ $13,451 to$22,400 ❑ $22,401 to$35,800 &r $35,801 or more ❑ 2 ❑ $16,020 or Less ❑ $16,021 to$25,600 ❑ $25,501 to$40,900 ❑ $40,901 or more ❑ 3 ❑ $20,160 or Less ❑ $20,161 to$28,800 ❑ $28,801 to$46,000 ❑ $46,001 or more ❑ 4 ❑ $24,300 or Less ❑ $24,301 to$31,950 ❑ $31,951 to$51,100 ❑ f $51,101 or more ❑ 5 ❑ $28,440 or Less ❑ $28,441 to$34,550 ❑ $34,551 to$55,200 ❑ $55,201 or more ❑ j 6 ❑ $32,580 or Less ❑ $32,581 to$37,100 ❑ $37,101 to$59,300 ❑ $59,301 or more ❑ 7 ❑ I $36,730 or Less ❑ I $36,731 to$39,650 ❑ $39,651 to$63,400 ❑ $63,401 or more ❑ j $ ❑ $40,890 or less $40,891 to$42,200❑ ❑ $42,201 to$67,500 ❑ $67,501 or more ❑ i According to Title 18, Section 1001 of the U.S. Code, it is a felony for any person to knowingly and willingly make false or froudule.nt statements to any department of the United States Government- 1, the undersigned, hereby certify that all statements contained herein, ore true and correct to the best of my knowledge and belief I understand the information I provide in this certification is subject to verification,and 1 agree to provide necessary documentation if requested. i Under the penalty of perjury,I certify that the above information is true and correct. EMPLOYEE SIGNATURE DATE 1 To be Completed by Employer. l � i The above-named person was hired previous to this certification on: �- i The above-named person is a new hire as of: The above-named person's Work Classification is: ` iy*,- ' Company Name: (_ CONTRACTORS, NO, Employer Name/Signature: MICHAELA.MAfU To Be Completed by Local Contracting Agency Preference Category: ❑Targeted Service Area ❑Youthbuild ❑McKinney Homeless ❑Other Section 3 tOIL Section 3 Resident Certification Employee Residing in Orange County Note: This form is for use in conjunction with the "Section 3 Business Certification Form"to(I)substantiate a certification as a Section 3 Business Concern; or (2) to substantiate a subcontracting written i commitment only. This form MAY NOT be used for the purpose of qualifying a new hire as a Section 3 j Resident. Only residents of Los Angeles County may qualify as Section 3 New Hires. I � ,.ME ZA - ADDRESS 1 I hereby certify that I am a Section 3 resident;based on the following qualification(s): 1 1. ❑ I am a Public Housing Resident E NAME OF PUBUC HOUSING SUE I AODAESS OF MCC HCUSING SITE f I 2. I am a low-income resident of the metropolitan area and: i 2016 NCQMe LIMITS l My household My household's gross annual income from all sources is: Size is: 1 $20,500 or Less ❑ $20,501 to$34,150 ❑ $34,151 to$54,600 $54,601 or more ❑ i 2 $23,400 or Less ❑ $23,401 to$39,000 ❑ $39,001 to$62,400 ❑ $62,401 or more ❑ 3 ❑ $25,350 or Less ❑ $26,351 to$43,900 ❑ $43,901 to$70,200 ❑ $70,201 or more ❑ 4 ❑ $29,2S0 or Less ❑ $29,251 to$48,750 ❑ $48,751 to$78,000 ❑ $78,001 or more ❑ S ❑ $31,600 or Less ❑ $31,601 to$52,650 ❑ $52,651 to$84,250 ❑ $84,251 or more El 6 ❑ $33,950 or Less ❑ $33,951 to$56,550 ❑ $56,551 to$90,500 ❑ $90,501 or more ❑ 7 ❑ $36,730 or Less ❑ $36,731 to$60,450 ❑ $60,451 to$96,750 ❑ $96,751 or more El 8 ❑ $40,890 or Less ❑ $40,891 to$64,350 ❑ $64,351 to 103,000 ❑ $103,001 or more ❑ 1 According to Title 18, Section 1001 of the U.S. Code, it is a felony for any person to knowingly and willingly make false or i f-audulent statements to any department of the United States Government 1, the undersigned, hereby certify that all I statements contained herein, are true and correct to the best of my knowledge and belief, I understand the information I provide in this certifCcotion is subject to verification,and I agree to provide necessary documentation if requested. I Linder the i that the above information is true and correct. ! +tF . ESIGNATURE GATE i i i To be Completed by Employer: The above-named person was hired previous to this certification on: The above-named person is a new hire as of: The above-named person's Work Classification is: C�C_�L+/e, Company Name: t dl Employer Name/Signature: //- TCHAELA.MAME6, .9PC0 _. � To Be Completed by Local Contracting Agency Preference Category: 0 Targeted Service Area 0 Youthbuild 0 McKinney Homeless ❑Other Section 3 i k-�3 1 t• C`11 Section 3 Resident Certification Employee Residing in Orange County Note: This form is for use in conjunction with the "Section 3 Business Certification Form"to(1)substantiate a certification as a Section 3 Business Concern; or (2) to substantiate a subcontracting written commitment only. This form MAY NOT be used for the purpose of qualifying anew hire as a Section 3 } Resident.Only residents of Los Angeles County may qualify as Section 3 New Hires. \F�1 ADDRESS I hereby certify that I am a Section 3 resident;based on the following quali€ication(s): i 1. ❑ I am a Public Housing Resident: j NAPAE Of PUBUC HOUSING SUE , i i AODRESS OF PUBUIC HOUSING SITE j 2. ZI I am a low-income resident of the metropolitan area and: i 2016TNCOMF LIMITS i My household My household's gross annual income from all sources is: Size is: 1 ❑ $20,500 or Less ❑ $20,501 to$34,150 ❑ $34,151 to$54,600 ❑ $54,601 or more ❑ 2 $23,400 or Less ❑ $23,401 to$39,000 $39,001 to$62,400 ❑ $62,401 or more ❑ 3 ❑ $26,350 or Less ❑ $26,351 to$43,900 ❑ $43,901 to$70,200 ❑ $70,201 or more ❑ 4 ❑ $29,250 or Less ❑ $29,251 to$48,750 ❑ $48,751 to$78,000 ❑ $78,001 or more ❑ 5 ❑ $31,600 or Less ❑ $31,601 to$52,650 ❑ $52,651 to$84,250 ❑ $84,251 or more ❑ i 6 ❑ $33,950 or Less ❑ $33,951 to$56,550 ❑ $56,551 to$90 500 ❑ $40,501 or more ❑ 7 ❑ $36,730 or Less ❑ $36,731 to$50,450 ❑ $60,451 to$96,750 ❑ $96,751 or more ❑ $ ElW,390 or Less ❑ $40,891 to$64,350 ❑ $64,351 to 103,000 ❑ $103,001 or more ❑ i According to Title 18, Section 1001 of the U.S. Code, it is a felony for any person to knowingly and willingly make false or fraudulent statements to any department of the United States Government. 1, the undersigned, hereby certify that all statements contained herein, are true and correct to the best of my knowledge and belief. I understand the information I provide in this certification is subject to verification,and I agree to provide necessary documentation if requested. i i Under th erlu ,I certify that the above information is true and correct. WPLO E NAN DATE ~ I t To be Completed by Employer: The above-named person was hired previous to this certification on: The above-named person is a new hire as of- The above-named person's Work Classification is: L�E� "o Ler I Company Name: SEMEL cbNTRAi Employer Name/Signature: aFE x To Be Completed by Local Contracting Agency Preference Category: D Targeted Service Area ❑Youthbuild U McKinney Homeless 17 Other Section 3 k �3 C`t Section 3 Resident Certification Employee Residing in Los Angeles County f Note: This form is for use in conjunction with the "Section 3 Business Certification form"to (1)substantiate a certification as a Section 3 Business Concern;or(2) to substantiate a written commitment. It may also be used for the purposes of qualifying a new hire as a Section 3 Resident. Only residents of Cos Angeles County may qualify as Section 3 New Hires. �4�6� /IJc�C✓t l/ i. NAME �. ACDRESS I hereby certify that I am a Section 3 resident;based on the following qualifications): IfI 1. ❑ I am a Public Housing Resident: II i 4i NAME OF PU8LIC HOUSING SITE 4 I( ACCAESS OF PUSIUC HOUSING 5T 2. d I am a low-income resident of the metropolitan area and: I 2016 LUCOME LIMITS j My 1 household My household's gross annual income from all sources is: Size is: I 1 $18.250 or Less ❑ $18,251 to$30,400 ❑ $30,401 to$48,650 Rf $48,651 or more ❑ i 2 ❑ $20,850 or Less ❑ $20,851 to$34,750 ❑ $34,751 to$55,600 ❑ $55,601 or more ❑ 3 ❑ $23,450 or Less ❑ $23,451 to$39,100 ❑ $39,101 to$62,550 ❑ $62,551 or more ❑ 4 ❑ $26,050 or Less ❑ $26,051 to$43,400 ❑ $43,401 to$69,450 ❑ $69,451 or more ❑ 5 ❑ $28,440 or Less ❑ 528,441 to$46,900 ❑ $46,901 to$75,C50 ❑ $75,051 or more ❑ i i b ❑ i $32,580 or Less ❑ $32,681 to$50,350 ❑ 1 $50,351 to$80,600 ❑ $80,601 or more ❑ 7 ❑ $36,730 or Less ❑ $36,731 to$53,850 ❑ $53,851 to$86,150 ❑ $86,151 or more ❑ 8 ❑ $40,890 or Less ❑ $40,891 to$57,300 ❑ $57,301 to$91,700 ❑ $91,701 or more ❑ i Accord ng to Title 18, Section 1001 of the U.S. Code, It is o felony for any person to knowingly and willingly make false or fraudulent statements to any department of the United States Government. 1, the undersigned, hereby certify that all statements contained herein, are true and correct to the best of my knowledge and belief. I understand the information 1 provide in this certification is subject to verification,and I agree to provide necessary documentation if requested. k i der the enalty of pe jury,I certify that the above information is true and rrect.7Q10 / MPLOlEE SIGNATURE DATE I To be Completed by Employer The above-named person was hired previous to this certification on: i The above-named person is a neav hire as of. The above-named person's Work Classification is: Company Name: SZOUEL CONTRACTORS, IWO, i Employer Name/Signature: To Be Completed by Loca Contracting Agency Preference Category: 0 Targeted Service Area 0 Youthbuild 0 McKinney Homeless 0 Other Section 3 i RELIABLE CONTRACTOR DECLARATION (page 1 of 2) CalRecycle 168(Revised 9/16) This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalRecycle) prior to authorizing a contractor(s) to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of funds to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Reliable Contractor Declaration (formerly Unreliable List) requirement of their Terms and Conditions. The Reliable Contractor Declaration (formerly Unreliable List) provision requires the following: Prior to authorizing a contractor(s) to commence work under the Grant, the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractor(s) stating that within the precedin three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the contractor(s). Please see the reverse of this page, or refer to the California Code of Regulations (www.calregs.com). If any of the events listed in Section 17050 have occurred, disclosure is required but will not necessarily result in CalRecycle refusing to approve the contractor. A signed statement explaining the facts and circumstances of the events must be attached to and submitted with this form. Contractor: Complete the form and send original to the Grantee. Grantee: Scan the form and upload it to the grant in CalRecycle's Grant Management System. For further instruction about logging into the Grant Management System and uploading this form, reference the Procedures and Requirements. Retain the original form in your grant file. GRANTEE INFORMATION GRANTEE AME: GRANT NUMBER: C� N� 164. el'c Wo. /S'� PRIMARY CONTACT NAME: CONTRACTOR INFORMATION CONTRACTOR NAME: SEQ'vEL CONTRACTORS, INC, AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: p MAILING ADDRESS: 13546 IMPERIAL HWY. ANTA FE SPRINGS, CALIF. W670 As the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has E occurred with respect to the above identified contractor. I Alternatively, as the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of California that within the preceding three(3)years, if any of the events listed in Section 17050 of Title 14, California Code o of Regulations, Natural Resources, Division 7, has occurred wi re pect to t e above identified co ractar, I have disclosed all such occurrences in an attached sin ement ex lains the facts a d circumstances of the listed events. SMhV�reSident Date DEC 2 p 2016 t C-13 SEQUEL CONTRACTORS, IN& RELIABLE CONTRACTOR DECLARATION (page 2 of 2) CalRecycle 168(Revised 9116) Title 14 CCR, Division 7, Chapter 1 Article 5. Unreliable Contractors,Subcontractors,Borrowers and Grantees Section 17050,Grounds for Placement on Unreliable List The following are grounds for a finding that a contractor,any subcontractor that provides services for a CalRecycle agreement, grantee or borrower is unreliable and should be placed on the CalRecycle Unreliable Contractor, Subcontractor, Grantee or Borrower List ("Unreliable List'). The presence of one of these grounds shall not automatically result in placement on the Unreliable List. A finding must be made by the Executive Director in accordance with section 17054,and there must be a final decision on any appeal that may be filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s)to CalRecycle due to fraudulent claims or reporting;or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act, Government Code section 12650 et seq;or (c) Default on a CalRecycle loan,as evidenced by written notice from'CalRecycle staff provided to the borrower of the default;or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycle;or (e) Filing voluntary or involuntary bankruptcy,where there is a finding based on substantial evidence, that the bankruptcy interfered with the CalRecycle contract,subcontract,grant or loan;or (f) Breach of the terms and conditions of a previous CalRecycle contract,any subcontract for a CalRecycle agreement,grant,or loan,resulting in termination of the CalRecycle contract,subcontract,grant or loan by the Cal Recycle or prime contractor;or (g) Placement on the CafRecycie's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility;or (h) The person, or any partner, member, officer, director, responsible managing officer, or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion,conspiracy, or any act in violation of any state or federal antitrust law in connection with the bidding upon, award of, or performance under any CalRecycle contract, subcontract,grant or loan;or (i) The person or entity is on the list of unreliable persons or entities,or similar list,of any other federal or California state agency;or (j) The person or entity has violated an Order issued in accordance with section 18304;or, (k) The person or entity has directed or transported to,has or accepted waste tires at,a site where the operator is required to have but does not have a waste tire facility permit;or, (I) The person or entity has transported waste tires without a waste fire hauler registration;or, (m) The person or entity has had a solid waste facility orwaste tire permit or a waste tire hauler registration denied, suspended or revoked;or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRecycle to remediate,clean,or abate a nuisance at the site;or (o) The following are additional grounds for a finding that,a person or entity described below should be placed on the Unreliable List: (1) The person or entity owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director,manager,partner,trustee,or any other management position with significant control(Principal Manager)in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person who owns 20%or more of the entity,if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List (5) The entity has another entity which owns 20%or more of the entity,if that other entity: 1. Is on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (6) Subsection(o)is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List C-14 Local Assistance Procedures Manual Exhibit 12-H Sample Bid (THE BIDDER'S EXECU770N ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONS77TUTE AN ENDORSEMENT AND EXECUTION OF THOSE CER77FIC4TIONS WHICHAREA PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder. SEWEL CON MCTORS, r1110` proposed subcontractor hereby certifies that he has_, has not_,participated in a previous contract or subcontract subject to the equal opportunity clauses,as required by Executive Orders 10925,11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity,all reports due under the applicable filling requirements. Mote: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b)(1)),and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing _ regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director,Office of Federal Contract_ Compliance,U.S.Department of Labor. Page 1 of 8 C-15 June 11,2014 SEQUEL cO CTORs, IN6.. Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376,Stats. 1985),the bidder here declares under penalty of perjury under the laws of the State of California that the bidder has_,has not been convicted within the preceding three years of any offenses referred to in that section,including any charge of fraud,bribery,collusion, conspiracy,or any other act in violation of any state or Federal antitrust law in connection with the bidding upon,award of, or performance of,any public works contract,as defined in Public Contract Code Section 1101,with any public entity,as defined in Public Contract Code Section 1100,including the Regents of the University of California or the Trustees of the California State University. The term"bidder"is understood to include any partner,member,officer,director,responsible managing officer,or responsible managing employee thereof,as referred to in Section 10285.1. Note: The bidder must place a checkmark after"has"or"has not'in one of the blank spaces provided.The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement.Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. PUBLIC COINTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162,the,Bidder shall complete,under penalty of perjury,the following questionnaire: Has the bidder,any officer of the bidder,or any employee of the bidder who has a proprietary interest in the bidder,ever been disqualified,removed,or otherwise prevented from bidding on,or completing a federal,state,or local government project because of a violation of law or a safety regulation? Yes No If the answer is yes,explain the circumstances in the following space. Page 2 of 8 C-16 June 11,2014 oun 604MCTORS, IN6, Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232,the Contractor,hereby states under penalty of perjury,that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 3 of 8 C-17 June 11,2014 S-1--aUn CONTRACTORS, tWC. Local Assistance Procedures Manual Exhibit 12-H Sample Bid Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY/COUNTY oWuwrmr—�10l� 'i3ow DEP,4RTMEYT OF PUBLIC WORKS. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of,or on behalf of,any undisclosed person,partnership, company,association,organization,or corporation;that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded,conspired,connived,or agreed with any bidder or anyone else to put in a sham bid,or that anyone shall refrain from bidding;that the bidder has not in any manner,directly or indirectly,sought by agreement,communication,or conference with anyone to fix the bid price of the bidder or any other bidder,or to fix any overhead,profit,or cost element of the bid price,or of that of any other bidder,or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true;and,further,that the bidder has not,directly or indirectly,submitted his or her bid price or any breakdown thereof,or the contents thereof, or divulged information or data relative thereto,or paid,and will not pay,any fee to any corporation, partnership,company association,organization,bid depository,or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 4 of 8 C-18 .Tune 11,2014 SEQUEL CONTRACTORS, Itq(, Local Assistance Procedures Manual Exhibit 12-H Sample Bid DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS,PART 29 The bidder,under penalty of perjury,certifies that,except as noted below,he/she or any other person associated therewith in the capacity of owner,partner,director,officer,manager: • is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any Federal agency; • has not been suspended,debarred,voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending;and • has not been indicted,convicted,or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification,insert the exceptions in the following space. N Exceptions will not necessarily result in denial of award,but will be considered in determining bidder responsibility. For any exception noted above,indicate below to whom it applies,initiating agency,and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 5 of 8 C-19 June 11,2014 MEL CONTRACTOM, 1140 Local Assistance Procedures Manual Exhibit 12-H Sample Did NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies,by signing and submitting this bid or proposal,to the best of his or her knowledge and belief,that: (1) No Federal appropriated funds have been paid or will be paid,by or on behalf of the undersigned,to any person for influencing or attempting to influence an officer or employee of any Federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal,amendment,or modification of any Federal contract,grant,loan,or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with this Federal contract,grant, loan,or cooperative agreement,the undersigned shall complete and submit Standard Form-ILL,"Disclosure of Lobbying Activities,"in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352,Title 31,U.S.Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts,which exceed$100,000 and that all such subrecipients shall certify and disclose accordingly. Page 6 of 8 C-20 June 11,2014 MEL CONTRACTORS, IN( Local Assistance Procedures Manual Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C.1352 Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract a. bid/offer/application LM a. initial b. grant b. initial award b, material change c. cooperative agreement c. post-award d. loan For Material Change Only: e. loan guarantee year quarter f. loan insurance date of last report 4. Namcd Address ofReporting Entity 5. If Reporting Entity in No.4 is Subawardee, Enter Name and Address of Prime: ri FISubawardee ,,er if known /./o� y ��,��/y�• �Congr ssronal District,if known Congressional District,if known 6. Federal Department/Agency: 7. Federal Program NamODescription: CFDA Number,if applicable 8. Federal Action Number,if known: 9. Award Amount,if known: A /`.' ,� 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual last name,first name,MI) address if different from No.10a) r (last name,first name,NE) (attach Continuation Sheet(s)if necessary) 11. Amount of Payment(check all that apply) 13. Type of Payment(check all that apply) $ actual ❑planned a. retainer b. one-time fee 12. Form of Payment(check all that apply): c. commission W Ba. cash d. contingent fee b, in-kind; specif},: nature e deferred value LJ f. other,specify 14. Brief Description of Services Performed or to be performed and Date(s)of Service,including officer(s),employee(s),or member(s)contacted,for P yment Indicated in Item 11: (attach Continuation Sheet(s)if nec- sary) 15. Continuation Sheet(s)attached: Yes No 16. Information requested through this form is authorized by Title 31 U.S.C.Section 1352. This disclosure of lobbying Signatur reliance was placed by the tier above when bis transaction 1, was made or entered into. This disclosure is required Print me: Ol as ack pursuant to 31 U.S.C.1352. This information will be reported to Congress semiannually and will be available for 'dent public inspection. Any person who fails to file the required Title: t� disclosure shall be subject to a civil penalty of not less than 5621802-722�ate: 'DEC $10,000 and not more than$100,000 for each such failure. Telephone No EC 2 0 20 Ib Authorized for Local Reproduction Federal Use Only: Standard form-LLL Staedard Form LLL Rev.09-L2-97 Page 7of8 C-21 June 11,2014 SEQUEL CONTRACTOKS, INC, Local Assistance Procedures Manual Exhibit 12-H Sample Bid INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient,at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C.section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which-the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name,address,city,state and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks"Subawardee"then enter the full name,address,city,state and zip code of the prime Federal recipient. Include Congressional District,if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name,if known. For example,Department of Transportation,United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action(item 1). If known,enter the full Catalog of Federal Domestic Assistance(CFDA)number for grants,cooperative agreements,loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item 1(e.g., Request for Proposal(RFP)number,Invitation for Bid(IFB)number,grant announcement number,the contract grant.or loan award number,the application/proposal control number assigned by the Federal agency). Include prefixes,e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency,enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a)Enter the full name,address,city,state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b)Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last Name,First Name and Middle Initial(Nil). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4)to the lobbying entity(item 10). Indicate whether the payment has been made(actual)or will be made(planned). Check all boxes that apply. If this is a material change report,enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box. Check all boxes that apply. If payment is made through an in-kind contribution,specify the nature and value of the in-kind payment. 13. Check the appropriate box. Check all boxes that apply. If other,specify nature. 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s)or employee(s)contacted or the officer(s)employee(s)or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s)is attached. 16. The certifying official shall sign and date the form,print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response,including time for reviewing instruction,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project (0348-0046),Washington,D.C.20503. SP-LLL-Instructions ae,.0"-90 XrDg» Page 8 of 8 C-22 June 11,2014 Local Assistance Procedures Manual EXHIBIT I5-G Local Agency Bidder DBE Commitment(Construction Contracts) EXHIBIT 15-G LOCAL AGENCY BIDDER DBE COMMITMENT(CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER lTO INSTRUCTIONS ON THERSE SIDE OF THHIS FORM T LOCATON LOCAL AGENCY: PROJECT DESCRIPTION: ANn) v � TOTAL CONTACT AMOUNT:S S3� 1-7 S. BID DATE: 13E C 2 00 1018 / -- BIDDER'S NAME: =,_DUEL CONTRACTORS, ING CONTRACT DBE GOAL: CONTRACT rMMOF WORK AND DESCRIPTION DBECERTNO. NAME OF EACH DBE DOLLAR AMOUNT TEM NO. OR SERVICES TO BE NYD EXPIRATION (Must be certified on the date bids DBE SUBCONTRACTED OR MATERLSLS DATE are opened-include DBE address O BE PROVIDED(or contracted if the and phone number) bidder is a DBE) PIP -1 9-1 7,p.yff For Local Agency to Complete: $�S Total Claimed DBE Sa. Local Agency Contract Number. Participation Federal-aid Project Number: Federal Share: Contract Award Date: Local Agency certifies that all DBE certifications have been verified and 1S, nat r f r� S t]�CK pigs den Linformation is complete and accurate. ��2 0 2016 562 S f Date (Area ode)Tel.No. Print Name Signature Date` Thomas S. Pack President Local Agency Representative Person to Contact (Please Type or Print) (Area Code)Telephone Number: Local Agency Bidder DBE Commitment(Construction Contracts) (Rev 6126/09) Distribution: (1)Copy—Fax or scan a copy to the Caltrans District Local Assistance Engineer(DLAE)within 30 days of contract execution.Failure to send a copy to the DLAE within 30 days of contract execution may result in de-obligation of funds for this project. (2)Copy—Include in award package to Caltrans District Local Assistance (3)Original—Local agency files Page 15-1 OB 12-04 C-23 June 29,2012 SEMIEL CONTRACTORS, INC. EXHIBIT 15-G Local Assistance Procedures Manual Local Agency Bidder DBE Commitment(Construction Contracts) INSTRUCTIONS-LOCAL AGENCY BIDDER DBE-COMMITMENT(CONSTRUCTION CONTRACTS) ALL BIDDERS: PLEASE NOTE: This information may be submitted with your bid.If it is not,and you are the apparent low bidder or the second or third low bidder,it must submitted and received as specified in the Special Provisions.Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract:Local Agency,Location,Project Description,Total Contract Amount,Bid Date,Bidder's Name,and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs.Prime contractors shall indicate all work to be performed by DBEs including,if the prime is a DBE,work performed by its own forces,if a DBE.The DBE shall provide a certification number to the Contractor and expiration date.Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work(who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier.Names of the First-Tier DBE Subcontractors and their respective item(s)of work listed should be consistent,where applicable, with the names and items of work in the"List of Subcontractors"submitted with your bid. There is a column for the DBE participation dollar amount.Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions.(If 100%of item is not to be performed or furnished by the DBE,describe exact portion of time to be performed or furnished by the DBE.)See Section "Disadvantaged Business Enterprise(DBE),"of the Special Provisions(construction contracts),to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated by the person bidding.Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award,Federal-aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. Page 15-2 June 29,2012 C-24 OR 12-04 SEOM CONTRACTOM, INC.. Local Assistance Procedures Manual Exhibit 15-H DBE Information-Good Faith Effort EXHIBIT I5-H DBE INFORMATION—GOOD FAITH EFFORTS DBE INFORMATION- GOOD FAITH EFFORTS Federal-aid Project No. L J GJ Bid Opening Date DEC 2 0 2G16 The City of Huntington Beach established a Disadvantaged Business Enterprise(DBE) goal of 4 %for this project.The information provided herein shows that a good faith effort was made. Lowest,second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts.Bidders should submit the following information even if the"Local Agency Bidder DBE Commitment"form indicates that the bidder has met the DBE goal.This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons,e.g.,a DBE firm was not certified at bid opening,or the bidder made a mathematical error. Submittal of only the"Local Agency Bidder DBE Commitment"form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled"Submission of DBE Commitment"of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder(please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified DBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested(please attach copies of solicitations,telephone records,fax confirmations,etc.): Names of DBEs Solicited Date of Initial Follow Up Methods and Dates Solicitation Page 1 OB 12-04 C-25 June 29,2012 SEQUEL CONTRACTORS, IN( Exhibit 15-H Local Assistance Procedures Manual DBE Information-Good Faith Effort C. The items of work which the bidder made available to DBE firms including,where appropriate, any breaking down of the contract work items(including those items normally performed by the bidder with its own forces)into economically feasible units to facilitate DBE participation.It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items ($) Of (I'/N) Contract fO ie,,A. J,-• D. The names, addresses and phone numbers of rejected DBE firms,the reasons for the bidder's rejection of the DBEs,the firms selected for that work(please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: /rev y�J o«/v/t At� /t,L- Names,addresses and phone numbers of firms selected for the work above: .s?1Jf1r Fps ..y E. Efforts made to assist interested DBEs in obtaining bonding,lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: rJ- �rt146XAe Page 2 June 29,2012 C-26 OB 12-04 SEQUEL CONTRACTORS, tidy. Local Assistance Procedures Manual Exhibit 15-H DBE Information-Good Faith Effort F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies,materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: 5'rC dl+� WI;f/T�reM/.. 4n rJ 1Lt DK. G. The names of agencies,organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms(please attach copies of requests to agencies and any responses received, i.e.,lists,Internet page download,etc.): Name of Agency/Organization Method/Date of Contact Results H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. Page 3 O B 3 2.04 C-27 June 29,2012 Mike Mahler From: The Weekly Bid Flash <support@theweeklybidflash.com> Sent: Tuesday, December 06, 2016 9:46 AM To: Mike Mahler Subject: Weekly Bid Flash DBE Ad Affidavit - EDINGER AVENUE REHABILITATTION FROM GRAHAM STREET TO SPRINGDALE STREET Proof of Publishing Affidavit To Whom It May Concern: Be it known that this is a sworn affidavit that Sequel Contractors, Inc. did place an advertisement we published on 12/6/2016 in our nationwide publications, Construction Star, Inc. and The Weekly Bid Flash, seeking Certified Disadvantaged subcontractors and/or material suppliers for the project EDINGER AVENUE REHABILITATTION FROM GRAHAM STREET TO SPRINGDALE STREET. A copy of the advertisement is below: Date Of Advertisement Placement: 12/6/2016 9:45:38 AM Sequel Contractors, Inc. An Equal Opportunity Employer, is requesting quotations from all qualified DBE,DVBE,UDBE,MBE,WBE,SBE,SLB,LBE,OBE sub-contractors and material suppliers for the following project: EDINGER AVENUE REHABILITATTION FROM GRAHAM STREET TO SPRINGDALE STREET City/Location: HUNTINGTON BEACH,CA Counties: San Bernardino,Orange, Riverside, Los Angeles Owner: City of HUNTINGTON BEACH Bid Date: Tuesday 12/20/2016 at 2:00 PM We are requesting bids for the following trades and/or supplies: NAICS Classifications Sector 23--Construction . Highway, Street, and Bridge Construction CSI Classifications DIVISION 2-SITE WORK . ASPHALT CONCRETE PAVEMENT AND BASE . ASPHALT PAVING . CONCRETE CURBS/GUTTERS . CONCRETE REMOVAL . PAVING/SURFACING . SIGNAGE Bid documents can be viewed at or obtained from: REQUESTING SUB-BIDS: FROM ALL QUALIFIED DBE/DVBE/MBEM/BE/UDBE/HUD-SECTION 3 CONTRACTORS&SUPPLIERS CITY OF HUNTINGTON BEACH EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET STPL-5181(189) Bid Date: DECEMBER 20, 2016 @ 2:00 PM SUB-BIDS AND SUPPLIERS FOR BUT NOT LIMITED TO: REMOVAL AND REPLACEMENT OF VARIOUS PCC AND A/C IMPROVEMENTS, ASPHALT PAVING, COLD MILLING, CONCRETE C/G AND FLATWORK, BMP'S, UTILITY ADJUSTMENTS, SIGNING AND STRIPING, SURVEY, LOOPS, 1 LAN DSCAPRE/I RR IGATION, FENCING,WET UTILITIES, TRAFFIC CONTROL,TRUCKING, ETC. Contractors shall furnish all labor services, materials,tools, equipment, supplies, transportation, utilities and all other items and facilities necessary for the completion for improvements to the project. SEQUEL CONTRACTORS, INC. 13546 IMPERIAL HWY. SANTA FE SPRINGS, CA 90670 (562)802-7227 FAX(562)802-7499 CONTACT: MICHAEL MAHLER AN EQUAL OPPORTUNITY EMPLOYER SEQUEL INTENDS TO SERIOUSLY NEGOTIATE WITH DBE/DVBE/MBENVBE/UDBE/HUD-SECTION 3 FIRMS PLANS&SPECS CAN BE VIEWED AT OUR PLAN ROOM INSURANCE, BONDING AND FINANCIAL ASSISTANCE AVAILABLE REQUESTING SUB-BIDS: FROM ALL QUALIFIED DBE/DVBE/MBENVBE/UDBE/HUD-SECTION 3 CONTRACTORS&SUPPLIERS CITY OF HUNTINGTON BEACH EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET STPL-5181(189) Bid Date: DECEMBER 20, 2016 @ 2:00 PM SUB-BIDS AND SUPPLIERS FOR BUT NOT LIMITED TO: REMOVAL AND REPLACEMENT OF VARIOUS PCC AND A/C IMPROVEMENTS, ASPHALT PAVING, COLD MILLING, CONCRETE C/G AND FLATWORK, BMP'S, UTILITY ADJUSTMENTS, SIGNING AND STRIPING, SURVEY, LOOPS, LANDSCAPRE/IRRIGATION, FENCING,WET UTILITIES, TRAFFIC CONTROL,TRUCKING, ETC. Contractors shall furnish all labor services, materials, tools, equipment, supplies, transportation, utilities and all other items and facilities necessary for the completion for improvements to the project. SEQUEL CONTRACTORS, INC. 13546 IMPERIAL HWY. SANTA FE SPRINGS, CA 90670 (562)802-7227 FAX(562)802-7499 CONTACT: MICHAEL MAHLER AN EQUAL OPPORTUNITY EMPLOYER SEQUEL INTENDS TO SERIOUSLY NEGOTIATE WITH DBE/DVBE/MBENVBE/UDBE/HUD-SECTION 3 FIRMS PLANS & SPECS CAN BE VIEWED AT OUR PLAN ROOM INSURANCE, BONDING AND FINANCIAL ASSISTANCE AVAILABLE Sequel Contractors, Inc. 13546 Imperial Highway Santa Fe Springs, CA 90670 Phone: (562)802-7227 Fax: (562)802-7499 Mike Mahler Published on 12/6/2016 12:00:00 PM by The Weekly Bid Flash and The Construction Star Trade and Focus Publications located at v/vV l i C"' �a I �C'i�afiGSitcom ,and 4vww constarl.com �..------- ---- — -.__ -- Phone: 1.800.479.5314 Fax: 1.619.688.0585 This solicitation Ad will run until the bid date Our publication is a listed approved source by the State of CA, Dept. of General Services, Office of Small Business Certification & Resources, in its Resource Packet. Since, 1989 our firm has been proud to help businesses reach Certified Disadvantaged firms statewide. If you should need any further information, please do not hesitate to contact us at 800-479-5314. Thank you again! Construction Bidboard Inc. 2 11622 El Camino Real, Suite 100 San Diego, CA 92130 r�5f,,;.iheweeiuybidflash.com 800-479-5314 3 Mike Mahler From: The Weekly Bid Flash <support@theweeklybidflash.com> Sent: Tuesday, December 06, 2016 9:46 AM To: Mike Mahler Subject: Copy of your DBE Ad - EDINGER AVENUE REHABILITATTION FROM GRAHAM STREET TO SPRINGDALE STREET Date Of Advertisement Placement: 12/6/2016 9:45:38 AM Sequel Contractors, Inc. An Equal Opportunity Employer, is requesting quotations from all qualified DBE,DVBE,UDBE,MBE,W BE,SBE,SLB,LBE,OBE sub-contractors and material suppliers for the following project: EDINGER AVENUE REHABILITATTION FROM GRAHAM STREET TO SPRINGDALE STREET City/Location: HUNTINGTON BEACH, CA Counties: San Bernardino, Orange, Riverside, Los Angeles Owner: City of HUNTINGTON BEACH Bid Date: Tuesday 12/20/2016 at 2:00 PM We are requesting bids for the following trades and/or supplies: NAICS Classifications Sector 23--Construction • Highway, Street, and Bridge Construction CSI Classifications DIVISION 2 - SITE WORK • ASPHALT CONCRETE PAVEMENT AND BASE • ASPHALT PAVING • CONCRETE CURBS/GUTTERS • CONCRETE REMOVAL • PAVING/SURFACING • SIGNAGE Bid documents can be viewed at or obtained from: REQUESTING SUB-BIDS: FROM ALL QUALIFIED DBE/DVBE/1VIBE/WBE/UDBE4UD-SECTION 3 CONTRACTORS & SUPPLIERS CITY OF HUNTINGTON BEACH EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET STPL-5181(189) 1 Bid Date: DECEMBER 20, 2016 @ 2:00 PM SUB-BIDS AND SUPPLIERS FOR BUT NOT LMTED TO: REMOVAL AND REPLACEMENT OF VARIOUS PCC AND A/C IMPROVEMENTS, ASPHALT PAVING, COLD MILLING, CONCRETE C/G AND FLATWORK, BMP'S, UTILITY ADJUSTMENTS, SIGNING AND STRIPING, SURVEY, LOOPS, LANDSCAPRE/IRRIGATION, FENCING, WET UTILITIES, TRAFFIC CONTROL, TRUCKING, ETC. Contractors shall furnish all labor services, materials, tools, equipment, supplies, transportation, utilities and all other items and facilities necessary for the completion for improvements to the project. SEQUEL CONTRACTORS, INC. 13546 IWERIAL HWY. SANTA FE SPRINGS, CA 90670 (562) 802-7227 FAX(562) 802-7499 CONTACT: MICHAEL MAHLER AN EQUAL OPPORTUNITY EMPLOYER SEQUEL INTENDS TO SERIOUSLY NEGOTIATE WITH DBE/DVBE/MBE/WBE/UDBE/HUD- SECTION 3 FIRMS PLANS & SPECS CAN BE VIEWED AT OUR PLAN ROOM INSURANCE, BONDING AND FINANCIAL ASSISTANCE AVAILABLE REQUESTING SUB-BIDS: FROM ALL QUALIFIED DBE/DVBE/MBE/WBE/UDBE/HUD-SECTION 3 CONTRACTORS & SUPPLIERS CITY OF HUNTINGTON BEACH EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET STPL-5181(189) Bid Date: DECEMBER 20, 2016 @ 2:00 PM SUB-BIDS AND SUPPLIERS FOR BUT NOT LIMITED TO: REMOVAL AND REPLACEMENT OF VARIOUS PCC AND A/C IMPROVEMENTS, ASPHALT PAVING, COLD MILLING, CONCRETE C/G AND FLATWORK, BMP'S, UTILITY ADJUSTMENTS, SIGNING AND STRIPING, SURVEY, LOOPS, LANDSCAPREARRIGATION, FENCING, WET UTILITIES, TRAFFIC CONTROL, TRUCKING, ETC. Contractors shall furnish all labor services, materials, tools, equipment, supplies, transportation, utilities and all other items and facilities necessary for the completion for improvements to the project. SEQUEL CONTRACTORS, INC. 13 546 1MPERIAL HWY. SANTA FE SPRINGS, CA 90670 (562) 802-7227 FAX(562) 802-7499 CONTACT: MICHAEL MAHLER AN EQUAL OPPORTUNITY EMPLOYER SEQUEL INTENDS TO SERIOUSLY NEGOTIATE WITH DBE/DVBE/MBE/WBE/UDBE/HUD- SECTION 3 FIRMS PLANS & SPECS CAN BE VIEWED AT OUR PLAN ROOM INSURANCE, BONDING AND FINANCIAL ASSISTANCE AVAILABLE Sequel Contractors, Inc. 13 546 Imperial Highway Santa Fe Springs, CA 90670 2 Phone: (562) 802-7227 Fax: (562) 802-7499 Mike Mahler mike c,sequelcontractors.com Published on 12/6/2016 12:00:00 PM by The Weekly Bid Flash and The Construction Star Trade and Focus Publications located at ,I, Ivbidfla0, com and u „ ,—ristarl.com Phone: 1.800.479.5314 Fax: 1.619.688.0585 This solicitation Ad will run until the bid date 3 Page 1 of 5 Messy a a Date: 12/06/16 -'10:00:52 AM From: Sequel Contractors, Mike Mahler Related To: " a' Subject: HUNTINGTON BEACH - EDINGER AVENUE S�/� � Subjec9 t: HUNTINGTON BEACH - EDINGER AVENUEzz �\ REQUESTING SUB-BIDS: FROM ALL QUALIFIED DBE/DVBE/MBE/WBE/UDBE/HUD-SECTION 3 CONTRACTORS & SUPPLIERS CITY OF HUNTINGTON BEACH EDINGER AVENUE REHABILITATION FROM GRAHAM STREET TO SPRINGDALE STREET ' STPL-5181(189) Bid Date: DECEMBER 20, 2016 @ 2:00 PM SUB-BIDS AND SUPPLIERS FOR BUT NOT LIMITED TO: REMOVAL AND REPLACEMENT OF VARIOUS PCC AND A/C IMPROVEMENTS, ASPHALT PAVING, COLD MILLING, CONCRETE C/G AND FLATWORK, BMP'S, UTILITY ADJUSTMENTS, SIGNING AND STRIPING, SURVEY, LOOPS, LANDSCAPRE/IRRIGATION, FENCING, WET UTILITIES, TRAFFIC CONTROL, TRUCKING, ETC. Contractors shall furnish all labor services, materials, tools, equipment, supplies, transportation, utilities and all other items and facilities necessary for the completion for improvements to the project. SEQUEL CONTRACTORS, INC. 13546 IMPERIAL HWY. SANTA FE SPRINGS, CA 90670 (562) 802-7227 FAX (562) 802-7499 CONTACT:'MICHAEL MAHLER AN EQUAL OPPORTUNITY EMPLOYER SEQUEL INTENDS TO SERIOUSLY NEGOTIATE WITH DBE/DVBE/MBE/WBE/UDBE/HUD-SECTION 3 FIRMS PLANS & SPECS CAN BE VIEWED AT OUR PLAN ROOM INSURANCE, BONDING AND FINANCIAL ASSISTANCE AVAILABLE - ----------------_: - -------- � 9 This message was sent by an interested party,for this bid. A reply to this message will go directly to the sending party. Phone Fax Recipients MethodNumber Number -Status Date Sent 1 A& S CEMENT CONTRACTORS, INC - Fax (714) 220- (714)220- Fax Sent 12/6/2016 ALBERT MADRIGAL 2694 0571 10:00:54 AM 2 A W ELECTRIC - ANDRE WHITMORE Fax (323) 751- (323) 751- Fax Sent 12/6/2016 1717 0171 10:00:54 AM 3 ACCU CONSTRUCTION - Estimator Fax (951) 657- (951) 657- Fax Sent 12/6/2016 8200 8281 10:00:54 AM http://www.ebidboard.com/reports/message_detail.asp?routeguid={ED8OA2EA-AFAA-4... 12/20/2016 Page 2 of 5 4 ACCU Construction, Inc'. - Dennis Yum "Email (714) 641- 12/6/2016 4730 10:00:53 AM 5 AJK Communications - Kiran Kaur Email (714) 444 12/6/2016 0946 10:00:53 AM 6 AJK Communications - Kiran Kaur Fax (714) 444- (714) 444- Fax Sent 12/6/2016 0946 0957 10:00:54 AM 7 All Flow Solutions - Janice Pope Fax (951) 443 (951) 848- Fax Sent 12/6/2016 4028 9699 10:00:54 AM 8 All Flow Solutions - Janice Pope Email (951) 443 12/6/2016 4028 10:00:53 AM 9 ALLWEST GEOSCIENCE INC- Estimator Fax (951) 284- (951) 284- Fax Sent 12/6/2016 7100 7111 10:00:54 AM 10 ALLWEST GEOSCIENCE INC - Estimator Email (951) 284 12/6/2016 7100 10:00:52 AM 11 Aramexx Construction Sal Samour Email (818) 428- 12/6/2016 8657 10:00:53 AM 12 Aramexx Construction - Sal Samour Fax (818) 428- (909) 591- Fax Sent 12/6/2016 8657 4569 10:00:54 AM AUTOMATED SWITCHING &CONTROLS, (626) 969- (626) 969- Fax Sent 12/6/2016 13 INC - DR MACCALLA Fax 8441 8741 10:00:54 AM AUTOMATED SWITCHING &CONTROLS, (626) 969- 12/6/2016 14 Email INC - DR MACCALLA 8441 \\ Ma n\a, 10:00:53 AM 15 Baja Trucking, Inc. - Ana Diaz Email (951} 488- 12/6/2016 0012 10:00:53 AM 16 Baja Trucking, Inc. - Ana Diaz Fax (951) 488- (951) 247- Fax Sent 12/6/2016 0012 9616 10:00:54 AM 17 Bali Construction Inc - Bruce Flatt Email (626) 442- 12/6/2016 8003 10:00:53 AM 18 Bali Construction Inc - Bruce Flatt Fax (626)442- (626) 242- Fax Sent 12/6/2016 ?. 8003 1521 10:00:55 AM 19 C B TRONICS - CLIFFORD_BAILEY Fax (661)295- (661) 295- Fax Sent 12/6/2016 0819 0819 10:00:54 AM 20 C G 0 CONSTRUCTION COMPANY- Fax (909) 483 (909) 483- Fax Sent 12/6/2016 CHARLES OJURI 5581 5583 10:00:54 AM 21 C.L. CONCRETE - CAMILO LOPEZ Fax (626) 334- (626) 334- Fax Sent 12/6/2016 v 2357 3517 10:00:54 AM 22 Calmex Engineering Inc, - 3ohn Rice Fax (909) 546- (909) 546- Fax Sent 12/6/2016 1311 x108 1318 10:00:54 AM 23 Calmex Engineering Inc, - John Rice Email (909) 546- 12/6/2016 g g 1311 x108 10:00:53 AM 24 Calmex Engineering Inc.Seat 2 - Tim Black Email (909) 771- � ;, 12/6/2016 9511 10:00:53 AM 25 Calmex Engineering Inc.Seat 2 - Tim Black Fax (909) 771- (909) 546- Fax Sent 12/6/2016 9511 1318 10:00:54 AM 26 CALMEX ENGINEERING, INC - Fax (909) 686- (909) 686- Fax Sent 12/6/2016 RICHARD MONTIEL 8613 8532 10:00:53 AM 27 Century Paving, Inc. Robert Jarvis Email (714) 522- 12/6/2016 2910 10:00:52 AM 28 Chambers Group - Robyn Vallejos Email (949) 261- 12/6/2016 5414 10:00:53 AM 29 Chambers Group- Robyn Vallejos Fax (949) 261- (866) 261- Fax Sent 12/6/2016 5414 3100 10:00:54 AM 30 CivilSource - Amy Amirani Email (949) 585- 12/6/2016 0477 10:00:53 AM 31 CL Surveying and Mapping Lam Le Email (909) 484- 12/6/2016 4200 10:00:52 AM 32 CL Surveying and Mapping - Lam Le Fax (909) 484- (909) 484- Fax Sent 12/6/2016 4200 4229 10:00:54 AM 33"Coleman Construction, Inc. - Fax (323) 295- (323) 295- Fax Sent 12/6/2016 Cammie Johnson 5484 1199 10:00:54 AM Coleman Construction, Inc. (323) 295- 12/6/2016 34 Cammie Johnson Email 5484 10:00:52 AM CONSOLIDATED CONTRACTING SERVICES, (949) 661- (949) 661- Fax Sent 12/6/2016 35 'INC. - Estimator Fax 3499 1058 10:00:54 AM 36 Dominguez General Engineering Inc- Fax (909) 461- (909) 461- Fax Sent 12/6/2016 Adolfo Dominguez 3658 3678 10:00:54 AM 37 r Email http://www.ebidboard.com/reports/message_detail.asp?routeguid={ED80AMA-AFAA-4... 12/20/2016 Page 3 of 5 Dominguez General Engineering Inc- (909)461- 12/6/2016 Adolfo Dominguez 3658 10:00:52 AM 38 Doty Brothers Equipment Company - Email (562)864- 12/6/2016 Chris Christy 6566 10:00:53 AM 39 Doty Brothers Equipment Company - Fax (562) 864- (562) 929- Fax Sent` _; 12/6/2016 Chris Christy 6566 9368 10:00:54 AM DSS Sweeping &Water Truck Rental - (760) 200- 12/6/2016 40 Juan Ibarra Email 7244 10:00:53 AM 41 E E ELECTRIC, INC - HENRY ESCA]EDA Fax (909) 829- (909) 829- Fax Sent' 12/6/2016 7818 0118 10:00:54 AM 42 E-Nor Innovations Inc Chidi Onumonu Fax (310) 513- (310) 513- Fax Sent 12/6/2016 4115 _ 6299 10:00:54 AM 43 E-Nor Innovations Inc Chidi Onumonu Email (310) 513- 12/6/2016 4115 10:00:53 AM 44 E.A. MENDOZA, INC. - Paul MENDOZA Fax (949)789 (949) 789- Fax Sent 12/6/2016 9100 9109 10:00:54 AM 45 EAGLE ASPHALT CONSTRUCTION, INC. - Fax (909)444 (909) 444- Fax Sent 12/6/2016 Estimator 5566 8311 10:00:54 AM 46 ELECTRICAL & NETWORK SOLUTIONS - Fax (951) 694- (909) 694- Fax Sent 12/6/2016 SHERRY LANG 8300 8335 10:00:54 AM 47 Exbon Development Inc. - Janet Lee Fax (310) 387- (562) 926- Fax Sent 12/6/2016 8763 9905 10:00:53 AM 48 Exbon Development Inc. - Janet Lee Email (310) 387- 12/6/2016 8763 10:00:52 AM 49 FAR EAST LANDSCAPE& MAINTENANCE - Fax (818) 402- (818) 292- Fax Sent- 12/6/2016 Estimator 8411 6282 10:00:54 AM 50 Fine Grade Equipment, Inc. John Baron Fax (661)949- (661) 722- Fax Sent 12/6/2016 8788 ` 8900 10:00:54 AM 51 Fine Grade Equipment, Inc. - John Baron Email (661)949- 12/6/2016 8788 10:00:52 AM 52 FITE CORPORATION - KATHLEEN FITE Fax (909)623- (909) 623- Fax Sent 12/6/2016 413-3 0645 10:00:54 AM 53 FUNDAMENT&ASSOCIATES - Fax (949)251- (949) 251- Fax Sent 12/6/2016 PAULO FUNDAMENT PE 1131 9434 10:00:54 AM 54 G &C INTERNATIONAL TRADE - Fax (323) 493- (323) 758- Fax Sent 12/6/2016 GERALD JACKSON 4219 0610 10:00:54 AM 55 Global Environmental Network - Estimator Fax (510) 777- (510) 777- Fax Sent 12/6/2016 9105 9116 10:00:54 AM 56 HIGH LIGHT ELECTRIC - ANDREA JOHNSON Fax (951) 352- (909) 352- Fax Sent 12/6/2016 9646 2497 10:00:55 AM 57 High Light Electric- Erwin Mendoza Fax (951) 352- (951) 352- Fax Sent 12/6/2016 9646 2498 10:00:54 AM 58 High Light Electric- Erwin Mendoza Email (951) 352- 12/6/2016 9646 10r00:53 AM J D JIMENEZ CONCRETE CONTRACTOR, (909) 989- (909) 982- Fax Sent 12/6/2016 59 INC - JOE JIMENEZ Fax 3615 ' ' 6204 ' 10:00:54 AM 60 J. S. Trucking Cristina Suarez Fax (818)365- (818) 365- Fax Sent 12/6/2016 1521 1521 10:00:54 AM 61 J, S. Trucking - Cristina Suarez Email (818) 365- 12/6/2016 1521 10:00:53 AM J.A. Salazar Construction &Supply Corp. - (562) 691- 12/6/2016 62 Jose Salazar Email 3647 10:00:53 AM 63 J•A. Salazar Construction &Supply Corp. - Fax (562) 691- (562) 691- Fax Sent 12/6/2016 Jose Salazar 3647 1092 10:00:54 AM 64 JESMAR CONSTRUCTION - Fax (714) 972- (714) 972- Fax Sent 12/6/2016 JESUS HERNANDEZ 2668 9331 10:00:54 AM 65 JM FIBER OPTICS,INC. - Fred Eckardt Email (909) 628- 12/6/2016 3445 10:00:53 AM 66 JM FIBER OPTICS, INC. - Fred Eckardt Fax (909) 628- (909) 628- Fax Sent 12/6/2016 3445 1990 10:00:55 AM 67 LAUER AND LOPAT PACIFIC (DVBE) - Email (949)429- 12/6/2016 Brian Lauer 3252 1000:52 AM 68 LAUER AND LOPAT PACIFIC (DVBE) - Fax (949) 429- (949) 429 Fax Blocked By 12/6/2016 Brian Lauer 3252 3260 Recipient 10:00:54 AM 69 MAMMOTH ELECTRIC - N/A Fax (714) 978- (714) 978- Fax Sent 12/6/2016 0807 8944 10:00:53 AM 70 Fax Fax Sent http://www.ebidboard.com/reports/message_detail.asp?routeguid={ED 80AMA-AFAA-4... 12/20/2016 Page 4 of 5 MIRAMONTES CONSTRUCTION COMPANY, (626) 330- (626) 330- 12/6/2016 INC - MIRIAM MIRAMONTES 1043 5463 100054 AM MLE ENVIRONMENTAL TECHNOLOGIES, (909) 989- 12/6/2016 71 INC VICTOR MUNIZ Email 7191 10:00:53 AM MLE ENVIRONMENTAL TECHNOLOGIES, (909) 989 (909) 989- Fax Sent 12/6/2016 72 INC VICTOR MUNIZ Fax 7191 7191 10:00:54 AM 73 Natures Image, Inc. - Cory Gallagher Email (949) 705- 12/6/2016 5829 10:00:52 AM 74 Natures Image, Inc. - Daniel Slinger Fax (949) 680- (949) 680- Fax Sent 12/6/2016 4400 4450 10:00:54 AM 75 Olivas Valdez Inc. - Fax (626) 915- (626) 915- Fax Sent 12/6/2016 ROBERT VALDEZFOLIVAS 7633 7683 10:00:54 AM 76 Ortiz Asphalt Paving, Inc. Eric Kizziar Email (909) 386- 12/6/2016_ 1200 x310 10:00:53 AM 77 Ortiz Asphalt Paving, Inc. - Eric Kizziar Fax (909) 386- (909) 386- Fax Sent 12/6/2016 1200 x310 1288 10:00t54 AM Premier West Contractors, Inc. - (800) 278- 12/6/2016 78 Lindy Alaska Email 0105 10:00:53 AM 79 PREMIER WEST CONTRACTORS, INC. - Fax (714) 279- (714) 279- Fax Sent 12/6/2016 TAMARA CASTILLO 0903 0856 10:00:54 AM 80 REYES & SONS ELECTRIC CO - Fax (818) 365- (818)365- Fax Sent 12/6/2016 MANNY FLORES 2030 2035 10:00:54 AM REYES &SONS ELECTRIC CO - (818) 365- 12/6/2016 81 MANNY FLORES Email 2030 10:00:53 AM 82 REYES CONSTRUCTION, INC. - Fax (909) 622- (909) 622- Fax Sent 12/6/2016 JOSEPH REYES 2259 3053 10:00:54 AM 83 RMA Group - Ed Lyon Email (909) 989 12/6/2016 1751 10:00:53 AM 84 RMA Group - Ed Lyon Fax (909) 989- (909) 989- Fax Sent 12/6/2016 1751 4287 10:00:54 AM ROBERT WADA&ASSOCIATES INC H�`' (714) 992- (714) 525- 12/6/2016 85y Fax Fax Sent Robert Wada �r 5461 9761 10:00:54 AM ROBERT WADA&ASSOCIATES INC rij (714) 992- 12/6/2016 86 ,d, Email 5461 10:00:52 AM Robert Wada 87 ROCK STRUCTURES CONSTRUCTION Fax (951) 371- (909) 351- Fax Sent 12/6/2016 COMPANY- ANTONIO PAREDES 1112 7797 10:00:54 AM i yyy 88 ROKEL SERVICES TRUCKING �%jj,; Fax (310) 608- (310) 608- Fax Sent 12/6/2016 MICHAEL STAFFORD zywyry�„�,,, !%„% 2608 2619 10:00:55 AM 89 ROYAL CONSTRUCTION - FLORO ROSAL Fax (626) 336- (626) 330- Fax Sent 12/6/2016 2769 5100 10:00:54 AM SAMROD CORPORATION_(NOT PART OF (661) 945- (661) 949- Fax Sent 12/6/2016 90 25050) - MICHAEL RODRIGUEZ Fax 3602 8536 10:00:54 AM 91 SCV Electric, Inc. - Ryan McAlister Fax (661) 775- (661) 775- Fax Sent 12/6/2016 3946 1535 10:00:54 AM 92 SCV Electric, Inc. - Ryan McAlister Email (661)775 12/6/2016 3946 10:00:52 AM 93 SDR SURVEYING INC - Steve Richardson Email (949) 554- 12/6/2016 4085 10:00:53 AM 94 SDR SURVEYING INC - Steve Richardson Fax (949) 554- (949) 542- Fax Sent 12/6/2016 4085 7140 10:00:54 AM SHAMROCK BASE CORPORATION (323) 223- (323) 223- 12/6/2016 95 Fax Fax Sent ROBERT GALVAN jOrIA 11 2366 2360 10:00:54 AM 96 Spec Tech, Inc. - Richard Thompson Fax (949) 743- (949) 743- Fax Sent 12/6/2016 5410 5415 10:00:54 AM 97 Spec Tech, Inc. - Richard Thompson Email (949) 743- 12/6/2016 5410 10:00:52 AM SUMMIT CONSULTING AND ENGINEERING, (626) 449- (626) 584- Fax Sent 12/6/2016 98 INC. - MS GASTELUM Fax 9052 0151 10:00:54 AM 99 The Carpet Recyclers - Wes Nelson Fax (866) 847- (562) 685- Fax Sent 12/6/2016 7286 0446 10:00:53 AM 100 The Carpet Recyclers - Wes Nelson Email (866) 847- 12/6/2016 7286 10:00:52 AM 101 Triumph Geo-Synthetics, Inc - Maria Flores Email (714) 237- 12/6/2016 1550 10:00:52 AM 102 Triumph Geo-Synthetics, Inc - Maria Flores Fax (714) 237- (714) 237- Fax Sent 12/6/2016 1550 1549 10:00:53 AM 103 Fax Fax Sent http://www.ebidboard.com/reports/message_detail.asp?routeguid={ED8OA2EA-AFAA-4... 12/20/2016 Page 5 of 5 UNITED TRAFFIC SERVICES AND SUPPLY- (626) 961- (626) 961 12/6/2016 DORA PINA 5736 4746 10:00:54 AM 104 VT ELECTRIC, INC. - Estimator Fax (909) 985- (909) 985- Fax Sent 12/6/2016 1755 8186 10:00:54 AM 105 VT ELECTRIC, INC. - Estimator Email (909) 985- 12/6/2016 1755 10:00:53 AM 106 W C GOOLSBY, INC - PATTY GOOLSBY Fax (800) 839- (714) 437- Fax Sent 12/6/2016 9697 7753 10:00:54 AM 107 WBI ENERGY SERVICES, INC - Fax (626) 351- (626) 351- Fax Sent 12/6/2016 WILLIAM WOOD 3620 3622 10:00:55 AM 108 WEAVER ELECTRIC, INC - Jim Antinone Email (714) 917- 12/6/2016 1165 10:00:52 AM 109 WEAVER ELECTRIC, INC Jim Antinone Fax (714) 917- (714) 917- Fax Sent 12/6/2016 1165 3011 10:00:54 AM 110 WESTERN PAVING CONTRACTORS, INC - Fax (626) 338- (626) 338- Fax Sent 12/6/2016 Shawn Hughes 7889 3799 10:00:54 AM 111 Western Paving Contractors, Inc. - Email (626) 338- 12/6/2016 Estimating Sales 7889 10:00:53 AM http://www.ebidboard.com/reports/message_detail.asp?routeguid=f EDWAMA-AFAA-4... 12/20/2016 `'' en LE ■�•Ji 4 C N p 211 cc O ~ N s i~ o 0 0 o e o F~ o 0 o o 0 o c o G o 0 0 0 E E -ate Q vv�v v n�� vvvvn v vvv n - vvvv w w ❑❑❑ n 1100 ❑` ❑F❑ ❑❑: El ❑ SZ I' to � � o �7j c c A N � � O "�i �1: �[.;� f� ❑�� lam` �� zK cs V cn ❑ � ! � i ; l I ; Ili ' ; i 'J w k � c � o c w q O U •��" O E i ct c,o �i a� o � I I ' l f i l A l i :, i F •:, E zH U N o v I N O 0 0 0� C3 'Q- Q V� Oi _ V^ O rI• ,>; E" E •E U � vvvvn v!vvvn _ vvvvn vvvvn .' Eli Ca H Q 40 sz a� iJ' L rn L y C ('� L v ct M Iza 1 f ice{ } 3 u _ �_.. N C N stw ay . �, Crol 1Oil - =. Q.` � w j *�`` i I I � •� � i !�I E I ! lu o a a c a c ❑ c o c U r/� �+ G4 0 ❑ o 0 0 0 _c c o g o 0 o c o 0 0 o o c c . o :a C7 = o to to Ec v n Cl =n to _ o to if, n `: ° ti ct �� sba' s+ W)in S? -Is re av(s si s4�ds s s a �^ V V V V V V V V r V V V N A ._ V V V V A ._ Eli el o pl O w' I O O '1 A ^' V 1 ` J � a - Bond No. Bid Bond BID BOND 'The American Institute of Architects, AIA Document No.A310(February, 1970 Edition) KNOW ALL MEN BY TEESE PRESENTS,that we Sequel Contractors, Inc. as Principal hereinafter called the Principal,and Travelers Casualty and Surety Company of America a corporation duly organized under the laws of the state of Connecticut as Surety, hereinafter called the Surety, are held and firmly bound unto City of Huntington Beach as Obligee,hereinafter called the Obligee,in the SUM Of Ten percent of the total amount of the 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 Edinger Avenue Rehabilitation(1516) 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 finnished in the prosecution thereof, or in the event of the failure of the Principal to ender 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 nth day of December 2016 Sequel Contract s Witness / "S By- A k Pr®si-den Namefritle Tray,eler asualty and Surety Company of meri��— Witness By: Timothy D. Rapp A -rFa:-t ORSC 21328(5/97) AGKNOWLEDGMENT State of California County of Orange ) On December 7, 2016 before me, Debra Swanson, Notary Public (insert name and title of the officer) personally appeared Timothy D. Rapp who proved to me on the basis of satisfactory evidence to be the person($)whose name($) ishwe subscribed to the within instrument and acknowledged to me that he%fie4hey executed the same in his/*eN#,retf authorized capacity(ie*, and that by hisAkerAieir signature(A on the instrument the person(if), or the entity upon behalf of which the person(if)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. N � " DEBRASWANSON W COMM.#2170759 X NOTARY PUBLIC-CAUFORN�A Ce ORANGE COUNTY MY COMM,EXR NOV 10.2020 N Signature L'17 Kim (Seal) WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER POWER OF ATTORNEY TRAVELERSJ Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company Attorney-In Fact No. 224524 Certificate No. 006726313 KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine Insurance Company, St.Paul Guardian Insurance Company,St. Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut, that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa,and that Fidelity and Guaranty Insurance Underwriters,Inc.,is a corporation duly organized under the laws of the State of Wisconsin(herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint Timothy D.Rapp,and Douglas A.Rapp of the City of Aliso Vie--jo State of California their true and lawful Attorney(s)-in-Fact, each in their separate capacity if more than one is named above,to sign,execute,seal and acknowledge any and all bonds,recognizances,conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF,the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this 31 st day of March 2016 Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company G�SU,� TM °F\0.E 6 <1•N DNS "t 1N 9 ...........9,�,r, PJ s� ,c�17�w0.11r �,pF� 0 O L • •` � d ... - �P'i 5 �(1 ; 71CORPDR4ttU r m �iCO A>E CI i W:'GORPOHAlf:1^` 0 w 3a 1� �� 411D cl 9 8 2 O ( 1977 AL SE .�/ =I i --- o: W HARiFORD, < FVIRIFDRD, O,r Z . �� l'✓^� / 'a 1.9J` `�: o' ��c"�'- a �y � 51 ry� o••. ,o. ' :.SEAL!a- bey 1•N, \ .� *� g d(iR X NCf�O �d 1......-;jaj'J b.' State of Connecticut By: City of Hartford ss. Robert L.Raney, enior Vice President On this the 31 st day of March 2016 before me personally appeared Robert L.Raney,who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,and that he,as such,being authorized so to do,executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. Cow' In Witness Whereof,I hereunto set my hand and official seal. W o,My Commission expires the 30th day of June,2016. tt Marie C.Tetreault,Notary Public 58440-8-12 Printed in U.S.A. WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other of cer completing this certikate veriPes only the identity of the individual who signed the document to which this certikate is attached,and not the truthfulness, accuracy, or validity of that document. State of California ) County of LOS ANGELS S ) On DEC 0 7 2018 before me, '"Y` k 3t t •Guay PUNG Date Here Insert Name and Title of the Officer personally appeared Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the personof whose name(j< is/w6 subscribed to the within instrument and acknowledged to me that he/fie/tI;< executed the same in his/het/tt►e authorized capacity(Les), and that by his/hef/tbefr signature*)on the instrument the person(& or the entity upon behalf of which the personal acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws 11•♦111110111♦♦110111110101P11f1111i/111P♦ _ DANIEL BUSTAMANTE : of the State of California that the foregoing paragraph is true and correct. 0 COMM. #2005801 NOTARY PU3LIC CALIFORNIA p WITNESS my hand and official seal. v' a LOS ANGELES COUNTY —' n /� / My Commission Expires JANUARY 31,?oi7 4 j/ �/ _ ••••♦•••f.♦♦1•••••••••••1.11.1••1.111••..• Signature ///lll/// �C7���TTTfW 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— L Limited ❑ General ❑ Partner— ❑ Limited ❑ General Individual ❑Attorney in Fact ElIndividual ❑Attorney in Fact Trustee -Guardian or Conservator ❑Trustee ❑ Guardian or Conservator Other: ❑ Other: Signer Is Representing: Signer Is Representing: 02016 National Notary Association •www.NationaiNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907