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Golden State Constructors - 2020-11-16 (2)
RECEIVED BY: CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerks Office (NNM) after signing/dating (Date) ', tRT CITY OF HUNTINGTON BEACH z INTERDEPARTMENTAL COMMUNICATION TO: City Treasurer FROM: City Clerk DATE: 4 1,7 1 1 SUBJECT: Bond Acceptance Ste- (c I have received the bonds for t�IPNY�1 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 (Council Approval Data) CC No. Agenda Item No. -)o - MSC No. City Clerk Vault No. 6-00.SC- Other No. _ SIRE System ID No. SLff �Ii g:Monns/bond transmittal to treasurer , 0 CITY OF HUNTINGTON BEACH 0 ~ IN1'ERDEPARmMEWAL COMMUNICATION DATE: 7/16/2021 TO: THOSE LISTED HEREON FROM: John Martin, PW Contract Administrator l SUBJECT: Retention Release Payment - PO#26660-OJ Supplier#33040 Co. #213 Residential Curb Ramp Project, Project#CC1620 Contractors Name: Golden State Constructors, Inc. Address: 208 E Orangethorpe Ave City, State and Zip Code: Placentia, CA 92780 Phone Number: 714-625-8758 City Business License Number: A267675 Notice of Completion (Date by City Clerk): 5/17/2021 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. I_Z/; ate Sean Crumby, Director o c Works I certify that there are no outstanding invoices on file. . IaiI >> Q7JP-f Date Joyce Zacks, Deputy City Treasurer I certify that no stop notices are on file, and that a guaranty bond has been filed with the City Clerk's Office. Date Robin Estanislau, City Clerk/Z��� �✓� 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 Bond No.: 2306042M MAINTENANCE BOND KNOW ALL PERSONS BY THESE PRESENTS- That Golden State Constructors (contractors name) 208_E 9LEog to horpe Avenue Placentia CA 92780 (contractor's street address,city and state and zip code) as Principal(hereinafter called Contractor),and: North American Specialty Insurance Company (surety's name) 777 S Figueroa St Suite 3700 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 New HamoShlre with its principal office in the city of 9verland Park Kansas as Surety(hereinafter called Surety),are held firmly bound unto CITY OF HUNTINGTON BEACH as Obligee (hereinafter called Owner), in the amount of Eight Hundred Sixty Thousand, ' Dollars (s 860,111.00 ), 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,finely by these presents, One Hundred Eleven and 00/100 WHEREAS,Surety is a duly admitted surety insurer under the laws of the State of Califomia;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 Surely is registered and listed with the Califomia Department of Insurance;and Contractor has by written agreement dated May 21 St .2e 21 entered into a contract with Owner for the Zone 3 ADA Ramps (CC1620) in accordance with drawings and specifications prepared by _Clty_of I[Un1ingtQR_Beac}] 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 pad 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 May 21 St ,2021. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that if Contractor shall, for a period of one year from and after the date of completion and acceptance of the Contract by Owner, repair and/or replace any and all defects arising in the Work, whether resulting from defective materials or defective workmanship, then this obligation shall be null and void; otherwise it will remain in full force and effect. The Surety hereby waives notice of any alteration or extension of time made by the Owner. Whenever Contractor shall be, and declared by Owner to be in default under the Contract, the Surety shall, within . thirty (30) days following Owners written notice of default, either: (a) remedy the default, or (b) shall promptly complete the Contract in accordance with its terms and conditions. Surety shall 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. I5<584/118138 t 1 I 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 Surely shall either: (a)remedy the default or breach by the Principal;or(b)shall promptly and faithfully take charge of the Work and complete the Work in accordance with the requirements of the Contract with a contractor other than the Principal,at its own expense, and make available as work progresses sufficient funds to pay the cost of completion less the unpaid balance of the Contract including other costs and damaees for which the surety may be liable hereunder, provided, however, that the procedure by which the Surety undertakes to discharge its obligations under this Bond shall be subject to the advance written approval of the Owner. Within thirty (30) days after Surety's receipt of a written notice from Owner of the failure of performance of the Contract by the Principal, it shall be the duty of the Surety to give to the Owner a notice, in writing, of the Surety's election to(a)remedy the default(s)of the Principal promptly,or(b)arrange for performance of the Contract promptly by a contractor other than the Principal, time being of essence to this Bond. In said Notice of Election, the Surety shall stale the date of commencement of its cure or remedy of the Principal's default(s) or its performance of the Contract. The Surety's obligations for cure or remedy, include but are not limited to: correction of defective work and completion of the Contract, additional legal, design professional and delay costs arising from Surety's actions or failure to act; and liquidated damages (or if no liquidated damages are specified in the Contract, actual damages caused by delayed performance or non-performance by the Principal). The Surety shall give prompt written notice to the Owner upon completion of the cure or remedy of the Principal's default(s)of its performance of the Contract. If the Surety does issue its Notice of Election and does not proceed to cure or remedy the Principal's default(s) of its performance of the Work within thirty (30)days after receipt of a written notice from Owner, Surety shall be deemed to be in default on this bond,and the Owner shall be entitled to enforce any remedy available to Owner. No right of action shall accrue on this bond to or for the use of any person or corporation other than the owner named . herein or the successors of Owner. Signed and sealed this 4th day of June 2021 Principal Raised Corporate Seal Golden St e onstrue ors [iAUST BEAFFIXED] ont Name) By: (Seal) j I Principal Raised Corporate Seal (MUST BE AFFIXED) (Title) North American Specialty Insurance Company u ty Na e) By: Ali Rand Spoh t rney-in-Fact a APPRO ED AS RM B i NOTES: Aicha . Ga es, City Attorney ! ,. Acknowledgments must be completed and returned N as pan of the bond. I'>,Q ♦/fit 3, 2. Raised Corporate Seals are mandatory. 3. Please attach Power of Attorney. 154584/118139 2 SiNVISS RE CORPORATE soLu'rIONS NORTH AMEKICAN SPECIALTY INSURANCE COMPANY IYASFIINIGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATrORNEI' KNOW ALI-hiEN By THESE PRESEN'LS,'I IIA"r North American Specialty Insurance Company,a corporation duly organized and existing under laws of the State of New Hampshire. and having its principal office in the City of Overland Park.Kansas.and Washington International Insurance Company, a corporation organized and existing under the laws ofihe Stme of Ne\v Iampshire and having its principal office in the City of Overlmid Park. Kansas,each clues hereby make,constitute and appoint: RANDY SPOT-IN. NIATfIIEN R. DOBYNS,and ASHLEY M. SPOHN JOINTLY OR SEVERALLY Its true and lawful Anorney(s)-in-Pact.to make,execute,seal and deliver, for and on its behalf and as its act and deed,bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies,as surety%obi contracts of suretyship as are or may be required or permitted by law. regulation,contract or otherwise.provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount Of. FIFTY MILLION(S50.000,000.00)DOLLARS Phis Powver of Attorney is granted and is signed by facsimile under and by the authority of the follo\ving Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly,called and held on the 9`K of play.2012: "RESOLVED.that any tvo of the Presidents,any Managing Director.any Senior Vice President,any Vice President,any Assistant Vice President. the Secretary or an.\Assistant Secretary be,and each or am of them hereby is authorized to execute a Po"vr of Attorney qualifying the attorney name(] in the given Power of Attorney to execute on behalf of the Company bonds. undertakings and all contracts of surety,and thin each or any of them hereby is authorized to attest to the execution of any such Power of Attorney will to attach therein the seal of the Conipany: and it is FURTHER RESOL V H).that the signature of Such officers and the seal of the Company,may be affixed to any such Power of Altomey or to any certificate relating thereto by facsimile,and any such Power of attorney or certificate hearing such facsimile signatures or facsimile sewl shall be binding upon the Company when so affixed and in the future with regard to any bond-undertaking or contract of surer•to which it is attached." ell eQc "q (P�%.� It, lF':G00.Pn%4r 96 `af SEAL :m`= lo,.n P.A.d.r.nn.S-m illPr.,mrnl nnr..ningnn Inr[rnam.,I In.nr.n[.Cl.,—, 22r' SEAL`� E pf%.2 1973 W"qc SSenf.r\icePmlAaM orx.nh Am[rion Spttlan lmm�nn[uniPrq O� m �i ... %� N .Se' 1bON•xrta�Or .WiQ'•..AU 4tq/tlnnnaM1ON It,mi[n.a A.au,.m,., PTndln�.n,nnnnn'rn,n— amp A Sant,\ill Prrudan.(N.,1h Amrdr.n 5,wcnln 1-o—,Compaq IN WITNESS WHEREOF.North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed.and these presents to be signed by their authorized officers this 14 day of FEBRUARY . 70 I S North American Specially Insurance Company Washington International Insurance Company State of Illinois Couniv of Cook ss: On this 14 day of FEBRUARY .201 S .before me.a Nolan Public personal]\,appeared Steven P.Anderson .Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Michael A.Ito. Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company.personally known to me,who being by me duly sworn.acknowledged that they signed the above Power of Attorney as officers of and acknow\'[edged said instrument to be the volumarx act and deed of their respective companies. OFFIOAL SFAL M.KENNY �i Noury Nbiic-Sun vl niimn ' MY(ammnYon E.p,, M.Kenny.Notnry Public 1]A./t(ly -. 1. Jefifev OoldberC . the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company,do hereby certify that the above and foregoing is awe and correct copy of a Powcr of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Connpany. which is still in fill bbrce and effect. IN WI"I-MESS %VI IEREOF, I have set nny hand and affixed the seals of the Companies this 411i day of June .20 21 Itratr coidurr4 Vitt Prt,ldtnl c A:9>,am S«rrun of u•a.nmrron imm�uuaul Insurm,t Con,pa.a k North Amman Smol,Inmranct Company CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of CALIFORNIA County of ORANGE On I L before me, ERIKA G. MORGAN, NOTARY PUBLIC. personally appeared RANDY SPOHN who proved to me on the basis of satisfactory evidence to be the person(5) whose nameH is/afe subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/heF/thei authorized capacity ties), and that by his/her�ltheisignature(s) on the instrument the person(5), or the entity upon behalf of which the personw acted, executed the instrument. ERIKA G. MORGAN I certify under PENALTY OF PERJURY under the laws of the State of co►w.ms�oIs California that the foregoing paragraph is true and correct. ' NOTOORANGEGE COUNTY � WITNESS my hand and official seal. Signature of #airy R1:1�. 'S --'�-5 - �,T.. L•ft ��,;.{; � ��'7�'.'•^t� n.`R "_._■__■ _'_{".'_*".4'•,-�.- ...t .ri?^-✓ �t"rTyXS``r;s't'i"'J'*h 1 •?T'yiy.. >. 'Ir}Jy a{.::..S.u1.1.•tri5�n h7:a�'..1..2. 5.�.ew�:s13.3"..�.1Y F_�'2�nGl t�Irl`A.�'�!1tia.:.4]r�i�t�".,CSi�.u33.8eF. Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER ❑ PARTNER(S) ❑ LIMITED © ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: _ NAME OF PERSON(S) OR ENTITY(IES) CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California } County of Orange } On 6/7/2021 before me, Claudia Cochran, Natary Public L ere insert name e�eL eo the raq personally appeared --Ronnie D. Cochran 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/ghekkey executed the same in his/herM-Aw authorized capacity(ieQ, and that by his/htrrffWeir signature(* on the instrument the personN, 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. CLAUDIA CDCHRAN COMM. #2277167 z WITNESS my"hand and-official seal. �• m Notary Public California o % �� z ., Orange County � M Corrlm.Ez ices Feb. 10,2023 Notary Public Signature (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM ThisJo+'m complies uilh runent Calii orniu s!aiutcs regarding Notary hvording und, DESCRIPTION OF THE ATTACHED DOCUMENT jneedcd, shoufdbecnmafrrrdandaurchcdtodadacumcnt9aknou•lrrlgnemb J:om other slater nor,be rontpleted"br documents being sent to that smte so long as the warding does nor h'cquire the California nomhi.to violate Cal+fa nia norary lm'. (Tile or description of attached doament) - State and County information must be the State and County where the document signers)personally appawrd before the noun,public for acknowiedgment. - Date of notarization must he the date that the signet(s)personally appeared which (Title or description of attached coatment continued) must also be the sane date the ackn.,lcdgmcn'1 is completed. - The acuity public must ptinr his or her name as it appears within his or her Number of Pages Document Date o imission foff.wed by a umtna and then your title fnotaty public). • R'int to vane(s) of document signeh(s) who personally appear to the time of notarization. CAPACITY CLAIMED BY THE SIGNER - ladicate the correct singular or plural forms by crossing off incorrect forms(ix. helshc/*ay,—is lace)or circling to correct`inns.Failure to corrcc:ly indicate this ❑ Individual (s) infornation maylcad to rejccrion of document recording. ❑ Corporate Officer - The notary seal impression must be clear and photographically reproducible. Impression must not cover:eat or lines. if seal impression snhudges, re-sodl if a (Title) suffiment area permits,otherwise complete a different acknowledgment form. ❑ Partner(s) - Sigrattne of the nutey public must match the signature on file with the office of the county clok. ❑ Attorney-in-Fact Additional information is not required but could help to ensum this ❑ Trustee(s) acknowledgment is rut misused or attached to a different documcct. Other Indhcare title or type or attached document,number of pages and dale. ❑ Indicate the capacity claimed by the signer. If the elained capaeip,is a corporate officer,indicate to tide(i.e.CEO,CFO,Seuetary). - Securely mach this document to the signed document with a staple. 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: CC1620 Project: Residential Curb Ramp Project The undersigned contractor on the above-referenced project ("Project')hereby certifies that all laborers, mechanics, apprentices, trainees, watchmen and guards employed by him or by any subcontractor performing work under the contract for the Project have been paid purstmt 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 261h day of May //,//; entia California. (Contractor Name) APPROVED O FORS¢ By: '%G// M'e&l E. Gates Clity Attorney 1 CONTRACTOR'S CERTIFICATE 1, Ronnie Cochran state and certify that: (Name of Declarant) l. Golden State Constructors is the general contractor to the City of Huntington Beach("City")on Contract No. CC1620 (the "Contract') for the construction of the public work of improvement entitled: Residential Curb Ramp Project (the"Project'). 2. All work to be performed pursuant to the Contract has been completed in accordance with the Contract Documents(as such term is defined in the Contract). 3. Except for the claims listed below and the disputed claims listed in paragraph five (5), all persons supplying labor, services, materials and equipment to the Project, including all claims against the contractor arising from the performance of the Contract, have been paid and satisfied(list unpaid debts and claims; if none, write "NONE"): None 4. Attached hereto are the lien waivers required by the Contract Documents, which lien waivers have been executed by all persons who performed work on or supplied labor, services, materials, and/or equipment for use at the Project. 5. Set forth below is a list of disputed claims or claims that are the subject of a Notice to Withhold filed pursuant to the Civil Code of the State of California (list all disputed claims; if none, write "NONE"). None 1 declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at Placentia,Ca on this) da ft-I 2021 (Signature ojDeclarant) APPROVED ASjnM Michae . Gates City ttomey 1 Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 Contract: CC1620 Project: Residential Curb Ramp Project The undersigned contractor on the above-referenced project("Project') hereby certifies that it has complied with title VII of the Civil Rights Act, the Equal Opportunity Act of 1972 and Executive Order 11246, and has not discriminated against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age or disability. The undersigned contractor also certifies that it has not maintained any segregated facilities at its establishments on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age or disability(with the exception of access for the disabled). I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. / Executed this 26th day of May 2 t Pla entia California. (Contractor Name) APPROVED F By: Mic I E. Gates Ci Attorney 1 (One of Three Originals) NORTH AMERICAN SPECIALTY INSURANCE COMPANY CONSENT OF SURETY PROJECT: Zone 3 ADA Ramps (CC1620) TO (OWNER) City of Huntington Beach Bond No. .' 206042 2000 Main Street Job / Bid No.: CC - 1620 Huntington Beach, CA 92648 Contract For: $845,925.00 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the North American Specialty Insurance Company, SURETY COMPANY, on bond of Golden State Constructors hereby approves the release of final payment to the Contractor. The Surety agrees that such release of final payment to the Contractor shall not relieve the Surety of any of its obligations to City of Huntington Beach, Owner, as set forth in the said Surety's bond. IN WITNESS WHEREOF, the Surety has hereunto set its hand this 21st day of June 2021 North American Specialty Insurance Company Surety 4 ljl �-�7�— �1/WiC.t J Matthew R. Dobyns , Attorney-in-fact CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the indk ideal %oho signed the document to which this certificate is attached. And not the truthfulness, accuracN, or validity of that document. State of CALIFORNIA County of _ORANGE_ On r I � ' before me, ERIKA G. MORGAN. NOTARY PUBLIC. personally appeared MATTHEW R. DOBYNS who proved to me on the basis of satisfactory evidence to be the personal whose names} is/ate subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/hef/theiF authorized capacity (iesj, and that by hisA%yAheir signatureW on the instrument the person(o, or the entity upon behalf of which the persons) acted, executed the instrument. W:R G MORGAI certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. E 610� WITNESS my hand and official seal. o' 14 m_U4 gnature otary Though the data below is not required by law; it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER ❑ PARTNER(S) LIMITED ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) SWISS RE CORPORATE SOLUTIONS NORTH AMERICAN SPECIALTY IN'SURAN'C17 COMPANY WASHIN'GTON IN'TFRNIATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN [I%'IIIISF. PRIiSFN'IS.'IIIA'I'Nosh American Specialty Insurance Company.it corporation duly organized and e\isting under laws of the State of Ncw I lantpshire.and having its principal oil-ice in the Cite of0vcrland Park. Kansas,and Washinghrn Inlcmalionnl Insurance Company. a corporation organized and existing under the Taos of the Slate of Nov I lampshire and hating its principal office in the City of Overland Park.Kansas.each does hereh, make,consti0nc and appoint: RANDY SPOI IN. MATI'I IE\\' R. DOBYNS,and AS]ILEY M.SPOI IN JOINTLY OR SEVERALLY Its true and lawful AOorne\'(s)-in-Fact.to make,c\erute. seal and deliver, lit and on its hchalf and as its act and(Iced,htmds or other writings obligaun'in the nature of a Nun!on behalf of each of-said Companies,as sumty,on contracts of suretyship as arc or ma\'be required or Permitted by Ira\'_regulation.contract or other\,i.se. pro\ided(hut no Mod or undertaking or contract or suretyship executed under this authorit\'shall exceed(hc amount of. FIFTY MILLION(S50,000,000.00)DOLLARS 'I his Power of Attorney is granled and is signed hY facsimile under and by'the authority'of the Iiollo\ving Resolutions adopted by the Boards of Directors of both North American Specials'Insurance Compare,and Washington International Insurance Company at meetings duly called and held on(he 9'of Mae.2012: -RESOLVED.(hat an\'t\so ofthe['residents,any'Managing Director,any Senior Vice President,am' Vice President,ant Assistant Vice President. the Secrctan'or an\'Assistant Secretar,Ise.and each or any of them herchv is authorized I(r execute It Iltmer of Altomey'qualifying(he:ntomcy' rallied in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surely.and that each or an,of them hereby is authorized to attest to the ececution of an\'such I'o\\cr of Attorney and to attach therein the seal of the Compare,: and it is FUR II IFR RESOLVED.that the signature of such o07ecrs and the seal of the Company may he affixed to an, such 1'o\Yer of Anorne,or to any certificate relating thereto by facsimile and any such Po\Yer nl Atiomcy or ceniticaw hearing such facsimile signatures or lacsimile seal shall Ise binding upon the Compare when so affixed and in the future\vith regard to anp bond.undertaking or contract of surer,to which it is attached." s°,Oowaa„yam Cry If 4 e ,#, ort;�e*c ��yyv. oruz t7f SfJfL _�= Ne•rnP.A.dee,en,Scnw,%'i,,Preild-1mw..el•o..mx...a...nn.r...ee.mp.n. 1� 6 senior\'Ice President n1 Sot!nmrrkv Sperwa•In,or.oee C.mp@nc pj Rv Sn.hxl A.Ib., nor xe nn min n mOMr memnmm mu—r.mpiq S Senwr,ire PrevIkem el Senn Awrk..spr<i.ln Imunnn C..,—, IN )VI INESS N71IERFOF.North American Specialty Insurance Compare'and Washington International Insurance Company have caused their official seals to be hereunto affixed.and these presents(n he signed by their authorized officers this 14 day of FEBRUARY ,20 18 Norlh American Specialq'Insurance Company Washington International Insurance Company State of Illinois Count\'of Cook ss: 0it This 14 day of Fr.BR UA RY . 2019 .beli re me.it Nolan Public persunaI l\'appeared Steven P.Anderson .Senior Vice President of Washington International Insurance Company and Senior Vice['resident of North American Specialty Insurance Company and Michacl A. Ito. Senior Vice ['resident of Washington International Insurance Company and Senior Vice ['resident of North American Specialty'Insurance Company. personally known to tie. \xho being by me duly s\\orn,acknowledged that they'signed the also\e Power of Attome_,as officers of told acknowledged said instrument to he the voluntan act and deed of their respective companies. OFFKW SEAL M."MMT Nouq Pubk-S of 1Y.i. \� Yr rarvrri lem" Y enn , ry M.K NorM Publi,: 1]ANptt I. JefGe\'Goldberg , the dul\'elected Assistant Secretary of North American Srxciab Insurance Compare'and Washington International Insurance Compan\'.do hereb\'cenifv that the alhow and foregoing is a true and correct copy of a Power of Auome\given by said North American Specialty'Insurance Company and Washington International Insurance Compare'.\\hich is still in full force and e0'rct. IN N'fl'NESS \ 11FRROF. I have set my[land and a0i\cd the seals of the Companies this 21g1 daY of June ,2p 21 1<niy Goldbeq,ic<Rmdent R Amnmt Smmr.or N'.slimxlm Werturiaul Irwe.<e('ompury A\Dolt Amnres SP.'cr.lr,Inwemce l'omlun• RECEIVED BY: CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office (Name) after signing/dating (Date) CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: City Treasurer FROM: City Clerk DATE: SUBJECT: Bond Acceptance I have received the bonds for (�D�Gf7iYl U /GfTC� (_ 1�1 �F�S (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. a3Dl tXX 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 0.20 (Council Approval Date) CC No. 10 Agenda Item No. M MSC No. City Clerk Vault No. �OUD,�SD Other No. SIRE System ID No. <5-LI0(03S g:/formstbond transmittal to treasurer Recorded in Official Records, Orange County Hugh Nguyen, Clerk-Recorder IIIIIIII111lil l Jill 11111[III[JillIllJJ11 Jill I1011111'lllIlnlllll NO FEE PLEASE COMPLETE THIS INFORMATION . $ R 0 0 1 2 5 6 9 2 7 3 S 2021000355568 2:55 pm 06/01121 RECORDING REQUESTED BY: 320 PP2A M2 1 0.00 0.00 0.00 0.00 0.00 0.00 0.000.000.00 0.00 WHEN RECORDED MAIL TO: CITY OF HUNTINGTON BEACH PUBLIC WORKS DEPARTMENT Attn:John Martin P.O. Box 190—2000 Main Street Huntington Beach,CA 92648 THIS SPACE FOR RECORDER'S USE ONLY TITLE OF DOCUMENT NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN by the City of Huntington Beach,owner in fee,2000 Main Street,Huntington Beach,CA 92648, that the contract heretofore awarded to Golden State Constructors, Inc.,who was the company thereon for coing the following work to- wit Residential Curb Ramp Project, Project#CC1620 That said work was completed 05/17=21 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 05/17/2021, per City Council Resolution No. 2003-70 adopted October 6,2D03. That upon said contract(Bond Company Name Here),was surety for the bond given by the said company as required by law. This document is solely for the official business of the City of Huntington Beach, as contemplated under Government Code Section 273a3 and should be recorded free of charge. O / /� s/sisl Dirac or ' r +6)Ic v arks or City Engineer Date . City of Huntington Beach,Californla STATE OF CALIFORNIA) County of Orange )ss: City of Huntington Beach ) I,the undersigned, say: I am an Agent of the City of Huntington Beach, owner in fee, in the foregoing NOTICE OF COMPLETION. 1 have read said NOTICE OF COMPLETION and know the contents thereof;the same is true of my knowledge. I declare under penalty of perjury that the foregoing is true and correct, and that said NOTICE OF COMPLETION was duly and regularly ordered to be recorded in the Office of the County Recorder of Orange /County. This document is solely the oHiclal business of Z/�2� the City of Huntington Beach, as contemplated �-�1 under Government code section 27383 and Direc4of of s or City Engineer Date should be recorded free of charge. City of Huntington Beach,California THIS PAGE IS ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION (Additional recording fee applies) RECEIVED BY: CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office (Name) after signing/dating (Date) CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: City Treasurer FROM: City Clerk DATE: 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. 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. Eh� Agenda Item No. � )—lel, MSC No. City Clerk Vault No. l�U U -0 Other No. SIRE System ID No. S-L/04A-3?9- g:/forms/bond transmittal to treasurer CDBG FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND GOLDEN STATE CONSTRUCTORS FOR ZONE 3 ADA RAMPS PROJECT 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 GOLDEN STATE CONSTRUCTORS , a hereinafter referred to as "CONTRACTOR." WHEREAS, the Federal Department of Housing and Urban Development is providing partial funding for this Contract to CITY through a Community Development Block Grant; WHEREAS, CITY has solicited bids for a public works project, hereinafter referred to as "PROJECT," more fully described as ZONE 3 ADA RAMPS (CC1620) in the City of Huntington Beach; and CONTRACTOR has been selected to perform said services, NOW, THEREFORE, in consideration of the promises and agreements hereinafter made and exchanged, the parties covenant and agree as follows; 1. STATEMENT OF WORK; ACCEPTANCE OF RISK CONTRACTOR shall complete and construct the PROJECT pursuant to this Agreement and the Contract Documents (as hereinafter defined) and furnish, at its own cost and expense, all labor, plans, tools, equipment, supplies, transportation, utilities and all other items, services and facilities necessary to complete and construct the PROJECT in a good and workmanlike manner. SF:16-5215-142605.doc/rev 12/2016 1 CONTRACTOR agrees to fully assume the risk of all loss or damage arising out I of the nature of the PROJECT, during its progress or prior to acceptance by CITY, from the action of the elements, from any unforeseen difficulties which may arise or be encountered in the prosecution of work, and for all other risks of any description in connection with the work, including, but not 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:16-5215-142605.docr"rev 12/2016 2 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 for Public If'orks Construction, published by Builders' News, Inc., 10801 National Boulevard, Los Angeles, CA 90064, and all amendments thereto, written and promulgated by the Southern California chapter of the American Public Works Association and the Southern California District Associated General Contractors of the California Joint Cooperative Committee as specified in the particular Plans, Specifications, Special Provisions and Addenda applicable to the Project; E. All bid documents, including the Notice Inviting Bids, the Special Instructions to Bidders, CONTRACTOR's proposal, (attached as Exhibit "A"), "Form HUD-4010," the Federal Labor Standards Provision of the United States (attached as Exhibit "B"), and "Standard Federal Equal Employment Opportunity Construction Contract Specifications," as established by Federal Executive Order 11246 (attached as Exhibit "C"). F. The particular Plans, Specifications, Special Provisions and Addenda applicable to the PROJECT. Anything mentioned in the Specifications and not indicated in the Plans or indicated in the Plans and not mentioned in the Specifications, shall be of like effect as if indicated and mentioned SF:16-5215-142605.doc/rev 12/2010 3 in both. In case of a discrepancy between any Plans, Specifications, Special provisions, or Addenda, the matter shall be immediately submitted. by CONTRACTOR to• the Department of Public Works of CITY (hereinafter referred to as "DPW"), and CONTRACTOR shall not attempt to resolve or adjust the discrepancy without the decision of DPW, save only at its own risk and expense. Should there be any conflict between the terms of this Agreement and the bid or proposal of CONTRACTOR, then this Agreement shall control and nothing herein shall be considered as an acceptance of the terms of the bid or proposal which is in conflict herewith. 3. COMPENSATION CITY agrees to pay and CONTRACTOR agrees to accept as full compensation for the faithful perfonnance 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 Eight hundred forty five thousand nine hundred twenty five Dollars ($� 845,925.00 ), as set forth in the Contract Documents, to be paid as provided in this Agreement. 4. COMMENCEMENT OF PROJECT CONTRACTOR agrees to commence the PROJECT within ten (10) working days after the Notice To Proceed is issued and diligently prosecute the PROJECT to completion within sixty _ (_ 0 ) consecutive working days from the day the Notice to Proceed is issued by DPW, excluding delays provided for in this Agreement. i 5. 'TIME OF THE ESSENCE j SF:16-5215-142605_docirev 12/2016 4 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 an and all changes, furnish materials and perform all work necessary within the scope of the PROJECT as DPW may require in writing. Linder 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:16-5215-142605.doc/rev 12/2016 5 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. .LNOTICE TO PROCEED No work, services, material, or equipment shall be performed or furnished under this Agreement unless and until a Notice to Proceed has been given to CONTRACTOR by CITY. CITY does not warrant that the work will be available on the date the Notice to Proceed is issued. In the event of a delay in commencement of the work due to unavailability of the job site, for any reason, relief to CONTRACTOR shall be limited to a time extension equal to the delay due to such unavailability. 8. BONDS Only bonds issued by California admitted sureties will be accepted. CONTRACTOR shall, prior to its performance of this Agreement, furnish the following two (2) bonds approved by the City Attorney: 1. A bond in this .amount of one hundred percent (100%) of the Agreement price to guarantee CONTRACTOR's faithful performance of the work; and 2. A bond in the amount of one hundred percent of the Agreement price to guarantee payment of all claims for labor and materials furnished. In addition, CONTRACTOR shall submit to CITY a bond in the amount of one hundred percent (100%) of the final Agreement price, including all change orders, to warrant such performance for a period of one (1) year after CITY's acceptance thereof within ten (10) days of filing of the Notice of Completion. SF:16-521.5-142605.doc;rev 12/2016 6 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 five hundred _ Dollars ($ 500.00 ) per each calendar day's delay in completing the work in excess of the number of working,/calendar days SF:16-521.5-142605.doc/rev 12/2016 7 set forth herein, which represents a reasonable endeavor by the parties hereto to estimate a fair compensation for the foreseeable damages CITY would sustain in the event of and by reason of such delay; and CONTRACTOR agrees to pay these damages herein provided, and further agrees that CITY may deduct the amount thereof from any monies due or that may become due to CONTRACTOR hereunder. For projects on the National Highway System (NHS), the local formula for liquidated damages will be provided. CONTRACTOR will be granted an extension of time and will not be assessed damages for any portion of the delay in the completion of the work due to unforeseeable causes i 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. I 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 SF:16-5215-142605.doc/irev 12/2016 g completion of the work shall be extended by the number of days CONTRACTOR has thus been delayed, but no allowance or extension shall be made unless a claim therefor is presented in writing to CITY within fifteen (15) days of the commencement of such delay. No claims for additional compensation or damages for delays, irrespective of the cause thereof, and including without limitation the furnishing of materials by CITY or delays by other contractors or subcontractors, will be allowed and an extension of time for completion shall be the sole remedy of CONTRACTOR. 12. DEMANDS FOR ADDITIONAL TIME OR MONEY A. Definitions. (1) "Change Order" means a document: signed by CONTRACTOR and CITY which authorizes an addition, deletion or revision in the work, or an adjustment in the Compensation under Section 3, or the Completion Time specified at Section 4. (2) "Demand" means a written demand for a Change Order by CONTRACTOR for any of the following: (a) A time extension; (b) Payment of money or damages arising from work done by, or on behalf of, CONTRACTOR pursuant to this, Agreement and payment of which is not expressly permitted. pursuant to Section 3 of this Agreement; (c) Payment of,in amount the CITY disputes; (d) Any disputers 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 SF:16-5215-142605.doc/rev 12/2016 9 differing materially from those indicated in this Agreement or the lContract Documents, or unknown physical conditions at the job site, of an.unusual nature, differing materially from those ordinarily encountered and generally recognized as inherent to work of the PROJECT; or. (f) A request for a time extension or additional payment based upon acts of neglect by CITY or due: to Fires, floods, labor disputes, epidemics, abnormal weather conditions or acts of God. B. A Demand for a time extension or payment of money or damages may only be granted by a Change Order. C. No Change Order may be granted except where CONTRACTOR has submitted a Demand to the DPW .(or his or her written designee). All Demands shall be submitted promptly, but in no event later than thirty (30) days after the occurrence of the event giving rise to the Demand. The Demand shall. be in writing and include all documents necessary to substantiate the :Demand. The DPW shall act on the Demand within fifteen. (15) days after receipt, including by requesting additional information from CONTRACTOR. to determine whether to approve the Change Order the Demand seeks. The DPW shall act on the Demand within fifteen (15) days after receipt of the additional information or within a period of time no greater than the time CONTRACTOR took to produce the additional information requested, whichever is greater. D. Notwithstanding the thirty (30) days to submit a Demand under Subparagraph C, in the case of differing or unknown site conditions, immediately upon encountering the conditions, CONTRACTOR shall notify the DPW in writing of the conditions, so that the CITY may promptly investigate the conditions. SF:16-5215-142605.doc rev 12/2016 10 E. If CONTRACTOR disputes the DPW's written response on the Demand, or the CITY fails to respond within the time prescribed, CONTRACTOR may so notify the City Engineer, in writing, either within fifteen (15) days of receipt of the City Engineer's response or within fifteen (15) days of the DPW's failure to respond within the time prescribed, respectively, and request an informal conference to meet and confev for settlement of the Demand. Upon CONTRACTOR's request, the DPW shall schedule a meet and confer conference within thirty (30) days to seek to resolve. F. CITY and CONTRACTOR shall execute appropriate Change Orders covering changes to the time or price by executing the Change Order by mutual agreement. If the CITY and CONTRACTOR are unable to reach a mutual agreement, then the City Engineer shall issue a written decision on the claim within a reasonable time. G. Following the meet and confer conference, if the Demand remains in dispute, CONTRACTOR may file a claim with the City as provided in Chapter 1 (commencing with Section 900) and Chapter 2 (commencing with Section 910) of Part 3 of Division 3.6 of Title 1 of the Government Code. For purposes of those provisions, the running of the period of time within which. a claim must be filed shall be tolled :from the time the time CONTRACTOR submits his or her Demand until the Demand is denied as a result of the meet and confer process, including any period of time utilized by the meet and confer process. 13. VARIATIONS IN ESTIMATED QUANTITIES 'The quantities listed in the bid schedule will not governn 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 SF:16-5215-142605.doc/ ev 12/2016 11 quantities listed in the bid.schedule, the bid price shall prevail subject to the provisions of this Section. DPW may, at its sole discretion, when warranted by the facts and circumstances, order an equitable adjustment, upwards or downwards, in payment to CONTRACTOR where the actual quantities used in construction of the PROJECT are in variation to the quantities listed in i the bid schedule. No claim by CONTRACTOR for an equitable adjustment in price or time for i completion shall be allowed if asserted after final payment wider 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 i :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 allprevious payments and less all previous retained amounts. i I 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 SF:16-5215-142605.doc/rev 12/2016 12 and CONTRACTOR, CITY may withhold from the final payment an amount not to exceed 150 percent of the value of any disputed amount of work. Payments shall be made on demands drawn in the manner required by law, each payment to be accompanied by a certificate signed by DPW, affirming that the work for which payment is demanded has been performed in accordance with the terms of the Agreement and that the amount stated in the certificate is due under the terms of the Agreement. ]Partial payments on the contract price shall not be considered as an acceptance of any part of the work. 15. WITHHELD CONTRACT FUNDS SUBSTITUTION OF SECURITIES At the request and at the sole cost and expense of CONTRACTOR, who shall retain beneficial ownership and receive interest, if any thereon, CITY shall permit the substitution and deposit therewith of securities equivalent to the amount of any monies withheld by CITY to ensure performance under the terms of this Agreement. 16. AFFIDAVITS OF SATISFACTION OF CLAIMS .After the completion of the work contemplated by this Agreement, CONTRACTOR shall file with DPW its affidavit stating that all workers and persons employed, all firms supplying materials and all subcontractors working upon the PROJECT have been paid in full and that there are no claims outstanding against the PROJECT for either labor or material, except certain items, if any, to be set forth in CONTRACTOR's affidavit covering disputed claims, or items in connection with Notices to Withhold, which have been filed under the provisions of the statutes of the State of.California. SF:16-5215-142605.doc/rev 12/2016 13 i 17. WAIVER OF CLAIMS 'The acceptance by CONTRACTOR of the payment of the final certificate shall i constitute a waiver of all claims against CITY under or arising out of this Agreement. 18. INDEMNIFICATION, DEFENSE, HOLD HARMLESS CONTRACTOR hereby agrees to protect, defend, indemnify and hold harmless CITY, its officers, elected or appointed officials, employees, agents, and volunteers from and against any and all claims, damages, losses, expenses, judgments, demands, defense costs, and consequential damage or liability of any kind or nature, however caused, including those resulting from death or injury to CONTRACTOR's employees and damage to CONTRACTOR's property, arising directly or indirectly out of the obligations or operations herein undertaken by CONTRACTOR, caused in whole or in part by any negligent act or omission of 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 when; caused by the active negligence, sole negligence, or willful misconduct of the CITY, its officers, elected or appointed officials, employees, agents, and volunteers. CONTRACTOR will conduct all defense at its sole cost and expense and CITY shall approve selection of CONTRACTOR's counsel: This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by CONTRACTOR. 19. WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY INSURANCE Pursuant to California Labor Code Section 1861, CONTRACTOR acknowledges awareness of Section 3700 et seq. of this Code, which requires every employer to be insured SF:16-521.5-142605.dcchev 12/2016 14 against liability for workers' compensation; CONTRACTOR. covenants that it will comply with such provisions prior to commencing performance of the work hereunder. CONTRACTOR shall maintain workers' compensation and employer's liability insurance in an amount of not less than the State statutory limits. CONTRACTOR shall require all subcontractors to provide such workers' compensation and employer's liability insurance for all of the subcontractors' employees. CONTRACTOR shall furnish to CITY a certificate of waiver of subrogation under the terms of the workers' compensation and employer's liability insurance and CONTRACTOR shall similarly require all subcontractors to waive subrogation. 20. INSURANCE In addition to the workers' compensation and employer's liability insurance and CONTRACTOR's covenant to defend, hold harmless and indemnify CITE.', 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 form which includes a designated general aggregate limit, the aggregate limit must be no less than One Million Dollars ($1,000,000) for this PROJECT. This policy shall name CITY, its officers, elected or appointed officials, employees, agents, and volunteers as (the "Additionally Insured Parties") as Additional Insureds, and shall specifically provide that any other insurance coverage which may be SF:16-5215-142605.doc/rev 12/2016 15 applicable to the PROJECT shall be deemed excess coverage and that CONTRACTOR's insurance shall be primary and non-contributory with any other valid and collectible insurance or self-insurance available to the Additionally Insured Parties. Any available insurance proceeds in excess of the minimum coverage amount specified herein shall be available to the Additionally Insured Parties;. All coverage available to CONTRACTOR shall also be available to the Additionally Insured Parties. Under no circumstances shall said above-mentioned insurance contain a self-insured retention without the express written consent of CITY; however, an insurance policy"deductible" of$5,000.00 is 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. i 21. _CERTIFICATES OF INSURANCE; ADDITIONAL INSURED ENDORSEMENTS Prior to commencing performance of the work hereunder, CONTRACTOR shall furnish to CITY certificates of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverages as required by this Agreement; the certificates shall: I. 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. SF:16-5215-142605.doc/rev 12/2016 16 'The requirement for carrying the foregoing insurance coverages shall not derogate from the provisions for indemnification of CITY by CONTRACTOR under the.Agreement. CITY or its representative shall at all times have the right to demand the original or a copy of all the policies of insurance. CONTRACTOR shall pay, in a prompt and timely manner, the premiums on all insurance hereinabove required. CONTRACTOR shall provide a separate copy of the additional insured endorsement to each of C,ONTRACTOR'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. PAYROLL RECORDS CONTRACTOR agrees to keep accurate payroll record showing the name, address, social security number, work classification, straight time and overtime hours worked each day and week, and the actual per diem wages paid to each journeyman, apprentice or worker employed by it in connection with the PROJECT and agrees to require each of its subcontractors to do the same. CONTRACTOR further agrees that its payroll. records and those of its subcontractors, if any, shall be available at all reasonable times to the CITY, and the employee or his representative, and the Division of Labor Standards Enforcement and the Division of Apprenticeship Standards, and to comply with all of the provisions of California Labor Code Section 1776, in general.. 23. CALIFORNIA PREVAILING WAGE LAW AND FEDERAL DAVIS- BACON ACT. A. The CITY has ascertained from the Director of Industrial.Relations of the State of California the general prevailing rate of per diem wages and the general prevailing rate SF:16••521.5-142605.doc/rev 12/2016 17 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 (S25) for each calendar day or portion thereof for each worker paid (either by CONTRACTOR or any of its subcontractors) less than the prevailing wage rate established for that particular craft or type of work. . C. This Agreement also is subject to the Federal Davis-Bacon Act. The minimum rate of wages for each craft or type of worker needed to execute the PROJECT shall be those as determined.by the United States Secretary of Labor. If there is a difference between the minimum wage rates predetermined by the Secretary of Labor and the general prevailing wage rates determined by the Director of the California Department of Industrial Relations for similar classifications of labor, CONTRACTOR and subcontractors shall pay not less than the higher wage rate. 24. CALIFORNIA EIGHT=HOUR LAW A. California Labor Code, Sections 1810 Est seq, shall apply to the performance of this Agreement; thereunder, not more than eight (8) hours shall constitute one day's work and CONTRACTOR and each subcontractor employed by its hereunder, shall not SF:16-5215-142605.doc/rev 12/2016 18 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 ( ode 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. 25, PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE Section 1773.8 of the California Labor Code, regarding the payment of travel and subsistence allowance is applicable to this PROJECT. 26. :EMPLOYMENT OF APPRENTICES Section 1777.5 of the California Labor Code, regarding the employment of apprentices is applicable to this PROJECT. 27. EQUAL EMPLOYMENT OPPORTUNITY :During the performance of this Agreement, CONTRACTOR agrees as follows: A. CONTRACTOR will not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, or national origin. CONTRACTOR will take affirmative action to ensure that applicants are SF:16-5215-142605.doc/rev 12/2016 19 employed, and that employees are treated during employment, without regard to their race, color, religion, sex, sexual orientation, gender identity, or national origin. Such action shall include, but not be limited to the following: Employment, upgrading, demotion, or transfer, recruitment or recruitment advertising; layoff or termination; rates of pay or other fornis of compensation; and selection for training, including apprenticeship. CONTRACTOR agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided by the contracting officer setting forth the provisions of this nondiscrimination clause,:. i B. CONTRACTOR. will, in all solicitations or advertisements for employees placed by or on behalf of CONTRACTOR,, state that all qualified applicants will receive consideration for employment without regard. to race, color, religion, sex, sexual orientation, gender identity, or national origin. C. CONTRACTOR will not discharge or in any other manner discriminate against any employee or applicant for employment because such employee or applicant has inquired about, discussed, or disclosed the compensation of the employee or applicant or another employee or applicant. This provision shall not apply to instances in which an employee who has access to the compensation information of other employees or applicants as a part of such employee's essential job functions discloses the compensation of such other employees or applicants to individuals who do not otherwise have access to such information, unless such disclosure is in response to a formal complaint or charge, in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or is consistent with CONTRACTOR's legal duty to furnish information. SF:16-5215-142605.doa`rev 12/2016 20 D. CONTRACTOR will send to each labor union or representative of workers with which it has a collective bargaining agreement or other contract or understanding, a notice to be provided by the agency contracting officer, advising the labor union or workers' representative of CONTRACTOR's commitments under Section 202 of Executive Order 11246 of September 24, 1965, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. E. CONTRACTOR will comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the United States Secretary of Labor. A copy of Executive Order 11246, as amended, is attached as Exhibit C. E. CONTRACTOR will furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by the rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books, records, and accounts by the contracting agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders. G. In the event of CONTRACTOR's non-compliance with the nondiscrimination clauses of this contract or with any of such rules, regulations, or orders, this contract may be canceled, terminated or suspended in whole or in part and CONTRACTOR may be declared ineligible for further Government contracts in accordance with procedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies involved as provided in Executive Order 11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law. SF:16-521.5-142605.doc/rev 12/2016 21 H. CONTRACTOR will include the provisions of sub-paragraphs A through G in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to section 204 of Executive Order 1,1246 of September 24, 1965, so that: such provisions will be binding upon each sub-contractor or vendor. CONTRACTOR will take such action with respect to any subcontract or purchase order as may be directed by the Secretary of Labor as a means of enforcing such provisions including sanctions for noncompliance: Provided, however, that in the event CONTRACTOR becomes involved in, or is threatened with, litigation with a sub-contractor or vendor as a result of such direction, CONTRACTOR may request the United States to enter into such litigation to protect the interests of the United States. 28. RECORD RETENTION Financial records, supporting documents, statistical records, and all other CONTRACTOR records pertinent shall be retained for a period of three years from the date of the City filing the Notice of Completion of the PROJECT. The only exceptions are the following: A. If any litigation, claim, or audit is started before the expiration of the 3- year period, the records must be retained until all litigation, claims, or audit findings involving the records have been resolved and Final action taken. 13. When the non-Federal entity is notified in writing by the Federal awarding agency, cognizant agency for audit:, oversight agency for audit, cognizant agency for indirect costs, or pass-through entity to extend the retention period. C. Records for real property and equipment acquired with Federal funds must be retained for 3 years after final disposition. SF:1 6-52 1 5-142605.doc%rev 12/2016 22 D. When records are transferred to or maintained by the Federal awarding agency or pass;-through entity, the 3-year retention requirement is not applicable to the non- Federal entity. E. Records for program income transactions after the period of performance. In some cases recipients must report program income after the period of performance. Where there is such a requirement, the retention period for the records pertaining to the earning of the program income starts from the end of the non-Federal entity's fiscal year in which the program income is earned. F. Indirect cost rate proposals and cost allocations plans. This paragraph applies to the following types of documents and their supporting records: indirect cost rate computations or proposals, cost allocation plans, and any similar accounting computations of the rate at which a particular group of costs is chargeable (such as computer usage chargeback rates or composite fringe benefit rates). (1) If submitted for negotiation. If the proposal, plan, or other computation. is required to be submitted to the Federal government (or to the pass- through entity) to form the basis for negotiation of the rate, then. the 3-year retention period for its supporting records starts from the date of such submission. (2) If not submitted for negotiation. If the proposal, plan, or other computation is not required to be submitted to the Federal government (or to the pass- through entity) for negotiation purposes, then the 3-year retention period for the proposal, plan, or computation and its supporting records starts from the end of the fiscal year (or other accounting period) covered by the proposal,plan, or other computation. SF:16-5215-142605.doc/rev 12/2016 23 i 29. NOT'ICE OF THIRD-PARTY CLAIM Pursuant to Public Contracts Code Section 9202, CITY shall provide notice to CONTRACTOR of receipt of any claim filed with CITY or a court of competent jurisdiction which arises out of performance of this agreement within ten (10) days of receipt of such claim or claims. 30. :DEFAULT AND TERMINATION If CONTRACTOR fails or refuses to prosecute the work hereunder with diligence, or fails to complete the work within the time specified, or is adjudged bankrupt or makes an assignment for the benefit of creditors or becomes insolvent, or violates any provision of this Agreement or the Contract Documents, CITY may give CONTRACTOR notice in writing of its intention to terminate this Agreement. Unless the violation is curedwithin ten (10) days after such Notice of Intention has been served on CONTRACTOR, CITY may, without prejudice to any other remedy it may have, terminate this Agreement upon the expiration of that time. Upon such default by CONTRACTOR, CITY may elect not to terminate this Agreement; in such event CITY may make good the deficiency in which the default consists and deduct the resulting costs from the progress payments then or to become due to CONTRACTOR. If it is subsequently determined by a court of competent jurisdiction that CITY's termination of this Agreement under this Section was wrongful, such termination shall be converted to a termination for convenience under Section 29 and any damages shall be assessed as set forth in Section 29. 31. 'TERMINA.TION 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 SF:16-5215-142605.dochev 12/2016 24 notice to CONTRACTOR. In the event of termination, under this Section CITY shall pay CONTRACTOR for value of work in place on the PROJECT through the termination period less all such-payments already made. In case of such termination for convenience, CONTRACTOR shall be entitled to receive payment for work executed., and costs incurred by reason of such termination. In no event shall CONTRACTOR be entitled to recover overhead, profit or CONTRACTOR's fee on work not performed. Such payment by CITY shall be CONTRACTOR's sole and exclusive remedy for termination by CITY for its convenience and CITY shall have no further obligation to CONTRACTOR. 32. :DISPOSITION OF PLANS ESTIMATES AND OTHER DOCUMENTS CONTRACTOR agrees that upon completion of the work to be performed hereunder, or upon expiration or earlier termination of this Agreement, all original plans, specifications, drawings, reports, calculations, maps and other documents pertaining to this Agreement shall be delivered to CITY and become its sole property at no further cost. 33. NONASSIGNABILITY CONTRACTOR shall not sell, assign, transfer, convey or encumber this Agreement, or any part hereof, or any right or duty created herein, without the prior written consent of CITY and the surety. 34. CITY EMPLOYEES AND OFFICIALS CONTRACTOR shall employ no CITY official nor any regular CITY employee in the work performed pursuant to this Agreement. No officer or employee of CITY shall have any financial interest in this Agreement in violation of the California Government Code, SF:16-5215-142605.doc/rev 12/2016 25 35. STOP NOTICES; RECOVERY OF ADMINISTRATIVE COSTS CITY shall be entitled to all reasonable administrative casts 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 (S 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. 36. NOTICES .Any notices, certificates, or other communications hereunder shall be given either by personal delivery to CONTRACTOR's agent (as designated in Section 1 hereinabove) or to CITY as the situation shall warrant, or by enclosing the same in a sealed envelope, postage prepaid, and depositing the same in the United States Postal Service, to the addresses specified below; provided that CITY and CONTRACTOR, by notice given hereunder, may designate different addresses to which subsequent notices, certificates or other communications will be sent: TO CITY: TO CONTRACTOR: City of Huntington Beach GOLDEN STATE CONSTRUCTORS ATTN: John Martin i, Public Works ATTN: _Ron Cochran 2000 Main Street 208 E Orangethorpe Ave Huntington Beach, CA 92648 Placentia, CA 92780 SF:16-5215-142605.dochrev 12/2016 26 37. 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. 38. [MMIGRATION CONTRACTOR shall be responsible for full compliance with. the immigration and naturalization laws of the United States and shall, in particular, comply with the provisions of the Immigration Reform and Control Act of 1978 (8 USC Section 1324a) regarding employment verification. 39. :LEGAL SERVICES SUBCONTRACTING PROHIBITED CONTRACTOR and CITY agree that CITY is not liable for payment of any subcontractor work involving legal services, and that such legal services are expressly outside the scope of services contemplated hereunder. CONTRACTOR understands that pursuant to Huntington Beach City Charter Section 309, the City Attorney is the exclusive legal counsel for CITY; and CITY shall not be liable for payment of any legal services expenses incurred by CONTRACTOR. 40. ATTORNEY'S FEES In the event suit is brought by either party to construe, interpret and/or enforce the terms and/or provisions of this Agreement or to secure the performance hereof, each party shall SF:16-5215-142605.doc/rev 12/2016 27 bear its own attorney's fees and the prevailing party shall not be entitled to recover its attorney's fees from the nonprevailing parry. 41. INTERPRETATION OF THIS AGREEMENT 'The language of all parts of this Agreement shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any of the parties. If any I 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 I to require the commission of any act contrary to law, and wherever there is any conflict between any provision contained herein and any present or future statute, law, ordinance or regulation contrary to which the parties have no right to contract, then the latter shall prevail, and the provision of this Agreement which is hereby affected shall be curtailed and limited only to the extent necessary to bring it within.the requirements of the law. 42. GOVERNING LAW 'This Agreement shall be governed and construed in accordance with the laws of the State of California. 43. DUPLICATE ORIGINAL 'The original of this Agreement and one or more copies hereto have been prepared and signed in counterparts as duplicate originals, each of which so executed shall, irrespective of SF:16-5215-142605.doe/rev 12/2016 28 the date of its execution and delivery, be deemed an original. Each duplicate original shall be deemed an original instrument as against any party who has signed it. 44. CONSENT Where CITY's consent/approval is required tinder this Agreement, its consent/approval for one transaction or event shall not be deemed to be consent/approval to any subsequent occurrence of the same or any other transaction or event. 45. SIGNATORIES Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify CITY fully for any injuries or damages to CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. 46. ENTIRETY The foregoing, and Exhibits "A" and "B" attached hereto, set forth the entire Agreement between the parties. No waiver or modification of this Agreement shall be valid unless in writing duly executed by both parties. The parties acknowledge and agree that they are entering into this Agreement freely and voluntarily following extensive arm's length negotiations, and that each has had the opportunity to consult with legal counsel prior to executing this Agreement. The parties also acknowledge and agree that no representations, inducements, promises, agreements or warranties, oral or otherwise, have been made by that party or anyone acting on that party's behalf, which are not embodied in this Agreement, and that that party has not executed this Agreement in reliance on any representation, inducement, promise, agreement, warranty, fact or circumstance not expressly set forth in this Agreement. SF:16-5215-142605.doc/rev 12/2016 29 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed it by and through their authorized officers on 2 , 20 ZED . CONTRA R• CITY OF HUNTINGTON BEACH, a municipal Corp the State of California By: Ronnie D. Cochran t�440j4v) r (print name) ITS: Chairman/President/Vice-President City Clerk IY49 (circle one) INITIA D AND APP ED: By: Director of Public Works Ronnie D. Cochran (print name) 71TE E A A OVED: ITS: Secretary / Chief Financial Officer / Asst. Secretary/Treasurer (circle one) City anager APPROV D AS TO FORM: v�,l City Atyorney SF:16-5215-142605.doc.%rev 12/2016 30 EXHIBIT A (Contractor's Proposal) SF:16-5215-142605.doc/rev 12/2016 31 SECTION C PROPOSAL for the construction of RESIDENTIAL CURB RAMP PROJECT CC No. 1620 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 60 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses,taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded,the AGENCY will reject all bids and will re-advertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find Bid Bond in the amount of 10% which said amount is not less than 10%of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond for_% ", as the case may be) Any standard Surety Bid Bond form is acceptable. Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received 'dder's Signature 1 10/23/20 C-z SECTION C PROJECT BID-SCHEDULE A CURB RAMP PROJECT, CC 1620 BID ITEMS Item Description Quantity Unit Unit Cost Total Cost No. (Extension) 1 Mobilization 1 LS $ 24,500 $ 24,500 2 Prepare Storm Water Pollution Prevention Plan(SWPPP) 1 LS $ 800 $ 800 3 Install&Maintain Construction BMPs 1 LS $ 1000 $ 1000 Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 4 Curb Ramp Detail 1 in Appendix H of Specifications (Item 109 includes all appurtenances, curb&gutter, depressed curb, 3150 343,350 sawcut,sidewalk, domes, retaining curb, etc.) EA $ $ Construct Curb Access Ramp per Caltrans Std. Plan A88A as shown on Curb Ramp Detail 1 in Appendix H of Specifications 17 5 (Item includes all appurtenances, curb&gutter,depressed curb, sawcut, sidewalk, domes, retaining curb, slot pave, etc.) EA $ 3600 $ 61,200 Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 6 Curb Ramp Detail 2 in Appendix H of Specifications (Item 2 includes all appurtenances, curb&gutter, depressed curb, sawcut, sidewalk, domes, retaining curb, etc.) EA $ 3175 $ 6350 Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 7 Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter, depressed curb, sawcut, sidewalk, domes, retaining curb, etc.) 30 EA $ 3300 $ 99,000 Construct Curb Access Ramp per Caltrans Std. Plan A88A as 8 shown on Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter,depressed curb, sawcut, sidewalk, domes, retaining curb, slot pave, etc.) 8 EA $ 3800 $ 30,400 9 Install truncated domes to existing Curb Ramp 10 EA $ 350 $ 3500 10 Install 4" PVC Sleeve for Street Assembly Sign per City of HB Std. Plan 401 10 EA $ 75 $ 750 11 Remove and replace existing sidewalk per City of HB Std. Plan 207. (Allowance) 1,000 SF $ 9.50 $ 9500 Remove and replaces existing 6"or 8"Curb and Gutter per 12 HB Std. Plan 205(Item includes all appurtenances, slot pave, etc.). (Allowance) 300 LF $ 55 $ 16,500 SUB-TOTAL BID AMOUNT (SCHEDULE A) $ 596,850 C-2.1 SECTION C PROJECT BID—SCHEDULE A CURB RAMP PROJECT, CC 1620 SUB-TOTAL BID AMOUNT IN WORDS: Five Hundred Ninety Six Thousand Eight Hundred Fifty Dollars Note: All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern. The Owner reserves the right to reject any or all proposals and bid items. In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract. C-2.2 SECTION C PROJECT ADDITIVE BID—SCHEDULE B CURB RAMP PROJECT, CC 1620 BID ITEMS Item Description Quantity Unit Unit Cost Total Cost No. (Extension) Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 1 Curb Ramp Detail 1 in Appendix H of Specifications (Item 40 includes all appurtenances, curb&gutter, depressed curb, 3150 126,000 sawcut, sidewalk, domes, retaining curb, etc.) EA $ $ Construct Curb Access Ramp per Caltrans Std. Plan A88A as shown on Curb Ramp Detail 1 in Appendix H of Specifications 3 2 (Item includes all appurtenances, curb&gutter, depressed curb, sawcut, sidewalk, domes, retaining curb, slot pave,etc.) EA $ 3600 $ 10,800 Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 3 Curb Ramp Detail 2 in Appendix H of Specifications (Item 3 includes all appurtenances, curb&gutter,depressed curb, sawcut, sidewalk,domes, retaining curb, etc.) EA $ 3175 $ 9525 Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 4 Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter,depressed curb, sawcut, sidewalk,domes, retaining curb, etc.) 17 EA $ 3300 $ 56,100 Construct Curb Access Ramp per Caltrans Std. Plan A88A as 5 shown on Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter, depressed curb, sawcut, sidewalk, domes, retaining curb, slot pave,etc.) 9 EA $ 3800 $ 34,200 6 Install truncated domes to existing Curb Ramp 9 EA $ 350 $ 3150 7 Remove and replace existing sidewalk per City of HB Std. Plan 207. (Allowance) 400 SF $ 9.50 $ 3800 Remove and replaces existing 6"or 8"Curb and Gutter per 8 HB Std. Plan 205(Item includes all appurtenances, slot pave, etc.). (Allowance) 100 LF $ 55 $ 5500 SUB-TOTAL ADITIVE BID AMOUNT (SCHEDULE B) $ 249,075 SUB-TOTAL ADDITIVE BID AMOUNT IN WORDS: Two Hundred Forty Nine Thousand Seventy Five Dollars Note: All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern. The Owner reserves the right to reject any or all proposals and bid items. In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract. C-2.3 SECTION C PROJECT BID SCHEDULE TOTALS RESIDENTIAL CURB RAMP PROJECT CC 1618 Sub-Total Bid - Schedule A 596,850 Sub-Total Additive Bid - Schedule B 249,075 TOTAL BID AMOUNT, BASIS OF AWARD (Schedules A+B) 845,925 TOTAL BID AMOUNT IN WORDS: Eight Hundred Forty Five Thousand Nine Hundred Twenty Five Dollars Notes: All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern. The Owner reserves the right to reject any or all proposals and bid items. In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract. C-2.4 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Bid Name and Address of State Class DIR PWC Dollar % of Item(s) Subcontractor License Registration# Amount Contract Number 4,6,7 Professional Curb Cut C61 1,3,5AIt PO Box 161 840095 D06 1000055822 45,225 5.3 Mira Loma, Ca 91752 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 onJD 26 2dltt Placentia CA Date City State Ronnie Cochran , being first duly sworn, deposes and says that he or she is President of Golden State Constructors 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. Golden St e Constructors Name o i r 4 ' ' q-" Signature of Bidder 208 E Orangethorpe Ave Placentia Ca 92870 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 RESIDENTIAL CURB RAMP PROJECT, (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. Golden State Constructors Contractor Ronnie Cochran By President Title Date: 10/26/20 C-s 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 lM 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. Golden State Constructors Contractor Ronnie Cochran By President Title Date: 10/26/20 C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Golden State Constuctors Bidder Name 208 E Orangethorpe Ave Business Address Placentia, Ca 92780 City, State Zip (714 )625-8758 ron@goldensci.com Telephone Number Email Address 867060 A,B,C-8 State Contractor's License No. and Class 11-05 Original Date Issued 11/2021 Expiration Date The work site was inspected by Ron Cochran of our office on 10/26 , 20t20. The following are persons, firms, and corporations having a principal interest in this proposal: Ronnie Cochran 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. Gold n t e C structors Compa a Signature of Bidder C-s Ronnie Cochran Printed or Typed Signature NOTARY CERTIFICATE Subscribed and sworn to before me this_day of , 201_ 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 ) County of ) On before me, Month, Day, and Year Insert Name and Title of Notary personally appeared Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature Signature of Notary Public (PLACE NOTARY SEAL ABOVE) C-9 CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California } County of Orange _ } On 10/26/2020 before me, Claudia Cochran Notary Public ere insert rame 8,,d lit e uf the officer) personally appeared —Ronnie D. Cochran ----- , who proved to me on the basis of satisfactory evidence to be the person(&) whose name(* is/arm subscribed to the within instrument and acknowledged to me that helm eM;ey executed the same in his/ -eir authorized capacity(i*, and that by his/ffnr444a�r signature(* on the instrument the personN, or the entity upon behalf of which the person(sl,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. CLAUDIA COCHRAN COMM. #2277. z WITNESS my hand and official Seal. Notary Public -California o z@my Orange County -• Comm.Expires Feb. 10,2023 Notary Public Signature (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM This fora+complies with current California statutes regarding notary wording arid, DESCRIPTION OF THE ATTACHED DOCUMENT ifnecded,should be comp/eled and attached to the document.Acknow1cdgments from other states may be cornpleled for documents being sent to that state so long as the wording does not require the California nolary to violate California notary law. (Title or description of attached document) • State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment, • Date of notarization must be the date that the signer(s)personally appeared which (Title or description of attached document continued) must also be the same date the acknowledgment is completed. • The notary public must print his or leer name as it appears within his or her Number of Pages Document Date commission followed by a comma and then your title(notary public). • Print the namc(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. ate/she/thy-is/ere)or circling the correct forms.Failure to correctly indicate this ❑ Individual (s) information may lead to rejection ofdocument 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 tinm. ❑ Partner(s) • Signature of the notary public must match the signature on file with the office of the county clerk. ❑ Attorney-in-Fact Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. ❑ Other •s Indicate title or type of attached document,number of pages and date. 4 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 with a staple. 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, "Demolition of existing concrete ADA ramps and construction of new ADA compliant curb ramps. Work included additional curb and gutter construction to ensure surface water flow around corner. All ramps met Caltrans requirements set forth in Standard Plan A88A"} 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 Rancho Cucumonga 10500 Civic Center Rancho Cucumonga, Ca Name and Address of Public Agency Name and Telephone No. of Project Manager: Romeo David 380K Curb ramps 7/2020 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Constructed 55 Curb ramps 2. Huntington Beach 2000 Main St Huntington Beach, Ca Name and Address of Public Agency Name and Telephone No. of Project Manager: Joe Fuentes,Todd Broussard 714-536-5431 550K Curb Ramps 3/2019 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Constructed curb ramps throughout the city 3. Anaheim 200 S Anaheim Blvd Anaheim Ca Name and Address of Public Agency Name and Telephone No. of Project Manager: Mike Wood 714-231-8372 200K- 1.6 million Annually Concrete Repairs on going since 2008 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Concrete Repairs throughout the city of Anaheim C-10 Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager, and Superintendent. For each of these critical positions, please list at least three projects for which the critical staff has performed similar work within the last five years. These projects do not have to be under the employment of the bidder of this project. Bidders are encouraged submit supplemental relevant project history in addition to the projects listed herein. 1. Ronnie Cochran- Owner of Golden State Constructors Name of proposed Project Manager Telephone No. of proposed Project Manager: 714-932-5974 Every job we performed since 2005 Project Name & Contract Amount Type of Work Date Completed Project Name & Contract Amount Type of Work Date Completed Project Name & Contract Amount Type of Work Date Completed 2. Ronnie Cochran- Owner Name of proposed Superintendent Telephone No. of proposed Superintendent: Same as above, as owner has been involved in every job GSCI has performed since Project Name & Contract Amount Type of Work Date Completed I started the company Project Name & Contract Amount Type of Work Date Completed Project Name & Contract Amount Type of Work Date Completed C-1 l 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://efiIing.dir.ca.gov/P WCR/ActionServiet?action=displayPWCRegistrationForm DIR's Contractor Registration searchable database: https://efiIing.dir.ca.gov/PWCR/Search.action I am aware and will comply with the provisions of Labor Code Section 1771.1(a) which states: "A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725.5. It is not a violation of this section for an unregistered contractor to submit a bid that is authorized by Section 7029.1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract Code, provided the contractor is registered to perform public work pursuant to Section 1725.5 at the time the contract is awarded." 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. Golden State Constructors Contractor Ronnie Cochran By ron@goldensci.com Email President Title Date: 10/26/2020 PWC Registration #: 1000004019 C-12 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low-Income Persons The bidder, under penalty of perjury,certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager(initial the applicable selections): Will ensure that 10%of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or X 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: Golden State Constructors Contact Person: Ronni ocbra ryl Contact Phone: 714 5- 5 Signed: A // � Date: 10/26/20 *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-13 EXHIBIT A DISADVANTAGED BUSINESS ENTERPRISE (DBE) This Project is subject to Part 200.321, Title 2, Code of Federal Regulations entitled "Contracting with Small and Minority Businesses, Women's Business Enterprises, and Labor Surplus Area Firms." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in Part 200.321, Title 2 CFR, shall be encouraged to participate in the performance of Contracts financed in whole or in part with federal funds.The Contractor should ensure that DBEs,as defined in Part 200.321, Title 2 CFR, have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps,as set forth in Part 200.321,Title 2 CFR, for this assurance. The Contractor shall not discriminate on the basis of race,color,national origin, or sex in,the award and performance of subcontracts. Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project, although there is no specific goal for DBE participation. C-14 EXHIBIT B DBE INFORMATION—GOOD FAITH EFFORTS Federal-aid Project No. CC Bid Opening Date 10/2740 The City of Huntington Beach established a Disadvantaged Business Enterprise(DBE)goal of 9% for this Project. The information provided herein shows that a good faith effort was made. Lowest,second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder DBE Commitment" form indicates that the bidder has met the DBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified DBEs soliciting bids for this Project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested(please attach copies of solicitations,telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods Solicitation and Dates Logans Marketing 10/22/20 emails - 10/22/20(emails attached) C-1_,- C. The items of work which the bidder made available to DBE firms including, where appropriate,any breaking down of the contract work items(including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items M of (Y/N) Contract Concrete Ready Mix N Concrete 21,000 2% 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 �et' � Logans Markert�ngcg*Y' -��6RFb-With the shortage of Cement in the industry we art currently experiencing,it is not prudent to use a third party administrator to order our concrete when we already have relationships with our ready mix suppliers. In addition Logans Marketing would have charged a 17% premium over the cost of what we are currently paying.This is not cost effective to the city nor would it give us a competitive advantage. Names, addresses and phone numbers of firms selected for the work above: Holiday Ready M ix-909-982-1 5 5 3-Doug Bowlen E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: N/A C-1 6 F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: N/A G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results N/A H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): There is no other available DBE businesses that we could utilize as there is only one subcontract available for this specific project, horiziontal curh cutting does not have any rPaic Pr d ht,cinpssps as DBE for this kind of work. NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. C-17 N GoDoiddy WORKSPACE Email Check Email Compose Address Book=- Settings-= Tools Help 1 Storage Warning! Q Search... 93%Full Buy More or remind me again in: 1 day v Go Go Ady.Search Save Search As: Add Folders Saved Search j- 7I Li Oi Storage Usage Upgrade tReepkei Reply to W Foruwrd DeMte Purge Mark os MOV2 t0 FOIdCr" 931% 1000 MB Spain LJ=_New Folder 'Search Results>Message Detail O Entue thread Subject: !e, Re:UDBE/MBE/SBEISLBE Inbox (1778) From: ellis logans<ahera@pacbel.net> (Add as Preferred Senders Bulk Mail Date: Thu,Oct 22,2020 10:37 am [purges (92) To: Ronnie Cochran<ron_. @goldensci.com> Drafts (3) Templates What concrete will you need? Send Later Thx Sent Items Trash Upu[gsl (737) Ellis On Thursday,October 22,2020,8:28:57 AM PDT,Ronnie Cochran<L(Ln@goldensci.com>wrote: I would need about 150 yds of concrete for this project,let me know. Thank you, Ronnie Cochran GSCI 714-625-8758(p) 714-625-8295(f) --------Original Message-------- Subject: UDBE/MBE/SBE/SLBE From: "Logans Marketing Seat 2, Ellis Logans"<ahera@pacbell.net> Date: Wed,October 21, 2020 4:08 pm To: rgn@goidensci.com Construction Bidboard A construction information G)mpany Notification: User Generated I Copyright©2003-2020.All rights reserved. Emall Check Ernati Compose Address Book. Settings Tools- Help Storage Warniny! Q Search... 0%Flls Br!Mare or remind me again in: 1 day v J ,Go AdY.search Saw Seamh As: Add Sawed Search �i _ �-�al Storage Usage rage Reply Reply to M Forward D.W. Purge �w 1000 Me Mew Folder 1001 1E Search Reaults>Message Detail! ❑Enure oveed Inbox (1778 Subject: [ Re:UDBE/MBEJSBE/SLBE _--1 _ _---__-__ ) From: ellls kgans<ahera@pacbel.net> (ndd as Prererted serder)d i Bulk Mad 1prgg] (g2) Date: Fri,Oct 23,2020 1020 am To: Ronnie Cochran<ron@goldensci.com> Drafts (3) Templates 520c-2500 =105.00$ 560-c-3250 =110.00$ Send Later Thx _4 Sent Items Trash fggl (737) Ellis Logans 1 On Friday,October 23,2020,8:15:49 AM PDT,Ronnie Cochran<ron@goldensci.cwm>wrote: Please provide quote for 520-C-2500 and 560-C-3250 mix designs.200 yards Ronnie Cochran GSCI 714-625-8758(p) 714-625-8295(f) --------Original Message-------- Subject: Re: UDBE/MBE/SBE/SLBE From:ellis logans<ahera@pacbell.net> Date:Thu,October 22,2020 10:37 am To: Ronnie Cochran <rgrL@goldensci.com> What concrete will you need? Thx Copyright®2003-2020.All rights reserved. Ellis Concrete,Asphalt and Aggregates Concrete Order Desk: (909)972-0410 • 1401 N. Benson Ave.,Upland,CA 91786 Concrete Dispatch:(909)972-0409 Corporate Office: (909)982-1553 Asphalt Dispatch:(909)972-0411 General Sales Fax: (909)652-9000 Quality Control Lab: (909)972-1553 www.hollidayrock.com Serving San Bernandino,Riverside,Oran e,Kern,Ventura and Los An eles Counties October2020 Materials Quote Quote 69084 Customer: GOLDEN STATE CONSTRUCTORS INC Phone#: Contact: Ron Fax#: Project Name: residential curb ramp project Miles: Location: Various Locations City: Huntington Beach Ready Mix Concrete Estimated Quantities: 200.00 Yards Mix Descri tion WCR CY Price Notes GB 520-C-2500 3C25N200 0.61 $88.50 GB 560-C-3250(3C32N200) 0.57 $91.00 Environmental Fee: $60.00 per load, No Fuel Surcharge FOB Job site, Sales Tax not included Unless specifically noted these mixes do not meet any MOE, Shrinkage,WCR,or Slump Requirements. Cost of temperature control is contractors responsibility. Holliday Rock does not warrant any particular temperature of concrete.Ice may be added at an additional cost of$20.00 per 401b bag.Reasonable notice must be given for ice orders. Prices are firm through December 31,2020 then add S2.50 per yard firm through March 31,2021. Public Works Contract Fee: $2,000/project. AB219 Fee: $200/load. Public WOrkslAB219: It is the buyers responsibility to determine if a project is Public Works&subject to AB219 requirements.Holliday Rock must be given notice by the buyer requesting this quote that the project quoted is Public Works&includes but is not limited to any state agency,California State University,University of California,or any political subdivision of the state(counties,cities,towns,villages,school districts,water districts,park districts,airport districts,etc.).Any failure of notification from the Buyer will result in the Buyer taking responsibility for all claims made against Seller for non-compliance of AB219. Standby Time: Calculated based on interval ordered by customer with a maximum of 4 minutes/yard free unloading time,excess time to be charged at$2lminute. Minimum Load Charges: Based on delivery of less than 10 cubic yards.$15/cubic-yard not taken. Operating Hours: 5 OOAM to 3 OOPM Monday-Friday.Upon acceptance by Holliday Rock concrete delivered on Saturday or between the hours of 3:OOPM to 5:OOAM on is an additional$5/yard.Concrete poured between 5.00PM to 5:OOAM may incur a plant opening charge of$250/hour with a 4 hour minimum. Material Availability: All sales are contingent upon plant&material availability. Wash OutlWash Down: Buyer will be responsible to provide adequate time&location in reasonable proximity to delivery site for driver(s)to clean&wash down their ready mix trucks chutes,hoppers,etc.after delivery. Scrape&Go: Unless noted in the pricing above Scrape&Go is not an included service.If proper wash outidown is not provided an$80Aoad surcharge will be applied. Product Variations/Color Added Concrete: Vanations in cement,sand,rock,mixing,job conditions&finishing techniques can alter the color of concrete.Holliday Rock cannot guarantee the uniformity of color as variations in color from load to load are common. Plans&Specs: The materials quoted are not warranted to be acceptable for any particular use,purpose,application,environment or soil condition.Materials are delivered in as is condition&no warrant is made as regards to the time to deliver or temperature at time of delivery. Testing:Independent lab testing or mix designs may require additional costs that will be at buyers expense. Excess Returned Concrete: Deliveries resulting in excess concrete returned back to Holliday Rock will incur a Disposal Fee of$150/partial-load&$300/full-bad. Delivery: All orders placed will be delivered to the best of our ability&we accept no responsibility for overtime which might occur. Cancellation Fees: Cancellations received within 48 hours of a designated pour time may incur a$5/yard cancellation fee. Schedule Changes: Federal DOT Standards apply to the hours a Truck Driver can operate their vehicle. Any changes made to a pour after the pour has been scheduled is at as trucking may not be available to accommodate such changes. Safety: Buyer must provide a safe ingress&egress for the delivery truck at the job site.Holliday Rock will not deliver to any job site deemed unsafe by Holliday Rock. Payment:Due at the end of the month following date of invoice.All projects are subject to preliminary notices. `his proposal is subject to a, ance by the buyer within 15 days hereof after which time it will be of no force or effect except at the discretion of the seller. Quoted by: Doug Bowlen Phone#: 951-529-5366 Email Adress: dbowlen@hollidayrock.com Fax#: 909-652-9000 IF A SOLE OWNER OR SOLE CONTRACTOR SIGN HERE: (1) Name under which business is conducted - (2) Signature (given and surname) of proprietor (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail IF A PARTNERSHIP, SIGN HERE: (1) Name under which business is conducted - (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail C-18 IF A CORPORATION, SIGN HERE: (1) Name 7ndlich 4buiness is conducted Golden State Constructors (2) (Signature) President (Title) Impress Corporate Seal here (3) Incorporated under the laws of the State of Ca (4) Place of Business 208 E Orangethorpe Ave (Street and Number) City and State Placentia, Ca (5) Zip Code 92870 Telephone No. 714-625-8758 (6) E-Mail ron@goldensci.com NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED C-19 List below names of president, vice president, secretary and assistant secretary, if a corporation; if a partnership, list names of all general partners and managing partners: Ronnie Cochran - President/Treasurer C-20 CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California } County of Orange _ } On 10/26/2020 before me, Claudia Cochran Notau Public (Here insert rame and title of the officer) personally appeared -------Ronnie D. Cochran -------- who proved to me on the basis of satisfactory evidence to be the person(&) whose name(* is/alp subscribed t0 the within instrument and acknowledged to me that he/MTeA4;ey executed the same in his/her4haw authorized capacity(*rk), and that by his/RtT4h4a r signature(* on the instrument: the personN, or the entity upon behalf of which the persons} acted, executed the instrument. certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correc . CLAUDIA COCHRAN COMM, #2277167 z WITNESS m _hand a icial seal. Qr QM Notary Public • California 0y Z Orange County X Comm.Expires Feb. 10,2023 Notary Public Signature (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM This form complies with current California statutes regarding notary wording arid, DESCRIPTION OF THE ATTACHED DOCUMENT ifneeded,should be completed and attacked to the document.A cknowledgments from other states nrav be completedJor documents being sent to that state so long as the wording does not require the California notary to violate California notary _ law. (Title or description of attached document) • State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s)personally appeared which (Title or description of attached document continued) must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her Number of Pages Document Date commission followed by a comma and then your title(notary public). - Fruit the names) of document signcr(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. ire/sheMey6-is/err)or circling the correct forms.Failure to correctly indicate this ❑ Individual (s) information may lead to rejection of document recording. ❑ Corporate Officer • The notary seal impression must be clear and photographically reproducible. Impression roust 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. Ll Attorney-in-Fact 0 Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. Other 1% 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). LL�L • Securely attach this document to the signed document with a staple. EXHIBIT C LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY: Huntington Beach LOCATION: City Wide PROJECT DESCRIPTION: Curb Ramp Project TOTAL CONTRACT AMOUNT:S $845,925 BID DATE: 10/27/20 BIDDER'S NAME: Golden State Constructors CONTRACT DBE GOAL: 9% CONTRACT iTEM OF WORK AND DESCRIPTION DBECERT NO. NAME OF EACH DBEDOLLARAMOUNT ITEM NO. R SERVICES TO BE AND EXPIRATION (Must be certified on the date bids DBE UBCONTRACTED OR MATERIALS DATE are opened-include DBE address O BE PROVIDED(or contracted if the d phone number) idder is a DBE) For Local Agency to Complete: Total Claimed DBE $ 0 Local Agency Contract Number: Participation Federal-aid Project Number: 0 ()/> Federal Share: Contract Award Date: Local Agency certifies that al l DBE certifications have been verified and information is complete and accurate. Sig atuie of Bidder 10/27/20 714-625-8758 Date (Area Code)Tel.No. Print Name Signature Date Ronnie Cochran Local Agency Representative Person to Contact (Please Type or Print) (Area Code)Telephone Number: Local Agency Bidder DBE Cormnitment(Construction Contracts) (Rev 6/26/09) C-21 PLEASE NOTE: This information may be submitted with your bid. If it is not, and you are the apparent low bidder or the second or third low bidder,it must be submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date. Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier.Names of the First-Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable,with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100%of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts), to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award, Federal-aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. C-22 EXHIBIT D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Golden State Constructos [proposed subcontractor Professional Curb Cut J hereby certifies that he/she/it haste, has not , participated in a previous contract or subcontract subject to the Equal Opportunity clauses, as required by Executive Orders 10925, 11114,or 11246, and that,where required, he/she/it has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently, Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. (eeoc.gov/employers/eeolsurvey/index.cfm) Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration by th Director, Office of Federal Contract Compliance, U.S. Department of Labor. Signature: Date: 10/26/20 Print Name: Ronnie Cochran Title: President C-23 EXHIBIT E NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) [NAME OF CONTRACT] To the City of Huntington Beach In conformance with Title 23 United States Code Section 112 and California Public Contract Code 7106 the bidder declares that the bid is not made in the interest of,or on behalf of,any undisclosed person,partnership,company,association,organization,or corporation;that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid,and has not directly or indirectly colluded,conspired,connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true; and, further,that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. By signing the Proposal, the Bidder has also signed this Noncollusion Affidavit. Bidders are cautiougil that m king a false Certification may subject the Bidder to criminal prosecution. Signature: Date: 10/26/20 Print Name: Ronnie Cochran Title: President C-24 EXHIBIT F DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The Bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated with Bidder in the capacity of owner, partner, director, officer, manager: • is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agency; • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted,convicted,or had a civil judgment rendered against him/her by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency,and dates of action. Note: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portio ereof s all also constitute signature of this Certification. Signature: Date: 10/26/20 Print Name: Ronnie Cochran Title: President C-25 EXHIBIT G NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal,to the best of his or her knowledge and belief,that: 1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan,the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment,or modification of any Federal contract,grant,loan,or cooperative agreement. 2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and t t dsuchnubrecipients shall certify and disclose accordingly. Signature: Date: 10/26/20 Print Name: Ronnie Cochran Title: President EXHIBIT H C-26 DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. I ape of Federal Action: 2. Status of Federal Action: 3. Report Type: FA ] a contract Ela-bid/offer/application F T 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 District,if known 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number,ifapplicable 8. Federal Action Number,if known: 9. Award Amount,if known: 10. a.Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual,last name,first name,MI) address if different from No. IOa) Golden State Constructors (last name,first name,MI) 208 E Orangethorpe AV9ttach Continuation Sheet(s)if necessary) Placentia, Ca 92870 H. Amount of Payment(check all that apply) 13. Type of Payment(check all that apply) $ Actual planned a.retainer b.one-time fee 12. Form of Payment(check all that apply): C.commission ® a.cash d.contingent fee b.in-kind; specify: nature a deferred value 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: Construct Curb Ramps (attach Continuation Sheet(s)if necessary) 15. Continuation Sheet(s)attached: Yes ❑ No 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into.This disclosure is required pursuant to 31 U.S.C. Print Name: Ronnie Cochran 1352. This information will be reported to Congress president semiannually and will be available for public inspection.Any Title: person who fails to file the required disclosure shall be subject 0�26�20 to a civil penalty of not less than$10,000 and not more than Telephone No.: 71 4-625-8758 Date. $100,000 for each such failure. Authorized for Local Reproduction Federal Use Only: Standard Form-LLL Standard Form LLL Rev.09-12-97 C-27 INSTRUCTIONS FOR COMPLETION OF EXHIBIT H, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 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 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9) For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10)(a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11)Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. C-28 12)Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13)Check the appropriate box(es). Check all boxes that apply. If other, specify nature. 14)Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15)Check whether or not a continuation sheet(s) is attached. 16)The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project(0348-0046), Washington, D.C. 20503. By my signature on this proposal I certify, under penalty of perjury under the laws of the State of California, that the foregoing questionnaire and statements of Public Contract Code Sections 10162, 10232 and 10285.1 are true and correct and that the bidder has complied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5, Title 2 of the California Administrative Code). C-29 EXHIBIT I FEDERAL LOBBYING RESTRICTIONS Section 1352, Title 31, United States Code prohibits Federal funds from being expended by the recipient or any lower tier subrecipient of a Federal-aid contract to pay for any person for influencing or attempting to influence a Federal agency or Congress in connection with the awarding of any Federal-aid contract, the making of any Federal grant or loan, or the entering into of any cooperative agreement. If any funds other than Federal funds have been paid for the same purposes in connection with this Federal-aid contract, the recipient shall submit an executed certification and, if required, submit a completed disclosure form as part of the bid documents. A certification for Federal-aid contracts regarding payment of funds to lobby Congress or a Federal agency is included in the Proposal. Standard Form - LLL, "Disclosure of Lobbying Activities," with instructions for completion of the Standard Form is also included in the Proposal. Signing the Proposal shall constitute signature of the Certification. The above referenced certification and disclosure of lobbying activities shall be included in each subcontract and any lower-tier contracts exceeding $100,000. All disclosure forms, but not certifications, shall be forwarded from tier to tier until received by the Engineer. The Contractor, subcontractors and any lower-tier contractors shall file a disclosure form at the end of each calendar quarter in which there occurs any event that requires disclosure or that materially affects the accuracy of the information contained in any disclosure form previously filed by the Contractor, subcontractors and any lower-tier contractors. An event that materially affects the accuracy of the information reported includes: 1) A cumulative increase if$25,000 or more in the amount paid or expected to be paid for influencing or attempting to influence a covered Federal action; or 2) A change in the person(s) or individual(s) influencing or attempting to influence a covered Federal action; or 3) A change in the officer(s), employees(s), or Member(s) contacted to influence or attempt to influence a covered Federal Action. C-30 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For RESIDENTIAL CURB RAMP PROJECT in the CITY OF HUNTINGTON BEACH OCTOBER 20, 2020 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) SHEET Al OF PROJECT SPECIFICATIONS Bids will be received from 1:00 PM to 2:00 PM only on the bid due date (10/27/2020) outside of the City Hall main entrance at 2000 Main St. in Huntington Beach. Staff will be present during this hour to receive bids only. Mailed bids are still accepted but must be received before the bid submission deadline. It in encouraged that bidders arrive earlier than normal to drop off bids to avoid a late delivery. Bids will be opened outside of City Hall immediately after 2:00 PM. Bidders are welcome to stay and attend the opening. Social distancing measures shall be observed and masks will be required for all in attendance. This update to the Notice Inviting Sealed Bids shall supersede all other bid delivery information noted on the project documents. A revised NISB is now included with the project documents. This is to acknowledge receipt and review of Addendum Numbe ne, dated October 20, 2020 1 ,vie Company Name By & - 2- Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. EXHIBIT B (Form HUD-4010, the Federal Labor Standards Provision of the United States) Federal Labor Standards Provisions U.S.Department of Housing and Urban Development Office of Labor Relations Applicability (1) The work to be performed by the classification The Project or Program to which the construction work requested is not performed by a classification in the wage covered by this contract pertains is being assisted by the determination; and United States of America and the following Federal Labor (2) The classification is utilizlad in the area by the Standards Provisicns are included in this Contract construction industry; and pursuant to the provisions applicable to such Federal (3) The proposed wage rate, including any bona fide assistance, fringe benefits, bears a reasonable relationship to the A. 1. (1) Minimum Wages. All laborers and mechanics wage rates contained in the wage determination. employed or working upon the site of the work, will be paid (b) If the contractor and the laborers and mechanics to be unconditionally and not less often than once a week, and employed in the classification (if known), or their without subsequent deduction or rebate on any account representatives, and HUD or its designee agree on the (except such payroll deductions as are permitted by classification and wage rate (including the amount regulations issued by the Secretary of Labor under the designated for fringe benefits where appropriate), a report Copeland Act (29 CFR Part 3), the full amount of wages of the action taken shall be sent by HUD or its designee to and bona fide fringe benefits (or cash equivalents thereof) the Administrator of the Wage and Hour Division, due at time of payment computed at rates not less than Employment Standards Administration, U.S. Department of those contained in the wage determination of the Labor, Washington, D.C. 20210. The Administrator, or an Secretary of Labor which Is attached hereto and made a authorized representative, will approve, modify, or part hereof, regardless of any contractual relationship disapprove every additional classification action within 30 which may be alleged to exist between the contractor and days of receipt and so advise HUD or its designee or will such laborers and mechanics. Contributions made or notify HUD or its designee within the 30-day period that costs reasonably anticipated for bona fide fringe benefits additional time Is necessary. (Approved by the Office of under Section I(b)(2) of the Davis-Bacon Act on behalf of Management and Budget under OMB control number 1215- laborers or mechanics are considered wages paid to such 0140.) laborers or mechanics, subject to the provisions of 29 CFR (c) In the event the contractor, the laborers or mechanics 5.5(a)(1)(iv); also, regular contributions made or costs incurred for more than a weekly period (but not less often be employed in the classification or their re than quarterly) under plans, funds, or programs, which representatives, and HUD or its designee do not agree cover the particular weekly period, are deemed to be the proposed classification and wage rate (including the amo constructively made or incurred during such weekly period. HUD of designated for fringe benefits, where appropriate HUD or its designee shall refer the questions, Including Such laborers and mechanics shall be paid the appropriate the views of all interested parties and the recommendation wage rate and fringe benefits on the wage determination of HUD or its designee, to the Administrator for for the classification of work actually performed, without determination. The Administrator, or an authorized regard to sklll, except as provided in 29 CFR 5.5(a)(4). representative, will issue a determination within 30 days of Laborers or mechanics performing work in more than one receipt and so advise HUD or its designee or will notify classification may be compensated at the rate specified for HUD or its designee within the 30-day period that each classification for the time actually worked therein. additional time is necessary. (Approved by the Office of Provided, That the employer's payroll records accurately Management and Budget under OMB Control Number set forth the time spent in each classification in which 1215-0140.) work Is performed. The wage determination (including any (d) The wage rate (including fringe__benefits where additional classification and wage rates conformed under 29 CFR 5.5(a)(1)(ii) and the Davis-Bacon poster (WH- appropriate) determined pursuant to subparagraphs 1321) shall be posted at all times by the contractor and its worker's a (c) of this paragraph, shall io paid r all subcontractors at the site of the work in a prominent and workers performing work in the classification under this accessible, place where it can be easily seen by the contract from the first day on which work is performed In the classification. workers. (II) (a) Any class of laborers or mechanics which Is not (ill) Whenever the minimum wage rate prescribed in the listed in the wage determination and which is to be contract for a class of laborers or mechanics includes a employed under the contract shall be classified in fringe benefit which is not expressed as an hourly rate, the conformance with the wage determination. HUD shall contractor shall either pay the benefit as stated in the approve an additional classification and wage rate and wage for an hourlytion a shall pay another bona fide fringe fringe benefits therefor only when the following criteria benefit or an hourly cash equivalent thereof. have been met: (iv) If the contractor does not make payments to a trustee or other third person, the contractor may consider as part form HUD-4010(0612009) Previous editions are obsolete Page 1 of 5 ref.Handbook 1344.1 SF:16-5215-142605.doc/rev 12/2016 32 of the wages of any laborer or mechanic the amount of any communicated in writing to the Laborers or mechanics costs reasonably anticipated in providing bona fide fringe affected, and records which show the costs anticipated or benefits under a plan or program, Provided, That the the actual cost incurred in providing such benefits. Secretary of Labor has found, upon the written request of Contractors employing apprentices or trainees under the contractor, that the applicable standards of the Davis- approved programs shall maintain written evidence of the Bacon Act have been met. The Secretary of Labor may registration of apprenticeship programs and certification of require the contractor to. set aside in a separate account trainee programs, the registration of the apprentices and assets for the meeting of obligations under the plan or trainees, and the ratios and wage rates prescribed in the program. (Approved by the Office of Management and applicable programs. (Approved by the Office of Budget under OMB Control Number 1215-0140.) Management and Budget under OMB Control Numbers 2. Withholding. HUD or its designee shall upon its own 1215-0140 and 1215-0017.) action or upon written request of an authorized (ii) (a) The contractor shall submit weekly for each week representative of the Department of Labor withhold or in which any contract work is performed a copy of all cause to be withheld from the contractor under this payrolls to HUD or Its designee if the agency is a party to contract or any other Federal contract with the same prime the contract, but if the agency is not such a party, the contractor, or any other Federally-assisted contract contractor will submit the payrolls to the applicant subject to Davis-Bacon prevailing wage requirements, sponsor, or owner, as the case may be, for transmission to which is held by the same prime contractor so much of the HUD or its designee. The payrolls submitted shalt set out accrued payments or advances as may be considered accurately and completely all of the information required necessary to pay laborers and mechanics, including to be maintained under 29 CFR 5.5(a)(3)(i) except that full apprentices, trainees and helpers, employed by the social security numbers and home addresses shall not be contractor or any subcontractor the full amount of wages included on weekly transmittals. Instead the payrolls shall required by the contract In the event of failure to pay any only need to include an individually Identifying number for laborer or mechanic, including any apprentice, trainee or each employee (e.g., the last four digits of the employee's helper, employed or working on the site of the work, all or social security number). The required weekly payroll part of the wages required by the contract, HUD or its information may be submitted in any form desired. designee may, after written notice to the contractor, Optional Form WH-347 is available for this purpose from sponsor, applicant, or owner, take such action as may be the Wage and Hour Division Web site at necessary to cause the suspension of any further hVoWwAw,dol.oov/esa1whd/forms/wh347instr,Win or its payment, advance, or guarantee of funds until such successor site. The prime contractor is responsible for violations have ceased, HUD or its designee may, after the submission of copies of payrolls by all subcontractors, written notice to the contractor, disburse such amounts Contractors and subcontractors shall maintain the full withheld for and on .account of the contractor or social security number and current address of each subcontractor to the respective employees to whom they covered worker, and shall provide them upon request to are due. The Comptroller General shall make such HUD or its designee if the agency is a party to the disbursements in the case of direct Davis-Bacon Act contract, but if the agency is not such a party, the contracts, contractor will submit the payrolls to the applicant 3. (1) Payrolls and basic records. Payrolls and basic sponsor, or owner, as the case may be,for transmission to records relating thereto shall be maintained by the HUD or its designee, the contractor, or the Wage and Hour contractor during the course of the work preserved for a Division of the Department of Labor for purposes of an period of three years thereafter for all laborers and investigation or audit of compliance with prevailing wage mechanics workin(i at the site of the work. Such records requirements. It Is not a violation of this subparagraph for shall contain the name, address, and social security a prime contractor to require a subcontractor to provide number of each such worker, his or her correct addresses and social security numbers to the prime classification, hourly rates of wages paid (including rates contractor for its own records, without weekly submission of contributions or costs anticipated for bona fide fringe to HUD or its designee. (Approved by the Office of benefits or cash equivalents thereof of the types described Management and Budget under OMB Control Number in Section I(b)(2)(B) of the Davis-bacon Act), daily and 1215-0149.) weekly number of hours worked, deductions made and (b) Each payroll submitted shall be accompanied by a actual wages paid. Whenever the Secretary of Labor has "Statement of Compliance," signed by the contractor or found under 29 CFR 5.6 (a)(1)(iv) that the wages of any subcontractor or his or her agent who pays or supervises laborer or mechanic include the amount of any costs the payment of the persons employed under the contract reasonably anticipated in providing benefits under a plan and shall certify the fallowing: or program described in Section i(b)(2)(8) of the Davis- (1) That the payroll for the payroll period contains the Bacon Act, the contractor shall maintain records.which Information required to be provided under 29 CFR 5.6 show that the commitment to provide such benefits is (a)(3)(ii), the appropriate Information is being maintained enforceable, that the plan or program is financially under 29 CFR 5.5(a)(3)(i), and that such information is responsible, and that the plan or program has been correct and complete; Previous editions are obsolete form HUD4010(0612009) Page 2 of 5 ref.Handbook 1344.1 SF:16-5215-142605.doe/rev 12/2016 33 (2) That each laborer or mechanic (including each helper, is not registered or otherwise employed as stated above, apprentice. and t-rainee) employed on the contract during shall be paid not less than the applicable wage rate on the the payroll period has been paid the full weekly wages wage determination for the classification of work actually earned, without rebate„ either directly or indirectly, and performed. In addition, any apprentice performing work on that no deductions have been made either directly or the job site in excess of the ratio permitted under the indirectly from the full wages earned, other than registered program shall be paid not less than the permissible deductions as set forth in 29 CFR Part 3; applicable wage rate on the wage determination for the (3) That each laborer or mechanic has been paid not less work actually performed. Where a contractor is performing than the applicable wage rates and fringe benefits or cash construction on a project in a locality other than that in equivalents for the classification of work performed, as which Its program Is registered, the ratios and wage rates specified in the applicable wage determination (expressed in percentages of the journeyman's hourly Incorporated into the contract. rate) specified in the contractor's or subcontractor's registered program shall be observed. Every apprentice (c) The weekly submission of a property executed must be paid at not less than the rate specified in the certification set forth on the reverse side of Optional Form registered program for the apprentice's level of progress, WH-347 shall satisfy the requirement for submission of the expressed as a percentage of the journeymen hourly rate "Statement of Compliance" required by subparagraph specified in the applicable wage determination. A_3'(Ij)(b)' Apprentices shall be paid fringe benefits in accordance d The falsification of an of the above certifications may( ) Y Y with the provisions of the apprenticeship program. If the subject the contractor or subcontractor to civil or criminal apprenticeship program does not specify fringe benefits, prosecution under Section 1001 of Title 18 and Section apprentices must be paid the full ,amount of fringe benefits 231 of Title 31 of the United States Code. listed on the wage determination for the applicable (lit) The contractor or subcontractor shall make the classification. If the Administrator determines that a records required under subparagraph A.3.(i) available for different practice prevails for the applicable apprentice inspection, copying, or transcription by authorized classification, fringes shall be paid in accordance with that representatives of HUD or its designee or the Department determination. In the event the Office of Apprenticeship of labor, and shall permit such representatives to Training, Employer and Labor Services, or a State interview employees during working hours on the job. If Apprenticeship Agency. recognized by the Office, the contractor or'subcontractor fails to submit the required withdraws approval of an apprenticeship program, the records or to make them available, HUD or its designee contractor will no longer be permitted to utilize may, after written notice to the contractor, sponsor, apprentices at less than the appfi, able predetermined rate applicant or owner, take such action as may be necessary for the work performed until an acceptable program is to cause the suspension of any further payment, advance, approved. or guarantee of funds. Furthermore, failure to submit the (it) Trainees. Except as provided in 29 CFR 5,16, required records upon request or to make such records trainees will not be permitted to work at less than the available may be grounds for debarment action pursuant to predetermined rate for the work performed unless they are 29 CFR 5.12. employed pursuant `,to and individually registered in a 4. .apprentices and Trainees. program which has received prior approval, evidenced by (1) Apprentices. Apprentices will be permitted to work at formal certification by the U.S, Department of Labor, less than the predetermined rate for the work they Employment and Training Administration. The ratio of performed when they are employed pursuant to and trainees to journeymen on the job site shall not be greater individually registered in a bona fide apprenticeship than ,permitted under the plan approved by the program registered with the U.S. Department of Labor, Employment and Training Administration. Every trainee Employment and Training Administration, Office of must be paid at not less than the rate specified in the Apprenticeship Training, Employer and Labor Services, or approved program for the trainee's level of progress, with a State Apprenticeship Agency recognized by the expressed as a percentage of the journeyman hourly rate Office, or if a person is employed in his or her first 90 specified in the applicable wage determination. Trainees days of probationary employment as an apprentice in such shall be paid fringe benefits in accordance with the an apprenticeship program, who is not individually provisions of the trainee program. If the trainee program registered in the program, but who has been certified by does not mention fringe benefits, trainees shall be paid the Office of Apprenticeship Training, Employer and Labor the full ,amount of fringe benel'its listed on the wage Services or a State Apprenticeship Agency (where determination unless the Administrator of the Wage and appropriate) to bet eligible far probationary employment as Hour Division determines that there is an apprenticeship an apprentice. The allowable ratio of apprentices to program associated with the corresponding journeyman journeymen on the job site In any craft classification shall wage rate on the wage determination which provides for not be greater than the ratio permitted to the contractor as less than full fringe benefits for apprentices. Any to the entire work force under the registered program. Any employee listed on the payroll at a trainee rate who is not worker listed on a payroll at an apprentice wage rate, who registered and participating in a training plan approved by Previous editions are obsolete form HUD4010(06/2009) Page 3 of 5 ref.Handbook 1344.1 SF:16-5215-142605.dochrev 12/2016 34 the Employment and Training Administration shall be paid awarded HUD contracts or participate in HUD programs not less than the applicable wage rate on the wage pursuant to 24 CFR Part 24. determination for the work actually performed. In addition, ill) No part of this contract shall he subcontracted to any any trainee performing work on the job site in excess of person or firm ineligible for award of a Government the ratio permitted under the registered program shall be contract by virtue of Section 3(a) of the Davls-i acon Act paid not less than the applicable wage rate on the wage or 29 CFR 5.12(a)(1) or to be awarded HUD contracts or determination for the work actually performed. in the participate in HUD programs pursuant to 24 CFR Part 24. event the Employment and Training Administration (III) The penalty for making false statements is prescribed withdraws approval of a training program, the contractor Will no longer be permitted to utilize trainees at less than in She U.S. Criminal Code, 18 U.S.C. Additionally, U.S. Criminal Code, Section 1 C11 0, Title 18, U.S.C., the applicable predetermined rate for the work performed "Federal Housing Administration transactions", provides in until an acceptable program is approved. park: 'Whoever, for the purpose of . . influencing in any (!if) Equal employment opportunity. The utilization of way the action of such Administration..... makes, utters or apprentices, trainees end journeymen under 29 CFR Part 5 publishes any statement knowing the same to be false..... shall be in conformity with the equal employment shall be fined not more than $6,000 or imprisoned not opportunity requirements of Executive Order 11246, as more than two years, or both-" emended, and 29 CFR Part 30. 11, Complaints, Proceedingis, or Testimony by 5. Compliance with Copeland Act requirements. The Employees. No laborer or�mechanic to whom the wage, contractor shall comply with the requirements of 29 CFR salary, or other labor standards provisions of this Contract Part 3 which are incorporated by reference in this contract are applicable shall be discharged or in any other manner 6. Subcontracts. The contractor or subcontractor will discriminated against by the Contractor or any insert in any subcontracts the clauses contained in subcontractor because such employee has filed any subparagraphs 1 through 11 in this paragraph A and such complaint or instituted or caused to be instituted any other clauses as HUD or its designee may by appropriate proceeding or has testified or is about to testify in any instructions require, and a copy of the applicable proceeding under or relating to the labor standards prevailing wage decision, and also a clause requiring the applicable under this Contract to his employer. subcontractors to include these clauses in any lower tier S. Contract Work Hours and Safety Standards Act. The subcontracts. The prime contractor shall be responsible provisions of this paragraph B are applicable where the amount of the for the compliance by any subcontractor or lower tier prime contract exceeds $100,000, As used in this paragraph, the subcontractor with all the contract clauses in this terms"laborers'and"mechanics'include watchmen and guards. paragraph. (1) Overtime requirements. No contractor or subcontractor 7. Contract termination; debarment. A breach of the contracting for any part of the contract work which may require or contract clauses in 29 CFR 5.5 may be grounds for involve the employment of laborers or mechanics shall require or termination of the contract and for debarment as a permit any such laborer or mechanic in any workweek in which the contractor and a subcontractor as provided in 29 CFR individual is employed on such work to work in excess of 40 hours in 5.12, . such workweek unless such laborer or mechanic receives 8. Compliance with Davis-Bacon and Related Act Requirements. compensation at a rate not less than one and one-half times the basic All rulings and interpretations of the Davis-Bacon and rate of pay for all hours worked in excess of 40 hours in such Related Acts contained in 29 CFR Parts 1, 3, and 5 are workweek. herein incorporated by reference in this contract (2) Violation; liability for unpaid wages; liquidated 9. Disputes concerning labor standards. Disputes damages. In the event of any violation of the clause set arising out of the labor standards provisions of this forth in subparagraph (1) of this paragraph, the contractor contract shall not be subject to the general disputes and any subcontractor responsible therefor shall be liable clause of this contract. Such disputes shall be resolved in for the unpaid wages. In addition, such contractor and accordance with the procedures of the Department of subcontractor shall be liable to the United States (in the Labor set forth in 29 CFR Parts S. 6, and 7. Disputes case of work done under contract for the District of within the meaning of this clause include disputes between Columbia or a territory, to such District or to such the contractor (or any of its subcontractors) and HUD or territory), for liquidated damages. Such liquidated its designee, the U.S. Department of Labor, or the damages shall be computed with respect to each individual employees or their representatives. laborer or mechanic, including watchmen and guards, 10. (1) Certification of Eligibility. By entering into this employed in violation of the clause set forth in contract the contractor certifies that neither it (nor he or subparagraph (1) of this paragraph, in the sum of$10 for each she) nor any person or firm who has an interest in the calendar day on which such individual was required or permitted to contractors firm is a person or firm ineligible to be work in excess of the standard workweek of 40 hours without payment awarded Government contracts by virtue of Section 3(a) of of the overtime wages required by the clause set forth in sub the Davis-Bacon Act or 29 CFR 5.12(a)(1) or to be paragraph(1)of this paragraph. Previous editions are obsolete form HUD-4010(D612009) Page 4 of 5 ref.Handbook 13441 SF:1.6-5215-142605.doc/rev 12/2016 35 i (3) Withholding for unpaid wages and liquidated darnages. HUD or its designee shall upon.its own action or upon written request of an.authorized representative of the Department of Labor withhold or cause to be withheld, from any moneys payable on account of work performed by the contractor or subcontractor under any such contract or any other Federal contract with the same prime contract, or any other Federally-assisted contract subject to the i Contract Work 'Hours and Safely Standards Act which is held by the same prime contractor, such sums as may be determined to be necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages as provided in the clause set forth in subparagraph (2) of this paragraph. (4) Subcontracts. The contractor or subcontractor shall insert in any subcontracts the clauses set forth in subparagraph (1) through (4) of this paragraph and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set: forth in subparagraphs (1) through (4) of this paragraph. C. Health and Safety. The provisions of this paragraph C are applicable where the amount of the prime contract exceeds$100,000. (1) No laborer or mechanic shall be required to work in surroundings or under working conditions which are unsanitary, hazardous, or dangerous to his health and safety as determined under construction safety and health standards promulgated by the Secretary of Labor by regulation. (2) The Contractor shall comply with all regulations issued by the Secretary of Labor pursuant to Title 29 Part 1926 and failure to comply may result in imposition of sanctions pursuant to the Contract Work Hours and Safety Standards Act, (Public Law 91-54, 83 Stat 96). 40 USC 3701 et. seg. (3) The contractor shall include the provisions of this paragraph In every subcontract so that such provisions will be binding on each subcontractor. The contractor shall take such action with respect to any subcontractor as the Secretary of Housing and Urban Development or the Secretary of Labor shall direct as a means of enforcing such provisions. I I Previous editions are obsolete form HUD-4010(06/2009) Page 5 of 5 ref.Handbook 1344.1 SF:16-521.5-142605.doc/rev 12/2016 36 EXHIBIT C United States Department of Labor Office of Federal Contract Compliance Programs Office of Federal Contract Compliance Programs. (OFCCP) Executive Order 11246,As Amended —wscLAIWIER-- Executive Order 11246—Equal Employment Opportunity SOURCE:The provisions of Executive Order 11246 of Sept. 24,1965,appear at 30 FR 12319, 12935,3 CFR,1964- 1965 Comp., p.339,unless otherwise noted. Under and by virtue of the authority vested in me as President of the United States by the Constitution and statutes of the United States,it is ordered as follows: Part I—Nondiscrimination in Government Employment [Part I superseded by EO 11478 of Aug.8,1969,34 FR 12985,3 CFR,1966-1970 Comp.,p.803] Part II - Nondiscrimination in Employment by Government Contractors and Subcontractors Subpart A—Duties of the Secretary of labor SEC. 201 The Secretary of Labor shall be responsible for the administration and enforcement of Parts II and III of this Order.The Secretary shall adopt such rules and regulations and issue such orders as are deemed necessary and appropriate to achieve the purposes of Parts II and III of this Order. [Sec.201 amended by EO 12086 of Oct.5, 1978,43 FR 46501,3 CFR,1978 Comp.,p.230] Subpart B—Contractors'Agreements SEC. 202 Except in contracts exempted in accordance with Section 204 of this Order,all Government contracting agencies shall include in every Government contract hereafter entered into the following provisions: During the performance of this contract,the,contractor agrees as follows: 1.The contractor will not discriminate against any employee or applicant for employment because of race,color, religion,sex,sexual orientation,gender identity,or national origin.The contractor will take affirmative action to ensure that applicants are employed,and that employees are treated during employment,without regard to their race,color,religion,sex,sexual orientation,gender identity,or national origin.Such action shall include, but not be limited to the following:employment,upgrading,demotion,or transfer; recruitment or recruitment advertising;layoff or termination; rates of pay or other forms of compensation;and selection for training, including apprenticeship.The contractor agrees to post in conspicuous places,available to employees and applicants for employment,notices to be provided by the contracting officer setting forth the provisions of this nondiscrimination clause. SF:16-5215-142605.doc/rev 12/2016 37 2.The contractor will,in all solicitations or advancements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to race,color, religion,sex,sexual orientation,gender identity,or national origin. 3.The contractor will not discharge or in any other manner discriminate against any employee or applicant for employment because such employee or applicant has inquired about,discussed,or disclosed the compensation of the employee or applicant or another employee or applicant.This provision shall not apply to Instances In which an employee who has access to the compensation information of other employees or applicants as a part of such employee's essential job functions discloses the compensation of such other employees or applicants to individuals who do not otherwise have access to such information, unless such disclosure is in response to a formal complaint or charge,In furtherance of an investigation,proceeding,hearing,or action,including an investigation conducted by the employer,or is consistent with the contractor's legal duty to furnish information. 4.The contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding,a notice,to be provided by the agency contracting officer,advis(ng the labor union or workers'representative of the contractor's commitments under Section 202 of Executive Order No. 11246 of September 24, 1965,and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 5.The contractor will comply with all provisions of Executive Order No. 11246 of Sept.24,1965,and of the rules, regulations,and relevant orders of the Secretary of Labor. 6.The contractor will furnish all information and reports required by Executive Order No. 11246 of September 24, 1965,and by the rules,regulations,and orders of the Secretary of Labor,or pursuant thereto,and will permit access to his books,records,and accounts by the contracting agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules,regulations,and orders. 7.in the event of the contractor's noncompliance with the nondiscrimination clauses of this contract or with any of such rules,regulations,or orders,this contract may be cancelled,terminated,or suspended in whole or In part and the contractor may be declared ineligible for further Government contracts in accordance with procedures authorized in Executive Order No. 11246 of Sept.24, 1965,and such other sanctions may be imposed and remedies invoked as provided in Executive Order No. 11246 of September 24, 1965,or by rule,regulation,or order of the Secretary of Labor,or as otherwise provided by law. 8.The contractor will include the provisions of paragraphs(1)through(8)in every subcontract or purchase order unless exempted by rules,regulations,or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order No. 11246 of September 24, 1965,so that such provisions will be binding upon each subcontractor or vendor.The contractor will take such action with respect to any subcontract or purchase order as may be directed by the Secretary of Labor as a means of enforcing such provisions including sanctions for noncompliance; Provided,however,that in the event the contractor becomes involved in,or is threatened with, litigation with a subcontractor or vendor as a result of such direction,the contractor may request the United States to enter into such litigation to protect the interests of the United States.[Sec.202 amended by EO 11375 of Oct. 13,1967,32 FR 14303,3 CFR, 1966-1970 Comp.,p.684, EO 12086 of Oct.5, 1978,43 FR 46501,3 CFR, 1978 Comp.,p.230,EO 13665 of April 8,2014,79 FR 20749,EO 13672 of July 21, 2014,79 FR 42971] SEC. 203 a.Each contractor having a contract containing the provisions prescribed in Section 202 shall file,and shall cause each of his subcontractors to file,Compliance Reports with the contracting agency or the Secretary of labor as may be directed.Compliance Reports shall be filed within such times and shall contain such information as to the practices,policies,programs,and employment policies,programs,and employment statistics of the contractor and each subcontractor,and shall be in such form,as the Secretary of Labor may prescribe. b.Bidders or prospective contractors or subcontractors may be required to state whether they have participated in any previous contract subject to the!!provisions of this Order,or any preceding similar Executive order,and in SF:16-5215-142605.doc/rev 12/2016 38 that event to submit,on behalf of themselves and their proposed subcontractors,Compliance Reports prior to or as an initial part of their bid or negotiation of a contract. c.Whenever the contractor or subcontractor has a collective bargaining agreement or other contract or understanding with a labor union or an agency referring workers or providing or supervising apprenticeship or training for such workers,the Compliance Report shall include such information as to such labor union's or agency's practices and policies affecting compliance as the Secretary of Labor may prescribe: Provided,that to the extent such information is within the exclusive possession of a labor union or an agency referring workers or providing or supervising apprenticeship or training and such labor union or agency shall refuse to furnish such information to the contractor,the contractor shall so certify to the Secretary of Labor as part of its Compliance Report and shall set forth what efforts he has made to obtain such information. d.The Secretary of Labor may direct that any bidder or prospectN'e contractor or subcontractor shall submit,as part of his Compliance Report,a statement in writing,signed by an authorized officer or agent on behalf of any labor union or any agency referring workers or providing or supervising apprenticeship or other training,with which the bidder or prospective contractor deals,with supporting information,to the effect that the signer's practice;and policies do not discriminate on the grounds of race,color,religion,sex,sexual orientation,gender identity,or national origin,and that the signer either will affirmatively cooperate in the implementation of the policy and provisions of this Order or that it consents and agrees that recruitment,employment,and the terms and conditions of employment under the proposed contract shall be in accordance with the purposes and provisions of the order.In the event that the union,or the agency shall refuse to execute such.a statement,the Compliance Report shall so certify and set forth what efforts have been made to secure such a statement and such additional factual material as the Secretary of Labor may require. [Sec.203 amended by EO 11375 of Oct. 13, 1967,32 FR 14303,3 CFR,1966--1970 Comp.,p.684; EO 12086 of Oct. 5, 1978,43 FR 46501,3 CFR,1978 Comp.,p.230,EO 13672 of July 21,2104,79 FR 42971) SEC. 204 a.The Secretary of Labor may,when.the Secretary deans that special circumstances in the national interest so require,exempt a contracting agency from the requirement of including any or all of the provisions of Section 202 of this Order in any specific contract,subcontract,or purchase order. b.The Secretary of Labor may,by rule or regulation,exempt certain classes of contract's,subcontracts,or purchase orders(1)whenever work is to be or has been performed outside the United States and no recruitment of workers within the limits of the United States is involved; (2)for standard commercial supplies or raw materials; (3)Involving less than specified amounts of money or specified numbers of workers;or(4)to the extent that they involve subcontracts below a specified tier. c.Section 202 of this Order shall not apply to a Government contractor or subcontractor that is a religious corporation,association,educational institution,or society,with respect to the employment of individuals of a particular religion to perform work connected with the carrying on by such corporation,association,educational institution,or society of its activities.Such contractors and subcontractors are not exempted or excused from complying with the other requirements contained in this Order. d.The Secretary of Labor may also provide,by rule, regulation,or order,for the exemption of facilities of a contractor that are in all rejects separate and distinct from activities of the contractor related to the performance of the contract: provided,that such an exemption will not interfere with or impede the effectuation of the purposes of this Order: and provided further,that in the absence of such an exemption all facilities shall be covered by the provisions of this Order., [Sec.204 amended by EO 13279 of Dec. 16,2002,67 FR 77141,3 CFR,2002 Comp.,p.77141—77144) Subpart C—mowers and Duties of the Secretary of Labor and the Contracting i►gencies SF:16-5215-142605.doc/rev 12/2016 39 SEC. 205 The Secretary of Labor shall be responsible for securing compliance by all Government contractors and subcontractors with this Order and any implementing rules or regulations.All contracting agencies shall comply with the terms of this Order and any implementing rules,regulations,or orders of the Secretary of Labor. Contracting agencies shall cooperate with the Secretary of Labor and shall furnish such information and assistance as the Secretary may require. [Sec.205 amended by EO 12086 of Oct.5, 1978,43 FR 46501,3 CFR, 1978 Comp.,p, 2301 SEC. 206 a.The Secretary of Labor may investigate the employment practices of any Government contractor or subcontractor to determine wheth'er or not the contractual provisions specified in Section 202 of this Order have been violated.Such investigation shall be conducted in accordance with the procedures established by the Secretary of Labor. b.The Secretary of Labor may receive and investigate complaints by employees or prospective employees of a Government contractor or subcontractor which allege discrimination contrary to the contractual provisions specified in Section 202 of this Order. [Sec.206 amended by EO 12086 of Oct. 5, 1978,43 FR 46501,3 CFR, 1978 Comp.,p.230] SEC. 207 The Secretary of Labor shall use his/her best efforts,directly and through interested Federal,State,and local agencies, contractors,and all other available instrumentalities to cause any labor union engaged in work under Government contracts or any agency referring workers or providing or supervising apprenticeship or training for or in the course of such work to cooperate in the implementation of the purposes of this Order.The Secretary of Labor shall,in appropriate cases,notify the Equal Employment Opportunity Commission,the Department of Justice,or other appropriate Federal agencies whenever it has reason to believe that the practices of any such labor organization or agency violate Title VI or Title VII of the Civil Rights Act of 1964 or other provision of Federal law. [Sec.207 amended by EO 12086 of Oct. 5, 1978,43 FR.46501,3 CFR, 1978 Comp.,p.2301 SEC. 208 a.The Secretary of Labor,or any agency,officer,or employee in the executive branch of the Government designated by rule,regulation,or order of the Secretary,may hold such hearings,public or private,as the Secretary may deem advisable for compliance,enforcement,or educational purposes. b.The Secretary of Labor may hold,or cause to be held,hearings in accordance with Subsection of this Section prior to imposing,ordering,or recommending the imposition of penalties and sanctions under this Order.No order for:debarment of any contractor from further Government contracts under Section 209(6)shall be made without affording the contractor art opportunity for a hearing. Subpart D--Sanctions and Penalties SEC. 209 In accordance with such rules,regulations,or orders as the Secretary of Labor may issue or adopt,the Secretary may: 1.Publish,or cause to be published,the names of contractors or unions which it has concluded have complied or have failed to comply with the provisions of this Order or of the rules,regulations,and orders of the Secretary of Labor. 2.Recommend to the Department of Justice that, in cases In which there is substantial or material violation or the threat of substantial or material violation of the contractual provisions set forth in Section 202 of this Order, appropriate proceedings be brought to enforce those provisions,including the enjoining,within the limitations SF:16-5215-142605.doc/rev 12/2016 40 of applicable taw,of organizations,individuals,or groups who prevent directly or indirectly,,or seek to prevent directly or indirectly,compliance with the provisions of this Order. 3.Recommend to the Equal Employment Opportunity Commission or the Department of Justice that appropriate proceedings be instituted under Title VIi of the Civil Rights Act of 1964. 4.Recommend to the Department of Justice that criminal proceedings be brought for the furnishing of false information to any contracting agency or to the Secretary of Labor as the case may be. 5.After consulting with the contracting agency,direct the contracting agency to cancel,terminate,suspend,or cause to be cancelled,terminated,or suspended,any contras,or any portion or portions thereof,for failure of the contractor or subcontractor to comply with equal employment opportunity provisions of the,contract. Contracts may be cancelled,terminated,or suspended absolutely or continuance of contracts may be conditioned upon a program for future compliance approved by.the Secretary of Labor. 6.Provide that any contracting agency shall refrain from entering into further contracts,or extensions or other modifications of existing contracts,with any noncomplying contractor,until such contractor has satisfied the Secretary of Labor that such contractor has established and will carry out personnel and employment policies in compliance with the provisions of this Order. (b)Pursuant to miles and regulations prescribed by the Secretary of Labor,the Secretary shall make reasonable efforts, within a reasonable time limitation,to secure compliance with the contract provisions of this Order by methods of conference,concillation,mediation,and persuasion before proceedings:shall be instituted under subsection(a)(2)of this Section,or before a contract shall be cancelled or terminated in whole or in part under subsection(a)(5)of this Section. [Sec,209 amended by EO 12086 of Oct.5, 1978,43 FR 46501,3 CFR,1978 Comp.,p.230] SEC, 210 Whenever the Secretary of Labor makes a determination under Section 209,the Secretary shall promptly notify the appropriate agency.The agency shall take the action directed by the Secretary and shall report the results of the action it has taken to the Secretary of Labor within such time as the Secretary shall specify.If the contracting agency fails to take the action directed within thirty days,the Secretary may take the action directly. [Sec. 210 amended by 60 12086 of Oct.5, 1978,43 FIR 46501,3 CFR,1978 Comp.,p 230] SEC. 211 If the Secretary shall so direct,contracting agencies shall not enter into contracts with any,bidder or prospective contractor unless the bidder or prospective contractor has satisfactorily complied with the provisions of this Order or submits a program for compliance acceptable to the Secretary of Labor. [Sec.211 amended by EO 12086 of Oct.5, 11.978,43 FIR 46501,3 CFR,1978 Comp.,p. 230] SEC. 212 When a contract has been cancelled or terminated under Section 209(a)(5)or a contractor has been debarred from further Government contracts under Section 209(a)(6)of this Order,because of noncompliance with the contract provisions specified in Section 202 of this Order,the Secretary of Labor shall promptly notify the Comptroller General of the United States. [Sec.212 amended by EO 1.2086 of Oct.5, 19713,43 FIR 46501,3 CFR, 197E Comp.,p. 2301 Subpart E—Certificates of Meat SEC. 213 SF:16-5215-142605.doc/rev 12/2016 41 The Secretary of Labor may provide for issuance of a United States Government Certificate of Merit to employers or labor unions,or other agencies which are or may hereafter be engaged in work under Government contracts,if the Secretary is satisfied that the personnel and employment practices of the employer,or that the personnel,training,apprenticeship, membership,grievance and representation,upgrading,and other practices and policies of the labor union or other agency conform to the purposes and provisions of this Order. SEC. 214 Any Certificate of Merit may at any time be suspended or revoked by the Secretary of Labor if the holder thereof,in the judgment of the Secretary,has failed to comply with the provisions of this Order. SEC. 215 The Secretary of Labor may provide for the exemption of any employer,labor union,or other agency from any reporting requirements imposed under or pursuant to this Order if such employer, labor union,or other agency has been awarded a Certificate of Merit which has not been suspended or revoked. Part ni—Nondiscrimination Provisions in Federally Assisted Construction Contracts i SEC, 301 Each executive department and agency,which administers a program involving Federal financial assistance shall require as a condition for the approval of any grant,contract,loan, insurance,or guarantee thereunder,which may involve a construction contract,that the applicant for Federal assistance undertake and agree to incorporate,or cause to be incorporated,into all construction contracts paid for in whole or in part with funds obtained from the Federal Government or borrowed on the credit of the Federal Government pursuant to such grant,contract,loan,insurance,or guarantee,or undertaken pursuant to any Federal program Involving such grant,contract,loan,insurance,or guarantee,the provisions prescribed for Government contracts by Section 202 of this Order or such modification thereof,preserving in substance the contractor's obligations thereunder,as may be approved by the Secretary of Labor, together with such additional provisions as the Secretary deems appropriate to establish and prated the interest of the United States in the enforcement of those obligations.Each such applicant shall also undertake and agree(1)to assist and cooperate actively with the Secretary of Labor in obtaining the compliance of contractors and subcontractors with those contract provisions and with the rules,regulations and relevant orders of the Secretary,(2)to obtain and to furnish to the Secretary of Labor such information as the Secretary may require for the supervision of such compliance, (3)to cant'out sanctions and penalties for violation of such obligations imposed upon contractors and subcontractors by the Secretary of Labor pursuant to Part II,Subpart D,of this Order,and(4)to refrain from entering into any contract subject to this Order,or extension or other modification of such a contract with a contractor debarred from Government contracts under Wart II,Subpart D,of this Girder. [Sec.301 amended by EO 12086 of Oct.5, 1978,43 FIR 46501,3 C F , 1978 Comp.,p.2.30] SEC. 302 a."Construction contract"as used in this Order means any contract for the construction,rehabilitation,alteration, conversion,extension,or repair of buildings,highways,or other improvements to real property. b.The provisions of Part II of this Order shall apply to such construction contracts,and for purposes of such application the administering department or agency shall be considered the contracting agency referred to therein. c.The term"applicant"as used in this Order means an applicant for Federal assistance or,as determined by agency regulation,other program participant,with respect to whom an application for any grant,contract,loan, insurance,or guarantee is not finally acted upon prior to the effective date of this Part,and it Includes such an applicant:after he/she becomes a recipient of such Federal assistance. SEC:. 303 SF:16-5215-142605.doc/rev 12/2016 42 a.The Secretary of Labor shall be responsible for obtaining the compliance of such applicants with their undertakings under this Order.Each administering department and agency is directed to cooperate with the Secretary of Labor and to furnish the Secretary such information and assistance as the Secretary may require in the performance of the Secretary's functions under this Order, b.In the event an applicant fails and refuses to comply with the applicant's undertakings pursuant:to this Order, the Secretary of Labor may,after consulting with the administering department or agency,take any or all of the following actions: (1)direct any administering department or agency to cancel,terminate,or suspend in whole or in part the agreement,contract or other arrangement with such applicant with respect to which the failure or refusal occurred; (2)direct any administering department or agency to refrain from extending any further assistance to the applicant under the program with respect to which the failure or refusal occurred until satisfactory assurance of future compliance has been received by the Secretary of Labor from such applicant; and (3)refer the case to the Department of Justice or the Equal Employment Opportunity Commission for appropriate law enforcement or other proceedings. c.In no case shall action be taken with respect to an applicant pursuant to clause(1)or(2)of subsection(b) without notice and opportunity for hearing. [Sec.303 amended by EO 12086 of Oct.5, 1978,43 Fit 46501,3 CFR,1978 Comp.,p.230] SEC. 304 Any executive department or agency which imposes by rule,regulation,or order requirements of nondiscrimination in employment,other than requirements imposed pursuant to this Order,may delegate to the Secretary of Labor by agreement such responsibilities with respect to compliance standards,reports, and procedures as would tend to bring the administration of such requirements into conformity with the administration of requirements Imposed under this Order: Provided,That actions to effect compliance by recipients of Federal financial assistance with requirements imposed pursuant to Title VI of the Civil Rights Act of 1964 shall be taken in conformity,with the procedures and limitations prescribed In Section 602 thereof and the regulations of the administering department or agency Issued thereunder. Part IV—Miscellaneous SEC. 401 The Secretary of Labor may delegate to any officer,agency,or employee in the Executive branch of the Government, any function or duty of the Secretary under Parts II and III of this Order. [Sec.401 amended by EO 12086 of Oct.5, 1978,43 FR 46501,3 CFR,1978 Comp.,p.230] SEC.402 The Secretary of Labor shall provide administrative support for the exertion of the program known as the"Plains for Progress.' SEC. 403 a. Executive Orders Nos. 10590(January 19, 1955),10722(August 5,1957), 10925(March 6,1961), 11114 (June 22, 1963),and 11162(July 28,1964),are hereby superseded and the President's Committee on Equal Employment Opportunity established by Executive Order No. 10925 is hereby abolished.All records and property in the custody of the Committee shall be transferred to the Office of Personnel Management and the Secretary of Labor,as appropriate. b. Nothing in this Order shall be deemed to relieve any person of any obligation assumed or imposed under or pursuant to any Executive Order superseded by this Order.All rules,regulations,orders,instructions, designations,and other directives Issued by the President's Committee on Equal Employment Opportunity and those issued by the heads of various departments or agencies under or pursuant to any of the Executive orders superseded by this Order,shall,to the extent that they are not inconsistent with this Order,remain in full force SF:16-5215-142605.doc/rev 12/2016 43 .I and effect unless and until revoked or superseded by appropriate authority. References in such directives to provisions of the superseded orders shall be deemed to be references to the comparable provisions of this Order. [Sec.403 amended by FO 12107 of Dec. 28, 1978,44 FIR 1055,3 CFR, 1978 Comp.,p,2641 SEC. 404 The General Services Administration shall take appropriate action to revise the standard Government contract forms to accord with the provisions of this Order and of the rules and regulations of the Secretary of Labor. j i SEC.405 This Order shall become effective thirty days after the date of this Order. i i I SF:16-5215-142605.doc/rev 12/2016 44 -1 OP ID: MH CERTIFICATE OF LIABILITY INSURANCE F1210212020 ATE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In Ileu of such endorsements. PRODUCER CONTACT Heberden Huntington Pacific Ins. Agency NAME PHONE -- AX 7901 Professional Circle Arc No.Ext: 714-841-6283 (Arc,No): 714-842-2638 Huntington Beach, CA 92648 ADDRESS: mark hunt acificinsurance.com Mark Heberden PRODUCER --— —�— CUSTOMER ID e:GOLDENS INSURER(S)AFFORDING COVERAGE NAIC i INSURED Golden State Constructors, Inc INSUR6tA:Landmark American Ins Co. 208 E. Orangethorpe Ave. ---- --------------- -- - _ - INSURER B:California Automobile Ins Co. 38342 Placentia, CA 92870 INSURERC:NorGUARD Insurance Co. _ 31470 INSURERD:StarStone National Ins.Comp 23496 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. -- _ INS TYPE OF INSURANCE POLICY NUMBER MMIDD EFL MMIDLI D LTR fYY" LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X LHA140880 01/31/2020 01/3112021 pREMISES(Ea occurrence $ 50,00 CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 5,00 X $2500 Deductible PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 ��-POLICY L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPIOP AGG $ 2,000,00 X P LOC _ S AUTOMOBILE LIABLITY X COMBINED SINGLE LIMIT $ 1,000,00 (Ea accident) B X .ANY ALTO BA04000OG41474 02/06/2020 02/0612021 BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (PER ACCIDENT) NON-OWNED AUTOS Deductible s UMBRELLA LIAB X OCCUR EACH OCCURRENCE 2,000,00 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,00 p 316SX200ALI 08M 9/2020 01131/2021 DEDUCTIBLE $ RE`1-NT,014 $ $ WORKERS COMPENSATION X T IMIT OTH- AND EMPLOYERS'LIABILITY C ANY PROPRIETORJPARTNERIEXECUTIVE YIN GOWC194546 02106/2020 i, 02/06/2021 EL.EACH ACCIDENT $ 1,000,00 OFFICERIMEMBER EXCLUDED* N 1 A (Mandrtory In NH) E L DISEASE-EA EMPLOYEES 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below I $ 1,000,00 DESCRIPTION OF OPERATIONS;LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) MICHAEL E. T The City of Huntington Beach its officers, elected or appointed officials, em,plo ees, a ents and volunteers are additional Insured as required by CITY ATTORNEY rltter5 contr�ct per the attached endorsement. Coverage is primary CITY )F HUNTINGTON BEACH and non-contributory. 30 days notice of of cancellation with 10 days for ,non-payment of premium. CERTIFICATE HOLDER CANCELLATION CITY012 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE of Huntington Beach THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City g ACCORDANCE WITH THE POLICY PROVISIONS. 2000 Main Street Huntington Beach„ CA 92648 AUTHORIZED REPRESENTATIVE 1�CL `0',_ O 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD Policy Number: LHA140880 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTWER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 0413 0 Insurance Services Office; Inc., 2012 Page 1 of 1 POLICY NUMBER: LHA140880 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations City of Huntington. Beach, its officers,elected or Various locations in the city appointed officials,employees,agents and Job Description: Curb, gutter and sidewalk repair volunteers 2000 Main St. P.O. Box 190 Huntington Beach CA 92648 Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section 11 —Who Is An Insured is amended to 2. If coverage provided to the additional insured is include as an additional insured the person(s) or required by a contract or agreement, the organization(s) shown in the Schedule, but only insurance afforded to such additional insured will with respect to liability for "bodily injury" or not be broader than that which you are required "property damage"caused, in whole or in part, by by the contract or agreement to provide for such "your work" at the location designated and additional insured. described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and CG 20 37 0413 0 ISO Properties, Inc., 2004 Page 1 of 2 ❑ B. With respect to the insurance afforded to these additional insureds; the following is added to Section Ili—Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: . 1. Required by the contract or agreement;or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 0413 cJ ISO Properties, Inc., 2004 Page 2 of 2 ❑ POLICY NUMBER: LHA140880 COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations Locations Of Covered Operations City of Huntington Beach, its officers, elected or Various locations in the city appointed officials, employees, agents and volunteers Job Description: Curb, gutter and sidewalk repair 2000 Main St. P.O. Box 190 Huntington Beach, CA 92648 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to 2. If coverage provided to the additional insured is include as an additional insured the person(s) or required by a contract or agreement, the organization(s) shown in the Schedule, but only insurance afforded to such additional insured with respect to liability for "bodily injury", "property will not be broader than that which you are damage" or "personal and advertising injury" required by the contract or agreement to caused, in whole or in part, by: provide for such additional insured. 1. Your acts or omissions; or B. With respect to the insurance afforded to these 2. The acts or omissions of those acting on your additional insureds, the following additional behalf; exclusions apply: in the performance of your ongoing operations for This insurance does not apply to "bodily injury" or the additional insured(s) at the location(s) "property damage"occurring after: designated above. 1. All work, including materials, parts or However: equipment furnished in connection with such work, on the project (other than service, 1. The insurance afforded to such additional maintenance or repairs) to be performed by or insured only applies to the extent permitted by on behalf of the additional insured(s) at the law; and location of the covered operations has been completed; or CG 2010 0413 Q Insurance Services Office, Inc., 2012 Page 1 of 2 ❑ THE FINAL PREMIUM IS j PREDICATED ON THE Bond No.: 2306042 FINAL CONTRACT PRICE (One of Three Originals) PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS: WHEREAS,City of Huntington Beach(hereafter referred to as"City")has, by written agreement dated 12- Z ,20Zo entered into a contract with Golden State Constructors, 208 E. Orangethoroe Ave., Placentia, CA 92870 (name and address of Contractor) (hereinafter referred to as"Principal"),for performance of the work described as follows: Zone 3 ADA Ramps(CC1620) (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 A.M.Best,Moody's,or Standard &Poor's,to validate that Surety has positive ratings of being secure or Stable;and Surety is registered and listed with the California Department of Insurance, NOW,THEREFORE,we,the undersigned,as Principal,and North American Specialty Insurance Company. 777 S Figueroa St,Suite 3700, Los Angeles-CA 90017 (name and address of Surety) as Surety,are held and firmly bound unto City in the penal sum of Eight Hundred Forty Five Thousand Nine Hundred Twenty Five and 00/100 Dollars($ 945 qm,no ),this amount being not less than one hundred percent of the price set forth in the Contract,in lawful money of the United States,for the payment of which sum,well and truly to be made, we bind ourselves, our heirs,executors,administrators and successors,jointly and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT if the Principal shall promptly,fully and faithfully perform each and all of the covenants,obligations and things to be done and performed by the Principal in strict accordance with the terms of the Contract as said contract may be altered,amended or modified from time to time;and if the Principal shall indemnify and save harmless City and all of City's officers,agents and employees(hereinafter collectively referred to as"Obligees")fromany and all losses, liability and damages, claims,judgments,stop notices,fees and costs of every description,whether imposed by law or in equity, which may be incurred by the Obligees by reason of the failure or default on the part of the Principal in the performance of any or all of the terms or the obligations of the Contract,including all alterations,amendments and modifications thereto,and any warranties or guarantees required thereunder,then this obligation shall be void;otherwise, it shall be and shall remain in full force and effect. l 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 71 74 i Bond No. 2306042 to automatically adjust the penal sum of this Bond to reflect such adjustments,alterations,changes, deletions,additions or other modifications. Surety agrees to provide written confirmation of such adjustments in the penal sum to City on not less than a quarterly basis. Surety also waives the provisions of Civil Code§§2845 and 2849. The obligations of this Bond shall survive the completion of the work described in the Contract as to all obligations and liabilities of the Principal which survive completion of the work. IN WITNESS WHEREOF,each party represents and warrants that this instrument has been duly executed by Principal and Surety,on the date set forth below,that the name of each corporate party being affixed hereto is such parry's proper legal name and that the individuals signing this instrument have been duly authorized pursuant to the authority of its governing body. Surety, by execution of this bond,waives any defense which Surety has or may have by reason of any failure of the Principal to execute or properly execute this bond. Dated: December 2nd, 2020 ATTEST Golden Sta onstr tors (Corporate Seal) Xle, in VIE Name: 2 A,4-- Title: l"!P�!"/l✓o✓� ATTEST North American Specialty (Corporate Seal) (Surety dame) By: Name: (Sig ture of Att rn y-in- act for Surety) DRA i (Attach Attorney-in-Fact Certificate) (27� - (Area Code&Telephone Number for Surety) APPROVED AS TO F i By. Michael E.Gates,City Attorney 1 Note: This bond must be executed in duplicate and dated,all signatures must be notarized,and evidence of the authority of any person signing as attomey-in-fact must be attached. PERFORMANCE BOND Page 2 of 2 15-4584/117174 SWISS RE CORPORATE SOLUTIONS NORTH ANIERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS,THAT North American Specialty Insurance Company,a corporation duly organized and existing under laws of the State of New Hampshire,and having its principal office in the City of Overland Park,Kansas,and Washington International Insurance Company,a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Overland Park,Kansas,each does hereby make,constitute and appoint: RANDY SPOHN,MATTHEW R.DOBYNS,and ASHLEY M.SPOHN JOINTLY OR SEVERALLY Its true and lawful Attomey(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its act and deed,bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by law,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of: FIFTY MILLION($50,000,000.00)DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 9`h of May,2012: "RESOLVED,that any two of the Presidents,any Managing Director,any Senior Vice President,any Vice President,any Assistant Vice President, the Secretary or any Assistant Secretary be,and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached." ♦Q��1nllulll�kry/ii ♦ p\AL Y/ ///�� �,mn��miumuny�b ♦yQ�oPpoi�:�(SG�� �p�ZIONq� By F?.oRPOjy�•:dG ��l•• p r�"•..py SEAL E Steven P.Anderson,Senior Vice President of Washington International Insurance Company Z27 SEAL I, ;Z t�sft�•;Z�f 1973 -u.n &Senior Vice President of North American Specialty Insurance Company s O: �m Michael A.Ito,S-emm ice resn ent at as mgton International Insurance Company nattna &Senior Vice President of North American Specialty Insurance Company IN WITNESS WHEREOF,North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed,and these presents to be signed by their authorized officers this 14 day of FEBRUARY 2018 . North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Cook SS: On this 14 day of FEBRUARY ,2018 before me,a Notary Public personally appeared Steven P.Anderson ,Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Michael A.Ito, Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company,personally known to me,who being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. OFFICIAL SEAL M.KENNY Notary Public-Slate of Illinois My Commission Expires M.Kenny,Notary Public 1 ' 12r0M7021 I, Jeffrey Goldberg , the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Company,which is still in fi111 force and effect. IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Companies this 211d day of December 20 20 Jeffrey Goldberg,Vice President&Assistant Secretary of Washington International Insurance Company&North American Specialty Insurance Company CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of CALIFORNIA County of ORANGE On December 2"d, 2020 before me, ASHLEY MARIE SPOHN, NOTARY PUBLIC, personally appeared RANDY SPOHN ® 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 ees), and that by his/her/their signatures} on the ASHLEY MARIE SPOHN [ instrument the personal, or the entity upon behalf of which the person(s) o COMM.#2188665 � g NOTARY PUBLIC CALIFORMA o acted, executed the instrument. ORANGE COUNTY ro My comm.expires Mar.27,2021 I certify under PENALLY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. am& to/)"& Sig re of Notary ''rr�sxOin .�-`.e. „'4` i.,.."+`"�''`N..�'.-.» `_'`sa� :� y ' #'',.r; '✓"sr Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER ❑ PARTNER(S) ❑ LIMITED ® ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California } County of Orange } On 12/2/2020 before me, Claudia Cochran, Notary Public , {Here msen nameand title of the officer) personally appeared ----Ronnie D. Cochran ------- who proved to me on the basis of satisfactory evidence to be the person(s)whose names} Ware subscribed to the within instrument and acknowledged to me that he/sheA4a---y executed the same in his/herA 4:4 i authorized capacity(*s), and that by hisffi-MYtq air signature(* on the instrument the personN, or the entity upon behalf of which the person Kacted, executed the instrument. certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. CLAUDIA COCHRAN WITNESS my hand and official seal. F) COMM. #2277167 Z tr o Notary Public•California o 1. Z A Orange County M Comm.Expires Feb.10,2023� Notary Public Signature (Notary Public Seal) ADDITIONAL OP fIOIdAL INFORMA'TIOIW INSTRUCTIONS FOR COMPLETING THIS FORM This Jorrrr complies with current California statutes regarding notary rworrling and, DESCRIPTION OF THE ATTACHED DOCUMENT if'needed,should be cvrnpleled and attached to the document.Ac•knowledgrrrents from other slates may be completed.jor documents being sent to that state so long as the wording does not require the California notary to violate California notan- law. (Title or description of attached document) • State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment, • Date of notarization must be the date that the signer(s)personally appeared which (Title or description of attached document continued) must also be the same date the acknowledgment is completed. - The notary public must print his or her name as it appears within his or her Number of Pages Document Date commission followed by a comma mid 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. ire/she/hey-is/ere)or circling the correct forms.Failure to correctly indicate this ❑ Individual (s) information may lead to rejection of document recording. ❑ Corporate Officer • The notary seal impression must be cleat 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. Other indicate title or type of attached document,number ofpages and date. ❑ Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). • Securely attach this document to the signed document with a staple. Bond No.: 2306042 (One of Three Originals) PAYMENT BOND (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS; WHEREAS,City of Huntington Beach(hereafter referred to as"City")has awarded to Golden State Constructors 208 E. Orangethorpe Ave, Placentia, CA 92870 (name and address of Contractor) (hereinafter referred to as"Principal"),a contract("Contract")for the work described as follows: Zone 3 ADA Ramps(CC1620) (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 North American Specialty Insurance Company 777 S Figueroa St Suite 3700 Los Angeles CA 90017 (name and address of Surety) as Surety,are held and firmly bound unto City in the penal sum of Eight Hundred Forty Five Thousand Nine Hundred Twenty Five and On/100 dollars($ 845,925 nn ),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 15-4584/117357 I 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: December 2nd, 2020 ATTEST Golden S Constructors (Corporate Seal) ame) By: Narne: Title: ATTEST North American Specialty Insurance Company (Corporate Seal) (Sujame) By: A t�j Name: R nd S ohn (Sig ature of Att a in-Fa(f for Surety) (Attach Attorney-in-Fact Certificate) ( _ (Area Co e&Telephone Number for Surety) APPROVED AS M: By: hael E.Gates,-City-Attorney Note: This bond must be executed in duplicate and dated,all signatures must be notarized,and evidence of the authority of any person signing as attorney-in-fact must be attached. PAYMENT BOND Page 2 of 2 1 5-4 5 84/1 1 73 5 7 SWISS RE CORPORATE SOLUTIONS NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS,THAT North American Specialty Insurance Company,a corporation duly organized and existing under laws of the State of New Hampshire,and having its principal office in the City of Overland Park,Kansas,and Washington International Insurance Company,a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Overland Park,Kansas,each does hereby make,constitute and appoint: RANDY SPOHN,MATTHEW R.DOBYNS,and ASHLEY M. SPOHN JOINTLY OR SEVERALLY Its true and lawful Attomey(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its act and deed,bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by law,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of: FIFTY MILLION($50,000,000.00)DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 9 h of May,2012: "RESOLVED,that any two of the Presidents,any Managing Director,any Senior Vice President,any Vice President,any Assistant Vice President, the Secretary or any Assistant Secretary be,and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future With regard to any bond,undertaking or contract of surety to which it is attached." Y/i ///� �pZIONq�uNw4rw LPO By SEAL_ :O E Steven P.Anderson,Senir Vice President of Washington International Insurance Company ?: SG./1l 1979 W.q g &Senior Vice President of North American Specialty Insurance Company Ere HANP':' Q i— EZ O Michael A.Ho,Semor Vice Pre�o.4 hmgton International Insurance Company _ aON &Senior Vice President of North American Specialty Insurance Company IN WITNESS WHEREOF,North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed,and these presents to be signed by their authorized officers this 14 day of FEBRUARY ,2018 North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Cook SS: On this 14 day of FEBRUARY ,2018 before me,a Notary Public personally appeared Steven P.Anderson ,Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Michael A.Ito. Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company,personally known to me,who being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. OFFICIAL SEAL M.KENNY Notary Public-State of Illinois My Commission Expires M.Kenny,Notary Public I 1=412021 1, Jeffrey Goldberg__the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Polder of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Company,which is still in full force and effect. IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Companies this 2nd day of December 20 20 Jeffrey Goldberg,Vice President&Assistant Secretary of Washington International Insurance Company&North American Specialty Insurance Company CALIFORNIA ALL-PURPOSE.ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of CALIFORNIA County of ORANGE On December 2"d, 2020 before me, ASHLEY MARIE SPOHN, NOTARY PUBLIC, personally appeared RANDY SPOHN ® 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 (ie-0, and that by his/her/their signature(s)on the A A A ASHLEY MARIE SPOHN instrument the person(s), or the entity upon behalf of which the persons} o COMM.#2188665 NOTARY PUBLIC CALIFORNIA o acted, executed the instrument. ORANGE COUNTY ry My comm.expires mar.27,2021 �f 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. Ot A127d1Z11 WSigof Notary 'i�i+i` ?'F``�"+ � s14_ 4F ;'er` ,ryur.'.. a..t�,'.r "`y .r-.....'Y„y`p r,- '" 4 '`% '��` ':-• - s ,,.; < s�td`m3. .Y' l<. < ,r?.`�``.r't,.'2.L'' ,�._. Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER ❑ PARTNER(S) ❑ LIMITED ® ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California } County of Orange _ } On 12/2/2020 before me, Claudia Cochran, Notary Public , (mare insert name and title of the o icer -' personally appeared ------Ronnie D. Cochran -- , who proved to me on the basis of satisfactory evidence to.be the person(s) whose names} Ware subscribed to the within instrument and acknowledged to me that he/'sheA4;gy executed the same in his/herfA#eir authorized capacity(i%*, and that by his/heir signature(* on the instrument the personi`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. CLAUDIA COCHRAN WITNESS m d and official seal. o W COMM. #2277167 Z Notary Public•California x z 'r Orange County M Comm.Ex ires Feb. 10,2023 Notary Public Signature (Notary Public Seal) ADDITIONAL OPTIONAL INF012MA'TION INSTRUCTIONS FOR COMPLETING THIS FORM This Joan complies with current Caliiybrnia statutes regarding notary wording and, DESCRIPTION OF THE ATTACHED DOCUMENT ifnceded,should be completed and attached to the document.Acknowledgments orn other states may be completed far documents being sent to that state so long as the wording does not require the California notary to violate California notary law. (Title or description of attached document) • State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s)personally appeared which (Title or description of attached document continued) must also be the same date the acknowledgment is completed. • The notary public roust pritit his or her name as it appears within his or her Number of Pages Document Date commission followed by a comma and then your title(notary public). • Priut 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. I}e/she/4+ey-is/ere)or circling the correct forms.Failure to correctly indicate this El Individual (s) information may lead to rejection of document recording. ❑ Corporate Offiber • The notary seal impression roust 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, ❑ Pailner(s) • Signature of the notary public must match the signature on file with the office of the county clerk. ❑ Attorney-in-Fact v Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached l.o a different document, Other Indicate title or type of attached document,number ofpages and date. ❑ Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer,indicate the tide(i.e.CEO,CFO,Secretary). • Securely attach this document to the signed document with a staple. 12/14/2020 Company Profile CALIFIII RNIA DEPARTMENT OF INSURANI;Ei COMPANY PROFILE Company Profile Company Search Company Information Company Search Results NORTH AMERICAN SPECIALTY INSURANCE COMPANY Company 1200 MAIN STREET Information KANSAS CITY, MO 64105 Old Company Names Agent for Service Old Company Names Effective Date Reference Information Agent For Service NAIC Group List Vivian Imperial Lines of Business 816 WEST SEVENTH STREET Workers' SUITE 930 Compensation LOS ANGELES CA 90017 Complaint and Request for Reference Information Action/Appeals Contact Information Financial Statements #: 29874 NAIC PDF's ----....- - --- --...__.........__....... ...................- - _ _....---- Annual Statements California Company ID #: 3 008-6 ..__........_:_.....__._...... - _._....._....__....._.................... Quarterly Date Authorized in California: 06/30/1989 Statements -- Company Complaint License Status: j UNLIMITED-NORMAL Company —� Company Type: Property&Casualty Performance& _ ! Comparison Data State of Domicile: —? NEW HAMPSHIRE I Company Enforcement Action Composite back to top Complaints Studies Additional Info NAIC Group List Find A Company Representative In Your Area NAIC Group#: 0181 SWISS RE 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. AIRCRAFT AUTOMOBILE BOILER AND MACHINERY BURGLARY DISABILITY FIRE LIABILITY MARINE PLATE GLASS SPRINKLER SURETY WORKERS'COMPENSATION https:/finteractive.web.insurance.ca.gov/companyprofile/companyprofile?event=companyProfile&doFunction=getCompanyProfile&eid=6943 1/2 12/14/2020 Surety Bonds-List of Certified Companies UNDERWRITING LIMITATION b/: $4,697,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MID, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY. INCORPORATED IN: Illinois. NEW YORK MARINE AND GENERAL INSURANCE COMPANY (NAIC #16608) BUSINESS ADDRESS: 412 Mt. Kemble Ave, Suite 300C, Morristown, NJ 07960 PHONE: (800) 774-2755. UNDERWRITING LIMITATION b/: $49,695,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY. INCORPORATED IN: New York. NGM Insurance Company (NAIC #14788) BUSINESS ADDRESS: 55 WEST STREET, KEENE, NH 03431. PHONE: (904) 380-7282. UNDERWRITING LIMITATION b/: $58,588,000. SURETY LICENSES c,f/: AL, AZ, AR, CO, CT, DE, DC, FL, GA, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY. INCORPORATED IN: Florida. NORTH AMERICAN SPECIALTY INSURANCE COMPANY (NAIC #29874) BUSINESS ADDRESS: 1200 MAIN ST. SUITE 800, KANSAS CITY, MO 64105 - 2478. PHONE: (816) 235-3700. UNDERWRITING LIMITATION b/: $25,914,000. https:/twww.fiscal.treasury.gov/surety-bonds/list-certified-companies.html#n 57/92 12/14/2020 Surety Bonds-List of Certified Companies SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VT, VA, VI, WA, WV, WI, WY. INCORPORATED IN: New Hampshire. NOVA Casualty Company (NAIC#42552) BUSINESS ADDRESS: 440 LINCOLN STREET, WORCESTER, MA 01653 - 0002. PHONE: (508) 853-7200. UNDERWRITING LIMITATION b/: $9,769,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD,TN, TX, UT, VT, VA, WA, WI, WY. INCORPORATED IN: New York. Back To Top O Ohio Casualty Insurance Company (The) (NAIC#24074) BUSINESS ADDRESS: 175 Berkeley Street, Boston, MA 02116. PHONE: (617) 357-9500 X-41177. UNDERWRITING LIMITATION b/: $187,920,000, SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, GU, HI, ID, IL, IN, IN KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY. INCORPORATED IN: New Hampshire. Ohio Farmers Insurance Company (NAIC#24104) DI ICJNICCC AnnDCCC• D n o.- Cnn1 1A1—t-finia4 ('nr.t...- nu nn"7C1 cnn9 https:/Iwww.fiscal.treasury.gov/surety-bonds/list-certified-companies.html*n 58/92 12/14/2020 North American Specialty Insurance Company-Company Profile-Best's Credit Rating Center North American Specialty Insurance Company AMB#:001866 NAIC#:29874 FEIN#:020311919 Mailing Address 1200 Main Street Suite 800 Kansas City, Missouri 64105 United States Web: www.swissre.com Phone: 816-235-3700 Fax: 816-235-3738 View Additional Address Information AM Best Rating Unit: AMB#: 058595 - Swiss Re Ltd Assigned to insurance companies that have, in our opinion, a superior ability to meet their ongoing insurance obligations. A+ Supera�►r View additional news, reports and products for this company. Based on AM Best's analysis, 058838- Swiss Re Ltd is the AMB Ultimate Parent and identifies the topmost entity of the corporate structure. View a list of operating insurance entities in this structure. Best's Credit Ratings Financial Strength Rating View Definition Rating: A+ (Superior) Affiliation Code: g (Group) Financial Size Category: XV($2 Billion or greater) Outlook: Stable Action: Affirmed 'R Effective Date: July 17, 2020 Initial Rating Date: June 30, 1984 ........ ___ ......... ......... ............................... ..._.. ....... ...... ratings.ambest.com/Search Res u Its.aspx?AltSrc=9 1/5 12/14/2020 North American Specialty Insurance Company-Company Profile-Best's Credit Rating Center Long-Term Issuer Credit Rating View Definition ........................... { Long-Term: as (Superior) I Outlook: Negative Action: Affirmed Effective Date: July 17, 2020 Initial Rating Date: August 23, 2006 u Denotes Under Review Best's Rating Best's Credit Rating Analyst Rating Office: A.M. Best Rating Services, Inc. Senior Financial Analyst: Dan Hofineister, CFA, CAIA, CPCU, ARe Senior Director: Carlos Wong-Fupuy Note: See the Disclosure information Form or Press Release below for the office and analyst at the time of the rating event. Disclosure Information Disclosure Information Form View AM Best's Rating Disclosure Form Press Release AM Best Affirms Credit Ratings of Swiss Reinsurance Company Ltd and Rated Affiliates; Revises ICR Outlook to Negative July 17, 2020 Rating History AM Best has provided ratings & analysis on this company since 1984. __ ......... .......... Financial Strength Rating Effective Date Rating 7/17/2020 A+ 12/20/2019 A+ ratings.am best.com/Search Results.aspx?AltSrc=9 2/5 12/14/2020 North American Specialty Insurance Company-Company Profile-Best's Credit Rating Center 12/13/2018 A+ 12/7/2017 A+ 10/13/2017 A+ u 12/16/2016 A+ 12/11/2015 A+ ......... Long-Term Issuer Credit Rating Effective Date Rating 7/17/2020 as 12/20/2019 as 12/13/2018 as 12/7/2017 as 10/13/2017 aa- u 12/16/2016 aa- 12/11/2015 aa- Best's Credit & Financial Reports Best's Credit Report-financial data included in Best's Credit Report reflects the data used in determining the current credit rating(s) for AM Best Rating Unit: AMB#: 058595- Swiss Re Ltd. Best's Credit Report-Archive- reports which were released prior to the current Best's Credit Report. Best's Financial Report-financial data included in Best's Financial Report reflects the most current data available to AM Best, including updated financial exhibits and additional company information, and is available to subscribers of Best's Insurance Reports. View additional news, reports and products for this company. ratings.ambest.com/SearchResu Its.aspx?AltSrc=9 3/5 12/14/2020 North American Specialty Insurance Company-Company Profile-Best's Credit Rating Center Press Releases Date Title Jul 17, 2020 AM Best Affirms Credit Ratings of Swiss Reinsurance Company Ltd and Rated Affiliates; Revises ICR Outlook to Negative i Dec 20, 2019 AM Best Affirms Credit Ratings of Swiss Reinsurance Company Ltd and Affiliates Dec 13, 2018 AM Best Affirms Credit Ratings of Swiss Reinsurance Company Ltd and Affiliates Dec 07, 2017 A.M. Best Removes From Under Review and Upgrades Issuer Credit Ratings of Swiss Reinsurance Company Ltd and Affiliates Oct 13, 2017 A.M. Best Places Credit Ratings Under Review Following Updated Best's Credit ' Rating Methodology Release Dec 16, 2016 A.M. Best Affirms Credit Ratings of Swiss Reinsurance Company Ltd and Its Affiliates 2 3 Page size 10 29 items in 3 pages ..._.... 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Best Company, Inc.and/or its affiliates ALL RIGHTS RESERVED. ratings.ambest.com/Se arch Results.aspx?AltSrc=9 5/5 NORTH AMERICAN SPECIALTY INSURANCE COMPANY BOND NO.: GOLST-406 BID BOND KNOW ALL MEN BY THESE PRESENTS: That we, GOLDEN STATE CONSTRUCTORS, (hereinafter called the Principal), and NORTH AMERICAN SPECIALTY INSURANCE COMPANY, a corporation organized and doing business under and by virtue of the laws of the State of NEW HAMPSHIRE, and duly licensed for the purpose of making, guaranteeing or becoming sole surety upon bonds or undertakings required or authorized by the laws of the State of CALIFORNIA, as Surety, are held and firmly bound unto CITY OF HUNTINGTON BEACH, (hereinafter called the obligee) in the sum equal to 10% of the accompanying bid of the Principal, not, however, in excess of TEN PERCENT OF THE TOTAL AMOUNT BID Dollars (10% OF BID AMOUNT), for the payment of which, well and truly to be made, we hereby bind ourselves and our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT WHEREAS, the above bounden Principal as aforesaid, is about to hand in and submit to the obligee a bid for RESIDENTIAL CURB RAMP PROJECT, JOB/BID NO.: CC 1620, in accordance with the plans and specifications filed in the office of the obligee and under the notice inviting proposals therefore. NOW, THEREFORE, if the bid or proposal of said principal shall be accepted, and the contract for such work be awarded to the principal thereupon by the said obligee, and said principal shall enter into a contract and bond for the completion of said work as required by law, then this obligation to be null and void, otherwise to be and remain in full force and effect. IN WITNESS WHEREOF, said principal and said Surety have caused these presents to be duly signed and sealed this 15TH day of OCTOBER, 2020. GOLD � S T NSTRUCTORS BY: �) NORTH AME ICAN SPECIALTY INSURANCE COMPANY BY: &��/= MATTHLW le. DOBYNS,ATTORNEY- - ACT SWISS RE CORPORATE SOLUTIONS NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS,THAT North American Specialty Insurance Company,a corporation duly organized and existing under laws of the State of New Hampshire,and having its principal office in the City of Overland Park,Kansas,and Washington International Insurance Company,a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Overland Park,Kansas,each does hereby make,constitute and appoint: RANDY SPOHN,MATTHEW R.DOBYNS,and ASHLEY M.SPOHN JOINTLY OR SEVERALLY Its true and lawful Attomey(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its act and deed,bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by law,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of: FIFTY MILLION($50,000,000.00)DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington international Insurance Company at meetings duly called and held on the 90'of May,2012: "RESOLVED,that any two of the Presidents,any Managing Director,any Senior Vice President,any Vice President,any Assistant Vice President, the Secretary or any Assistant Secretary be,and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached." \�\\\�1`11L 11111ri // �NW1M11a11aalUq///y G F._ B SEAL .t,,= Steven P.Anderson,Senior Vice President of Washington Inferno[Dual Insurance Company 2e SEAL ;z Wt 1973 c �` &Senior Vice President of North American Specialty Insurance Company s O0_ m yyAMPS��L't\ //� N IIIII111 \\`\\\ 3 Zoo Michael A.1Bto,for r�ce merest ent o�gton Internationa n�Company tua •• &Senior Vice President of North American Specialty Insurance Company IN WITNESS WHEREOF,North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed,and these presents to be signed by their authorized officers this 14 day of FEBRUARY 12018 . North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Cook ss: On this 14 day of FEBRUARY ,20 18 ,before me,a Notary Public personally appeared Steven P.Anderson ,Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Michael A.Ito, Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company,personally known to me,who being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. OFFICIAL SEAL M.KENNY v Notary PubliC-State of Illinois My Commission Elates M.Kenny,Notary Public I 17A412021 1, Jeffrey Goldberg the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Company,which is still in full force and effect. IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Companies this 15th day Doff October 20 20 Jeffrey Goldberg,Vice President&Assistant Secretary of Washington hnemational htsmance Company&North American Specialty Insurance Company CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of CALIFORNIA County of ORANGE On 1�� , / before me, ERIKA GUIDO, NOTARY PUBLIC, personally appeared MATTHEW R. DOBYNS ® who proved to me on the basis of satisfactory evidence to be the person whose names) is/afe subscribed to the within instrument and acknowledged to me that he/she{ hey executed the same in his/heF/thei authorized capacity {yes), and that by his/heF/thei signature(-S) on the instrument the personfs), or the entity upon behalf of which the personw acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of ERIKAGUIDO California that the foregoing paragraph is true and correct. COMM.#2190052 :k NOTARY PUBLIC CALIFORNIA 7-0 WITNESS my hand and official seal. ORANGE COUNTY My Comm.expires May 5,2021 ----Signature of Notary Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER ❑ PARTNER(S) ❑ LIMITED ® ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) CALIFORNIA ALL- PURPOSE CERTIFICATE ',OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California } County of Orange } On 10/20/2020 before me, Claudia Cochran, Notary Public Here insert name and ti a oft e o leer personally appeared -----Ronnie D. Cochran ---- , who proved to me on the basis of satisfactory evidence to be the person(,.) whose name(* is/ar-e subscribed to the within instrument and acknowledged to me that he/9b&#;,-_y executed the same in his/hero it authorized capacity(I*, and that by his/ 4a& signature(* on the instrument the personN, or the entity upon behalf of which the person(-,;, acted, executed the instrument. certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. CLAUDIA COCHRAN COMM. #2277167 z !::�WITNES an al seal. X_-� - Notary Public-California o i Z �� Orange County M Comm.Expires Feb. 10,2023 Notary Public Signature (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM This for•nr complies with current Cali;forniu statutes regarding notary wording and, DESCRIPTION OF THE ATTACHED DOCUMENT f needed,should be conrpleled and attached to the docurnenl.Acknowledgments frwn other states maybe completed for documents being sent to that slate so long as the wording does nor require the California nolary to violate California notary law. (Title or description of attached document) - State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment. - Date of notarization must be the date that the signer(s)personally appeared which (Title or description of attached document continued) must also be the same date the acknowledgment is completed. - The notary public must print his or her name as it appears within his or her Number of Pages Document Date commission followed by a comma and then your title(notary public). - Print the name(s) df 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. #jeJshe%}rey-is/ere)or circling the correct forms.Failure to correctly indicate this ElIndividual (s) information may lead to rejection of document recording. ❑ Corporate Officer - The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines.If seal impression smudges,re-seal if a (Title) sufficient area permits,otherwise complete a different acknowledgment form. ❑ Partner(s) - Signature of the notirry 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 ensue 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 sinner. If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). - Securely attach this document to the signed document with a staple. - - - - - - ---------- City of Huntington Beach 20oo Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov 77,1900 Office of the City Clerk Robin Estanislau, City Clerk December 28, 2020 Golden State Constructors Attn: Ron Cochran 208 E. Orangethorpe Ave. Placentia, CA 92780 Dear Mr. Cochran: Enclosed is a copy of the TDBG Funded Construction Contract between the City of Huntington Beach and Golden State Constructors for Zone 3 ADA Ramps Project" approved by the Huntington Beach City Council on November 16, 2020. Sincerely, 4�� �&4v4Jvt4d Robin Estanislau, CIVIC City Clerk RE:ds Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand f Golden S+aie GorKinw-}ors.Irr. 208 E.Oange+Fvpe Ave. Placerrtia.GA 928-70 ly yroll 2- I S/ f RECEIVED BY: __._ __ --CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office (Name) after signing/dating (Date) CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: City Treasurer FROM: City Clerk DATE: /4—g/�wZy SUBJECT: Bond Acceptance I have received the bonds for (Company Name) CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. C"30000.2-/ 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 (Council Approval Date) CC No. No. )0_l g MSC No. City Clerk Vault No. Z-1a LO 10• SD Other No. SIRE System ID No. g:/forms/bond transmittal to treasurer City of Huntington Beach File #: 20-1981 MEETING DATE: 11/16/2020 REQUEST FOR CITY COUNCIL ACTION SUBMITTED TO: Honorable Mayor and City Council Members SUBMITTED BY: Oliver Chi, City Manager PREPARED BY: Sean Crumby, Director of Public Works Subject: Accept the lowest responsive and responsible bid and authorize execution of a construction contract with Golden State Constructors in the amount of $845,925 for the Zone 3 Residential Curb Ramp Project, CC-1620; and, authorize appropriation of funds Statement of Issue: On October 27, 2020, bids were publically opened for the Zone 3 Residential Curb Ramp project. City Council action is requested to award a construction contract to Golden State Constructors, the lowest responsive and responsible bidder. Financial Impact: The total cost of the project, including contingency and supplemental expenses, is $990,000. Funds for this project are available in the current fiscal year budget in the CDBG Account 23985063.82300 ($400,000) and Measure "M" Account 21390004.82300 ($400,000). Additionally, an appropriation of $190,000 from the Measure °M" Fund is requested. Recommended Action: A) Accept the lowest responsive and responsible bid submitted by Golden State Constructors in the amount of $845,925; and, B) Appropriate $190,000 from the undesignated Measure "M" Fund (213) fund balance to Account 21390004.82300; and, C) Authorize the Mayor and City Clerk to execute a construction contract in a form approved by the City Attorney. Alternative Action(s): Reject all bids, or provide staff with alternative direction. Analysis: The Americans with Disabilities Act (ADA) requires that cities provide facilities and programs that are City of Huntington Beach Page 1 of 2 Printed on 11/12/2020 powerel*LegistarTIA File #: 20-1981 MEETING DATE: 11/16/2020 accessible to individuals with disabilities. Some of Huntington Beach's street intersections and crossings require curb access ramps to comply with ADA.requirements. Additionally, ADA requires that when a construction project occurs, the area within that project is updated to meet the current standards. This project consists of installing ADA compliant curb ramps predominately in Maintenance Zone 3, where the City's annual pavement maintenance project has identified streets to overlay with new asphalt. Bids were publicly opened on October 27, 2020, with the following results: BIDDER'S NAME ID AMOUNT Golden State Constructors 845,925 Nobest, Inc. 911,600 Kalban, Inc. 1,208,200 Horizons Construction Company Int'I, Inc. 1,229,888 CJ Construction 1,257,400 FS Contractors, I nc. 1,291,400 Vido Samarzich, Inc. 1,317,300 Ifaro Communication Construction, Inc. 1,330,500 Gentry General Engineering, Inc. 11,370,556 Hardy and Harper, Inc. P1,430,598 Golden State Constructors has successfully completed similar projects to this one in the past. Therefore, staff recommends awarding a contract to Golden State Constructors in the amount of $845,925. The total cost of the project is approximately $990,000. This total includes the construction contract, a ten percent (10%) construction contingency, and supplemental expenses for labor compliance and inspection. The engineer's estimate for this project was $950,000. Environmental Status: The project is categorically exempt pursuant to Class 1, Section 15301(c) of the California Environmental Quality Act. Strategic Plan Goal: Enhance and maintain infrastructure Attachment(s): 1. Vicinity Map City of Huntington Beach Page 2 of 2 Printed on 11/12/2020 powered LegistarTM �o 0 u~i Sq� � �j co BOLSA AVE. FC O NTS N = McFADDEN N AVE. Z U E*I ER AVE. 0 F0 a m a HEIL AVE. o' o WARNER AVE. m w o Q =SLATER AVE. 405 Z cn 0 A N Z TAL ERT AVE. ui 0 ELLIP AVE. GARFIELD : Q AVE. \ W m 2 U~j RD � ~ � 424 425 JE ORKTO AVE. C0 �� � � RD RD qS 1 � �� N � ADAMS Ld 434 435 N AVE. N, RD RD U) CF INDIANAPOLIS C444 445 AVE. _ PROJECT LOCATION �`'Y o J 0 o CURB RAMP INSTALLATIONS INCLUDE A LANTA z z_= AVE. x REPORTING DISTRICT'S (RD) 424, 425, 434, �C w Q 435, 444, 445 Fq,L z � m HAMILTON AVE. BANNING LEGEND AVE. RD BOUNDARY ZONE 3 RESIDENTIAL CURB RAMP PROJECT PROJECT LOCATION MAP ejj CITY OF HUNTINGTON BEACH � DEPARTMENT OF PUBLIC WORKS 1 OF 1 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For RESIDENTIAL CURB RAMP PROJECT in the CITY OF HUNTINGTON BEACH OCTOBER 20, 2020 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) SHEET Al OF PROJECT SPECIFICATIONS Bids will be received from 1:00 PM to 2:00 PM only on the bid due date(10/27/2020)outside of the City Hall main entrance at 2000 Main St. in Huntington Beach. Staff will be present during this hour to receive bids only. Mailed bids are still accepted but must be received before the bid submission deadline. It in encouraged that bidders arrive earlier than normal to drop off bids to avoid a late delivery. Bids will be opened outside of City Hall immediately after 2:00 PM. Bidders are welcome to stay and attend the opening. Social distancing measures shall be observed and masks will be required for all in attendance.This update to the Notice Inviting Sealed Bids shall supersede all other bid delivery information noted on the project documents.A revised NISB is now included with the project documents. This is to acknowledge receipt and review of Addendum Number One, dated October 20, 2020 Company Name By Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. SECTION A NOTICE INVITING SEALED BIDS for the construction of RESIDENTIAL CURB RAMP PROJECT CC No. 1620 in the CITY OF HUNTINGTON BEACH PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated project and will receive such bids immediately outside of the Huntington Beach City Hall between 1:00 and 2:00 PM on October 27, 2020. Bids will be publicly opened outside of the Huntington Beach City Hall immediately after 2:00 PM. Bidders are welcome to attend the bid opening. Social distancing measures will be observed and face coverings will be required for all in attendance. Copies of the Plans, Specifications, and contract documents are available from the Office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648, upon payment of a $10.00 nonrefundable fee if picked up, or payment of a$30.00 nonrefundable fee if sent by UPS ground delivery(bidder shall pay additional costs for special delivery). Plans, Specifications, and contract documents can be downloaded free on AGENCY website at: hqp://www.huntinglonbeachca.gov/govemment/departments/public works/Bids/ Open website,then click on"Current Advertised Projects"tab. This is a Davis-Bacon project and the Federal Regulations will be enforced. Any contract entered into pursuant to this notice will incorporate the provisions of the Federal Labor Standards, which are on file at the office of the Director of Public Works,2000 Main Street, Huntington Beach,CA 92648. The AGENCY will deduct 5% retention from all progress payments. The Contractor may substitute an escrow holder surety of equal value to the retention in accordance with the provisions of the Public Contract Code,Section 10263. The Contractor shall be beneficial owner of the surety and shall receive any interest thereon. The AGENCY hereby affirmatively ensures that minority business enterprises will be afforded full opportunity to submit bids in response to this notice and will not be discriminated against on the basis of race, color, national origin, ancestry, sex, or religion in any consideration leading to the award of contract. No bid shall be considered unless it is prepared on the approved Proposal forms in conformance with the Instructions to Bidders as determined by the AGENCY. The bid must be accompanied by a certified check, cashier's check, or bidder's bond made payable to the AGENCY for an amount no less than 10% of the amount bid. The successful bidder shall be licensed in accordance with provisions of the Business and Professions Code and shall possess a State Contractor's License Class A at the time of award. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. All extension of unit prices will be subject to verification by the AGENCY. In case of a variation between the unit price and the extension, the unit price will govern. Project Description: This project will provide the construction of curb access ramps and truncated domes to existing ramps throughout the city. These locations are prioritized from a list compiled by Public Works staff, based on requirements for the upcoming residential pavement management project and public requests. The proposed locations are listed in the Appendix along with Contractor guidelines and provisions to meet all Federal requirements. The contract shall allow the Contractor 60 working days to complete the contract. The Project Disadvantage Business Enterprises (DBE) goal is 9% The AGENCY reserves the right to reject any or all bids, to waive any irregularity and to take all bids under advisement for a maximum period of 60 days. BY ORDER of the CITY COUNCIL of the CITY OF HUNTINGTON BEACH, CALIFORNIA, the 29th day of June 2020, by Resolution No. 2020-39. Attest: /s/Robin Estanislau CITY CLERK OF THE CITY OF HUNTINGTON BEACH SECTION A NOTICE INVITING SEALED BIDS for the construction of RESIDENTIAL CURB RAMP PROJECT CC No. 1620 in the CITY OF HUNTINGTON BEACH PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated projects and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California 92648, up to the hour of 2:00 PM on October 27, 2020. Bids will be publicly opened in the Council Chambers unless otherwise posted. Copies of the Plans, Specifications, and contract documents are available from the Office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648, upon payment of a $10.00 nonrefundable fee if picked up, or payment of a $30.00 nonrefundable fee if sent by UPS ground delivery (bidder shall pay additional costs for special delivery). Plans, Specifications, and contract documents can be downloaded free on AGENCY website at: http://www.huntingtonbeachca.y,ov/govemment/departments/public works/Bids/ Open website,then click on"Current Advertised Projects"tab. This is a Davis-Bacon project and the Federal Regulations will be enforced. Any contract entered into pursuant to this notice will incorporate the provisions of the Federal Labor Standards, which are on file at the office of the Director of Public Works,2000 Main Street, Huntington Beach, CA 92648. The AGENCY will deduct 5% retention from all progress payments. The Contractor may substitute an escrow holder surety of equal value to the retention in accordance with the provisions of the Public Contract Code,Section 10263. The Contractor shall be beneficial owner of the surety and shall receive any interest thereon. The AGENCY hereby affirmatively ensures that minority business enterprises will be afforded full opportunity to submit bids in response to this notice and will not be discriminated against on the basis of race, color, national origin, ancestry, sex, or religion in any consideration leading to the award of contract. No bid shall be considered unless it is prepared on the approved Proposal forms in conformance with the Instructions to Bidders as determined by the AGENCY. The bid must be accompanied by a certified check, cashier's check, or bidder's bond made payable to the AGENCY for an amount no less than 10% of the amount bid. The successful bidder shall be licensed in accordance with provisions of the Business and Professions Code and shall possess a State Contractor's License Class A at the time of award. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. All extension of unit prices will be subject to verification by the AGENCY. In case of a variation between the unit price and the extension, the unit price will govern. Project Description: This project will provide the construction of curb access ramps and truncated domes to existing ramps throughout the city. These locations are prioritized from a list compiled by Public Works staff, based on requirements for the upcoming residential pavement management project and public requests. The proposed locations are listed in the Appendix along with Contractor guidelines and provisions to meet all Federal requirements. The contract shall allow the Contractor 60 working days to complete the contract. The Project Disadvantage Business Enterprises (DBE) goal is 9% The AGENCY reserves the right to reject any or all bids, to waive any irregularity and to take all bids under advisement for a maximum period of 60 days. BY ORDER of the CITY COUNCIL of the CITY OF HUNTINGTON BEACH, CALIFORNIA, the 29th day of June 2020,by Resolution No. 2020-39. Attest: /s/Robin Estanislau CITY CLERK OF THE CITY OF HUNTINGTON BEACH Switzer, Donna From: Christine Gonzalez <cgonzales@scng.com> Sent: Thursday, October 1, 2020 3:02 PM To: Switzer, Donna Subject: Re: NISB CC No. 1620 Attachments: 11415709.pdf Cost $1,391.00, pub HB Wave 10/8, 10/15, 10/22. Legal Advertising Chrissy Gonzalez 2190 S. Towne Centre Place, Suite 100 Anaheim, CA 92806 714-796-6736 M-F 8:00 a.m. - 4:30 p.m. Closed Sat. and Sun. On Thu, Oct 1, 2020 at 10:55 AM Switzer, Donna<Donna.Switzerksurfcityjhb.org>wrote: Hi Chrissy, Please publish the attached Notice Inviting Sealed Bids for CC No. 1620, in The Wave, on October 81h, 151h and 22°d, 2020. Thank you! D0vw1,WSwit';wx, CMC Deputy City Clerk - City of Huntington Beach 2000 Main Street - Huntington Beach, CA 92648 (714)374-1649 i SECTION A NOTICE INVITING SEALED BIDS for the construction of RESIDENTIAL CURB RAMP PROJECT CC No. 1620 in the CITY OF HUNTINGTON BEACH PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH,as AGENCY,invites sealed bids for the above stated projects and will receive such bids in the office of the City Clerk,Second Floor,2000 Main Street, Huntington Beach,California 92648, up to the hour of 2:00 PM on October 27, 2020. Bids will be publicly opened in the Council Chambers unless otherwise posted. Copies of the Plans,Specifications,and contract documents are available from the Office of the Director of Public Works,2000 Main Street, Huntington Beach,CA 92648, upon payment of a$10.00 nonrefundable fee if picked up,or payment of a$30.00 nonrefundable fee if sent by UPS ground delivery (bidder shall pay additional costs for special delivery). Plans, Specifications,and contract documents can be downloaded free on AGENCY website at: hftp://www.huntingfonbeachca.gov/government/departments/public works/Bids/ Open website,then click on"Current Advertised Projects"tab. This is a Davis-Bacon project and the Federal Regulations will be enforced. Any contract entered into pursuant to this notice will incorporate the provisions of the Federal Labor Standards,which are on file at the office of the Director of Public Works,2000 Main Street, Huntington Beach,CA 92648. The AGENCY will deduct 5% retention from all progress payments. The Contractor may substitute an escrow holder surety of equal value to the retention in accordance with the Provisions of the Public Contract Code, Section 10263. The Contractor shall be beneficial owner of the surety and shall receive any interest thereon. The AGENCY hereby affirmatively ensures that minority business enterprises will be af- forded full opportunity to submit bids in response to this notice and will not be discriminated against on the basis of race,color,national origin,ancestry,sex,or religion in any consider- ation leading to the award of contract. No bid shall be considered unless it is prepared on the approved Proposal forms in conform- ance with the Instructions to Bidders as determined by the AGENCY.The bid must be ac- companied by a certified check, cashier's check, or bidder's bond made payable to the AGENCY for an amount no less than 10%of the amount bid. The successful bidder shall be licensed in accordance with provisions of the Business and Professions Code and shall pos- sess a State Contractor's License Class A at the time of award. The successful Contractor and his subcontractors will be required to possess business li- censes from the AGENCY. All extension of unit prices will be subject to verification by the AGENCY. In case of a variation between the unit price and the extension,the unit price will govern. Proiect Description: This project will provide the construction of curb access ramps and truncated domes to existing ramps throughout the city.These locations are prioritized from a list compiled by Public Works staff, based on requirements for the upcoming residential Pavement management project and public requests.The proposed locations are listed in the Appendix along with Contractor guidelines and provisions to meet all Federal require- ments. The contract shall allow the Contractor 60 working days to complete the contract. The Project Disadvantage Business Enterprises(DBE)goal is 9% The AGENCY reserves the right to reject any or all bids,to waive any irregularity and to take all bids under advisement for a maximum period of 60 days. BY ORDER of the CITY COUNCIL of the CITY OF HUNTINGTON BEACH,CALIFORNIA, the 29th day of June 2020,by Resolution No.9020_39. Attest: /s/Robin Estanislau CITY CLERK OF THE CITY OF HUNTINGTON BEACH Published Huntington Beach Wave Oct.8,15,22,2020 11415709 '.. CITY OF HUNTINGTON BEACH PUBLIC WORKS DEPARTMENT 2000 Main Street P . O Box 1 90 Huntington Beach , CA 92 64 8 LETTER OF TRANSMITTAL Fax (714) 374-1573 Attention: Robin Estanislau Date: October 1, 2020 To: City Clerk Project/C.C. No.: CC No. 1620 2000 Main Street Regarding: RESIDENTIAL CURB RAMP PROJECT Huntington Beach. CA 92648 ® We are sending you: ❑ By Mail ❑ By Fax Mail(Number of pages including this sheet ❑ We are hand delivering: ❑ Attached ❑ Under a separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change Order ❑ Other: Item# I Copies I Pages I Description 1 1 2 NOTICE INVITING SEALED BIDS FOR CC NO. 1620 RESIDENTIAL CURB RAMP PROJECT These are transmitted as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ® For your action ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For reviewlcomment ❑ Other: Remarks: Per Resolution 2020-39 (adopted on 6/29/20), the City Council authorized the advertisement of the above listed residential curb ramp project. Please find the attached Notice Inviting Sealed Bids for advertisement on 10/8/20, 10/15/20, and 10/22/20. The bid opening is scheduled for October 27, 2020 at 2:00 PM in the City Council Chambers. Please note, if City Hall is not yet open to the public we will issue an addendum and change the bid delivery instructions. If you have any questions regarding the enclosed attachment, feel free to contact me at gabriel.munozmorrisna surfcity-hb.org or(714) 375-8444. cc: file By: Gabrie M orris,PE,Associate Civil Engineer N �AeAal Curb Qavvy CC N0. 1�020 2: DoFr� CITY OF HUNTINGTON BEACH PROJECT NAME: Residential Curb Ramp Project CC#: CC 1620 BID OPENING DATE: 10/27/2020 TIME & LOCATION: 2:00 PM I Outside City Hall ENGINEER'S ESTIMATE: $700,000.00 BIDS SUBMITTED (AS READ AT OPENING) BIDDER'S NAME FINAL APPARENT BID RANK AMOUNT All Amedcirt Asphalt 5. CJ`Constructlon S UV EBS General Engineering,Inc. K FS Contractors Inc. f? N ^ TD"hD a k Golden State Constructors t f Hardy&Harper, Inc, cu K Horizons Construction Company Inl'I Inc. L ` IE General Engineering Inc, Kal.ban Inc. J 0� %+ MBC Enterprises Inc. Nationwide.General I Construction Services x Nobest, Inc. Onyx Paving Company, Inc. PCN#, Inc. Vido Samarzich, Inc. , ' , omw►+n� i PTS 10022019 Version 15 CC1620.xlsx UNSUCCESSFUL BIDS CC - 1620 Residential Curb Ramp Project City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ Naivw.huntingtonbeachca.gov Office of the City Clerk Robin Estanislau, City Clerk April 23, 2021 Alfaro Communications Construction, Inc. 15614 S. Atlantic Ave. Compton, CA 90221 RE: Residential Curb Ramp Project —CC No. 1620 Enclosed please find your original bid bond for CC-1620. Sincerely, Robin Estanislau, CIVIC City Clerk RE:ds Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand SECTION C PROPOSAL for the construction of RESIDENTIAL CURB RAMP PROJECT CC No. 1620 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 aworking 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. Vat such time the contract is not awarded, the AGENCY will reject all bids and will re-advertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-I If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option,be considered null and void. d 11 Accompanying this proposal ofbid, find R Bo1n in the amount of /00 1 awhich said amount is not less than I Mo 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: I ddenda .ti'o. Date Received idder'%Sign t C-2 SECTION C PROJECT BID—SCHEDULE A CURB RAN'IP PROJECT, CC 1620 BID ITEMS Item Description Quantity Unit Unit Cost Total Cost No. (Extension) 1 Mobilization 1 LS 3900 S 3900 2 Prepare Storm Water Pollution Prevention Plan(SWPPP) 1 LS 19�0 1950 3 Install& Maintain Construction BMPs 1 LS 3000 3000 Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb rutting machine as shown on 4 Curb Ramp Detail 1 in Appendix H of Specifications (Item 109 includes all appurtenances,curb&gutter, depressed curb, 5000 545000 sawcut, sidewalk,domes, retaining curb, etc.) EA $ Construct Curb Access Ramp per Caltrans Std. Plan A88A as shown on Curb Ramp Detail 1 in Appendix H of Specifications 17 5 (Item includes all appurtenances, curb&gutter, depressed curb, sawcut,sidewalk, domes, retaining curb, slot pave, etc.) EAS 5000 S 85000 Horizontal Curb Cut Curb Access Ramp per Caltrans Sod. Plan A88A using horizontal curb cutting machine as shown on 2 6 Curb Ramp Detail 2 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter, depressed curb. 900p 18000 sawcut, sidewalk,domes, retaining curb,etc.) EA S Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 7 Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances. curb&gutter,depressed curb, sawcut, sidewalk,domes, retaining curb, etc.) 30 EA S 5000 S 15000 Construct Curb Access Ramp per Caltrans Std. Plan A88A as 8 shown on Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter,depressed 72000 curb, sawcut, sidewalk,domes, retaining curb, slot pave, etc.) 8 EA S 9000 S 9 Install truncated domes to existing Curb Ramp 10 EA $ 300 S Moo Install 4" PVC Sleeve for Street Assembly Sign per City of HB 10 Std. Plan 401 10 EA S 195 S 1950 11 Remove and replace existing sidewalk per City of HB Sid. )0 10000 Plan 207. (Allowance) 1,000 SF S S Remove and replaces existing 6"or 8" Curb and Gutter per 12 HB Std. Plan 205(Item includes all appurtenances,slot pave, 16500 etc.). (Allowance) 300 LF S 5 S SUB-TOTAL BID AMOUNT (SCHEDULE A) $ 910,300.00 C-2.1 SECTION C PROJECT BID—SCHEDULE A CURB RAMP PROJECT, CC I620 SUB-TOTAL BID AMOUNT IN WORDS: Nine hundred and ten thousand, three hundred Dollars Note: All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern. The Owner reserves the right to reject any or all proposals and bid items. In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract. C-2.2 SECTION C PROJECT ADDITIVE. RID— SCHEDULE 13 CURB RAYIP PROJECT, CC 1620 BID ITENIS Item Description Quantity Unit Unit Cost Total Cost No. (Extension) Horizontal Curb Cut Curb Access Ramp per Caltrans Sid. Plan A88A using horizontal curb cutting machine as shown on 1 Curb Ramp Detail 1 in Appendix H of Specifications (Item 40 includes all appurtenances, curb&gutter, depressed curb. �000 200000 sawcut, sidewalk,domes, retaining curb, etc.) EA $ $ Construct Curb Access Ramp per Caltrans Sid. Plan A88A as 3 2 shown on Curb Ramp Detail 1 in Appendix H of Specifications 27000 (Item includes all appurtenances, curb&gutter, depressed 9000 curb, sawcut, sidewalk, domes, retaining curb,slot pave, etc.) EA S S Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 3 Curb Ramp Detail 2 in Appendix H of Specifications (Item 3 includes all appurtenances, curb&gutter,depressed curb, 5000 15000 sawcut, sidewalk, domes, retaining curb, etc.) EA a $ Horizontal Curb Cut Curb Access Ramp per Caltrans Sid. Plan A88A using horizontal curb cutting machine as shown on 4 Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter,depressed curb, 5000 85000 sawcut, sidewalk, domes, retaining curb, etc.) 17 EA S S Construct Curb Access Ramp per Caltrans Std. Plan A88A as 5 shown on Curb Ramp Detail 3 in Appendix H of Specifications $1000 (Item includes all appurtenances, curb&gutter,depressed 9(100 curb, sawcut, sidewalk, domes, retaining curb, slot pave, etc.) 9 EA S S 6 Install truncated domes to existing Curb Ramp 9 EA I S 000 S 2700 7 Remove and replace existing sidewalk per City of HB Sid, 4000 Plan 207. (Allowance) 400 SF S 10 S 5500 Remove and replaces existing 6'or 8-Curb and Gutter per 8 HB Std. Plan 205(Item includes all appurtenances, slot pave, etc.). (Allowance) 100 LF S $ SUB-TOTAL ADITIVE BID AMOUNT (SCHEDULE B) $ 420,200.00 SUB-TOTAL ADDITIVE BID AMOUNT IN WORDS: Four hundred and twenty thousand ,two hundred Dollars Note: All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern. The Owner reserves the right to reject any or all proposals and bid items. In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract. C-2.3 SECTION C PROJECT BID SCHEDULE TOTALS RESIDENTIAL CURB RAMP PROJECT CC 161N S910.300.00 Sub-Total Bid - Schedule A Sub-Total Additive Bid - Schedule B $420.200.00 TOTAL BID AMOUNT, BASIS OF AWARD (Schedules A+B) 1.330.500.00 TOTAL BID AMOUNT IN WORDS: one million, three hundred thirty thousand, five hundred Dollars Notes: All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern. The Owner reserves the right to reject any or all proposals and bid items. In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract. C-2.4 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Bid Name and Address of State Class DIR I'NN C Dollar % of Item(s) Subcontractor License Registration amount Contract 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 famished 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 01111 at ,_ Date o6 State O u rph t A atwl, n,.Z , being first duly swom, deposes and says that he or she is —� of aiC,- rGW*' i,(Is„-c .1+.-4k11e part' making the foregoinj bid that the bid is not made in the interest of,or on the behalf of,any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further,that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof,or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization,bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Name of Bidder M &,A o, k4aL L-uZ Si ature of Bidde Is 6I 4 S Rt44� (\ hr, CA,t,z1l Address of Bidder C4 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 RESIDENTIAL CURB RAMP PROJECT, (I)(wexit) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, isfamiliar with the operation to be performed and the hazards involved." The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal-OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. l Contractor By Title Date: l o — 2 3 -7�i 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? D Yes 940 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. 1 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. P� ` W VV-,l—N, (A .,m,A C4\ASCYItiIok yriC Contractor By v - P�e�; dam Title Date: C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: A� Ash QV%A%hU ja-i � ►c Cs 61, V Bidder Name I561 u Business Address Can,to 6 r. CA 9 o tz I Crt�� State Zip (310 ) d6g_ auq ha%d ; .ac( -t&Dar►,od( Ps., Telephone Number Email Address —t 912.:a7 -A . CA ex,Ss : P l C� i Can �C Z —1 State Contractor's License No. and Class 3 _ -2 o _ Ztan$ Original Date Issued S — 3 � -2 0 2L Expiration Date The work site was inspected by our office on k a _7L 20E.6 The following are persons firms, and corporations having a principal interest in this proposal: M ar..�.:,-t�Z: y • �es�d a..F , Se c.r�1,�,r.f 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. L 1 f�� ,OLo Company Name Signa f BiddeV C-8 YI/ 9 1 &4 l/I /AN r1 NC-Z Printed or Typed Signature NOTARY CERTIFICATE Subscribed and swom to before me this,2�day of Qc/y i e., 20A10. 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 C;/ n/,Fon ., ) County of Los At"ae s ) / On /V /o`f /aV 1'a before me, P9v10 Mi, u Z— /✓v ow /i.//,C- Month, Day, and Year n �n Insert Name and Title of Notary personally appeared !'►'/AV '614 /V//�. ,e-L Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(y) whose nameJ, is/afe subscribed to the within instrument and acknowledged to me that pdshe/tJky executed the same in 4igfher/lhprf authorized capacity(*T and that by l 4her/t�err signatureV#ron the instrument the person(K, or the entity upon behalf of which the personf 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. DAVID HUM WITNESS my hand and official seal. COMM. 42286651 z Ir i Notary Public.Ca1ilania o Los AnOn Cam Comm.f� fires 2023 Signatur g re of Notary Public (PLACE NOTARY SEAL ABOVE) C-9 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, "Demolition of existing concrete ADA ramps anti construction of new ADA compliant curb ramps. Work included additional curb and putter construction to ensure surface water flow around corner. All ramps met Caltrans requirements set forth in Standard Plan A88A"', 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 live years: DISTRICT 8 rc 08-OR3014R 73800 Dinah Shore.Palm Desert. Ca 9221 1 Name and Address of Public Aaencv Name and Telephone No. of Project Manager: DIKE. CHIGOZIE (951)-232-8642 8772.853.40 CONSIRIILLS, RFCONSTRIICTCIIRR RAMPS 05/31/19 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: CONSTRUCT S RFCONSTRI ICf CI IRR RAMPS Caltrans (12-0i\44804) 6533 Marine Way. Irvine . CA 92626 Name and Address of Public Agency Name and Telephone No. of Project Manager: Moussa Essayli 949-279-8816 nioussa.essayli@dot.ca.gov dot.ca.gov S I.1 54.104.60 2/10/2020 Place minor concretc.Curb ramp and sidewalk Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Place minor concrete.Curb ramp and sidewalk City of l-luntington Beach-(Traffic Signal Modifications at Gothard St. &, Talbert Avc.) 2000 Main �• Slrrrt 1-fun6noinn Reach CA 9')04R Name and Address of Public Agenev Name and Telephone No. of I roject Manager: Joseph Fuentes 714-536-5259 5368.461.50 6/4/2018 .Curb & GutteeConstntct Curb Access Ramps Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Traffic Signal Modifications ,Curb X Gutter.Construct Curb Access Ramps.Concrete nn- at rpthoreand Tnlhen Avemie C-10 Bidder's Critical Staff Listed below are the names of-the bidders proposed Construction Project Managcr. and Superintendent. For each of these critical positions. please list at least three projects for which the critical staffhas performed similar work within the last five years. These projects do not have to be under the employment of the bidder of this project. Bidders are encouraged submit supplemental relevant project history in addition to the projects listed herein. I. Jamal Dcaoufi Name of proposed Project Manager Telephone No. of proposcd Projcct Manager: 714-240-9272 traffic Signal Modifications at Gothard St. & Talbert Ave.S368.461.50 Curb & Gtltter.GOnStrUCI rnrh ACcers Ratnps_1OLB Projcct Name & Contract Amount Type of Work bate Completed Caltrans (12-OM4804)SI.154.104.60 Place minor concretc,Curb ramp and sidewalk 2/10/2020 project Name & Contract Amount Type of Work Date Completed Caltrans 08-OR3014R CONSTRUCT & RF'CONSfRUCT CURB RAMPS 5772.853.40 05/31/19 Projcct Name & Contract Amount Type of Work Date Completed jose mendoza Nance of proposcd Superintendent "I"cicphone No. of proposcd Superintendent: 3239018606 traffic Signal i`loditications at Gothard St. & Talbert Avc.$368.461.50 Curb & Gutter.Construct Curb Access Ramps 2019 Projcct Name & Contract Amount "Type of Work Date Completed Caltrans (12-0\,14804)SI.154.104.60 Place minor concretc.Curb ramp and sidewalk 2/10/2020 Projcct Name & Contract Amount Type of Work Dale Completed Caltrans 08-OR3014R CONSTRUCT & RECONSTRUCT CUR13 RAMPS $772.853.40 05/31/19 Projcct Name & Contract Amount Type of Work Date Completed C-II 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 anew public works Contractor Registration Program,which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July I through June 30 state fiscal year) with the California Department of Industrial Relations(DIR).Currently the annual non-refundable registration fee for Contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 http://www.dir.c&gov/DLSE/Public Works/SB854FactSheet-6.30.14.pdf DIR's Contractor Registration Link—Call (844) 522-6734 https://efiling.dir.ca.gov/PWCR/ActionServiet?action=displayP WCRegistrationFonn DIR's Contractor Registration searchable database: https://efiling.dir.ca.gov/PWCR/Semh.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 fiuthermore 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. ALo mCADL^i k 1„c Contractor By a Cc,, of !AM 4.�^ Email \4. n Title Date: ` 0— 2 —o� o.Z t� / PWC Registration tt: ` 6 0 0 0 ` 2 3 b C-12 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low-Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager(initial the applicable selections): / ✓ Will ensure that 10%of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968;or Will hire no new employees in conjunction with this project. Will award 10%of its sub-contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub-contracts related to this project. Contractor ALG�irr, G„nnw.krn� CyF�o n t C�.cFsr �t �,pti• i�c --r Contact Person: Ao A'r Contact Phone: 3lu- — 8C1 LA Q Signed: Date: *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub- contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Precious non-compliance kith Section 3 could result in disqualification. c iz - - EXHIBIT A DISADVANTAGED BUSINESS .NT .RP ISE (DBE) This Project is subject to Part 200.321. Title 2, Code of Federal Regulations entitled "Contracting with Small and Minority Businesses. Women's Business Enterprises, and Labor Surplus Area Finns." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in Part 200.321, Title 2 CFR, shall be encouraged to participate in the performance of Contracts financed in whole or in part with federal funds.The Contractor should ensure that DBEs,as defined in Part 200.321, Title 2 CFR, have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps,as set forth in Part 200.321,Title 2 CFR, for this assurance. The Contractor shall not discriminate on the basis of race,color, national origin, or sex in the award and performance of subcontracts. Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project, although there is no specific goal for DBE participation. C-ta EXHIBIT B DBE INFORMATION—GOOD FAITH EFFORTS Federal-aid Project No. C—C � L Z b Bid Opening Date The City of Huntington Beach established a Disadvantaged Business Enterprise(DBE)goal of 9% for this Project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder DBE Commitment" form indicates that the bidder has met the DBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement W—a._. Cw� a i n Q E B. The names and dates of written notices sent to certified DBEs soliciting bids for this Project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested(please attach copies of solicitations,telephone records, fax confirmations,etc.): Names of DBEs Solicited Date of Initial Follow Up Methods Solicitation and Dates w a n," Cn... ' a-% 0 2 F C-ts vco/NLV UCP Web Application-List UP toto Main Back To QVW Form (iicenseForm ► tM) Search Returned 1 Records Query Criteria Tue Jan 28 10:19:59 PST 20; CertHicatlon Types: DBE Firm Name: Alfaro Communications construction Finn ID 48013 DBA Name ALFARO COMMUNICATIONS CONSTRUCTION INC. DBA ACCI Firm Name ALFARO COMMUNICATIONS CONSTRUCTION INC. DBA ACCI Address Linet 15614 S. ATLANTIC AVE. Address Une2 City COMPTON State CA Zip Code1 90221 Zip Code2 Mailing Address Line1 Mailing Address LIne2 Mailing City Mailing State Mailing ZIp Code1 Mailing Zip Code2 Certification Type DBE EMail mayra.acci@gmail.com Contact Name HUGO ALFARO Area Code 310 Phone Number 669-8949 Extension. Aft Area Code Aft Phone Number Extension Fax Area Code Fax Phone Number Agency Name LOS ANGELES COUNTY METRO TRANSPORTATION AUTHORITY (MTA) Counties 19; 30; 33; 36; 56; Districts 07; 08; 12; DBE NAICS 237130; 237310; 237990; 238210; 561730; ACDBE NAICS https l/ucp Aot.ca.9w1querySubrrut.htm imaco'U UCP Web Apppcatfon-List Work Codes C9867 LANDSCAPING CONTRACTOR; 03530 CONSTRUCTION & RELATED MACHINEM COMMUNICATIONS SERVICES; E4910 ELECTRIC SERVICES; Licenses A General Engineering Contractor; C07 Low Voltage Systems Contractor; C10 Electrical Cont Landscaping Contractor; Trucks Gender M Ethnicity HISPANIC Firm Type DBE httpsJ/ucp.dot.ca.goVIg uerySUbmit.htm 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 (YIN) Contract U-)t ..J D B D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firths 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: W `AMA CQ v t. O e E Names, addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: C-16 F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results H. Any additional data to support a demonstration of good faith efforts(use additional sheets if necessary): e- NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. C-17 11cwlv[v UCP Web APPfication-List 5-!S!p to Main Content Back To QUWorm F (iicenseFot-m htm) Search Returned 1 Records Query Criteria Tue Jan 28 10:19:59 PST 20, Certification Types: DBE Finn Name: Alfaro Communications construction Firm ID 48013 DBA Name ALFARO COMMUNICATIONS CONSTRUCTION INC. DBA ACCI Firm Name ALFARO COMMUNICATIONS CONSTRUCTION INC. DBA ACCI Address LIne1 15614 S. ATLANTIC AVE. Address Une2 Cfty COMPTON State CA Zip Code1 90221 ZIP Code2 Mailing Address LIne1 Mailing Address LIne2 Mailing City Mailing State Mailing Zip Code1 Mailing Zip Code2 Certtfication Type DBE EMail mayra.acci@gmail.com Contact Name HUGO ALFARO Area Code 310 Phone Number 669-8949 Extension Aft Area Code Alt Phone Number Extension Fax Area Code Fax Phone Number Agency Name LOS ANGELES COUNTY METRO TRANSPORTATION AUTHORITY (MTA) Counties 19; 30; 33; 36; 56; Districts 07; 08: 12; DBE NAILS 237130: 237310; 237990; 238210; 561730; ACDBE NAICS httpsPucp_dot.c gw/querySubmiLhtm U<acU'v UCP Web Application-List COMMUNICATIONS SERVICES; E4910 ELECTRIC SERVICES;Work Codes C9667 LANDSCAPING CONTRACTOR; D3530 CONSTRUCTION & RELATED MACHINEM Licenses A General Engineering Contractor; C07 Low Voltage Systems Contractor; C10 Electrical Cont Landscaping Contractor; Trucks Gender M Ethnicity HISPANIC Firm Type DBE https:H/ p-dOt-m,gOv/quary5ubmii.htm IF A SOLE OWNER OR SOLE CONTRACTOR SIGN HERE: (1) Name under which business is conducted (2) Signature (given and surname) of proprietor (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail IF A PARTNERSHIP, SIGN HERE: (1) Name under which business is conducted (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business (Street and Number) City and State (4) "Zip Code Telephone No. (5) E-Mail C-18 IF A CORPORATION, SIGN HERE:(1)Name under which business is conducted "AM Q)M&i5n11V%1 4 4%Drs (2) (Signature) v - ere-S ; Ae ,,1- (Title) �_ �,Im�1press Corporate Seal here (3) Incorporated under the laws of the State of a V%id\ Iy_ %.0M (4) Place of Business I S G 1 �1 �L®ee� c- P..,t_ mm, i CtL (Street and Number) City and State cc w..Pfo vt ,� C pt (5) Zip Code Q\ a 11. Telephone No. (6) E-Mail Tea[L r J %*,A�L • Q"%, NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED C-19 California All-Purpose Certificate of Acknowledgment Ftary public or other officer completing this certificate verifies only the identiTy of the individual who signed thment to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Los Angeles S.S. On 10/26/2020 before me, David Munoz - A Notary Public personally appeared Mayra Martinez r^e a'Spner.Ii who proved to me on the basis of satisfactory evidence to be the person(&rwhose names, is/subscribed to the within instrument and acknowledged to me that the/tpeyexecuted the same in hisser/tlieit'authorized capacityQp<and that by t1i8fher/theirsignature*ron the instrument the person(s�._or the entity upon behalf of which the person(%)-�cted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is DAVID AEUN02 true and correct. c coMM. #2286651 z Notary Public-Califomh i Los AmeWs Cw* WITNESS m and official seal. Comte. 23 W a .t OPTIONAL INFORMATION AI!hOUgh rhP❑1lprinanon!n ibis sELGOn is nOi ra0tn/C r:b_v lall' d CUnI(I D/BVCR(Ira U(!U/enr relnoVi]t nrlf/le8fr8Chnlenf O( V).S dehnGrJGCgmen!;r,.w,;a tdhor Ize(d docmna-w eod may Prove usehN fo persons relyrnu on in attacned ooeumw I! Description of Attached Document The preceding Certificate of Acknowledgment is attached to a Method of Signer Identification document titled/for the purpose of City of Huntington Beach- proved to me on the basis of satisfactory evidence: Residential Curb Ramp Project I CC No. 1620 ;f fonn(s)of identification ❑aedible witnesses) containing 31 pages, and dated 10/26/2020 Notarial event is detailed in notary journal on: The signer(s) capacity or authority is/are as: page n 1 9 entry a 6 - ❑ Individual(s) Notary contact: David Munoz ❑ Attomey-in-fact J Corporate Officer(s) Vice-President other (951) 722-7027 ❑ Additional Signer f Signer(s)Thumbprints(s) Alfaro Communications Construction Company XI On Notary Journal ❑ GuardianlConservator ❑ Partner-Limited/General ❑ Trustee(s) ❑ Other: representing: ?07c-.'r" tJpla'r IBa'^�c CeniC' AII R c'.•s Rese�x. You _an U"-O as, '•r5 br^' '11c' .Ivr s i•a' ::ea r-c L-•a•..��I✓r ' List below names of president, vice president, secretary and assistant secretary, if a corporation; if a partnership, list names of all general partners and managing partners: M a, ray t lU�- -7--. N C-20 EXHIBIT C LOCAL AGENCY BIDDER DBE COMMITMENT(CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE � SIDE FOF THIS FORM I LOCAL AGENCY: C a[�� HV`ww�NQfeY�/B�Vh LLOOCATION� 20- M1AwtG I,V�C PROJECT DESCRIPTION: l x. o TOTAL CONTRACT AMOUNT:s l 3� 0,-50D BID DATE: to — BIDDERSNAME: PIt.CrR_��pVUY1wU A-6 CC1/\S GALLS A 1 y"- Ol.\• ` .hL CONTRACT DBE GOAL: CONTRACT TEM OF WORK AND DESCRIPTION DBE CERT NO. NAME OF EACH DBE DOLLAR AMOUNT ITEM NO. SERVICES TO BE AND EXPIRATION (Must be cmifwd as the due bitla DBE UBCONTRACTED OR MATERIALS DATE w opr d-include DBE adAw 170 BE PROVIDED(or contrayed if The oil plaint numba) s a DBE) 4 q/3oD -r.+ J c, •IIZ Igwo CT a 1 A .I— ou -0 For Local Agency to Complete: Total Clamed DBE f 1 .3TOU I,xal Agency Contract Ntunber pMUCV� odrnl-aid Prgect Nomhi i Q 0 % ede al tihare t imt t Award Dak. ,.cal -%ii cy ccmfks that all 1)111 ccmlcattoas havc hecn scnftcd and information is complec ant eectuak tit of B l`Dak 1 r(Atm Code)Tr . Pnnt Name Sigtuttue Tim, .gt Q�ak` I oral Agatcy Repre esc erson n(-2 Plmae Type or Prot) Area Code)Tekpbooe Numbs: ;sal Agrncr BW&r DBI(tmmutnrta K onoucuem t ntanvi iRrt e]e 041 ( -21 PLEASE NOTE: This information may be submitted with your bid. If it is not, and you are the apparent low bidder or the second or third low bidder,it must be submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the constriction contract: Local Agency, Location, Project Description. Total Contract Amount. Bid Date, Bidders Name, and Contract DBE Coal. 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 (constriction contracts). to determine how to count the participation of DBE firths. Exhibit 15-G must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award, Federal-aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. C-22 EXHIBIT D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder [proposed subcontractor l hereby certifies that he/she/it has,l/, has not_, participated in a previous contract or subcontract subject to the Equal Opportunity clauses, as required by Executive Orders 10925, 11114,or 11246, and that, where required, he/she/it has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently, Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. (eeoc.gov/employers/eeolsurvey/index.cfin) Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Signature: > Date: Print Name: j� Title: t CA �YY V\. C-u EXHIBIT E NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) [NAME OF CONTRACT] To the City of Huntington Beach In conformance with Title 23 United States Code Section 112 and California Public Contract Code 7106 the bidder declares that the bid is not made in the interest of,or on behalf of,any undisclosed person,partnership,company,association,organization,or corporation;that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid,and has not directly or indirectly colluded,conspired,connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price,or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof,or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. By signing the Proposal, the Bidder has also signed this Noncollusion Affidavit. Bidders are cautioned that making a false Certification may subject the Bidder to criminal prosecution. Signature: Date: 1 — Z —2 U Print Name: \ I � Title: V. CAL T ✓tSL ✓` C-24 EXHIBIT F DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS, PART 29 The Bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated with Bidder in the capacity of owner,partner,director,officer, manager: • is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agency; • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted, convicted, or had a civil judgment rendered against him/her by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Note: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also co of this Certification. Signature: Date: 2� Print Name: , I L Title: �l Ylbt. C-25 EXHIBIT G NONL.OBBY NG CERT FI ATION FOR FEDERAL_ ID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief,that: 1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment,or modification of any Federal contract,grant, loan,or cooperative agreement. 2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than$100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Signature: Date: Print Name: tnQ.Z Title: Vt CL — reSt WYAT EXHIBIT H C-26 DISCL.OSURF OF L.OBBYLNG ACTIVITIF.3 COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 1. Report T-vpe: ®a.contract Ela bid oRaapphcalcm ® a,stein b gram b.mural award b Mwinl change, c.couperame agrtcrrimit c.post-award 11.loan For Materhd Change Only: r� e,k g year grans f Mum an m.wamccainawe date of last report a. Name and Address of Repordeg Entity S. If Reporting Entity la No.4 la Sobawardee, Enter Name and Address of Prime: 1 ❑Subawardcc Rp �yyS�4 .Tier ifkmwn vpsnl e— Vv 1T � � �O�tv�� CongressioPM District.ifknown s614 .flitlil!W � Congressional DiseriM M... N 1 6. Federal Deprdem/Ageacy: \��^I Federal Program NutlDesc r °a,,:`` n 1 'A CFDA Namber,ifapplicable NIT 11. Federal Acwa Namber,disown: 9. Award Amount.dkmwn: Nis WkA 10. a.Namr and Addrenof Lobby Eadty b. IadfvfdWs Performing Servkn (mcludmg Ilf WivdwL lau riarrie,firrt rune,MII address rfdiRereot from No.l0a) N \ (im name,first name,MI)) (attach('onbnwton Shxt(s)if nec `v essary) \ P 11. Amount of Payment(check all that apply) 13. Type of payment(check all that apply) S `y\ Aciwl ❑plamed a.reamer b.uric-brae ice IL Form of Payment(check W dam applyl: c.carmmssmrr ea cash , d.cmtmgmi let b.m-kmd, specify: name e deRrred vahic f oil=,specify 1 14. Brief Description of Services Performed or to be performed and DatNs)of Service,including oflicer(s).employee(s),or member(s)committed.for Psyment Indicated la Item 11: a\ \ (awch Cmtmwtim Sheet(s)ifneccasvy) �V IS. Condonation SYeet(s)attached: Yes O No Ik. Information requested t1wough that fwm is wtl weed by Title 31 U.S.C.Sectmo 1352. Thu disclosure of kibbymg rel®ce Sigmao won placed by the late above when has transaction was made or emend ram.Thu dwicanae is taloned purtsimt to 31 U S.C. Print Name. 1352. Thin information wig be reported to Congress sc ri mwlly and will be available for public tnapeclam. Any Tide. V(,c.L r e.aS ✓s person who fala m file the rapmed mxlosme shoo be rAjml --mo�tt� m a civil penalty of rimless&an S IOAW and not a mat than Teiephiew No.:36 -ill 4-30140 \ Date. — S 100,000 for each sicb failure. Authmzed for Local Reprodiaton Federal Use Only: Standard Form-1.1.1. Standard Form LLL Rev.09-12-97 C-27 INSTRUCTIONS FOR COMPLETION OF EXHIBIT H, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. section 1352. The filing of' a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Ottice 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. ) 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. C-28 12) Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13) Check the appropriate box(es). Check all boxes that apply. If other, specify nature. 14) Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s) or employee(s) contacted or the officer(s) employce(s) or Member(s) of Congress that were contacted. 15) Check whether or not a continuation sheet(s) is attached. 16) The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information. including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. By my signature on this proposal 1 certify, under penalty of perjury under the laws of the State of California, that the foregoing questionnaire and statements of Public Contract Code Sections 10162. 10232 and 10285.1 are true and correct and that the bidder has complied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5, Title 2 of the California Administrative Code). C-29 EXHIBIT 1 FEDERAL LOBBYING RESTRICTIONS Section 1352, Title 31, United States Code prohibits Federal funds from being expended by the recipient or any lower tier subrecipient of a Federal-aid contract to pay for any person for influencing or attempting to influence a Federal agency or Congress in connection with the awarding of any Federal-aid contract, the making of any Federal grant or loan, or the entering into of any cooperative agreement. If any funds other than Federal funds have been paid for the same purposes in connection with this Federal-aid contract, the recipient shall submit an executed certification and, if required, submit a completed disclosure form as part of the bid documents. A certification for Federal-aid contracts regarding payment of funds to lobby Congress or a Federal agency is included in the Proposal. Standard Form - LI..L, "Disclosure of Lobbying Activities,' with instructions for completion of the Standard Form is also included in the Proposal. Signing the Proposal shall constitute signature of the Certification. The above referenced certification and disclosure of lobbying activities shall be included in each subcontract and any lower-tier contracts exceeding $100,000. All disclosure forms. but not certifications, shall be forwarded from tier to tier until received by the Engineer. The Contractor, subcontractors and any lower-tier contractors shall file a disclosure form at the end of each calendar quarter in which there occurs any event that requires disclosure or that materially affects the accuracy of the information contained in any disclosure form previously filed by the Contractor, subcontractors and any lower-tier contractors. An event that materially affects the accuracy of the information reported includes: 1) A cumulative increase if$25,000 or more in the amount paid or expected to be paid for influencing or attempting to influence a covered Federal action;or 2) A change in the person(s) or individual(s) influencing or attempting to influence a covered Federal action; or 3) A change in the oflicer(s), employees(s), or Member(s) contacted to influence or attempt to influence a covered Federal Action. C-30 City of Huntington Beach Public Works Department 2000 Main Street Tel (714) 536-5431 Fax (714) 374-1573 ADDENDUM NUMBER ONE For RESIDENTIAL CURB RAMP PROJECT in the CITY OF HUNTINGTON BEACH OCTOBER 20. 2020 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) SHEET Al OF PROJECT SPECIFICATIONS Bids wil De received from 1 00 PM to 2 00 PM only on the bid due date(10/27/2020)outside of the City Hall main entrance at 2000 Main St in Huntington Beach Staff will be present during this hour to receive bids only Mailed bids are still accepted but must be received before the bid submission deadline It in encouraged that bidders arrive earlier than normal to drop off bids to avoid a late delivery Bids wall be opened outside of City Hall immediately after 2 00 PM Bidders are welcome to stay and attend the opening Social distancing measures shall be observed and masks will be required for all in attendance This update to the Notice Inviting Sealed Bids shall supersede all other bid delivery information noted on the project documents A revised NISB is now included with the project documents This is to acknowledge receipt and review of Addendum Number One, dated October 20, 2020 --') Alfaro Communications Construction,Inc Company Name By 10/22/2020 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. No. 5082-3 STATE OF CALIFOFL\IA DEPARTMENT OF INSURANCE SAN FRANCISCO Amended Certificate of Authority THIS IS TO CERTIFY that,pursuant to the Insurance Code of the State of Cul Jornia, Endurance Assurance Corporation of Delaware, organized under the laws of Delaware, subject to its Articles of Incorporation or other fundamental organizational documents. is hereby authorized to transact within this State, subject to all provisions of this Certificate, the fnllmvfng clusws of insurance. Fire,Marine,Surety, Disability,plate Glass, Liability,Workers' Compensation, Common Carrier Liability, Boiler and Machinery,Burglary,Credit, Sprinkler,Team and Vehicle,Automobile,Aircraft,and Miseellaneous as such classes are now or may hereafter be defined in the Insurance laws of the.State of California. 'IBIS CERTIFICATE is expressly conditioned upon the holder hereof now and hereafter being in full compliance with all, and nor in violation ofanv, of the applicable laws and laaful requirements made under authority of the laws ofthe Stare of California as long as such haws or requirements are in effect and applicable, and as such laws and requirements now are, or may hereafter be changed or amended. IN WITNESS WHEREOF, effective as of the 23'd day of August. 2016, 1 have hereunto set niv hand and caused my official seal to be a,fixed this 23'd do)-of August. 2016. Dave Jones raa.an«cwrmnsoae. .� By Carol Fmir for Joel Iaucher Chwf ctepn NOTICE: Qualification with the Secretary of State must be accomplished as required by the California Corporations Code promptly after issuance of this Certificate of Authority. Failure iodo so will be a violation oflnsurwnce Code section 701 and will be grounds for revoking this Certificate of Authority pursuant to the covenants made in the application therefor and the conditions contained herein. °AIA Document A310TM - 2010 Bid Bond Bid Bond No:N/A CONTRACTOR: SURETY: (Nome. (cr;al.vuous and orldr'essj (Aranre, legal counts and principal plate Alfaro Communications Construction, Inc. o(husLlecrj Endurance Assurance Corporation 15614 S. Atlantic Ave. 4 Manhattanville Road Campton, CA 90221 Purchase, NY 10577 This document has important legal consequences.Consultation with OWNER' an attorney is encouraged with (Nmue. legal st,offs and address) respect to its completion or City of Huntington Beach modification. 2000 Main St. Any singular reference to Huntington Beach, CA 92648 Contractor,Surety.Owner or BOND AMOUNT:Ten Percent of theTotal Amount Bid(10%of Bid Amount) other party shall be considered .. plural where applicable. PROJECT: Residential Curb Ramp Project (.fame, location or address, and Project number, ifeinl'1 ['reject Number,if any:CC No, 1620 The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety hind themselves.their heirs,executors,administrators,successors and assigns.joindy 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 thejurisdiclion of the Project and othcnrise 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 it)the Owner the .. difference,not to exceed the amoum of this Bernd,between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with[mother party to perform the work covered by said hid,then this obligation shah be null and void,ofhcnvise to remain in fill force and effect.'I he Surely 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 aggrcgmc 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(66)days. I f 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 he Contractor. "'bell this Bond tins 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 decried deleted heicfrcm and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished;the intent is that this Bond shall be construed as a statutory hand and not as a common hov hood. Signed and scaled this 26th day of October 2020 Alfaro Communications Construction,Inc. (Principal (Witness) V-1-L$ 7p cl Endurance Assurance_ oratio (Suratt' cafJ (WifneCs) (Title) Irene Lilupng, Attor a in-F AIA Document A310"-2010.Copyright O 1%3,1970 and 2010 by The Amerean Institute df Architects.All rights reserved.WARNING:This At A` Init. Document is protected by U.S.Copyright Law and International Tr ies.Unauthorized reproduction or distribution of this AIA'Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under this law.'rnrs t document was created on 01272012 07.23:12 under the terms of AIA Documents-On-Demand"'older ne. 30063974e3,and is not to msala.This tlocumenl is licensed by The Amencon Ineutula of Architects for one-eme use only.and may not be reproduced mart In its cannleuon.ren,n 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 Li- I 2 0 _7 i�U before me, Robyn R. Kargari Notary Public, Date Insert Name of Notary exactly as it appears on the official seal personally appeared Irene Luong Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) 'l E•°••�E ROBYN R.KARGARI acted, executed the instrument. COMM. # 2296844 XI certify under PENALTY OF PERJURY under the laws of NOTARY PUBLIC-CALIFORNIA X `- ORANGE COUNTY N the State of California that the foregoing paragraph is true MY COMM.EXP.JULY 13,2027 IQ and correct. Witness my hand a Ial seal. Signature � Place Notary Seal Above Si tur otary ublic'-Robyn R. I argan OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of the form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer—Title(s): ❑ Corporate Officer —Ttle(s): ❑ Partner ❑Limited (--]General ❑ Partner ❑Limited❑General ❑ Attorney in Fact •• ❑ Attorney in Fact M. ❑ Trustee • Lew,•• ❑ Trustee • ❑ Guardian or Conservator Top of thumb here ❑ Guardian or Conservator Top of thumb here ❑ Other: ❑ Other. Signer is Representing: Signer is Representing: �W SOMPO INTERNATIONAL POWER OF ATTORNEY 1043 KNOW ALL BY THESE PRESENTS, that Endurance Assurance Corporation, a Delaware corporation, Endurance American Insurance Company, a Delaware corporation, Lezon Insurance Company, a Texas corporation, andfor Bond Safeguard Insurance Company, a South Dakota corporation, each, a -Company' and collectively,'Sompo International'do hereby constitute and appoint:YUNG T.MULLICK,JAMES W.MOILANEN,IRENE LUONG,P.AUSTIN NEFF,EMILIE GEORGE as true and lawful Attorney(s)-In-Fact to make,execute.seal,and deliver for,and on its behalf as surety or cosurely;bonds and undertakings given for any and all purposes.also to execute and deliver on its behalf as aforesaid renewals,extensions,agreements,waivers,consents or stipulations relating to such bonds or undertakings provided however,that no single bond or undertaking so made,executed and delivered shall obligate the Company for any portion of the penal sum thereof in excess of the sum of TEN MILLION Dollars(S10,000,000.00). Such bonds and undertakings for said purposes,when duly executed by said attorney(s)-in-tact,shall be binding upon the Company as fully and to the same extent as if signed by the President of the Company under its corporate seal attested by its Corporate Secretary. This appointment is made under and by authority of certain resolutions adopted by the sole shareholder of each Company by unanimous written consent effective the 15- day of June,2019,a copy of which appears below under the heading entitled'Certificate. This Power of Attorney is signed and sealed by facsimile under and by authority of the following resolution adopted by the sole shareholder of each Company by unanimous written consent effective the 15^day of June,2019 and said resolution has not since been revoked,amended or repealed: RESOLVED,that the signature of an individual named above and the seal of the Company may be affixed to any such power of attorney or any certificate relating thereto by facsimile,and any such paver of attorney or cedificate bearing such facsimile signature or seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. IN WITNESS WHEREOF, each Company has caused this instrument to be signed by the folloving officers,and its corporate seal to be affixed this 15' day of June,20t9. E`nd�rance Assurance CK.2sel Endurance American ///��Y Leaon Insurance Company Bond Safeguard B In' n tine c�gf��{p�/�Pp / 1 `�7�� „_ ^ / n �p/y�/j��In/g/uragcGCoq�pay: �npel; 1 . By: � ' ' .erK_d•/lAyuns Ricard ` `t9 J RiclarldAp,aio ouRichard Appel;+$.VRB,4on Richard Appo lyS4P•BhSenior Counsel Richartl Appel; Soni ounsel Richard A ppeh„SVP-B..Nenyio ou el i.PeS..... q.,% •:¢swan insol•.t �.IAAtic, P�°W�"W 4,`oc.'b1` �.o°'. :�c..oµvo�ar a�� :........... C: : :G F.•'o'.: 4droti' TL t W.: SOURI •C" SEAL °' 1. SEAL ;�, SEAL < DM07A '.D1 `�'• 2002 `_A'• 1996 •o" INSURANCE , 5? t � e,OZO p. COM1PA � DEAWARE. ) DIAWARE 'o 0 O Lf '•......,...,...++ '`•...,.,,.... ACKNOWLEDGEMENT On this 15s day of June,2019,before me,personally came the above signatories known to me,who being duly sworn,did depose and say that of each of the Companies;and that he executed said instrument on behalf of each Company by authority of his off' under theby s of each Company;' �.uR,9 u.ua By: Amy aylor.Not ublic&Mymmission Lxpim.'5/923; CERTIFICATE ogc I,the undersigned Officer of each Company,DO HEREBY CERTIFY that „ 1.That the original power of attorney of which the foregoing is a copy was duly executed on behalf of each Company and has not since been revoked amended or modified; that the undersigned has compared the foregoing copy thereof with the original power of attorney,and that the same is a true and correct copy of the original power of attorney and of the whole thereof; 2.The following are resolutions which were adopted by the sole shareholder of each Company by unanimous written consent effective June 15,2019 and said resolutions have not since been revoked,amended or modified. 'RESOLVED,that each of the individuals named below is authorized to make,execute,seal and deliver for and on behalf of the Company any and all bonds, undertakings or obligations in surety or co-surety with others: RICHARD M.APPEL,BRIAN J.BEGGS.CHRISTOPHER DONELAN,SHARON L.SIMS. CHRISTOPHER L.SPARRO,MARIANNE L.WILBERT ;and be it further RESOLVED,that each of the individuals named above is authorized to appoint allomeys-in-fact for the purpose of making,executing,sealing and delivering bonds, undertakings or obligations in surety or co-surety for and on behalf of the Company.' 3. The undersigned further certifies that the above resolutions are true and correct copies of the resolutions as so recorded and of the whole thereof. IN WITNESS WHEREOF,I have hereunto set my hand and affixed the corporate seal this 26(h day of October 2020 By. Dance S. n�,.Wy NOTICE' U.S.TREASURY DEPARTMENT'S OFFICE OF FOREIGN ASSETS CONTROL IOFAC7 No coverage is provided by this Notice nor can it be construed to replace any provisions of any surety bond mother surety coverage provided. This Notice provides information concerning possible impact on your surety coverage due to directives issued by OFAC. Please read this Notice carefully. The Office of Foreign Assets Control(OFAC)administers and enforces sanctions policy, based on Presidential declarations of"national emergency'. OFAC has identified and listed numerous foreign agents,front organizations,terrorists,terrorist organizations,and narcotics traffickers as-Specially Designated Nationals and Blocked Persons*. This list can be located on the United States Treasury's webstle-Id!ps7Ywmv.treasury novirespurca-conted"acronsISDN-List. In accordance with OFAC regulations.if it is determined that you or any other person or entity claiming the benefits of any coverage has vidatee U.S.sanctions lax or is a Specially Designated National and Blocked Person,as identified by OFAC,any coverage will be considered a blocked or frozen contract and all provisions of any coverage provided are immediately Subject to OFAC. When a surety bond or other form of surety coverage is considered to be such a blocked or frozen contract,no payments nor premium refunds may be made without authorization tram OFAC. Other limitations on the premiums and payments may also apply. Any reproductions am void. Surety Claims Submission:LexonClximAdminlslratim(Msomm-intl.comintl.com Telephone:615-553.9500 Mailing Address:Sompo International;12890 Lebanon Road;Mount Juliet,TN 37122.2870 Alfaro Communication Construction Inc 15614 S. Atlantic Avenue Compton CA 90221 l f5 CitV of Huntin ton Beach SEALED BID : Residential Curb Ramp Project, CC No 1620 f "DO NOT OPEN WITH REGULAR MAIL" To: City Clerk City of Huntington Beach 2000 Main Street Huntington Beach , CA 92648 l i City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 • w-,Nryv.huntingtonbeachca.gov Fe. Office of the City Clerk Robin Estanislau, City Clerk April 23, 2021 CJ Concrete Construction, Inc. 10142 Shoemaker Ave. Santa Fe Springs, CA 90670 RE: Residential Curb Ramp Project — CC No. 1620 Enclosed please find your original bid bond for CC-1620. Sincerely, 44oL, Robin Estanislau, CIVIC City Clerk RE:ds Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand SECTION C PROPOSAL for the construction of RESIDENTIAL CURB RANIP PROJECT CC No. 1620 in the CITY OF TIUNTINCTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTING TON 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 Citv 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 60 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 it contract with AGENCY at the unit and/or lump sum prices set forth in the lollowing 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 xvork 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 appwtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. [fat such time the contract is not awarded, the AGENCY will reject all bids and will re-advertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-I If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find Q d 61W in the amount of which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond for_% ", as the case may be) Any standard Surety Bid Bond form is acceptable. Bidder shall signify receipt of all Addenda here, if any: Addenda .No. Date Received Bi der's Signature /O'dc-dL C-z SECTION C PROJECT BID- SCHEDULE A CURB RAMP PROJECT,CC 1620 BID ITEMS Item Description Quantity Unit Unit Cost Total Cost No. (Extension) 1 Mobilization 1 LS 2 Prepare Storm Water Pollution Prevention Plan(SWPPP) 1 LS $ 12•0 $ 12,QC0 S Install&Maintain Construction BMPs 1 LS $ U 06 $ a, FOG Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 109 4 Curb Ramp Detail 1 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter, depressed curb, UO` sawcut, sidewalk, domes, retaining curb, etc.) EA $ $ �� Construct Curb Access Ramp per Caltrans Sid, Plan A88A as shown on Curb Ramp Detail 1 in Appendix H of Specifications 17 S (Item includes all a g p Q appurtenances, curb& utter, depressed c� curb, sawcut, sidewalk, domes, retaining curb, slot pave, etc.) •� $ Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 2 6 Curb Ramp Detail 2 in Appendix H of Specifications (Item IZ •o� includes all appurtenances, curb &gutter,depressed curb, `� sawcut, sidewalk, domes, retaining curb, etc.) EA $V• $ Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 7 Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter,depressed curb. c sawcut, sidewalk, domes, retaining curb, etc.) 30 EA $000 " $ �S�•coo Construct Curb Access Ramp per Caltrans Std. Plan A88A as 8 shown on Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter, depressed ra �✓ curb, sawcut, sidewalk, domes, retaining curb, slot pave,etc.) 8 FA $ $ +i.000 9 Install truncated domes to existing Curb Ramp 10 FA $ (o1S $ V, 2so �u Install 4' PVC Sleeve for Street Assembly Sign per City of HB c� • '" 10 Std. Plan 401 10 FA $ 3CO' $ 5,000 Remove and replace existing sidewalk per City of HB Std. &0 00 11 Plan 207. (Allowance) 1,000 SF $ i O $ 1 o,000 Remove and replaces existing 6'or 8'Curb and Gutter per 12 HB Std. Plan 205(Item includes all appurtenances, slot pave, �f c� 22 s etc.).(Allowin ance) 300 LF $ f S $ ,S� SUB-TOTAL BID AMOUNT (SCHEDULE A) C-2.1 SECTION C PROJECT BID- SCHEDULE A CURB RAMP PROJECT, CC 1620 SUB-TOTAL BID AMOUNT IN WORDS: f hfi I)-odt(d f i f 1 f . 11� fhws.-+ncl -f;'fle hvnc%rd -[i �1 � IJ �,rs gncl .Z-tro c-MtS. Note: All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern. The Owner reserves the right to reject any or all proposals and bid items. In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract. C-2? SECTION C PROJECT ADDITIVE BID —SCHEDULE B CURB RAMP PROJECT, CC 1620 BID ITEMS Item Description Quantity Unit Unit Cost Total Cost No. (Extension) Horizontal Curb Cut Curb Access Ramp per Caltrans Sid. Plan A88A using horizontal curb cutting machine as shown on 1 Curb Ramp Detail 1 in Appendix H of Specifications (Item 40 includes all appurtenances. curb &gutter, depressed curb, I ' ' sawcut, sidewalk,domes, retaining curb, etc.) EA $ �1,�1�� $ jam cc" Construct Curb Access Ramp per Caltrans Sid. Plan A88A as shown on Curb Ramp Detail 1 in Appendix H of Specifications 3 2 (Item includes all appurtenances, curb&gutter, depressed curb, sawcut, sidewalk, domes, retaining curb, slot pave. etc.) EA $.Si Sw $ 5�6 Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 3 Curb Ramp Detail 2 in Appendix H of Specifications (Item 3 includes all appurtenances, curb& gutter, depressed curb, •mac.. sawcut, sidewalk, domes. retaining curb, etc.) FJ1 $ 5'y(A2 $ V•50o Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 4 Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter, depressed curb. c sawcut. sidewalk, domes. retaining curb. etc.) 17 EA $5, IUy $ g�, 700 ,.. Construct Curb Access Ramp per Caltrans Sid. Plan A88A as 5 shown on Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb& gutter, depressed curb, sawcut, sidewalk. domes, retaining curb, slot pave,etc.) 9 EA $ S•SCGO $ `"(C1 50U 5U 1 6 Install truncated domes to existing Curb Ramp 9 EA $ � $ ,1150" Remove and replace existing sidewalk per City of HB Std. 7 Plan 207. (Allowance) 400 SF $ $ Remove and replaces existing 6-or 8'Curb and Gutter per a HB Sid. Plan 205(Item includes all appurtenances, slot pave, etc.). (Allowance) 100 LF $ $ ✓ SUB-TOTAL ADITNE BID AMOUNT (SCHEDULE B) E 4 00 ` 5C " SUB-TOTAL ADDITIVE BID AMOUNT IN WORDS: (L't /lVOld -ACUSeW t° j�jirl hV)Cb(_C% 111 1-811 -'1 Note: All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern. The Owner reserves the right to reject any or all proposals and bid items. In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract. C-2.3 SECTION C PROJECT BID SCHEDULE TOTALS RESIDENTIAL CURB RAMP PROJECT CC 1618 Sub-Total Bid - Schedule A 4V 15(,01 Sub-Total Additive Bid - Schedule B 4 `/0U' TOTAL BID AMOUNT, BASIS OF AWARD (Schedules A+B) y00 TOTAL BID AMOUNT IN WORDS: ow miUic/7 - oc h'rnclf(C/ fifyl 3-rv{n ff CV,Sd' d -fur vr) ird di,lliw-s afid Zerc C cnls Notes: All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern. The Owner reserves the right to reject any or all proposals and bid items. In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract. C-2.4 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or 510,000, whichever is greater, and the portion of the work to be done by such subcontractor. Bid Name and Address of State Class DIR PWC Dollar %of Item(s) Subcontractor License Re&trntlon 8 Amount Contract Number ` Sicnn —7t C 9 t � (�rll�f tcurt g�ha�9S uaoass d�� �s ,n Sb�U f �• K 3 rn l(u l IA41, I n59 By submission of this proposal, the Bidder certifies: I. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be fumished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 10/26/2020 Registrations Contractor Information Registration History Ellective Date Expiration Data Loyal Entity Name JOSE CORTEZ 07131118 OBW19 Legal Entity Type OL21/ffi 08/30118 Sala Proprietorship Status 07Nt119 0erlW22 Acliva Registration Number 1000055822 Registmtian effective data 07MI119 Registration expiration data 06r30R2 Maning Address P.O.BOX 161 MIRA LOW 91752 CA United State... Physical Address 5320 CAPELLA COURT MIRA LOMA 91752 CA U... Email Address prof asswnalcurt c.t@gm.il.. Trade N.nm)DBA PROFESSIONAL CURB CUT License Number(a) CSLS:840095 Legal Entity Information Federal Employment IdentifIcallon Number: Solo Proprietor Name: JOSE CORTEZ Worker's Compensation Do you lease employees through Professional Employer Organization(PEO(7: No Exempt from workers'compensation insurance Exempt Reason: Owner/Operator https://cadir.secure.force.wm/ContractorSearchlregistrationSearchDetails?id=a 1 Rt00000027xn8EAA /1 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 tha the foregoing is true and correct and that this declaration is executed on i�� , at fgC4. J ,_Lf Date City State 411 C Sa/n a , bein first duly sworn, deposes and says that he or-she is /r4 of �T CMWK << party making the foregoing bid that the bid is not made in the nterest 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. CT CA C/cam Cc17#/ A5;P' C17 /nc Name of Bidder Sign ture of Bidder lGl1,� S�ot/Ngepr 1�Vt Sa/1tgfe1jt r Address of Bidder Cf- 9p(076F 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 RESIDENTIAL CURB RAMP PROJECT, (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 instntction, 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. Cckyrllcf 160 xr ntractor By p/�slclfnf Title Date: O t:f c, rr o (/th t o p,d C-s 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 I"No If the answer is yes, explain the circumstances in the space provided. N J.4" 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 1 will comply with such provisions before commencing the performance of the work of this contract. c r ccncrc-t (-cnVruc-Pr-r1, /1l r C ntractor BY Pirsic/�/tf Title Date: C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: C T Conu-ee G S1rvct1ct7, Inc Bi rName Busines q( Add G r s � City, State Zip ( TUO --7-7-7 aaaa- r'C+che1 C%ciin( biz 0 Telepho .e _yjbq Email Address State Contractor's License No. and Class �Y- �. `l V Original Date Issued LJ 3G 1 Expiration Date The work site was inspected by f1CC f a1 our office on 01Wf 'U"h 2Qlw The following are persons, firms, apd corporations having a e,r_in tpal interest in this pro osal: CT CCnCtg Ccns7r�c_Cn /nG �I,/7n C Sni�G ��rGlJ�rcr hn C Sgin0 - ffS0?(#- C Scor)c - r !1u r John C SC+i n o al e jClj71'2,el-e cf 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. CT CchCt c CchIPL)c icn , lr) f Com ny ame� Signatuk of Bidder C-8 70hn C snrr?o Printed or Typed Signature NOTARY CERTIFICATE 1/1 Subscribed and sworn to before me thQU day of G 2WIZ . 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 f t7 j 1n1 q ) County of I0SngrKS )On OCb`r .20"'00PO beforeme, )q7ePe1 j tejj1neneZ, 1VC7'CJt1 �tbHc Month, Day, and Year 7' Insert Name and Title of Notary personally appeared 'l Ghn C- Sorn0 Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the persorr(-s) whose name(o is/am subscribed to the within instrument and acknowledged to me that hetsheAwy executed the same in hisAwkkir authorized capacity4c&), and that by his e"ignaturo(4.on the instrument the person(r 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. IUCNEI AN l .NNENE2 No"pubk-CIMIN, E°m^'k Ion cwlty 7I 0 Signature */C ^ Expves Signature of blic (PLACE NO" A OVE) C-v 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, "Demolition of existing concrete ADA ramps and construction of new ADA compliant curb ramps Work included additional curb and gutter construction to ensure surface water flow around corner. All ramps met Caltrans requirements set forth in Standard Plan A88A"1 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)1,(a,S t St 4' ,oht C/ Name land 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. ki 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. �.k k 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-10 Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager, and Superintendent. For each of these critical positions, please list at least three projects for which the critical staff has performed similar work within the last five years. These projects do not have to be under the employment of the bidder of this project. Bidders are encouraged submit supplemental relevant project history in addition to the projects listed herein. 1. td e S Ctal N me of proposed Project Manager Telephone No. of proposed Project Manager: Qa-r?�J-a7Iq pl m St .stet- -4 --toclud Project Name& Contract Amount Type of Work Date Completed Project Name & Contract Amount Type of Work Date Completed Project Name & Contract Amount Type of Work Date Completed 2. Oc� �� C/tl Name of proposed Superintendent Telephone No. of proposed Superintendent: 9y) �vy ./_ / 7 S G t Irg0- &cG �R�d Project Name & Contract Amount Type of Work Date Completed Project Name & Contract Amount Type of Work Date Completed Project Name & Contract Amount Type of Work Date Completed C-II CJ Concrete Construction, Inc. LETTER OF QUALIFICATION Confidential Company Information Corporate Office: 10142 Shoemaker Ave. Santa Fe Springs, Ca. 90670 Phone: 562-777-2222 Fax: 562-777-2220 Contractors Class 8 License: A-720989(established 1993) Cal. Resale#: NONE Fed. ID Number: 95-4578126 State EIN#: 423-6338 D &r 8 Number: NONE California Corporation #: 1770884 9-29-1995 NAICS 238910 DIR(RWCR) Public Work Reg At 1000002154 COMPLETED OR CURRENT PROJECTS (partial list) Owner Class of Work/Description Date Completed Value CITY OF LONG BEACH Annual Maintenance Contract/ ON CALL Pat Abadl Curb Gutter Sidewalks Driveways ADA Ramps 9-2012 to Current. 30,000,000.00 Capital Projects Coordinator IV Department of Public Works 562-570-6963 333 W.Ocean Blvd.Long Beach,Ca.90802 CITY OF ONTARIO Annual Maintenance Contract / ON CALL Dale Adcock Curb Gutter Sidewalks Driveways ADA Ramps 6-2011 to Current 15,500,000.00 Senior Engineer Management.Services 909-395-2605 1425 Bonier Ave.Ontario,Ca. 91761 CITY OF GARDEN GROVE Annual Maintenance Contract/ON CALL Bob Mungey Curb Gutter Sidewalks Driveways ADA Ramps 6-201.1 to Current 10,200,000.00 Senior Engineer Department of Public Works 714-741.-5040 11222 Acacia Parkway Garden Grove,CA.92B42 CITY OF LAKEWOOD Annual Maintenance Contract/ON CALL Max.Withrow. Curb Gutter Sidewalks Driveways ADA.Ramps 6-2010 to Current 10,400,000.00 Senior Engineer Department of Public Works 562-866-9771 5050 Clark Ave. Lakewood,.Ca.90712 CITY OF CERRITOS Annual Maintenance Contract/ON CALL Mary Anne Wozniak Curb Gutter Sidewalks Driveways ADA Ramps 6-2012 to Current 4,600,000.00 uepanment or ruoiic worns Maintenance Superintendent 18125 Bloomfield Ave.Cerritos,.Ca.90703 562-860-0311 CITY OF ORANGE Annual Maintenance Contract Alan Troung Curb Gutter Sidewalks Driveways ADA Ramps 6-2013 to 12-2015 1,275,000-00 Senior Engineer Department:of Public Works 714-744-SS68 300 E.Chapman Ave.Orange,Ca.92866 CITY OF COSTA MESA Annual Maintenance Contract/ON CALL Fariba Fazelia Curb Gutter Sidewalks Driveways ADA Ramps 6-201" 11,200,000.00 Senior Engineer 77 Fair Dr.Costa Mesa,Ca.92626 714-754-5222 CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771.1(a)), passed by the California State Senate on June 20, 2014,established a new public works Contractor Registration Program,which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July I through June 30 state fiscal year) with the California Department of Industrial Relations(DIR). Currently the annual non-refundable registration fee for Contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 http://www.dir.ca.gov/DLSEIPublic Works/SB854FactSheet-6.30.14.pdf DIR's Contractor Registration Link—Call(844) 522-6734 https://efi ling.dir.ca.gov/PWCR/ActionServlet?action=dispiayPW CRegistrationFonn DIR's Contractor Registration searchable database: https://efiling.dir.ca.gov/PWCR/Search.action I am aware and will comply with the provisions of Labor Code Section 177).l(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. CT ccno- t CCrK*Ve en,/nC- Con ct By ra(hell PC! Ity. bfz Email Title Date: Q[-Irbil g (PPI Idea U PWC Registration #: /0E/0Lb? 1 Sy C-12 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135• Economic Opportunities for Low and Very Low-Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager(initial the applicable selections): Will ensure that 10%of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968, or S Will hire no new employees in conjunction with this project. Will award 10%of its sub-contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub-contracts related to this project. Contractor: LT CencreH co/)4yetten,InL Contact Person: TGhn C S affi c Contact Phone: SCa7 U 9L/ Signed: Date: *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub- contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-13 EXHIBIT A DISADVANTAGED BUSINESS ENTERPRISE (DBE) This Project is subject to Part 200.321. Title 2, Code of Federal Regulations entitled "Contracting with Small and Minority Businesses, Women's Business Enterprises, and Labor Surplus Area Firms." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in Part 200.321, Title 2 ChR, shall be encouraged to participate in the performance of Contracts Financed in whole or in part with federal funds. The Contractor should ensure that DBEs, as defined in Part 200.321, Title 2 CFR, have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps,as set forth in Part 200.321,Title 2 CFR. for this assurance. The Contractor shall not discriminate on the basis of race, color, national origin, or sex in the award and performance of subcontracts. Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project, although there is no specific goal for DBE participation. G14 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For RESIDENTIAL CURB RAMP PROJECT in the CITY OF HUNTINGTON BEACH OCTOBER 20, 2020 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications. and Special Provisions: 1) SHEET Al OF PROJECT SPECIFICATIONS Bids will be received from 1 00 PM to 2.00 PM only on the bid due date (10/27/2020) outside of the City Hall main entrance at 2000 Main St. in Huntington Beach. Staff will be present during this hour to receive bids only. Mailed bids are still accepted but must be received before the bid submission deadline. It in encouraged that bidders arrive earlier than normal to drop off bids to avoid a late delivery. Bids will be opened outside of City Hall immediately after 2:00 PM. Bidders are welcome to stay and attend the opening. Social distancing measures shall be observed and masks will be required for all in attendance. This update to the Notice Inviting Sealed Bids shall supersede all other bid delivery information noted on the project documents. A revised NISB is now included with the project documents. This is to acknowledge receipt and review of Addendum Number One, dated October 20, 2020 Cr Ccnicttlt Cc/id&c17c/7 //7C Company Name Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. EXHIBIT B DBE INFORMATION—GOOD FAITH EFFORTS Federal-aid Project No. Bid Opening Date C / c7 o The City of Huntington Beach established a Disadvantaged Business Enterprise(DBE) goal of 9% 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 G!r! N-ewS B. The names and dates of written notices sent to certified DBEs soliciting bids for this Project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested(please attach copies of solicitations,telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods Solicitation and Dates fQ tC rC C-15 C. The items of work which the bidder made available to DBE firms including, where appropriate,any breaking down of the contract work items(including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items ($) of (YIN) Contract D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved),and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidders rejection of the DBEs: fleciJt Cec rtjl4t ed Names, addresses and pph��o�''ne ngmbers of firms selected for the work above: t J tE 4M1C11fd 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: llfa,Pt S<< f�f4chccC C-16 F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases fro the prime contractor or its affiliate: G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists. Internet page download, etc.): Name of Agency/Or anizatio Method/Date of Contact Results S-et tic H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): PI-rust S-�f �4c�c� NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. C-17 IF A SOLE OWNER OR SOLE CONTRACTOR SIGN HERE: (1) Name under which business is conducted !V� (2) Signature (given and surname)of proprietor (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail IF A PARTNERSHIP, SIGN HERE: (1) Name under which business is conducted (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail C-18 IF A CORPORATION. SIGN HERE: (1) Name under which business is conducted l (Gncfolf- CCl)f f y f"f c77, loc (2) (Signature) (Title) Impress Corporate Seal here (3) Incorporated under the laws of the State of Coo- rr)I el (4) Place of Business 1 G119 Shc-en101-o' ^ (Street and Number) City and State san�u �! a r (5) Zip Code W 070 Telephone No. .SW (6) E-Mail rath�l i C° C 110C - bJL NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED C-19 CALIFORNIA ACKNOWLEDGMENT CIVIL CODE 4 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 16 S h)):t Iw's On tJ C-tcb'r a V~•}`')6 before me, t2rich-cl -j/xlr(9 jm lne2 Iva'7ury p blre Date Here Insert Name and Title of the Officer personally appeared SeN-A& Nome(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the persor"h whose name(e}is/me•subscribed to the within instrument and acknowledged to me that he/shefthey executed the same in hisA+erlthew. authorized capacity0es), and that by hieRSerftMr signatureM on the instrument the persona}-or the entity upon behalf of which the person(#mcted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing RACNEL ANDIIEA 11rEMEZ paragraph is true and correct. Notary Public-CalMormx LmAntr'K county WITNESS my hand and official seal. EDfnmrySKM 12)05370 *'yC=m.ExRxr"1 Sep 15,202) Signature Place Notary Seal and/or Stamp Above Signature of NotaryVubYc OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Docy li/+eqt G Title or Type of Document: 16 pi suI *knM?n X{a� Document Date: GC)`"tw a(Jt 13c31 U Number of Pages: Signer(s) Other Than Named Above: h on e Capacity(ies) Claim by ign r(s) ain o Signer's Name: �/ n Signer's Name: //� O Corporate Officer- Title(s): f O Corporate Officer le(s): D Partner- D Limited D General ❑ Partner- ❑ Limited ❑ General O Individual ❑ Attorney in Fad ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Trustee O Guardian or Conservator ❑ Other: ❑ Other: S' er is r senti g ry n /nc Signer is Representing: 02019 National Notary Association List below names of president, vice president, secretary and assistant secretary, if a corporation; if a partnership, list names of all general partners and managing partners: JChn r -�elr/1 G �S�6 JChn Sarno /rsiC r ohn C- Sarno cCrc ry John C SarI1G c-ze EXHIBIT C LOCAL AGENCY BIDDER DBE COMMITMENT(CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY: CI 1�tCD/{ LOCATION: tj in?!�1 13rzjCh, �'tt PROJECT DESCRIPTION, Curb 99w Pro�cf TOTAL CONTRACT AMOUNT:S - BID DATE: )C'/GbC,- BIDDER'S NAME: g CCn CI e7t CCn•�t� CONTRACT DBE GOAL: CONTRACT TEM OF WORK AND DESCRIPTION BE CERT NO NAME OF EACII DBE DOLLAR AMOUN 1 ITEM NO, DR SERVICES TO BF ND I-XPIRATION (Must he ccrntied on the date bids DBE SUBCONTRACTED OR MATERIALS DATE are opened- include DBE adilm O BE PROVIDED(or contracted if the and phone number) idder is a DBE) For Local Agency to Complete: Total Claimed DBE s Local Agency Contract Numbcr Parnapation Federal-aid Project Number. oho Federal Share: Contract Award Dam: Local Agency certifies that all DBE certifications have been venfied and mfomralnm is complete and accurate. Si ture of Bidder 0C tNi,a61`fA„mac 1 510) »>a002 Date (Am Code)Tel No Print Name Stgnattuc --- Udm 7chh C- sane Local Agency Representatrse Person to Contact (Pkue Type or Pnm) (Area Code)Telephone Number Local Aamq Bidder DBE Coanoutionat(Caowwuctwn Contraevt (Rev 626iVat C-21 PLEASE NOTE: This information may be submitted with your bid. If it is not, and you are the apparent low bidder or the second or third low bidder, it must be submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. 'File form has a column for the Contract Item Number and Itern 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 DBL, work perforned 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, Fcderal-aid Project Number, Federal Share, Contract Award Date fields and verifv that all inforrualion is complete and accurate before signing and filing. C-22 EXHIBIT D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder r1 (chi/s k (cA-fkLlc4icn, ih( [proposed subcontractor J hereby certifies that he/she/it has ✓ , has not_, participated in a previous contract or subcontract subject to the Equal Opportunity clauses, as required by Executive Orders 10925, 11114, or It 246, and that, where required, he/she/it has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of S10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. (eeoc.gov/employers/ceoisurvey/index.cfm) Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Signature: J, Date: 67C-14fr C9 d Print Name: J 4-ho C. S e-f1 n c Title: V/< SI clJ11t C-23 EXHIBIT E NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) [NAME OF CONTRACT] To the City of Huntington Beach In conformance with Title 23 United States Code Section 112 and California Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person,partnership,company,association,organization,or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid,and has not directly or indirectly colluded,conspired,connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true;and, further,that the bidder has not,directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. By signing the Proposal, the Bidder has also signed this Noncollusion Affidavit. Bidders are cautioned that making a false Certification may subject the Bidder to criminal prosecution.Signature: Date: OC-16&, C�64h,a cad Print Name: �l G h� C -So //r, Title: C-u EXHIBIT F DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The Bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated with Bidder in the capacity of owner, partner, director, officer, manager: • is not currently under suspension, debarment, voluntary exclusion,or determination of ineligibility by any Federal agency; • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted,convicted, or had a civil judgment rendered against him/her by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Note: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Signature: I Date: �G�� (9 1,9 cd 6 Print Name: , Tchn C - ,Sarin Title: C-25 EXHIBIT G NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: 1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment,or modification of any Federal contract,grant, loan,or cooperative agreement. 2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Signature: � Date: U �']fG�*I o�r/ � aGv Print Name: J C//,o C- ,Saw c, Title: EXHIBIT H C-26 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.hid otter application ❑ a. initial b.grant b initial award h.material change c voopvratisc agreement c.post-award d loan For Material Change Only: c. 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, F:ntrr Name end.\dJrcs of Prime: Finnic Subawudee Tier .if known Congressional District,if known Congressional District-it known 6. Federal I/epartment'Agenq- 7. Federal Program Name/Description: CFDA Number.it applicable %. Federal.lotion Number,,I known 9. Award Amount,it known 10. a.Name and Address of Lobby Entity It. Individuals Performing Senior (including IF mdn Wual,last name.first name.MII addreSS if different from No 1W (last name.FIN,nanw. W) (anach('ontinuanon Shoal S)If niecssarv) If. Amount of P.y t(eketk all that apply) 13. Type of Pao mcni tcheck all that apph I S Actual ❑planned a.retainer b.one-time fee 12. Form or Payment(check all that apply): C.cAmmta,IMi Ba.cash — d.contingent fee It.in-kind; specify: nature a deferred value f other.specify 14. Brief Description of Sen ices Performed or to Ise performed and Dale(sl of Service,including oMeeris),employee(,),or memberls)contacted,for Payment Indicated In Item If: (attach Continuation Sheens)dnecessary) 15. Continuation Sheet(,)attached: \'es O No ❑ 16. Information requested through this fiutn is authonved by Title ) 31 U.SC Section 1352 This disclosure of lobbying reliance Signatures was placed by the tier above when his transaction was made or ` entered into. This disclosure is required pursuant to 31 US C. Pont Name:� e-/y) L G/n L' 1152. This information will be reported to (ongres, P" S1 f[/H semiannually and will be available for public inspection. Any Tide: person who fads to file the rcgtured disclosure shall be suhjecl to a etyil penalty of not less than SIO.0(10 and not more than Telephone No.: _V_/d —n7_ W? Date: 16 2 O )e $100.000 for each such failure. Authonrcd for Local Reproduction Federal Use Only: Standard Form-LLL Standard Form LLL Rev 09.12-97 C-27 INSTRUCTIONS FOR COMPLETION OF EXHIBIT FI DISCLOSURE OI, 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 tiling pursuant to title 31 U.S.C. section 1352. The tiling 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 Fedcral 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) Identity 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) Identity 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 (late of the last, previously submitted report by this reporting entity for this covered Federal action. 4) Enter the full name, address. city, state and rip 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 subawardec of the prime is the first tier. Subacvards include but are not limited to subcontracts, subgrants and contract awards tinder grants. 5) If the organization tiling the report in Item 4 checks "Subawardee" then enter the full name, address, city, state and zip code of the prime Federal recipient. Include Congressional District; if known. 6) Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7) Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. S) Enter the most appropriate Federal identifying number available for the Federal action identification in item I (e.g., Request for Proposal (RFP) number. Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-00 L" 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). I I) 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. C-28 12)Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution. specify the nature and value of the in-kind payment. 13)Check the appropriate box(es). Check all boxes that apply. If other, specify nature. 14) Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15)Check whether or not a continuation shect(s) is attached. 16)The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send continents 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 (0345-0046), Washington, D.C. 20503. By my signature on this proposal I certify, under penalty of perjury under the laws of the State of California, that the foregoing questionnaire and statements of Public Contract Code Sections 10162, 10232 and 10285.1 are true and correct and that the bidder has complied with the requirements of Section 3103 of the Fair Employment and blousing Commission Regulations (Chapter 5, Title 2 of the California Administrative Code). C-29 ExHIBrr 1 FEDERAL LOBBYING RESTRICTIONS Section 1352. "ritle 31, United States Code prohibits Federal funds from being expended by the recipient or any lower tier subrecipient of a Federal-aid contract to pay for any person for influencing or attempting to influence a Federal agency or Congress in connection with the awarding of any Federal-aid contract, the making of any Federal grant or loan, or the entering into of any cooperative agreement. If any funds other than Federal funds have been paid for the same purposes in connection with this Federal-aid contract, the recipient shall submit an executed certification and. if required. submit a completed disclosure form as part of the bid documents. A certification for Federal-aid contracts regarding payment of funds to lobby Congress or a Federal agency is included in the Proposal. Standard Form - LLL, `Disclosure of Lobbying Activities," with instructions for completion of the Standard Form is also included in the Proposal. Signing the Proposal shall constitute signature of the Certification. The above referenced certification and disclosure of lobbying activities shall be included in each subcontract and any lower-tier contracts exceeding $100,000. All disclosure forms, but not certifications, shall be forwarded from tier to tier until received by the Engineer. The Contractor, subcontractors and any lower-tier contractors shall file a disclosure form at the end of each calendar quarter in which there occurs any event that requires disclosure or that materially affects the accuracy of the information contained in any disclosure form previously tiled by the Contractor, subcontractors and anv lower-tier contractors. An event that materially affects the accuracy of the information reported includes: 1) A cumulative increase if 525,000 or more in the amount paid or expected to be paid for influencing or attempting to influence a covered Federal action; or 2) A change in the person(s) or individual(s) influencing or attempting to influence a covered Federal action; or 3) A change in the officer(s), employces(s), or Member(s) contacted to influence or attempt to influence a covered Federal Action. C-30 Compliance News Daily Focus Journal Publication Affidavit-Declaration Of Publication -- State of California CJ Concrete Construction.Inc Contact: Rachel Jimenez is seeking certified and qualified DBE.MBE,WBE 10142 Shoemaker Ave subs and/or suppliers to provide Santa Fe Springs ,CA.90670 Demo,Trucking, tree removal , roots and tree Phone:(562) 777-2222 pruning, survey,engineering , excavation,grading . Fax:(562) 777-2220 truncated domes, Email:rachelj@cjinc.biz for City of Huntington Beach 2000 Main St. Bid Due on:10/27/2020 at 02:00 PM Huntington Beach CA 92648 in Huntington Beach Solicitation Number: 1620 ,CA We are an Equal Opportunity Employer. The CJ Concrete Construction.Ine Good Faith Effort ad has been published in both the Compliance News Internet and Hard-Copy publications. Located Online at: http://www.compliancenews.com/classified_daily The undersigned declares: 1 am over the age of 18 years and a citizen of the United States. I am the principal publisher of the Compliance News Monthly Trade Journal in the City of Long Beach, County of Los Angeles,and the State of California. The notice,a true copy of which is attached was published on Fri Oct 09 18:47:30+0000 2020 1 declare under penalty of perjury that the foregoing is true and correct. Executed at Long Beach, California Henry Sprague III Copyright 2005 Compliance News DVBE#0018455 All Rights Reserved CJ Concrete Construction,Inc LOG Good Faith Effort for Bid Solicitation 1620 Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Important Instructions NOTE: If your bid-package includes form STD-840, you MUST write "See attached Log sections A, B, & C" on STD-840 and include STD-840 with your GFE documents. 1.) Read and complete Section A. 2.) We have completed Section B for you. 3.) Complete Section C by making follow-up phone calls to the firms listed below. ->For DVBE firms, call at least 3 firms. ->For DBE, MBE, & WBE firms, call all of them. SPECIAL DIRECTIONS FOR CALTRANS PROJECTS: As of June 1, 2010 Caltrans now requires primes that do not meet their UDBE & DBE goal to do the following: I. A. Go to the CalTrans project calendar webpage at http://dapI.dot.ca.gov/hq/esc/oe/catendar and log-in using your bid package registration and password. B. Hit on the project number your bidding. C. Hit "See Opt-in records". D. Print this page. You must now contact these Opt-in DBE's as part of your search for participation. 2. Now hit your browser back-button and hit "Primes: Advertise for help" Be sure your listed in the CalTrans "Primes Seeking Assistance". As of Sept. 2010, Caltrans suggests the following further steps to support Good Faith Effort (GFE). 1. Attend networking opportunity events at mandatory Caltrans pre-bids & district meetings. Include with your GFE, information that you attended the meeting along with the event brochure. 2. As you reach the bid opening date, ask yourself how likely you are to meeting the goal. If its apparent you may not, then do another GFE. This should be done 5 days of bid opening. SPECIAL DIRECTIONS FOR FEDERALLY FUNDED PROJECTS: Review your bid documents and search for any references to the Small Business Administration (SBA) and the Minority Business Development Agency (MBDA). If the agencies are mentioned in the bid documents you MUST post your opportunity through their websites. Contact us for more details. A. Awarding Department Contact Instructions v I/<a( S ei ei t l Many California Good-Faith Efforts may require the bidding contractor to CALL the awarding department or owner and talk with their Good-Faith representative. SEE YOUR CONTRACT DOCUMENTS FOR THIS TELEPHONE NO. Call it and record the result below. Awarding Department Contact Action CJ Concrete Construct ion,lnc contacted the awarding department issuing this contract at(tel number) at (time) on (date) and discussed Good-Faith Effort with (Awarding Department Contact) Remarks:(left message, etc.) Phone call was made by (Prime Rep's do_signature) B. Federal, State, & Local Agencies Contacted On 10/09/20, CJ Concrete Construction,Inc contacted: 1. Federal Agency: System for Award Management (SAM) at https://www.sam.gov/portal/SAM/##1 191 at 06:47PM on 10/09/2020 2. State Agency: Office of Small Business & DVBE Certification (OSDC) http://www.pd.dgs.ca.gov/smbus at 06:47PM on 10/09/2020 3. California Unified Certification Program (CUCP) at http://www.dot.ca.gov/ucp/GetLicenseForm.do at 06:47PM on 10/09/2020 4. Local referral organization: Compliance News (www.compliancenews.com) at 06:47PM on 10/09/2020 See Next Page for Firms C. Summary of Firms Sent Bid Invitations 27 total firms were sent invitations. Company Name: KAL ARCHITECTS, INC. Address: 12 j Mauchly Drive, Irvinc,CA, 92618 Phone: (949)450-8420, Fax: (949)450-9424 Work Categories: 00; 17388 INTERIOR DECORATING & DESIGN; C8704 ARCHITECT; C9801 BUILDING CONSTRUCTION; C8720 CIVIL ENGINEERING; P.¢on Solici on Information Dates-Time/s Solicited by Phone: �q Q e `,- C/ Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: MORAS EQUIPMENT AND CONSTRUCTION, INC. Address: 9245 NAN ST. PICO RIVERA,CA, 90660 Phone: (562) 244-3003, Fax: (562) 395-5555 Work Categories: 03; 04; 05; 06; 07; 08; 10; 11; 12; C9907 CONSTRUCTION EQUIPMENT RENTAL; C8775 Construction Management - Oil and Gas Pipeline and Releted Structure Construction; C8777 Construction Management - Power and Communication Line and Related Structure Constructi Phone Solicitation Information Date/s-Time/s Solicited by Phone: 1 e'/I,�i-Z I `l I "m Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: Axiom Engineering & Science Corp Address: 1322 Bell Ave. Ste. Ig Tustin,CA, 92780 Phone: (714) 247-1002, Fax: (714) 247-1006 Work Categories: O1; 02; 03; 04; 05; 06; 07; 08; 09; 10; 1 I; 12; 18734 LABORATORY TESTING AND ANALYSIS; C8760 LAND SURVEYOR; C8723 MATERIALS TESTING SERVICES; C8715 CONSULTANT, ENGINEERING; C8713 CONSULTANT, ENVIRONMENTAL; C8780 Engineering- Geotechnical; C8720 CIVIL EN Phone Solicitation Information Date/s-Times Solicited by Phone: ALPPe' b° C7 61n Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: BELL TRUCKING, INC. Address: 15711 RYON AVENUE BELLFLOWER,CA, 90706 Phone: (310) 993-7005, Fax: (866)623-8349 Work Categories: 05; 06; 07; 08; 09; 11; 12; C9774 TRUCKER; Pho a Splicitati Information Dates-Times Solicited by Phone: l G jy/a� L 10 � i.S C11" Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: S. MELGAR INVESTIGATIONS, INC. Address: 2081 Business Center Drive, 209 Irvine,CA, 92614 Phone: (800) 6354270, Fax: (909)6954433 Work Categories: 00; 17381 DETECTIVE & ARMORED CAR SERVICES; Phone oUcitaf�Qn Inform tion Dates-Timels Solicited by Phone: I U/1d 1d L"' /0 ,)? Am, Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: Coast Surveying, Inc Address: 15031 Parkway Loop, Suite B Tustin,CA, 92780 Phone: (714) 918-6266, Fax: (714)918-6277 Work Categories: 00; C0700 CONSTRUCTION STAKING SUPPLIER; C8760 LAND SURVEYOR; Poone,Solici tion Information Date/s-Time/s Solicited by Phone: )G/la/dc J C:.)(-0 o 0 Person Contacted and Commments forSolicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: CIVIL WORKS ENGINEERS, INC. Address: 3151 Airway Ave., Suite T-I Costa Mesa CA, 92626 Phone: (714) 966-9060, Fax: (714) 966-9085 Work Categories: 01; 02; 03; 04; 05; 06; 07; 08; 09; 10; 11; 12; C8710 ENGINEERING; C8716 ARCHITECTURAL ENGINEER; C8742 MECHANICAL ENGINEERS; C8707 FEASIBILITY STUDIES; C8715 CONSULTANT, ENGINEERING; C8703 TRAFFIC ENGINEER; C8720 CIVIL ENGINEERING; C8730 SAFETY STUDIES; Ph ne $olicitation Information Date/s-Times Solicited by Phone: t o// a (D /U 3 3 'm Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: Ultrasystems Environmental Inc Address: 16431 Scientific Way Irvine,CA, 92618 Phone: (949) 788-4900, Fax: (949) 788-4901 Work Categories: 01; 02; 03; 04; 05; 06; 07; 08; 09; 10; 11; 12; C8795 Environmental-Regulatory; J9510 ENVIRONMENTAL QUALITY; C8713 CONSULTANT, ENVIRONMENTAL; C8790 Environmental - Acoustic/Noise Studies; C8792 Environmental - Biological Studies; C8700 CONSULTANT,NON EN Phclne Solicitation Information Date/s-Time/s Solicited by Phone: l e�lld ld" 0 /()- 4114077 . Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: GOLDEN MASONRY Address: P.O. BOX 59146 NORWALK,CA, 90652 Phone: (562) 906-9747, Fax: (562)906-0947 Work Categories: 07; 08; 11; 12; C5501 STEEL STRUCTURES; C5570 STEEL CRIB WALL; C9829 RETAINER WALLS; C9842 MASONRY; Pons Solicitation Information Dates-Times Solicited by Phone: I G11j Phone r l C `/ 7 aM Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: APSI CONSTRUCTION MANAGEMENT Address: 8885 RESEARCH IRVINE,CA, 92618 Phone: (949) 679-0202, Fax: (949) 679-0212 Work Categories: 00; C8770 CONSTRUCTION MANAGEMENT; C9802 BUILDING CONSTRUCTION; C8720 CIVIL ENGINEERING; Ph ne olicit n Information Date/s-Time/s Solicited by Phone: LgPR� � /1 17 AM Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: SFC COMMUNICATIONS, INC. Address: 65 POST, SUITE 1000 IRVINE,CA, 92618 Phone: (949) 553-8566, Fax: (949) 266-9390 Work Categories: 00; C8713 CONSULTANT, ENVIRONMENTAL; Phone 5olicita#Qn Inform Hon Dates-Times Solicited by Phone: 1G//d/1) "' // ' 7 -,`n Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: SEQUOIA CONSULTANT, INC Address: 361 W. Grove Avenue Orange,CA, 92865 Phone: (714) 974-6316, Fax: (714) 974-6193 Work Categories: 00; C8723 MATERIALS TESTING SERVICES; C9810 SMALL STRUCTURES; C8720 CIVIL ENGINEERING; Ph ne Solicitation Information Dates-Time/s Solicited by Phone: 1-71J Z)" 4:2 /l 3./- nip Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: G& F Concrete Cutting, Inc. Address: 13653 ALONDRA BLVD. SANTA FE SPRINGS,CA, 90670 Phone: (562) 229-0227, Fax: (562) 229-0231 Work Categories: 05; 07; 08; 11; 12; C9905 CUTTING; C1901 ROADWAY EXCAVATION; C1940 DITCHES EXCAVATION; C9904 CORING; C1920 STRUCTURE EXCAVATION; C5111 CONCRETE OVERLAY, DRILL & BOND; C9980 DEMOLITION; C4040 CLEAN & SEAL PAVEMENT JOINTS - ROUT& SEAL CRACKS; C5100 CONCRET PligneSolicitation Information Date/s-Time/s Solicited by Phone: /6 //3 (D ) / 77 C 0 . Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: Afsaneh Enterprises, Inc. Address: 9910 Irvine Center Drive Irvine,CA, 92618 Phone: (949) 333-1000, Fax: (949) 333-1055 Work Categories: 07; 08; E4810 TELEPHONE COMMUNICATIONS; Phq°a Splicit400n Information Date/s-Time/s Solicited by Phone: l U / ,-)6 l/ f/3 --f In Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: LEGEND TECHNOLOGIES UNLIMITED Address: 29 RAINBOW FALLS IRVINE,CA,92603 Phone: (949) 856-0299, Fax: (949) 856-2005 Work Categories: 00; 17850 MISCELLANEOUS AUDIO VISUAL SERVICES; Phpne olicitation Information Date/s-Time/s Solicited by Phone: / 1ld4.7 ' (4l / / .5c;� e7/)') Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: C. BERMUDEZ TRUCKING Address: 13812 PREMIER AVENUE BELLFLOWER,CA, 90706 Phone: (562) 824-0363, Fax: (562) 804-1609 Work Categories: 00; C9774 TRUCKER; Phone Solicitation Information Date/s-Time/s Solicited by Phone: Jf1 G Q /C9 , "S ow - Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: WINCORP SOLUTIONS Address: 2151 MICHELSON DRIVE SUITE 225 IRVINE,CA, 92612 Phone: (949) 387-6284, Fax: (877) 907-1155 Work Categories: 00; I7360 PERSONNEL SUPPLY SERVICES; C8700 CONSULTANT,NON ENGINEERING; Phoon j Solicitation Information Date/s-Time/s Solicited by Phone: 14 / IdAf fe a /1 / `f of77 Person Contacted and Commments forSolicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: LEJEND CORPORATION Address: 15515 RYON AVENUE BELLFLOWER,CA, 90706 Phone: (562) 755-0562, Fax: (562) 6334999 Work Categories: 03; 04; 05; 07;08; 11; 12; C9774 TRUCKER; Phone$olicitation Information Date/s-Times Solicited by Phone: bf-10M, 6i) /. 23 n Person Contacted and Commments for Solicitation: 1620 City of Huritington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: DDB ENGINEERING, INC. Address: 25 Mauchly Suite 323 Irvine,CA, 92618 Phone: (949) 727-4008, Fax: (949) 727-4079 Work Categories: 00; C8707 FEASIBILITY STUDIES; C8703 TRAFFIC ENGINEER; C8720 CIVIL ENGINEERING; C8730 SAFETY STUDIES; Phone olicitation Information Dates-Times Solicited by Phone: 1 �/)d -C " l-? 3 7 FM Person Contacted and Commments for Solicitation: 1620 City of Hulaington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: CLR ANALYTICS, INC Address: 25 MAUCHLY SUITE 315 IRVINE,CA, 92618 Phone: (949) 864-6696, Fax: (949)264-4440 Work Categories: 05; 06; 07; 08; 11; 12; C8700 CONSULTANT, NON ENGINEERING; fhpneh�icI ion formation Date/s-Times Solicited by Phone: 1, 4 ( JJ Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: DIANA PRINCE CONSTRUCTION, INC. Address: 16 FAITH IRVINE,CA, 92612 Phone: (714) 550-9377, Fax: (714) 242-7616 Work Categories: 05; 06; 07; 08; 11; 12; C9854 PAINTING STRUCTURES; Phone S9licita In rmation Date/s-Time/s Solicited by Phone: / e' 1?7a ° • 50 'qm . Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: DAHL, TAYLOR & ASSOCIATES, INC Address: 2960 S. DAIMLER STREET SANTA ANA,CA, 92705 Phone: (949) 756-8654, Fax: (959)502-0777 Work Categories: 00; C8716 ARCHITECTURAL ENGINEER; C8742 MECHANICAL ENGINEERS; C8707 FEASIBILITY STUDIES; C8703 TRAFFIC ENGINEER; C8720 CIVIL ENGINEERING; C8730 SAFETY STUDIES; 11 Pb9ne S licita n Information Date/s-Time/s Solicited by Phone: 1 C' l3 ff rW /6: N `7m Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: Project Partners, Inc. Address: 23195 LA CADENA DR., STE 101 LAGUNA HILLS,CA,92653 Phone: (949) 852-9300, Fax: (949) 582-9322 Work Categories: 05; 07; 08; 11; 12; C8701 BUSINESS ADMINISTRATION; C8716 ARCHITECTURAL ENGINEER; C8742 MECHANICAL ENGINEERS; C8707 FEASIBILITY STUDIES; I7360 PERSONNEL SUPPLY SERVICES; C8715 CONSULTANT, ENGINEERING; C8706 DESIGN BRIDGES; A0780 LANDSCAPE& HORTICULTURAL S TUqn� .D ritatio}1 Information C4m Date/a-Times Solicited by Phone: / / [t� Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: ADVANTEC CONSULTING ENGINEERS, INC. Address: 1200 ROOSEVELT Irvine,CA, 92620 Phone: (949) 8614999, Fax: (949) 502-5522 Work Categories: 01; 02; 03; 04; 05; 06; 07; 08; 09; 10; 1 l; 12; C8710 ENGINEERING; C8715 CONSULTANT, ENGINEERING; C8703 TRAFFIC ENGINEER; C8720 CIVIL ENGINEERING; Phone Solicitation Information Dates-Times Solicited by Phone: kll3lde CQ, 16' r/- 407 Person Contacted and Commments for Solicitation: 162-0 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: FULLER TRUCKING Address: 17909 WOODRUFF AVE. #79 BELLFLOWER,CA, 90706 Phone: (562) 650-0576, Fax: (562)461-7654 Work Categories: 05; 06; 07; 08; 1 l; 12; C9774 TRUCKER; 1ho*gSy licit �n�nGf �t�n Dates-Times Solicited by Phone: // Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: UMANZOR & SON TRUCKING Address: 11942 PLUTON ST. NORWALK,CA, 90650 Phone: (562) 307-7065, Fax: (562) 219-8716 Work Categories: 00; C9774 TRUCKER; IPhpn7 olicita o n)nformation Date/s-Time/s Solicited by Phone: c, 3 C7 CI/`1 Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Company Name: Schafer Consulting Inc Address: 8105 Irvine Center Drive Suite 1020 lrvine,CA, 92618 Phone: (949) 788-7780, Fax: (949) 788-7781 Work Categories: Management Consulting, Offices Of Certified Public Accountants,Other Management Consulting Services Phone olicit on infor ation Datels-Time/s Solicited by Phone: / o //3��' !/ lct 0 g) Person Contacted and Commments for Solicitation: 1620 City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Affidavit of Fax Solicitation The undersigned employee of Compliance News Publishing, located in the City of Long Beach,County of Los Angeles, and the State of California, declares that bid solicitation letters have been faxed to the following 27 firms listed below at 06:47PM on 10/09/2020. I am over the age of 18 years and a citizen of the United States. I declare under penalty of perjury that the foregoing is we and correct. Executed at Long Beach, California. Henry Sprague III CJ Concrete Construction,Inc 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 KAL ARCHITECTS, INC. 12-j Mauchly Drive, Irvine,CA,92618 We are seeking certified and qualified DBE,MBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Constructionjne 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 MORAS EQUIPMENT AND CONSTRUCTION, INC. 9245 NAN ST. PICO RIVERA,CA,90660 We are seeking certified and qualified DBE,MBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Ine 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 Axiom Engineering & Science Corp 1322 Bell Ave. Ste. I g Tustin,CA,92780 We are seeking certified and qualified DBE,N1BE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. If you have any questions please do not hesitate to contact its. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Inc 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 BELL TRUCKING, INC. 15711 RYON AVENUE BELLFLOWER,CA,90706 We are seeking certified and qualified DBE,A1BE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. I f you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Inc 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 S. MELGAR INVESTIGATIONS, INC. 2081 Business Center Drive, 209 Irvine,CA,92614 We are seeking certified and qualified DBE,116E,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Ine 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 Coast Surveying, Inc 15031 Parkway Loop, Suite B Tustin,CA,92780 We are seeking certified and qualified DBE,NIBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Inc 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 CIVIL WORKS ENGINEERS, INC. 3151 Airway Ave., Suite T-1 Costa Mesa,CA,92626 We are seeking certified and qualified DBE,MBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Inc I0142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 Ultrasystems Environmental Inc 16431 Scientific Way Ir vine.CA,92618 We are seeking certified and qualified DBE,MBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Inc 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 GOLDEN MASONRY P.O. BOX 59146 NORWALK,CA,90652 We are seeking certified and qualified DBE,MBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are pennitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Inc 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 APSI CONSTRUCTION MANAGEMENT 8885 RESEARCH IRVINE,CA,92618 We are seeking certified and qualified DBE,N'1BE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE 01" SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Omer Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Ine 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 SFC COMMUNICATIONS, INC. 65 POST, SUITE 1000 IRVINE,CA,92618 We are seeking certified and qualified DBF.,MBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, 'trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,lnc 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 SEQUOIA CONSULTANT, INC 361 W. Grove Avenue Orange,CA,92865 We are seeking certified and qualified DBE,MBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract.No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Inc 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 G & F Concrete Cutting, Inc. 13653 ALONDRA BLVD. SANTA FE SPRINGS,CA,90670 We are seeking certified and qualified DBE,MBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Inc 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 Afsaneh Enterprises, Inc. 9910 Irvine Center Drive Irvine,CA,92618 We are seeking certified and qualified DBE,MBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are pennitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Ine 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 LEGEND TECHNOLOGIES UNLIMITED 29 RAINBOW FALLS IR V INE,CA,92603 We are seeking certified and qualified DBE,N1BE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Ine 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 C. BERMUDEZ TRUCKING 13812 PREMIER AVENUE BELLFLOWER,CA,90706 We are seeking certified and qualified DBE,IIMBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Inc 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 WINCORP SOLUTIONS 2151 MICHELSON DRIVE SUITE 225 IRVINE,CA,92612 We are seeking certified and qualified DBE,NIBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Inc 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 LEJEND CORPORATION 15515 RYON AVENUE BELLFLOWER,CA,90706 We are seeking certified and qualified DBE,ntBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. F you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Inc 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 DDB ENGINEERING, INC. 25 Mauchly Suite 323 Irvine.CA,92618 We are seeking certified and qualified DBE,MBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Inc 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 CLR ANALYTICS, INC 25 MAUCHLY SUITE 315 IRVINE,CA,92618 We are seeking certified and qualified DBE,MBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction4ne 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 DIANA PRINCE CONSTRUCTION, INC. 16 FAITH IRVINE,CA,92612 We are seeking certified and qualified DBE,MBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Inc 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 DAFIL, TAYLOR & ASSOCIATES, INC 2960 S. DAIMLER STREET SANTA ANA,CA,92705 We are seeking certified and qualified DBE,NIBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Inc 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 Project Partners, Inc. 23195 LA CADENA DR., STE 101 LAGUNA I-IILLS,CA,92653 We are seeking certified and qualified DBE,MBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are pennitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Ine 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 ADVANTEC CONSULTING ENGINEERS, INC. 1200 ROOSEVELT Irvine,CA,92620 We are seeking certified and qualified DBE,MBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract.No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Inc 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 FULLER TRUCKING 17905 WOODRUFF AVE. #79 BELLFLOWER,CA,90706 We are seeking certified and qualified DBE,MBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St, Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction,Inc 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 UMANZOR & SON TRUCKING 11942 PLUTON ST. NORWALK,CA,90650 We are seeking certified and qualified DBE,MBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract, No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 CJ Concrete Construction4tic 10142 Shoemaker Ave Santa Fe Springs ,CA 90670 Telephone: (562) 777-2222 Fax: (562) 777-2220 INVITATION TO BID October 09, 2020 Schafer Consulting Inc 8105 Irvine Center Drive Suite 1020 Irvine,CA,92618 We are seeking certified and qualified DBE,NIBE,WBE subcontractors and/or suppliers for: Project: City of Huntington Beach 2000 Main St. Huntington Beach CA 92648 Location: Huntington Beach ,CA Bid Due Date: 10/27/20 at 02:00 PM PST Solicitation Number: 1620 Contact: Rachel Jimenez Quotes are needed for: Demo, Trucking, tree removal , roots and tree pruning, survey, engineering , excavation, grading . truncated domes, . Subcontractors will be required to enter into our standard contract. No modifications to the contract are permitted. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Oct 27, 2020 with a copy of your certification to Rachel Jimenez at (562) 777-2220 THE AMERICAN INSTITUTE OF ARCHITECTS q& AIA Document A310 Bid Bond KNOW ALL MEN BY THESE PRESENTS, that we CJ Concrete Construction, Inc. 10142 Shoemaker Ave, Santa Fe Springs, CA 90670 (HMO naen lull name am waress w legal u:fe0 Cmeaaor) as Principal, hereinafter called the Principal, and Merchants Bonding Company (Mutual) P O Box 14498, Des Moines, IA 50306 (Here asen roll rr ma ma address or legal utx of surely) a corporation duly organized under the laws of the State of Iowa as Surety, hereinafter called the Surety, are held and firmly bound unto City of Huntington Beach 2000 Main St Huntington Beach, CA 92648 (Hem rexrI.ull nerve Ma adores orlegal uce or Omer) as Obligee, hereinafter called the Obligee, in the sum of Ten Percent of Amount Bid (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 Residential Curb Ramp Project (Here inxerl hA Nm aaerew aria deaaatxx,W ygea NOW,THEREFORE,if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid,and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds,if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid,then this obligation shall be null and void,otherwise to remain in full force and effect. Signed and sealed this 22nd day of October 2020 CJ Concrete Construction Inc. (Prin 'pa (deal) (Witness) By: it jid o t (Title) Merchants Bonding Company MutualZ___ 1{ O (Surety) (Seal) B . ) Jennifer Castillo / me -in-Fact AIA DOCUMENTRCHI•BID BOND•AIAAV EE W.WA 1970 IN ED•THE AMER16AN MSTITOtE Of ARCHITECTS,V]5 N Y.AVE..Nw,WASHINGTON,O.C.20006 State of Arizona County of Maricooa On this 22nd day of October , 20 20 before me personally appeared Jennifer Castillo personally known to me or proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the foregoing instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity on behalf of which the person(s) acted, executed the instrument. By\' j"Lz 1 V yu ILIL f1 t �/� Notary Public tf ELAWE ANKENEY Melanie Ankeney Notary ,j, n. of An M cona arlcopa county commission a ssaeze My Commission Expires: My commission Ea Plres July 12, 2023 t JuIY 12. 2023 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 CLrjjrcrn q I ' } County of IDS .�n et( r S } On � ' r �V�hI before me, }2nCh� I �h�lY���`y111 tY1PZ, N�Cl/y I��IC r -u ma.n cram•• a�na•a K.-- ,ramt personally appeared joho C .SClrn� who proved to me on the basis of satisfactory evidence to be the persorT(stwhose name(s}is/are subscribed to the within instrument and acknowledged to me that he/skeA49y-executed the same in hisAie4t4eic-authorized capacity(iee}, and that by his/haEfthei signature(#on the instrument the persort(stor the entity upon behalf of which the persons--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 d offcial seal. iuCXEL Abu,- MENEZ _ Notary public-CaliforniaG / Los Anpelm County �11�1 oeur.Edon/Sep 15,0 VVV��I My Canm.6plres Sep 15,2027 Notary Public Signature (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING TrnS FORM Thix form complies with current Cal forma statutea regardigg notorr w•orrling mu( DESCRIPTION OF THE ATTACHED DOCUMENT f needed.should be couipleredondauuched to the document.Acknowledgments 1 7-� from other states ram be completed for documents being sent to that state so long 0.1 C 61 m the warding does nor require the California notary to violate California notary (Title or description of attached document State and County information must be the State and County where the document signer(s)personally appeared bet'ore the notary public foracknowdedgment. • Date of notarisation must be the date that the signer(s)personally appeared which (Title or description of attached document continued) most also be the same date the acknowledgment is completed. • the notary public must print his or her name as it appears within his or her Number of Pages�—Document Date commission followed by a comma and then,your title(notary public). • Print the namc(s) of document signcrfs) who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural Corns by crossing off incorrect fortes(i.e. 4tYshc/4vy-is lore)or circling the correct forms.Failure to correctly indicate this ❑ Individual (s) information may lead to rejection of document recording. Cporporate Ifice • The notary seal impression must be clear and photographically reproducible. I f [ SI��n Impression must not cover test or lines. If seal impression smudges, re-scal 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) acknosdefgmern is not misused or attached to a ditTerem document. Dttler 11 Indicate title or type of attached document,number of pages and date. ❑ Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). 2015 Version vrvw.NolaryClasses.com 800-873-0865 Securely attach this document to the signed document with a staple. MERCHANTS�+� BONDING COMPANY. POWER OF ATTORNEY Know All Persons By These Presents,that MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of Iowa(herein collectively called the'Companies")do hereby make,constitute and appoint,individually, Chrystal Hedges; David J McKee;Jennifer Castillo;Joseph A Clarken III;Melanie Ankeny;Patrick R Hedges;'fed H Rarrick their true and lawful Attomey(s}in-Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments 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. This Power-of-Attorney is granted and is signed and sealed by facsimile under and by authority of the following By-Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23. 2011 and amended August 14, 2015 and adopted by the Board of Directors of Merchants National Bonding,Inc.,an October 16.2015. 'The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys-in-Fact, and to authorize them to execute on behalf or the Company, and attach the seal of the Company thereto, bonds and undertakings,recognizances,contracts of indemnity and other writings obligatory in the nature thereof.' 'The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company,and such signature and seal when so used shall have the same force and effect as though manually fixed." In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and aut hority hereby given to the Attorney-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of i is obligations under its bond. In connection with obligations in favor of the Kentucky Department of Highways only,it is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner. Department of Highways of the Commonwealth of Kentucky at least thirty(30)days prior to the modification or revocation. In Witness Whereof,the Companies have caused this instrument to be signed and sealed this 4lh day of September 2020 pPOq BQ •'p�. \Ppp�4FOy•• MERCHANTS BONDING COMPANY(MUTUAL) *A, .:vo 4r. �: o R y: .4 A.x.y<: MERCHANTS NATIONAL BONDING, INC. :2 ;Z: •_•• :3� �� :0., 2003 •;c�: : ; 1933 y ;c, By %dj1 . ,. , .:��1�,' • bt.�,.. ..•\1al\• President STATE OF IOWA " COUNTY OF DALLAS ss. On this 4th day of September 2020 , before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL)and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument are the Corporate Seals of the Companies;and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. tiPRtAy 0 POLLY MASON Z •••, t Commission Number 750576 �1 fLSP o My Commission Expires o y1r January 07, 2023 Notary Public (Expiration of notary's commission does not invalidate this instrument) I,William Warner,Jr.,Secretary of MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING, INC.,do hereby certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies,which is still in full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 22nd day of October ,2020 e:y?0•jkPOg9.e0•: �,O,��J\NP 9yq•• :2•. 'Z: •e-• 1933 r c: Secretary 2003 n• :y�, POA 0018 (1/20) ••• CJ Concrete Construction.Inc. 10142 Shoemaker Ave. Santa Fe Springs,CA 90670 I �u oT � C(t, Of �Vnjlvlljon Vac I 10•4;1•� c biA -fine: 2:00 rojccf P 61et" WAMc. { cslaerrt al Ct b P P C.C• NO . IVZO City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 • xvw%v.huntingtonbeachea.gov Office of the City Clerk Robin Estanislau, City Clerk April 23, 2021 FS Contractors, Inc. 14838 Bledsoe Street Sylmar, CA 91342 RE: Residential Curb Ramp Project — CC No. 1620 Enclosed please find your original bid bond for CC-1620. Sincerely, 9'4�"a,o.) Robin Estanislau, CIVIC City Clerk RE:ds Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand SECTION C PROPOSAL for the construction of RESIDENTIAL CURB RAMP PROJECT CC No. 1620 in the CITY OF HUNTINGTON BEACH TO THE IIONOIZA13LE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON 13EACII: 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 60 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. 11' 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 lailure to enter into a contract in the manner and time prescribed will result in fa-feiture 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 ofcomparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. Tfll AGENCY RESERVI-S 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 (late. If at such time the contract is not awarded, the A(![-NCY will reject all bids and will re-advertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and wards shall govern over figures. C-f 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 a bid bond in the amount of I 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 for10% as the case may be) Any standard Surety Bid Bond form is acceptable. Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's Sizoature 2 c -z SECTION C PROJECT BID-SCHEDULE A CURB RAMP PROJECT,CC 1620 RID ITEMS Item Description Quantity Unit Unit Cost Total Cost No. (Extension) 1 Mobilization 1 LS $ .3 000 $ 3,��C00 2 Prepare Storm Water Pollution Prevention Plan (SWPPP) 1 LS $ 3,,5'00 $ 3 S 00 3 Install& Maintain Construction BMPs 1 LS $ 73,S OO $ 3 S Op Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 109 4 Curb Ramp Detail 1 in Appendix H of Specifications (Item includes all appurtenances. curb&gutter depressed curb, sawcut. sidewalk domes retaining curb, etc.) EA $ SL)OO $ sl ! OQD Construct Curb Access Ramp per Caltrans Std. Plan A88A as & shown on Curb Ramp Detail 1 in Appendix H of Specifications 17 (Item includes all appurtenances, curb&gutter, depressed S JUO OS p00 curb, sawcut, sidewalk, domes. retaining curb. slot pave. etc) EA $ $ O i Horizontal Curb Cut Curb Access Ramp per Caltrans Std Plan A88A using horizontal curb cutting machine as shown on 6 Curb Ramp Detail 2 in Appendix H of Specifications (Item 2 includes all appurtenances, curb&gutter, depressed curb. O 00 D sawcut. sidewalk, domes, retaining curb, etc ) FA $ Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 7 Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances. curb&gutter. depressed curb, sawcut sidewalk. domes, retaining curb etc ) 30 EA $ S1000 $ I-S- x000 Construct Curb Access Ramp per Caltrans Std Plan A88A as 8 shown on Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances. curb&gutter.depressed curb, sawcut. sidewalk, domes, retaining curb, slot pave, etc) 8 EA $ �O $ r,J 9 Install truncated domes to existing Curb Ramp 10 EA $ �0 $ 18 Install 4" PVC Sleeve for Street Assembly Sign per City of HB Std Plan 401 10 EA $ 2.Sb $ Y DO 11 Remove and replace existing sidewalk per City of HB Std Plan 207 (Allowance) 1,000 SF $ �! $ ll OOO Remove and replaces existing 6'or 8'Curb and Gutter per 12 HIS Std Plan 205(Item includes all appurtenances, slot pave, etc) (Allowance) 300 LF $ $ SUB-TOTAL BID AMOUNT (SCHEDULE A) $ 9)�4 SOU. ('-2.1 SECTION C PROJECT BID—SCHEDULE A CURB RAMP PROJECT, CC 1620 SUB-TOTAL BID AMOUNT IN `WrORDS: r f I / `rt 1Kt 4��tA :cU/f e-4U4 +r 0✓S4,J T r/ IVe- Note All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern The Owner reserves the right to reject any or all proposals and bid items. In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract c -:1 SECTION C PROJECT ADDITIVE BID—SCHEDULE B CURB RAMP PROJECT, CC 1620 RID ITEMS Item Description Quantity Unit Unit Cost Total Cost No. (Extension) Horizontal Curb Cut Curb Access Ramp per Caltrans Std Plan A88A using horizontal curb cutting machme as shown on 1 Curb Ramp Detail 1 in Appendix H of Specifications (Item 40 includes all appurtenances. curb 6 gutter depressed curb, �^ sawcut, sidewalk, domes, retaining curb, etc) EA $ Sr000 $ 2.00 1300 Construct Curb Access Ramp per Caltrans Std Plan A88A as 2 shown on Curb Ramp Detail 1 in Appendix H of Specifications 3 (Item includes all appurtenances. curb&gutter. depressed curb, sawcut sidewalk, domes retaining curb slot pave. etc 1 EA $ .Sr $ C 00 Horizontal Curb Cut Curb Access Ramp per Caltrans Sid Plan A88A using horizontal curb cutting machine as shown on 3 Curb Ramp Detail 2 in Appendix H of Specifications (item 3 includes all appurtenances. curb&gutter. depressed curb, S sawcut. sidewalk. domes, retaining curb. etc) EA $ 'J00 $ UO i U Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 4 Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances. curb 6 gutter. depressed curb. p sawcut. sidewalk domes retaining curb. etc 1 17 EA $ .Srtx0 $ OS000 Construct Curb Access Ramp per Caltrans Sid Plan A88A as 6 shown on Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb 8 gutter, depressed curb, sawcut, sidewalk. domes. retaining curb, slot pave. etc 1 9 EA $ SibpO $ S 1 000 6 Install truncated domes to existing Curb Ramp 9 EA $ SO D $ S Q 0 7 Remove and replace existing sidewalk per City of HB Sid Plan 207 (Allowance) 400 SF $ Remove and replaces existing 6'or 8"Curb and Gutter per a HB Sid Plan 205(Item includes all appurtenances, slot pave, pp QQ 0O C etc) (Allowance) 100 (F $ J O $ SUB-TOTAL ADITIVE BID AMOUNT (SCHEDULE B) $ 37f ,` 0 0. SUB-TOTAL ADDITIVE BID AMOUNT IN WORDS. I / T(�re� hl'"(4(!L� Seyc"� -SIX �{ 60S�.d vtiv(< Note All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern The Owner reserves the right to reject any or all proposals and bid items In addition, the City reserves the right to Include or remove Bid Schedule B in the award of the contract. ( -2.3 SECTION C PROJECT BID SCHEDULE TOTALS RESIDENTIAL CURB RAMP PROJECT CC 1618 Sub-Total Bid - Schedule A 6) 14 Sub-Total Additive Bid - Schedule B 37b 9p0 �u TOTAL BID AMOUNT, BASIS OF AWARD (Schedules A+B) ��29 ,, y t) U. u' TOTAL BID AMOUNT IN WORDS: Notes. All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern. The Owner reserves the right to reject any or all proposals and bid items. In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract. C-2.a 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 D/R PWC Dollar % of Item(s) Subcontractor License Registration a Amount Contract Number �" 4 k G�7VRVEt 4,ts::il ?/Ar W47lc�(p 00,44A, 4-1 4 To F 12&4 PD(at EV * i 5C*V1 aTtem,Ch 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 10/27/2Q at Sylmar CA Date City State Jose Angel Fierros being first duly sworn, deposes and says that he or she is President of FS Contractors. Inc. the party making the foregoing bid that the bid is not made in the interest of,or on the behalf of,any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true;and, further, that the bidder has not,directly or indirectly, submitted his or her bid price or any breakdown thereof,or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. FS Contractors- Inc_ Name of Bidder r", Signature ckklidder 14838 Bledsoe St. Sylmar,CA 91342 Address of Bidder C4 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 RESIDENTIAL CURB RAMP PROJECT, (Ixwexit) 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. FS Contractors, Inc. Contractor By Lj President Title Date: 10/27/20 C-s 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 proprietar} interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Fedcral. State or localgovernment project because of a violation of law or a safety regulation? Cl Yes J 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-G 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. 1 am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers 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. 173 Contractnrc Inc. Contractor Xr6-o. By President Title Date: 10/27/20 C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: FS Contractors, Inc. Bidder Name 14838 Bledsoe St. Business Address Sylmar CA 91342 City. State Zip ( 818 ) 838-6040 martha a fcontractorsinc.com Telephone Number I.mail Addre.s 1005940 A-C8-C27 State Contractor's License No. and Class 4/31/15 Original Date Issued 7/31/21 Expiration Date The work site was inspected by Angel Fierros of our office on September 27 , 2020. The following are persons, firms.and corporations having a principal interest in this proposal: Jose Angel Fierros, President Salomon Fierros_ Vice-President Jose Ernesto Fierros, Corporate 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. FS Contractors, Inc. Company Name j -q!!�j F Signature df Bidde C-e Jose Angel Fierros nC Printed or Typed Signature c NOTARY CERTIFICATE t� le Subscribed and sworn to before me this_day of , 201_ A notary public or other officer completing this certificate verifies ly the identity of the individual who signed the document, to which this certificatc js attached, and not the truthfulness, accuracy, or validity of that document. State of ) County of ) / On before me; Month, Day,and Year Insert Name and Title of Notary personally appeared i i� Name(s)of Signer(s) i who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the withiryinstrument and acknowledged to me that he/she/they executed the same in his/her/their authoryLed capacity(ies),and that by his/her/their signature(s)on the instrument the person(s), or the��eWty 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. WI71 my hand and official seal. Signature Signature of Notary Public (PLACE NOTARY SEAL ABOVE) C-9 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate venfies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California ) County of Los Angeles ) On October27, 2020 before me, Martha Isih•I 1 onel Riuhi- Nolan �t_ Date Here Insert Name and Title of the Officer personally appeared Jose Angel Fierros Narrw*of SignerW who proved to me on the basis of satisfactory evidence to be the persona) whose nameW is/are subscribed to the within instrument and acknowledged to me that he/she/Vwy executed the same in hisfAr/,their authorized capacity(ijo, and that by his/ber/Weir signatureWon the instrument the person(s), or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of Califomia that the foregoing paragraph is true and correct. IAAP7H A ISABEL LOPEZ RIUBI WITNESS my hand and official seal. '1 NMIV Pubk-r,AlflprniJl �.•� La AMPW County Signature 4 `- yr:oTT.E.a•n M+r n.ton Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the locum r fraudulent reattachment o/this loan to an unintended document. Description of Attached Document Title or Type of Document: _ _ Docum ate: Number of Pages: Sigrer(s) Other Than Named CapachAles) Claimed by Signer(s) Signer's Name: Signer's Name: Corporate Officer — Title(s): ❑Corporate Officer — Title(s): Partner — Limited Gene O Partner — ' Limited -General Individual Attor Fact ❑ Individual Attorney in Fact Trustee dian or Conservator ❑Trustee Guardian or Conservator Other: _ Other: Signer resenting: Signer Is Representing: C2014 National Notary Association • www,NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item M5907 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, "Demolition of existing concrete ADA ramps and construction of new ADA compliant curb ramps. Work included additional curb and putter construction to ensure surface water flow around corner. All ramps mct Caltrans requirements set forth in Standard Plan A88A"} Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. Listed below are the names. address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: 1 City of Fullerton 3O3 West Commonwealth Ave. Fullerton. CA 92832 Name and Address of Public Agency Name and Telephone No. of Project Manager: Joseph Hernandez (714) 738-6845 $554.142 Curb/Gutter & Sidewalk Reconstruction 12/16/17 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Reconstruction of sidewalk. curb and :'utter, asphalt berm, brick pavers, driveway approaches. alley approaches, alley return, alley gutter, and access ramps at various locations throughout the City. including root pruning and clear and grub of tree roots for concrete reconstruction 2. City of Manhattan Beach 3621 Bell Ave. Manhattan Beach. CA 90266 Name and Address of Public Agency Name and Telephone No. of Project Manager: Tim Birthisel 14 533-3050 EXT. 722 S 143.562 Curb Ramps Construction 8/24/20 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: CDBG Project consisted ofrcconstruction 38 ADA curb ramps throughout the Cite. 3. City of'Orange 300 F. Chapman Ave. Orange. CA 92866-1591 Name and Address of Public Agency Name and Telephone No. of Project Manager. Ivador Munoz (714) 744-5547 5301A37.47 ADA Curb Ramps & Sidewalk Improvements 7/29/20 Contract Amount Type of'Work Date Completed Provide additional project description to show similar work: CDBG Project consisted of'reconstruction 47 ADA curb ramps. curb and gutter, cross nutter spandrel throughout the City. C-10 Bidder's Critical Staff Listed below are the names of the bidders proposed Constriction ['reject Manager, and Superintendent. For each of these critical positions. please list at least three projects for which the critical staff has performed similar work within the last five years. These projects do not have to be under the employment of the bidder of this project. Bidders are encouraged submit supplemental relevant project history in addition to the projects listed herein. I. Aneel Fierros Name of proposed Project Manager Telephone No. of proposed ['reject Manager: (818) 974-0895 Citvwidc Curb Ramp Improvements Phase V Concrete Repairs $390,722 6/1/17 Project Name & Contract Amount Type ol'Work Date Completed Curb Cafe Extension Concrete Repairs $153.350 6/10/19 Project Name & Contract Amount Type of Work Date Completed 14/15 & 15/16 Curb Gutter Sidewalk Improvements $160.6971 .70 11/29/16 Project Name & Contract Amount Type of Work Date Completed 2, Ernesto Fierros Name of proposed Superintendent Telephone No. of proposed Superintendent: (818) 335-0775 RMD10C6673 Parkway_Concrete Ma ntenance S4 Million Concrete Improvements 10/23/20 Project Name & Contract Amount Type of Work Date Completed Citywide Concrete Repair FY 2019-20 $210,900.00 Concrete Repairs 1 1/23/20 ['reject Name & Contract Amount Type of Work Date Completed Curb Ramps Construction S143.562.99 Concrete Improvements 8/24/18 Project Name & Contract Amount Type of Work Date Completed C-1I CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771.1(a)), passed by the California State Senate on June 20,2014,established a new public works Contractor Registration Program,which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July I through June 30 state fiscal year) with the California Department of Industrial Relations(DIR). Currently the annual non-refundable registration fee for Contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 http://www.dir.ca.gov/DLSUPublic Works/SB854FactSheet-6.30.14.pdf DIR's Contractor Registration Link —Call (844) 522-6734 https://cfiling.dir.ca.gov/P WCP/ActionServlet?action=displayP WCRegistrationForFn DIR's Contractor Registration searchable database: https://cfiling.dir.ca.gov/PWCR/Search.action 1 am aware and will comply with the provisions of Labor Code Section 1771.1(a)which states: -A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725.5. It is not a violation of this section for an unregistered contractor to submit a bid that is authorized by Section 7029.1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract Code, provided the contractor is registered to perform public work pursuant to Section 1725.5 at the time the contract is awarded." 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. FS Contractors, Inc. ContractBY r marthaafscontractorsane_com Email President Title Date: 10/27/20 PWC Registration #: 1000033438 C-12 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24,Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low-Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director,officer,or manager(initial the applicable selections): Will ensure that 10%of all new hires as a result of this project shall meet all requirements of Section 3 ofCFR Part 135 of the HUD Act of / 1968;or v Will hire no new employees in conjunction with this project. Will award 10%of its sub-contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub-contracts related to this project. Contractor FS Contractors, Inc Contact Person Jose Angel Fierrns Contact Phone 818 838-6040 Signed 'I.-, Date: $Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub- contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-13 .EXHIBIT A DISADVANTAGED 13USINESS ENTERPRISE: (DBE.) This Project is subject to Part 200.321, Titic 2. Code of Federal Regulations entitled "Contracting with Small and lv4inority Businesses. Women's 13usiness Enterprises, and Labor Surplus Area Firms." The Regulations in their entirety arc incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined ill Part 200.321. Title 2 CPR, shall be encouraged to participate in the performance of Contracts financed in whole or in part with federal funds. The Contractor should ensure that DBEs.as defined in Part 200.321, Title 2 CPR. have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps,as set forth in Part 200.321.Title 2 C1=R. for this assurance. The Contractor shall not discriminate on the basis of race, color, national origin. or sex in the award and performance of subcontracts. Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project. although there is no specific goal for DBE participation. C-14 EXHIBIT B DBE. INFORMATION—GOOD FAITH EFFORTS Federal-aid Project No. CC No. 1620 Bid Opening Date t 0/Z/70 The City of Huntington Beach established a Disadvantaged Business Enterprise (DBE)goal of 9% for this Project. The information provided herein shows that a good faith effort was made. Lowest,second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder DBE Commitment" form indicates that the bidder has met the DBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified DBEs soliciting bids for this Project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested(please attach copies of solicitations,telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods Solicitation and Dates CL Surveying and Mapping 10/22/20 WML. ypMLtV*pJY1J* C-15 C. The items of work which the bidder made available to DBE firms including, where appropriate,any breaking down of the contract work items(including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder-Normally Breakdown of Amount Percentage Performs Item Items (S) of (YIN) Contract 6LA0,0le 0 D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: tIA- 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: I�IAc C-16 F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: Nib 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 A enc /Or anization Method/Date of Contact Results A H. Any additional data to support a demonstration of good faith efforts(use additional sheets if necessary): NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. C-17 1 0/2 7120 2 0 FS Contractors, Inc. Mail-RE: Huntington Beach-Residential Curb Ramp(9%DBE Goal)-Request for Quote MGmail Ying Kwan <ying@fscontractorsinc.com> RE: Huntington Beach - Residential Curb Ramp (9% DBE Goal) - Request for Quote 1 message Jennifer McMeans <jennifer@cl-survey.com> Tue, Oct 27, 2020 at 8:52 AM To: Ying Kwan <Ying@fscontractorsinc.com> Cc: Angel Fierros <Angel@fscontractorsinc.com>, Martha Lopez <martha@fscontractorsinc.com>, Lam Le <lam@cl- survey.com> Hi Ying, The price would be $S00 per intersection. Thank you, Jennifer McMeans Office Manager jennifer@cl-survey.com (909)484-4200 Tel. CL Surveying and Mapping 1269 Pomona Road, Suite 108 Corona, CA 92882 L SURVEYING & MAPPING From: Ying Kwan [mailto:Ying@fscontractorsinc.com) Sent: Tuesday, October 27, 2020 8:51 AM To: Jennifer McMeans Cc: Angel Fierros; Martha Lopez; Lam Le Subject: Re: Huntington Beach - Residential Curb Ramp (9% DBE Goal) - Request for Quote Jennifer: What if not all the intersections have monuments. Can you provide a unit price per intersection? https://mail.google.conVmail/u/0?ik=2f9b12eaaf&view=pt&search=all&permthid=thread-a%3Ar5948684412219858275%7Cmsg-f%3A1681720797002... 1/4 10/27/2020 FS Contractors, Inc. Mail-RE:Huntington Beach- Residential Curb Ramp(9%OBE Goal)-Request for Quote Ying Kwan Project Manager FS Contractors, Inc. 14838 Bleasoe Street Sylmar,CA 91342 818-838-6040 818-838-6171 Fax On Tue, Oct 27, 2020 at 8:46 AM Jennifer McMeans <jennifer@cl-survey.com> wrote: Hi Ying, For task item 5 we are anticipating 85 monuments so 85 intersections and the same with bid schedule B. 37 monuments, 37 intersections. Please reach out to Lam if you have any questions. Thank you, Jennifer McMeans Office Manager jennifer@cl-survey.com (909) 484-4200 Tel. CL Surveying and Mapping 1269 Pomona Road, Suite 108 Corona, CA 92882 L SURVEYING & MAPPING I 'p From: Ying Kwan (mailto:Ying@fscontractorsinc.com] Sent: Monday, October 26, 2020 2:45 PM To: Jennifer McMeans Cc: Angel Fierros; Martha Lopez; Lam Le Subject: Re: Huntington Beach - Residential Curb Ramp (9% DBE Goal) - Request for Quote https://mail.google.con/maillul0?ik=2f9bl2eaaf&view=pt&search=all&permthid=thread-a°/3Ar5948684412219858275%7Cmsg-f%3A1681720797002... 214 10/27/2020 FS Contractors,Inc. Mail-RE: Huntington Beach-Residential Curb Ramp(9%DBE Goal)- Request for Quote Jennifer: For Task 5 - Monument Preservation, how many intersections are included for bid schedule A and 6, respectively? Ying Kwan Project Manager FS Contractors, Inc. 14838 Bleesoe Street Sylmar,CA 91342 818-838-6040 818-838-6171 Fax On Mon, Oct 26, 2020 at 2:10 PM Jennifer McMeans <jennifer@cl-survey.corn> wrote: Good afternoon Ying, Attached is our cost to provide survey. Thank you, Jennifer McMeans Office Manager jennifer@cl-survey.Cont (909) 484-4200 Tel. CL Surveying and Mapping 1269 Pomona Road, Suite 108 Corona, CA 92882 iL L SURVEYING & MAPPING I u From: Ying Kwan [mailto:Ying@fsconlractorsinc.com] Sent: Monday, October 26, 2020 11:16 AM To: Jennifer McMeans https://mail.google.com/mail/u10?ik=2fgbi2eaaf&view=pl&search=all&permthid=thread-a%3Ar5948684412219858275°/7Cmsg-f°/,3Al681720797002... 3/4 10/27/2020 FS Contractors,Inc. Mail-RE: Huntington Beach-Residential Curb Ramp(9% DBE Goal)-Request for Quote Cc: Angel Fierros; Martha Lopez; Lam Le Subject: Re: Huntington Beach - Residential Curb Ramp (9% DBE Goal) - Request for Quote Jennifer: Will you be providing a quote for this project? Please complete and return the attached EEO certification form with your quote. Thank you. Ying Kwan Project Manager Fs Contractors, Inc. 14838 Bledsoe Street Sylmar,CA 91342 818-838-6040 818-838-6171 Fax On Thu, Oct 22, 2020 at 11:26 AM Ying Kwan <Ying fscontractorsinc.com> wrote: Jennifer: Please provide a quote for monument preservation. See attached bid documents. The bid is due next Tuesday, October 27, 2020. Please contact me if you have any questions. Thank you. Ying Kwan Project Manager FS Contractors, Inc. 14838 Bledsoe Street Sylmar, CA 91342 818-838-6040 818-838-6171 Fax htlps://mail.google.mm/mail/ul0?ik=2f9b 12eaaf&view=pt&search=all&permthid=thread-a%3Ar5948684412219858275%7Cmsg-f%3A1681720797002... 4/4 IF A SOLE OWNI:iR OR SOLE CONTRACTOR SIGN HERE: (1) Name raider which business is conducted N/A (2) Signature (given and surname) of proprietor (3) Place of Business (Street and Number) City and State (4) Zip Code "relephone No. (5) E-Mail Ih A PARTNERSHIP. SIGN 1-1F.RE: (1) Name under which business is conducted NSA (2) Signature (given and surname and character of p:uvner) (Note: Signature must be made by a general partner) (3) Place or Business (Street and Number) Citv and State (4) Zip Code Telephone No. (5) E-Mail CA 8 IF A CORPORATION. SIGN HERE: (1) Name under which business is conducted FS Contractors, Inc. (2) (Signature) President (Title) Impress Corporate Seal her: (3) Incorporated under the laws of the State of California (4) Place of Business 14838 Bledsoe St. Sylmar, CA 91342 (Street and Number) City and State Sylmar, CA (5) Zip Code 91342 Telephone No. (818)838-6040 (6) E-Mail marthana fscontractorsinc.com NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED See, P� C-19 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A rotary public or other officer completing this certificate verifies only the identity of the individual who signed the 1 document to which this certificate is attached,and not the truthfulness, accuracy,or validity of that document. State of California ) County of Los Angeles ) On October 27, 2020 before me, Marsha IGahel I upez Riuhi- Nohrn Puhhc Date Here Insert Name and Title of the Officer personally appeared Jose Angel Fierros Nam,W of Signer(* — who proved to me on the basis of satisfactory evidence to be the persop(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 capacitybes),and that by his/her/thelr signature(a)on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of Califomia that the foregoing paragraph is true and correct. WITNESS my hand and official seal. 3 Signature Slynaturo of No Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the docum r fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: _ Docum ate: Number of Pages: _ __ , Signer's) Other Than Named Capecity(ies) Claimed by Signer(s) Signer's Name: _ Signer's Name: Corporate Officer — Title(s): Corporate Officer — Title(s): Partner — Limited Gene Partner — ❑Limited _1 General Individual Attor Fact ❑Individual ❑Attomey in Fact Trustee rdian or Conservator ❑Trustee ❑Guardian or Conservator Other: ❑ Other: _ Signer presenting Signer Is Representing: C2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item a5907 List below names of president, vice president, secretary and assistant secretary, if a corporation: it' a partnership, list names ofall general partners and managing partners: Jose Ansel Pierros President Salomon Eierros Vice President Jose Ernesto Pierros Corporate Secretary C-20 IiX11I131I C LOCAL AGENCY BIDDER DBE COMMITMENT(CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY UT"r QF%&MW GCN PJFIC* LOCATION Huntington Bach PROJECT DESCRIPTION RESIDENTIAL CURB RAMP PROJECT TOTAL CONTRACT AMOUNT S�. 29I,Noo BID DATE 10/27/20 BIDDER'S NAME FS Contractors,Inc CONTRACT DBE GOAL: / a rim NTRACT EM OF WORK AND DESCRIPTIONBE CERT NO NAME OF EACH DB LLAR AMOUNT EM NO. R SERVICES TO B AND EXPIRATION (Must be certified on the due BE UBCONTRACTED OR MATERIALS DATE are opened- include DBE O BE PROVIDED(or contracted if the and phone number) Willa is a DBE) K44T eft 0 - For Local Agency to Complete: Total Claimed DBE E M &,rCO Local Agency Convect Number p�lclpaBm { L� Federal-aid Ptu)ect Number Ard-7 Federal Share Convect Award Date. Local Agerwy ccnitics that all DBL certifications have been sad7ed and r O information is complete and accurale SI re BKW 10/27/20 (818) 838-WO Date (Area Code)Tel No Print Name Signature Jose Angel Fierros Local Agency Represemattve Person to Contact (Please Type or Print) (Area Code)Telephone Number 1.wal Apm)Btdder DBE Cmutarmna ICamuumm Canvacbl IRe, d2609) C-21 PLEASE NOTE: This information may be submitted with your bid. If it is not, and you are the apparent low bidder or the second or third low bidder, it must be submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bit] nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location. Project Description. Total Contract Amount. Did 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 DBF--•s. 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 DBF. The DBE shall provide a certification number to the Contractor and expiration date. lamer the DBE prime's and subcontractors' certification nurnbers.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 DBF' address and phone number). IMPORTANT: Identify all DBF firms participating in the project regardless of tier. Nantes ofthe 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 \'our bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed D1113 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 perfonned or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE-.) See Section "Disadvantaged Business Enterprise (1)13E)." of the Special Provisions (construction contracts). to determine how to count the participation of 1)81" firms. Exhibit 15-G trust 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, Conti-act Award Date fields and verify that all information is complete and accurate before signing and filing. C-22 EXHIBIT D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder FS Contractors. Inc. [proposed subcontractor J hereby certifies that he/she/it has_, has not_, participated in a previous contract or subcontract subject to the Equal Opportunity clauses, as required by Executive Orders 10925, 1 1 1 14, or 11246, and that, where required, he/she/it has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of 510,000 or under are exempt.) Currently, Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. (ecoc.gov/employers/ecoisurvey/index.cfm) Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. (J Signature: K ( v Date: 10/27/20 Print Name: Jose Angel Fierros Title: President C-23 EXHIBI-I' D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The biddel-FS Contractors, Inc. [proposed subcontractor CL Surveying and Mapping, Inc. ,1 hereby certifies that he/she/it hasx . has not_, participated in a previous contract or subcontract subject to the Equal Opportunity clauses. as required by ExeeLItlVe Orders 10925, 1 1 1 14, or 11246, and that, where required, he/she/it has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency. or the former President's Committee on Equal Lmployment Opportunity, all reports due under the applicable filling requirements. Note: '['he above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (I)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CPR 60-1.5. (Generally only contracts or subcontracts of S10.000 or under arc exempt.) Currently, Standard Form 100 (LBO-1) is the only report required by the Executive Orders or their implementing regulations. (eeoc.gov/employers/eeolsurvcy/indcx.ctni) 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 CPR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director. Office of Federal Contract Compliance, U.S. Department of Labor. Signature: pate: 10/27/20 Print Namc: Lam Le "I isle: President C-23 EXHIBIT E NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) FS Con�'Ac�otS , � [NAME OF CONTRACT] To the City of Huntington Beach In conformance with Title 23 United States Code Section 112 and California Public Contract Code 7106 the bidder declares that the bid is not made in the interest of,or on behalf of,any undisclosed person,partnership,company,association,organization,or corporation;that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid,and has not directly or indirectly colluded,conspired,connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true;and, further,that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof,or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. By signing the Proposal, the Bidder has also signed this Noncollusion Affidavit. Bidders are cautioned that making a false Certification may subject the Bidder to criminal prosecution. Signature: Date: 10/27/20 Print Name: Jose Angel Fierros Title: President C-24 EXHIBIT F DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS, PART 29 The Bidder, under penalty of pedury, certifies that, except as noted below, he/she or any other person associated with Bidder in the capacity of owner, partner, director, officer, manager: • is not currently under suspension, debarment, voluntary exclusion,or determination of ineligibility by any Federal agency; • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending;and • has not been indicted,convicted, or had a civil judgment rendered against him/her by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Note: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Signature: r je'7 '1 Date: 10/27/20 Print Name: Jo grl F' rr Title: President C-25 EXHIBIT G NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: 1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment,or modification of any Federal contract,grant, loan,or cooperative agreement. 2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31. U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10.000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipiients shall certify and disclose accordingly. Signature: r Date: 10/27/20 Print Name: Jose Angel Fierros Title: President EXHIBIT H C-26 DISCLOSURE OF LOII13YING ACTIVITIES NIA COMPLETE THIS FORNI TO DISCLOSE LOBBYING ACTIVITIES PURSUANTTO 31 U.S.C. 13i2 I. '1'spe of Federal Action: 2 States of Federal Action: 3. Report'I)pe: Ela.contract El. bid/oiTcr/applicatran ❑ a,initial b grant b,initial mvard b.material change c.cooperative agreement c,post-m.ard d.loan For ddnteri:d Chunge Only- C.loan guarantee rear quarter f.loan insurance Jwv of last report 1. N:une and Address of Reporting Entity 5, If Reporting F-ntily in No.J is Suhawurdee. Enter Name and Address of Trine•: ❑ Prime Subawardec Tier ,it known Congressional District.it known Congressional District.if known 6. Federal Depurintent/Agency: 7. Federal Program Name/Description: CFDA Number,if applicable N. Federal Action,Nmuher,it known: 9. Award AnumnL if known: 10. a.NIIInC and Address of Lobby Emit% It. Indi,Wants Performing Scn'ices (including (If individual,last name,first name.ml) address l'different from No. IOa) (last name,first name,h11) (anach Continuation Sheets)if necessary) it. Antoan of Payment(check ill that apply) 13. 'Type of Payment(check all that apply) S Actual planned a.retainer b one-time fee 12. Form or Payment(check all that apply): c.commission Ba cash d.contingent fee b.in-kind: specify: nature a deferred value I.other,specify 14. Brief Description of Services Performed or to he performed and Ducts)of Sen'ice,including olficertsk employee(sk or rnemhcr(s)contacted,for Payment Indicated in Item 11: taaach Continuation Sheets)if necessary IS Conlinuation Sheet(s)attached: 1'es ❑ No 11 16. Information requested through this form is authorized by'I'itle 31 U.S.0 Section 1352, ']his disclosure of lobbying reliance Signature: sans placed by the tier above when his transaction wits made or entered into,'I'his disclosure is required pursuant to 31 U.S.C. Print Name: lase Angel Fierros 1352. 'Phis information will be reported to Congress scallUn edlr and will M available for public inspection.Any 'fide President person who dui is to file the required disclosure shall M subject to a civil penalty of not less than S10,000 and not more than Telephone No.: (813)538-6040 Date: 10/27/20 S 100.000 for each such failure Authorized for Luca)Reproduction Fedend Use Onh': Standard Form-IAA- Standard Form LLL Rev,09-12-97 C-27 INSTRUCTION'S FOR CONIPLf TION OP EX1-11BIT I-l. DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity. whether subavvardee 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 iv9anagement and Budget for additional information. 1) Identif' the type of covered Federal action for which lobbying activity is and/or has been secured to influence, the outcome ofa covered Federal action. 2) IdentiN 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 namc, 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 subawardce, e.g., the first subawardce ofthe prime is the first tier. Subawards include but are not limited to subcontracts. subgrants and contract awards under grants. 5) If the organization tiling the report in Item 4 checks "Subawardec" then enter the full name. address, city, state and zip code ofthe prime Federal recipient. Include Congressional District. i f 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 namc 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) Linter the most appropriate Federal identifving number available for the Federal action identification in item I (c.u.. Request for Proposal (RI-P) number, Invitation for Bid (HAI) 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.. "R F P-D E-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 cntit, 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). 1 I)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. C-28 12)Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13)Check- the appropriate box(cs). Check all boxes that apply. Ifother. 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) ol'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) crnployee(s) or Member(s) of Congress that were contacted. 15)Check whether or not a continuation shect(s) is attached. 16)The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources. gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of' this collection of information. including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0046). Washington, D.C. 20503. By my signature on this proposal I certify. under penalty of perjury tinder the laws of the State of California, that the foregoing questionnaire and statements of' Public Contract Code Sections 10162. 10232 and 10285.1 arc true and correct and that the bidder has complied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5. Title 2 of the California Administrative Code). C-29 EXHIBIT I FEDERAL LOBBYING RESTRICTIONS Section 1352. Title 31. United States Code prohibits Federal funds from being expended by the recipient or any lower tier subrccipicnt of a Federal-aid contract to pay for any person for influencing or attempting to influence a Federal agency or Congress in connection with the awarding ofany Federal-aid contract, the making ofany Federal grant or loan, or the entering into ofany cooperative agreement. I f anv funds other than Federal funds have been paid for the same purposes in connection with this Federal-aid contract. the recipient shall submit an executed certification and, if'rcquired, submit a completed disclosure form as part of the bid documents. A certification for Federal-aid contracts regarding payment of funds to lobby Congress or a Federal agency is included in the Proposal. Standard Form - L.LL.. "Disclosure of Lobbying Activities." with instructions for completion ofthe Standard Form is also included in the Proposal. Signing the Proposal shall constitute signature ofthe Certilication. The above referenced certification and disclosure of lobbying activities shall be included in each subcontract and any lower-tier contracts exceeding $100.000. All disclosure forms. but not certifications. shall be forwarded from tier to tier until received by the Engineer. The Contractor. subcontractors and anv lower-tier contractors shall file a disclosure form at the end of each calendar quarter in which there occurs any event that requires disclosure or that materially affects the accuracy ofthe information contained in any disclosure form previously filed by the Contractor, subcontractors and anv lower-tier contractors. An event that materially affects the accuracy of the information reported includes: I) A cumulative increase if 525.000 or more in the amount paid or expected to be paid for influencing or attempting to influence a covered Federal action: or 2) A change in the person(s) or individual(s) influencing or attempting to influence a covered Federal action: or 3) A change in the officer(s). employecs(s), or Member(s) contacted to influence or attempt to influence a covered Federal Action. C-30 City of Huntington Beach Public Works Department 2000 Main Street Tel (714) 536-5431 Fax (714) 374-1573 ADDENDUM NUMBER ONE For RESIDENTIAL CURB RAMP PROJECT in the CITY OF HUNTINGTON BEACH OCTOBER 20, 2020 Notice To All Bidders' Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1 t SHEET Al OF PROJECT SPECIFICATIONS Bids will be received from 1 00 PM to 2 00 PM only on the bid due date(10/27/2020)outside of the City Hall main entrance at 2000 Main St in Huntington Beach Staff wil be present during this hour to receive bids only Mailed bids are still accepted but must be received before the bid submission deadline It in encouraged that bidders arrive earlier than normal to drop off bids to avoid a late delivery Bids will be opened outside of City Hall immediately after 2 00 PM Bidders are welcome to stay and attend the opening Social distancing measures shall be observed and masks will be required for all in attendance This update to the Notice Inviting Sealed Bids shall supersede all other bid delivery information noted on the project documents A revised NISB is now included wrath the project documents This is to acknowledge receipt and review of Addendum Number One, dated October 20, 2020 C FS Contractors_ Inc. Company Name By 10/27/20 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. Bond No. NIA BID OR PROPOSAL BOND KNOW ALL MEN BY THESE PRESENTS, that we FS Contractors, Inc. as Principal, (hereinafter called the Principal), and RLI Insurance Company , a corporation duly organized under the laws of Illinois and authorized to transact a general surety business in the State of California as Surety, (hereinafter called the Surety), are held firmly bound unto: City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 as OBLIGEE, (hereinafter called the Obligee), in the sum equal to 10% of the accompanying bid of the Principal, not, however, in excess of Ten Percent of the Total Amount of the Bid for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION IS SUCH, That, whereas, the Principal has submitted or is about to submit to the Obligee a Proposal or bid, dated on or about the date mentioned below, for: (1) the performance of the designated work, or (2) the furnishing of the specified goods, supplies or products, to-wit: Residential Curb Ramp Project NOW, THEREFORE, if the Principal shall not legally withdraw said bid within or at the times permitted therefor, but shall duly make and enter into a written contract with the Obligee, in accordance with the terms of said proposal or bid, or any amendment thereof acceptable to the Principal, within the time permitted therefore after such contract forms are presented to the Principal for execution, should the Obligee award the Principal the said work or contract or any part thereof and if the Principal shall give bond or bonds for the faithful performance thereof, and/or for payment for labor and materials going thereinto, as in the specifications or contracts provided: or if the Principal shall in case of failure so to do, pay the Obligee the damages which the Obligee shall have actually suffered by reason of such failure, not exceeding the penal sum of this bond, then this obligation shall be null and void, otherwise to be and remain in full force and virtue. PROVIDED, HOWEVER, that no action shall lie, or claim be enforced hereunder, unless the award on the basis of said bid shall have been made within thirty (30) days after the formal opening of said bid, or within the time specified within the bid provisions, whichever time shall be greater, and unless the Obligee hereunder shall give notice to Surety of said award at the time of notification to the Principal; and unless legal action to enforce any claim hereunder shall have been commenced within six (6) months from the date of the formal opening of said bid. PROVIDED, always, that this Bond shall not be valid and binding upon Surety unless accompanied by a Certified Copy of a Power of Attorney authorizing the undersigned Attorney-in-Fact to execute such a bond, the Serial Number upon which Copy of Power of Attorney shall correspond with the Bond Number set out above. Signed, sealed and dated this 27th day of October , 2020 FS Contractors, Inc. Principal Name By: � r/z'„^-. Prncipal / RLI Insurance Company Name of Surety Company By: (Sa ` — Attorney-in-Fact, Peter Micciche POWER OF ATTORNEY RLI Insurance Company Contractors Bonding and Insurance Company 9025 N.Lindbergh Dr. Peoria,IL 61615 Phone: 800-645-2402 Know All,yen by These Presents: That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the approving officer if desired. That RIA Insurance Company and/or Contractors Bonding and Insurance Company, each an Illinois corporation, (separately and together, the"Company")do hereby make, constitute and appoint: Patricia%enizo. Pietro 69icciche,Aneel Nunez. Elsa Escobar iointly or severally in the City of Glendale , Stale of California its true and lawful .Agent(s) and Attorney(s) in Fact, with full power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all bonds and undertakings in an amount not to exceed Twenty Five Million Dollars ( $25,000,000.110 ) for any single obligation. The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon the Company as if such bond had been executed and acknowledged by the regularly elected officers of the Company. RIA Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have each further certified that the following is a true and exact copy of a Resolution adopted by the Board of Directors of Inch such corporation,and is now in force, to-wit: "All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary,any Assistant Secretary,Treasurer, or any Vice President,or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds, policies or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies,undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile." IN WITNESS WHEREOF, the RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have caused these presents to be executed by its respective Vice President with its corporate seal affixed this 16th day of October , 2020 RLI Insurance Company w y sG.,, yPpNCf col,,, Contractors Bonding and Insurance Company SFAL Barton W.Davis Vice President State of Illinois l +oz „[[tN ors,•" )} County of Peoria SS CFR Il FICATE On this 16th day of October 7WO before me,a Notary Public, 1, the undersigned officer of RLI Insurance Company and/or personally appeared Barton W. Davis , who being by me duly sworn, Contractors Bonding and Insurance Curnpany, do hereby certify acknowledged that he signed the above Power of Attorney as the aforesaid [hat the attached Power of Attomey is in full force and effect and is officer of the RLI Insurance Company and/or Contractors Bonding and irrevocable, and furthemtore, that the Resolution of the Company as Insurance Company and acknowledged said instrument to be the voluntary set forth in the Power of Attorney, is now in force. In testimony act and deed of said corporation. whereof, I have hereunto set my hand and the seal of the RLI Insurance Coin tyar and/or Contracts Bonding_artd Insurance ,,y Compan}'this �T day of C7C�O GAY LLOO By: `J.�l.]�h4/ RLI Insurance Companv Contractors Bonding and Insurance Cornpmp Catherine D.Glover Notary Public GTMERINEO.S /� DOFAdAL t 191-4(_AIrbtey P"C-ski Byyyronyrtk m Jeffrey 0.J�ickg U Corporate Secretary 111IM302021: A005&D19 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California ) County of Los Angeles ) On C�lober L-t 2�>n before me, Noelle C. Rodriguez Notary Public Date Here Insert Name and Title of the Officer personally appeared Peter Micciche Names)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) Is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacityQes),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 I is true and correct. NOEL0"r y C.ROORTOUR w Notary Public.[e111o.nl4 WITNESS my hand and official seal. ay -11.E. ....[Dump �,�� [ ssion rlZJ6A3J - r Comm.IE.�,.es p.1C.2012 Signature Signature of Notary bli 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: Signers) Other Than Named Above: Capacitypes) 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 91 Attorney in Fact ❑ Individual ❑Attomey 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) Rem tt5907 FS Contractors, Inc. 14838 Bledsoe St. Sylmar, CA 91342 Pao pq" City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ w%tiNv.huntingtonbeachca.gov ,Ee Office of the City Clerk Robin Estanislau, City Clerk April 23, 2021 Gentry General Engineering, Inc. 9277 Archibald Avenue Rancho Cucamonga, CA 91730 RE: Residential Curb Ramp Project — CC No. 1620 Enclosed please find your original bid bond for CC-1620. Sincerely, ` _RobiinEstanislau, CIVIC City Clerk RE:ds Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand SECTION C PROPOSAL for the construction of RESIDENTIAL CURB RAi1111 PROJECT CC No. 1620 in the CITI' OF HUNTINGTON BEACII 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 I funtin,ton Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 60 working days_ starting from the date of the Notice to Proceed. 131DDER 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 SLIM 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 FRO\4 THE.. CONTRACT. It is a_reed 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. War such time the contract is not awarded, the AGENCY will reject all bids and will re-advertise the project_ In the case of discrepancies in the amounts bid. unit prices shall govern over extended amounts, and words shall govern over figures. 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 a hrd Iwunl in the amount of I W u which said amount is not less than 101/6 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 "Bidders Bond for_% ", as the case may be) Anv standard Surety Bid Bond form is acceptable. Bidder shall signify receipt of all Addenda here, if anv AddendaNa. Dare Received drier'+.Si nature -- City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431 . Fax (714) 374-1573 ADDENDUM NUMBER ONE Foi RESIDENTIAL CURB RAMP PROJECT in the CITY OF HUNTINGTON BEACH OCTOBER 20. 2020 Notice To All Bidders: Please note the following clarification to the Project Plans. Specifications. and Special Provisions 1) SHEET All OF PROJECT SPECIFICATIONS &ds wtl�be f ece,ved from 1 00 PM to 2 00 PM only on the bid due date I10 27 20201 outside of the City Hall main entrance at 2000 Main St in Huntington Beach Staff well be present during this hour to receive bids only Mailed bids are still accepted but must be received before the bid submission deadline It in encouraged that bidders arrive earlier than normal to drop off bids to avoid a late delivery Bids will be opened outside of City Hall immediately after 2:00 PM. Bidders are welcome to stay and attend the opening Social distancing measures shall be observed and masks will be required for all in attendance This update to the Notice Inviting Sealed Bids shall supersede all other bid delivery information noted on the project documents. A revised NISB is now included with the protect documents This is to acknowledge receipt and review of Addendum Number One. dated October 20. 2020 Company Name By Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal SECTION C PROJECT BID-SCHEDULE A CURB RAMP PROJECT,CC 1620 BID ITEMS Item DcKriptioe Quantity Unit Unit Cost Total Coat No. (EsMadom) 1 Mobikzsbon 1 LS $".I11111IIII $ i5,111I1L(111 2 Prepare Storm Water Pollution Prevention Plan(SWPPP) 1 LS $ 1 .7 7A.00 $ 1.77h.00 3 install 8 maintain Construction BMPs 1 is $h._'IIIion $ h200,00 Horizontal Curb Cut Curb Access Ramp per Caltrans Std Plan A88A using horizontal curb cutting machine as shown on 4 Curb Ramp Detail 1 in Appendix H of Specifications (Item 109 includes all appurtenances,curb 8 gutter, depressed curb. sevvcut, sidewalk, domes, retaining curb, etc.) EA $ `._'III I IIII V06.0000 Construct Curb Access Ramp per Caltrans Std Plan ABBA as 5 shown on Curb Ramp Detail 1 in Appendix H of Specifications 17 (Item includes all appurtenances,curb 8 gutter, depressed Curb, sawca sidewalk, domes, retaining curb,slot pave, etc.) EA Horizontal Curb Cut Curb Access Ramp per Caltrans Std Plan A88A using horizontal curb cutting machine as shown on 6 Curb Ramp Detail 2 in Appendix H of Specifications (Item 2 includes all appurtenances,curb&gutter, depressed curb, sawcut, sidewalk. domes,retaining curb, etc I EA V.200.00 $ 10.400,011 Horizontal Curb Cut Curb Access Ramp per Caltrans Slid Plan A88A using horizontal curb cutting machine as shown on 7 Curb Ramp Detail 3 in Appendix H of Specifications (item includes all appurtenances. curb 8 gutter, depressed curb. sawcut, sidewalk, domes, retaining curb, etc 1 30 EA $�,2011.00 $ I Construct Curb Access Ramp per Caltrans Std Plan A88A as a shown on Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances. curb 8 gutter, depressed curb,sawcut, sidewalk, domes, retaining curb,slot pave, etc I B EA $5,201 00 $ 41,600.00 9 Install truncated domes to existing Curb Ramp 10 EA $S-(I.(10 $ } 7011 IIII 10 Install 4" PVC Sleeve for Street Assembly Sign per City of 148 Std Plan 401 10 EA $ -17i.011 $3,7i(I IIII 11 Remove and replace existing sidewalk per City of HB Std Plan207 (Allowance) 1.000 SF $x.`(I Remove and replaces existing 6' or 8' Curb and Gutter per 12 HB Std. Plan 205(Item includes all appurtenances slot pave, etc) (Allowance) 300 LF $ 70.00 $ 21 .0011.00 SUB-TOTAL BID AMOUNT(SCHEDULE A) :_949,126.00 C-2 1 SECTION C PROJECT BID — SCHEDULE A CURB RAMP PROJECT,CC 1620 SUB-TOTAL BID AMOUNT IN WORDS. nine hundred forty-nine thousand one hundred twenty-six dollars Note All extensions of unit prices will be subject to verification by Owner In case verification is required between the unit price and the extension, the unit price will govern The Owner reserves the right to reject any or all proposals and bid items. In addition. the City reserves the right to include or remove Bid Schedule B in the award of the contract C-2.I SECTION C PROJECT ADDITIVE BID— SCHEDULE B CURB RAMP PROJECT, CC 1620 BID ITEMS Item Daeai/Kw Qa+Mtky Unit Unit Cold Total Con Ne, (Eatenaien) Horizontal Curb Cut Curb Access Ramp per Caltrans Slid Plan A88A using horizontal curb cutting machine as shown on 40 1 Curb Ramp Detail 1 in Appendix H of Specifications (Item includes all appurtenances,curb 8 gutter, depressed curb, f sawcut, sidewalk, domes, retaining curb etc.I EA S >,ho0,011 S ---1.III If l.1111 } Construct Curb Access Ramp per Caltraris Std Plan A88A as 2 showri on Curb Ramp Detail 1 in Appendx H of Specifications 3 (Item includes all appurtenances, curb 8 gutter, depressed curb, sawcut, sidewalk, domes, retaining curb, slot pave, etc.) EA $?.6110.1111 S 1 b,iiflll.11ll Horizontal Curb Cut Curb Access Ramp per Caltrans Std Plan A88A using horizontal curb cutting machine as shown on 3 Curb Ramp Detail 2 in Appendix H of SpecAcations (Item 3 includes all appurtenances, curb 8 gutter, depressed curb. sawcut, sidewalk, domes, retaining curb, etc ) EA S 5.000.00 S 16.80000 Horizontal Curb Cut Curb Access Ramp per Caltrans Std Plan A88A using horizontal curb cutting machine as shown on 4 Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances,curb 8 gutter, depressed curb. 4i ,p11 III I sawcut, sidewalk, domes, retaining curb, etc 1 17 EA S5,600.00 $ Construct Curb Access Ramp per Caltrans Std Plan A88A as S shown on Curb Ramp Detail 3 in Appendix H of Specrfications (Item includes all appurtenances, curb 8 gutter, depressed curb, sawcut, sidewalk, domes, retaining curb,slot pave, etc I 9 EA $�.Ir11i1.U(1 $ >II-all(1.(Ill 8 Install truncated domes to existing Curb Ramp g EA $X 70 00 $ 7,X�0 01) Remove and replace existing sidewalk per City of HB Std Plan207 (Allowance) 400 SF SX0q) $ t,.31111.o0 Remove and replaces existing 6'or 8'Curb and Gutter per a HB Std Plan 205(hem includes all appurtenances, skit pave. etc) (Allowance) 100 LF $ 70 oo S7.lioli IIII SUB-TOTAL ADITIVE BID AMOUNT(SCHEDULE B) $ 421.430.00 SUB-TOTAL ADDITIVE BID AMOUNT IN WORDS: four hundred twenty-one thousand tour hundred thirty dollars Note All extensions of unit prices will be subject to verification by Owner In case verification is required between the unit pnce and the extension, the unit price will govem The Owner reserves the right to reject any or all proposals and bid items In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract. C-2.3 SECTION C PROJECT BID SCHEDULE TOTALS RESIDENTIAL CURB RAMP PROJECT CC 1619 Sub-Total Bid - Schedule A 940.126.00 Sub-Total Additive Bid - Schedule B 421.430 00 TOTAL BID AMOUNT. BASIS OF AWARD (Schedules A+B) TOTAL BID AMOUNT IN WORDS one million three hundrrd seventy thousand five hundreu i,lt,;-S.x dolla- Notes All extensions of unit prices will be subject to verfcation by Owner. In case verification is required between the unit price and the extension. the unit price will govern The Owner reserves the right to reject any or all proposals and bid items. In addition. the City reserves the right to include or remove Bid Schedule B in the award of the contract. C-_2.4 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104. the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10.000. whichever is greater, and the portion of the work to be done by such subcontractor. Bid Name and Address of Slate Oaxr DIR PWC Dollar % of Item(s) subcontractor License Registration a Amount Contract 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 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BV BIDDER AND SUBMMED 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 I n ,? moat It.u,chu r 'uc:uu,a,z .( \ Date Cin, .dale ';" """ ( ' "(' ` being first duly sworn, deposes and says that he or she is r.t, rnt of i;nu (kn r.tl I nemccnne. Ini 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 anv 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 anv corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. (i:ntr, lii nit.t n^_nwitin.T. ln, Name of Bidder Jtguatutc of Btddet \rchih;tL1 \\inu: ll.uuhi� ( ucenttmc.r. (• V ')I ,;ti Address of Bidder 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(that document. State of California County of San Bernardino ) On I D /z 7/L before me, Nicole Dye, Notary Public (insert name and title of the officer) personally appeared Brenton Gentry who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/a'V6 subscribed to the within instrument and acknowledged to me that he/s�0 6y executed the same in his/h)ef/thXir authorized capaaty(ies). and that by his/hy,r/t*ir 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 P. MICOLE DYE Maury PWIk Calilanu WITNESS my hand and official seal 02- San lerrurCpq Cwnty CommlttW 0 2325135 y Comm.Expvm aar 20.2024 Signature (Seal) 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 RESIDENTIAL CURB RAMP PROJECT, (I)(wexit) 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 persott who, by reason gjexperience or indructio», is familiar wish the operation to be performed and the hazards itn-olved" 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 anv said subcontractor or subcontractors with the requirements contained herein Contractor By President Title Date: t)nohrr 'n,n DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Flas the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietarw 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 rcculation" ❑ Yes VNo If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a pan of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. 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. iewn General 1 ntmcennc, Inc Contractor By Prcaklcnt Title Date: BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Gcnir\ General Engineering, Inc. Bidder Name 'C' \rrhihald A\cnue Business Address RYnCho ( uCs110112a CA 17311 City, State Zip ( 909 ) 33n-11 'h ecntngcncrtl(n'gmad.cum Telephone Number Email Address State Contractor's License No. and Class Original Date Issued 1un� Expiration Date The work site was inspected by Rrcntim ( e°tn of our office ontlCn)her2r, 20fn The following are persons, firms, and corporations having a principal interest in this proposal _ tumccrrv . In_ 13iauun (icnlr� - I'rr,id.ni 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. (irntn General h winccrur;. Inc. Company Name Signature of Bidder fircnton (icnuc Printed or Typed Signature NOTARY CERTIFICATE Subscribed and sworn to before me this_ day of . 201_ 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 ) plra,c ,cc .ut.,eh�d County of ) On before me, Month, Day, and Year Insert Name and Title of Notary personally appeared Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) islare subscribed to the within instrument and acknowledged to me that he/she/thev 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. 1 certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct WITNESS my hand and official seal Signature .: .ut.lCh:d Signature of Notary Public (PLACE NOTARY SEAL ABOVE) ACKNOWLEDGMENT 1 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached. and not the truthfulness, accuracy, or _validity of that document. State of California County of San Bernardino ) On -7/Z before me. Nicole Dye, Notary Public (insert name and title of the officer) personally appeared Brenton Gentry who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/wt subscribed to the within instrument and acknowledged to me that he/spe/ttyq executed the same in his/tjer/th)?fr authorized capacity(ies), and that by his/h�r/tt 4ir 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. WCOEE DYE WITNESS my hand and official seal MSnk *MCMN"" � s."e.moaww� com+wua�+:us+ts " My Comm.Erpfref MY 20.2024 Signature (Seal) 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. "Demolition of existing concrete ADA ramps and construction of new ADA comPliant curb ramps. Rork included additional curb and gutter construction to ensure surface water flow around corner. All ramps met Caltrans requirements set forth in Standard Plan A88A"I Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years 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' please sec attached Name and Address of Public Agency Name and Telephone No. of Project Manager Contract Amount Type of Work Date Completed Provide additional project description to show similar work Name and .Address of Public .Agency Name and Telephone No. of Project Manager Contract Amount Type of Work Date Completed Provide additional project description to show similar work' a3EGENTRYGENER) ENGINEERING Prior Projects 2013-534,500.00 2016-$504,420 City of Fontana City of Baldwin Park Damaged Street/Sidewalk Alleyway Street/Sidewalk Asphalt & Concrete R&R Asphalt & Concrete R&R 83S3 Sierra Ave 14403 Pacific Ave Fontana, Ca 9233S Baldwin Park, Ca 91706 Jason Jojola: No Email Address Chase Fidler: 909.3S0.6636 626.960.4011 2014 -$30,000.00 2016-$619,075 City of Rancho Cucamonga City of Bloomington Solar Shade Structure ADA Ramp-Repair/Maintenance/Replaced 8794 Lion St. 825 E. 3'Street Rancho Cucamonga, Ca 91730 San Bernardino, CA 92415 909.477.2730(No Email Address) Haile Ford: 909.387.7936 2015 -$49S,000 City of Whittier 2016-$173,604 Fire Loop/Fire Sprinkler Repair City of Montclair 9401Painter Ave Alleyway Street/Sidewalk Asphalt & Concrete Whittier, Ca 90605 5111 Benito St Karla Embry: Montclair, Ca 91763 562.332.9303 Steve Stanton: 909.625.9444 2015-$41,000 City of Glendora 2017-$325,000 Water Improvement City of Upland 116 E. Foothill Blvd. Damaged Street/Sidewalk Glendora, Ca 91741 Asphalt & Concrete R&R Carlos Cigneros: No Email Address 1370 North Benson Ave 626.786.1285 Upland, Ca 91785 Tony Trejo: 909.631.3918 9277 Archibald Ave. off:909.330.1128 Ranrhn ruramnnoa rA Qt 7in far QnQ 7AA CFRA 2017-$624,688 2018-$547,950 Santa Ana City of Pasadena Repair Maintenance/Replaced Miscellaneous Concrete Repair Damaged Street/Sidewalk 100 Garfield Ave Asphalt & Concrete R&R Pasadena, Ca 91101 20 Civic Center Plaza Morley Saralya: Santa Ana, Ca 92701 626.744.3703 Victor So: 714.647.S076 2018-$2.2 Million City of Torrance 2017-$694,000 Downtown Torrance Active Transportation City of Corona Improvements Miscellaneous Concrete Repair 20500 Madrona Ave 400 S. Vicentia Ave, Ste. 210 Torrance, Ca 90503 Corona, Ca 92882 Justin Gatza: Barry Ghaemi: 310.618.3032 951.739.4961 2019-$288,974 2017-$30,000 City of Barstow City of San Diego Water Treatment Plant Dewatering Pad & Wall Demo/Backfill/Compact Existing 2200 Riverside Dr. Vault Location Barstow, Ca 92311 422 W. Washington St. Kody Topkins: San Diego, Ca 92103 760.252.2538 Matt Cavan: 951.684.1909 2019 - $544,342 Torrance Unified School District 2018-$1.2 Million Anza, Arnold and Hickory ES Site Drainage City of Torrance 21400 Ellinwood Dr Damaged Street/Sidewalk Torrance, CA 90503 Asphalt & Concrete R&R Joe Winterburn: 20S00 Madrona Ave "aifourbeattVus.com Torrance, Ca 90503 (949) 502-4000 Shin Furukawa: 310.618.3073 2019 - $714,000 City of Hermosa Beach 8"Street Improvements Project 8"Street Hermosa Beach, CA 90254 Reed Salan: (310) 318-02 29 9277 Archibald Ave. off: 909.330.1128 Ranrhn rnramnnoa CA 9171n far anQ ,)"Or,RA 2019-$267,000 Costa Mesa Sanitary District Indus Sewer Main Replacement 20122 Santa Ana Ave Newport Beach, CA 92660 Rob Harriers: _ (949)548-1192 2019-$285,744 City of Fullerton Curb/Gutter and Sidewalk Reconstruction Fullerton, CA 92831 Jose Medina: (714) 738-6863 2019-$139,573 City of Irvine Ranch Park Bike Trail Rehabilitation Irvine, CA 92618 Anthony Caraveo: (949) 724-7365 2019-$644,763 City of Thousand Oaks Concrete Replacement and Sidewalk Repair Program Thousand Oaks,CA 91320 Michelle McCarty: (805)449-2477 2020-$1,369,000 City of Torrance Sidewalk Repair for Handicap Accessibility Torrance,CA 90505 Shin Furukawa: (310)791-6900 2020-$19,546 City of Fontana San Bernardino at Cypress Driveway Improvements Fontana, CA 92335 Christopher Smethurst: (909)350-6649 9277 Archibald Ave. off:909.330.1128 Ranrhn rnramnnaa rA g173(1 far QM 7AA Of,RR 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 Project Name& Contract Amount Tvpe of Work Date Completed Project Name& Contract Amount Type of Work Date Completed Project Name& Contract Amount Type of Work Date Completed Name of proposed Superintendent Telephone No of proposed Superintendent Project Name& Contract Amount Type of Work Date Completed Project Name& Contract Amount Type of Work Date Completed Project Name& Contract Amount Type of Work Date Completed a3SGENTRYGENER ) ENGINEERING Prior Projects 2013-$34,500.00 2016-$504,420 City of Fontana City of Baldwin Park Damaged Street/Sidewalk Alleyway Street/Sidewalk Asphalt & Concrete R&R Asphalt & Concrete R&R 8353 Sierra Ave 14403 Pacific Ave Fontana, Ca 92335 Baldwin Park, Ca 91706 Jason Jojola: No Email Address Chase Fidler: 909.350.6636 626.960.4011 2014-$30,000.00 2016-$619,075 City of Rancho Cucamonga City of Bloomington Solar Shade Structure ADA Ramp-Repair/Maintenance/Replaced 8794 Lion St. 825 E. V Street Rancho Cucamonga, Ca 91730 San Bernardino, CA 92415 909.477.2730 (No Email Address) Haile Ford: 909.387.7936 2015-$495,000 City of Whittier 2016-$173,604 Fire Loop/Fire Sprinkler Repair City of Montclair 9401Painter Ave Alleyway Street/Sidewalk Asphalt & Concrete Whittier, Ca 90605 5111 Benito St Karla Embry: Montclair, Ca 91763 562.332.9303 Steve Stanton: 909.625.9444 2015-$41,000 City of Glendora 2017-$325,000 Water Improvement City of Upland 116 E. Foothill Blvd. Damaged Street/Sidewalk Glendora, Ca 91741 Asphalt & Concrete R&R Carlos Cigneros: No Email Address 1370 North Benson Ave 626.786.1285 Upland, Ca 91785 Tony Trejo: 909.631.3918 9277 Archibald Ave. off: 909.330.1128 Ranrhn rl lfamnnPA rA ci 72n far 4nC 34A CIARA 2017-$624,688 2018-$547,950 Santa Ana City of Pasadena Repair Maintenance/Replaced Miscellaneous Concrete Repair Damaged Street/Sidewalk 100 Garfield Ave Asphalt & Concrete R&R Pasadena, Ca 91101 20 Civic Center Plaza Morley Saralya: Santa Ana, Ca 92701 626.744.3703 Victor 5o: 714.647.5076 2018-$2.2 Million City of Torrance 2017 -$694,000 Downtown Torrance Active Transportation City of Corona Improvements Miscellaneous Concrete Repair 20500 Madrona Ave 400 S. Vicentia Ave, Ste. 210 Torrance, Ca 90503 Carona, Ca 92882 Justin Gatza: Barry Ghaemi: 310.618.3032 951.739.4961 2019-$288,974 2017- $30,000 City of Barstow City of San Diego Water Treatment Plant Dewatering Pad & Wall Demo/BackfiII/Compact Existing 2200 Riverside Dr. Vault Location Barstow, Ca 92311 422 W. Washington St. KodyTopkins: San Diego, Ca 92103 760.252.2538 Matt Cavan: 951.684.1909 2019 - $544,342 Torrance Unified School District 2018-$1.2 Million Anza, Arnold and Hickory ES Site Drainage City of Torrance 21400 Ellinwood Dr Damaged Street/Sidewalk Torrance, CA 90503 Asphalt & Concrete R&R Joe Winterburn: 20500 Madrona Ave Torrance, Ca 90503 (949) 502-4000 Shin Furukawa: 310.618.3073 2019 - $714,000 City of Hermosa Beach 8'"Street Improvements Project 8'Street Hermosa Beach, CA 902S4 Reed Salan: (310) 318-0229 9277 Archibald Ave. off:909.330,1128 Ranrhn furamnnua i-A gi 7Rn far OnQ 7dd AFAR 2019- $267,000 Costa Mesa Sanitary District Indus Sewer Main Replacement 20122 Santa Ana Ave Newport Beach, CA 92660 Rob Harriers: (949) 548-1192 2019 - $28S,744 City of Fullerton Curb/Gutter and Sidewalk Reconstruction Fullerton, CA 92831 Jose Medina: (714) 738-6863 2019-$139,573 City of Irvine Ranch Park Bike Trail Rehabilitation Irvine, CA 92618 Anthony Caraveo: (949) 724-736S 2019- $644,763 City of Thousand Oaks Concrete Replacement and Sidewalk Repair Program Thousand Oaks,CA 91320 Michelle McCarty: (805)449-2477 2020- 51,369.000 City of Torrance Sidewalk Repair for Handicap Accessibility Torrance, CA 90S05 Shin Furukawa: (310) 781-6900 2020- $19,S46 City of Fontana San Bernardino at Cypress Driveway Improvements Fontana, CA 92335 Christopher Smethurst: (909)350-6649 9277 Archibald Ave. off:909.330.1128 Ranrho ruramnnoa rA Q173n far QnQ -)AA Q6RR CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTI F ICATE Pursuant to SB 854 (citing Labor Code Section 1771.I(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. MR. FACT SHEET on SB 854 http://www.di r.ca.govfDLSE/PublicW orks/SB854FactSheet-6.30.14.pdf DIR's Contractor Registration Link -Call (844) 522-6734 h ttps://efi I i ng.d i r.ca.gov/P W C R/A ct i on Sere I et°action=di spl ay P W C Regi strat i on Form DIR's Contractor Registration searchable database: https://efiling-dir ca.gov/PWCR/Search.acfion 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 20I03 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 we]I as for ALL subcontractors at the time of submitting the bid. Gentr% General I ngmeenn:. Inc. ('wuractor � By gentrn_Keneral it tmaiLcum Email President Title Date PWC Registration #: 10000-141,S9 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24. Code of Federal Reeulations, 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(lnwal the crpphcahle selection.) 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 emplovees in conjunction with this project. Will award 101% of its sub-contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub-contracts related to this project Contractor Gentry General Engineering, Inc Contact Person Trenton Gentry Contact Phone. Signed Date October 27, 2020 'Note The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A el an 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 Housin¢and Urban Development Act, as amended in 1902 (HUD). Previous non-compliance %ith Section 3 could result in disa ualifica lion. EXHIBIT A DISADVANTAGED BUSINESS ENTERPRISE (DBF) This Project is subject to Part 200.321, Title 2, Code of Federal Regulations entitled "Contracting with Small and Minority Businesses, Women's Business Enterprises. and Labor Surplus Area Firms." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the Citv that disadvantaged business enterprises (DBEs), as defined in Part 200321. Title 2 CFR, shall be encouraged to participate in the performance of Contracts financed in whole or in part with federal funds. The Contractor should ensure that DBEs. as defined in Part 200.321, Title 2 CPR, have the opportunity to participate in the performance of' this Contract and shall take all necessary and reasonable steps, as set forth in Part 200,121, Title 2 CFR, for this assurance. The Contractor shall not discriminate on the basis of race, color, national origin. or sex in the award and performance of subcontracts. Failure to cam. out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project, although there is no specific goal for DBE participation. EXHIBIT B DBE INFORMATION— GOOD FAITH EFFORTS Federal-aid Project No. Bid Opening Date The City of Huntington Beach_established a Disadvantaged Business Enterprise(DBE)goal of9% 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 11 o ak 1,, he ,clt I,.rl<,iou,i. 1D131 .ub, will I, r„r, t,, hc ,�nt��lir. it ,J), „ntrr.one I�I,hkntunitic. ,iris B The names and dates ofwritten notices sent to certified DBEs soliciting bids for this Project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested(please attach copies of solicitations, telephone records, fax confirmations, etc ) Names of DBEs Solicited Date of Initial Follow Up Methods Solicitation and Dates kill Nenrk to he .clf performed; DBF subcontractors to be sought it whcuntractim-, OppOrtumlirs .arse 1 .l 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 (YIN) Contract all work to be self performed: DBE subcontractors to be sought iCwbcontracting,unponmiitics a i;c 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: all work to be sell-pcl lonned: DRE :uhconnactors to besought it subcontractin, opportunities arise 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: all work to he :clt-pci IMmcd. DBE subcontractors to be sought if subcontracting opportunities arise 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: all 1\nik III be pelt-! CI b11 I11of DB �tihcwitrllctllr; to he IIti L'ht it subcon1r:ICrIi1L' Iltim it t l 1111UCN Jrl;e 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 .III lcl,rk 1., hr .rll-nrrf lnnrd: DBI 11111,1111t1 11IMI ill he 'iIwelit it ulicontractine lulnnrnunnr; an.; H Anv additional data to support a demonstration of good faith efforts(use additional sheets if necessary): all %cork In he ,cll-pertlxmcd: Mil ;uhcontracion to he ;uueM it >uhcomttacune upporlunulc, al INC— NOTE- USE ADDITIONAL SHEETS OF PAPER IF NECESSARY IF A SOLE OWNER OR SOLE CONTRACTOR SIGN MERE: (I) Namc tinder which business is conducted (_) Signature (given and surname) of proprietor (i) Place of Business (Street and Number) Citv and State (4) Zip Code Telephone No. (5) E-Mail IF A PARTNERSHIP, SIGN HERE: (1) Name under which business is conducted (2) Signature (given and sumame and character of partner) (Note: Signature must be made by a Leneral partner) (3) Place of Business (Street and Number) Citv and State (4) Zip Code Telephone No. (5) Uklail IF A CORPORATION. SIGN HERE: (]) Name under which business is conducted (ientr� (icneral l n mecnng. hre (Signature) 1'rc.ulcnt (Title) Impress Corporate Seal here (3) Incorporated under the laws of the State of r (4) Place of Business ` 277 Archibald Av enue (Street and Number) City and State Rancho Cucanwnar. CA (5) ZipCode y173t� Telephone No. �`�tt`tl ;;(�-II '_x (6) E-Mail gentr%¢eneraha _mail.com NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of San Bernardino ) On before me. Nicole Dye, Notary Public (insert name and title of the officer) personally appeared Brenton Gentry who proved to me on the basis of satisfactory evidence to be the person(s) whose names) Is/ subscribed to the within instrument and acknowledged to me that he/spr6/ttjey executed the same in his/h r/tf Or authorized capacity(les) and that by his/*/thgfr 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. ,�• MKDIE DYE WITNESS my hand and official seal ( ' ` y^ C�^q CDmmixan I!I I5175 rl Cp .Eaprn wr ID.lOI4 Signature (Seal) List below names of president, vice president, secretary and assistant secretary, if a corporation. if a partnership, list names of all general partners and managing partners: 1r.rrt.ul - (ii,ni,nt ( irnii . \ to Pt 1,1r11t - tI, t.ut ( I:nt;'. EXHIBIT C LOCAL AGENCY BIDDER DBE COMNI T11ENT (CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM IIK'Al .\(il:NC\ I CSCAI1ON� I'R) JU I MSCRIPI'RIN' 10I. l CON'IR:\CI':\\lot"S'I`S 19D DA IF BIDOI',R'S N:\\Ili: CON I RAC I DIIE.(iu:\I.: '))N''I'R:\C'I 1'I'I'.\I OF R'I IRK AND OESCRIVIIONOBF.CE:R'I"NI). N:\\Ili ui' FACII 1)[11'IH4.1:\R ,\\Ilrl'N''I' I'I'E:\I NI OR SI(R\'ICES 'IO IiP 1ND E.NPIR:VI ION (\Iml K.cmlili.d un Ow d.Itc hid. )BF. SI'BCVN'IRAC"I"El uli ..\I:11'F:H LV.. I),\'IF: uc ,fron.d - inahnla Dnh: addr>. 10 Bii PRIA IDE I11or conlr:mled it'd, and plwrnc nwnArl +iddet i'a I ME), f I For Local Agency to Complete: 'I'.ual C6unwd OBIT I o:.J.\den:r Conb:rel Nund).T I':vti:ipalion — Fodcrah and Ih olca Nluubcr u . �0 hdaal Sh.uc. G.nrrn.I:\.sand Oml I Deal.\gru:� r<n Ji..Ihal:d1 Dlil'..:ndi.an.nm Im"1"',)ar twd mW inibm)uli�.n i.:ongdn.and aaurue S iaroalurc of IiIJJ:r Ualc L1rra('�Kic)Tel \�� Print Name Sipwum I""al Aga):)'Il rprcnau:n 'e PaN�n la(onlnel fi'Iran:'I.,tk or Print) — C\rea C.,&i'frl<pLrnie Nrnn14, I.nel.lga ) lu.Wn UMW.r,�nun�mrm;)'•ruuuanm.lrrv.nlal PLEASE NOTE: This information may be submitted with your bid. If it is not, and you are the apparent low bidder or the second or third low bidder, it must be submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the constriction 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 farces. 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 arc 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 \'our 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 I:-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. EXHIBIT D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION Thebidder lirnU� ( racial I ncnnriin•_. In [proposed subcontractor ] hereby certifies that he/shelt 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/shelt 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 he submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1 5 (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. (eeoc.gov/emplovers/eeolsurveyfndex.cfm) Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. �j Signature �"' '' Date: tktohrr " Print Name' lirrnt m (knu� Title: her idrnt EXHIBIT E NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) [NAME OF CONTRACT) To the City of Huntington Beach In conformance with Title 23 United States Code Section 112 and California Public Contract Code 7106 the bidder declares that the bid is not made in the interest of. or on behalf of. any undisclosed person, partnership, company, association, organization, or corporation. that the bid is genuine and not collusive or sham, that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid. and has not directly or indirectly colluded, conspired,connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding, that the bidder has not in any manner, directly or indirectly, sought by agreement. communication, or conference with anvone to fix the bid price of the bidder or anv 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 anvone 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 divulued information or data relative thereto, or paid, and will not pay, any fee to anv corporation, partnership, company association, organization, bid depository, or to anv member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion .Affidavit is part of the Bidder's Proposal. By signing the Proposal, the Bidder has also signed this Noncollusion Affidavit. Bidders are cautioned that making a false Certification may subject the Bidder to criminal prosecution Signature _ �` --_— .� Date Print Name Hrcnton tientrr Title pre ident ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document State of California County of San Bernardino ) On 012 7/2 U before me. Nicole Dye, Notary Public (insert name and title of the officer) personally appeared Brenton Gentry who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/ate subscribed to the within instrument and acknowledged to me that he/she/tb6y executed the same in his/h¢r/ttgfr authorized capacity(ies). and that by his/"Ottir 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 . NICOEE DYE WITNESS my hand and official seal. Noc,ryvubtx oirwn,: San BernarCina Counry Commnuon a 7775135 y Comm. Emrm*w Signature (Seal) EXHIBIT F DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The Bidder, under penalty of perjury, certifies that, except as noted below, he/she or anv other person associated with Bidder in the capacity of owner, partner, director, officer, manager • is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agent} • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted, convicted, or had a civil judgment rendered against him/her by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency. and dates of action Note Providing false information may result in criminal prosecution or administrative sanctions The above certification is part of the Proposal Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification Signature- V'iu '��" — Date Print Name fir n m G ntr, Title c>i lrnt EXHIBIT G NONLOBBYING CERTIFICATION FOR FEDERAIrAID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: 1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment,or modification of any Federal contract,grant, loan, or cooperative agreement. 2) if any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Signature: Date: October 27. -1020 Print Name: Brenton Gcntry Title: President EXHIBIT H DISCLOSURE: OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PI RSI AST TO 31 U.S.C. 135'_ I. type of Feder l Actlun: 2. `bear (Fed":\salon: ). Rrp.rttry": a ccuaract ❑- hw offs appiwat son .I nnbal h grant h maws aw and h mm,nal>iww, pw+p,raln,art,rntrnl . p.rt-nutd d loan For Material llonpe Ord): , I.Ian gwrnticc war quancr 1 I.wrn nt trews dal,of la\I rcp.In J. Nnur uw \dJrr.."d Rcp.niue tulm) ❑ It Rrp.rt mf FoUt)is No,a i>wubawartim tinter Narwrand \/drr.a of Prince: F-II'n w. ID \uhao arJcc Ito d k.... / merr..n r.a11161 nr1,d krhmo I .r.en�.i.aul lh. n.), 1 kthlwn 6. Federal Iklcrrtmem \w•m-): l.derml pn.eram \a.r DVwTipd=: I tU\ \umhr r,it ap+h.ahlc IL Federal.\clf.rl Nunshor,it kth. 11 r. load/ \.m wnl.It M. a.Nand aid.\/dream of la>bln Fltiiy b. Imdiyidanta Perh>rtulmf Senica l including II Imo u4wl Lpl runts. line runw. \III addm,,it ddl,rtl tnmi\o Iual Ilan runty.tiN rums. \Ih i sll.ah C m.bnualn•wn ShcAl>I d m-„axan 1 I- \imams ul Pa)nrat IcMrh Al that aPPh I Id. 1)pr Id Pal nrnl rh.'ak all that apply I S \awl I pLuvwJ a tamer h .."-tins k, 12. Farms of psymeot I,lurk all Ilul apply r. a,nmuuam Ba cwh J nntingent lcc h us-knld_ .peal, nature a d,krtcd ,ahw 1' who..p„J♦ l* lfrkf l)xripdom of Nenhe>Performed or to be pefflrmhd .eid I I,I. I yrnkv,Including .dlleniak mplo)eeiak or mrewbrKal c..m/acle/-for Pa)rrrnt Irw.ral.tl In helm 11: Iatlaa.C'.nlmom m xhnYl+l rl rw„ee>an 1 1( C'unllmmallow Mreegyl attod": \ea Nm lI 16. Inhrmulrm ,q.,[L-d thrungh Ihn tom,n awla.ru,d M 1 nlc 41 1 N C. 4ah.n 1312 The,dt"k urc 4klhhy ng relmrwc Signature '1�)IA mar placcJ M th,trcr ah,t,ahcn hn tratt>wlmm.&,ma&.r cnto,d man ]1m drwlos. c n rt+quir d ransuanl In l l 1 5 C Poll\anw " 1312 -Ilan mhrnutwn o,ll b, r Ltd to oegr,— 'nunrnualh aid rill Iw.'.lack I.r puMrc ontr,tnn xm Ink p,a rn»Ih,lark k,Iik the nyun,d dre,kwure.hall h,wh)>vl to a cud perulh .,I not k, than SR11lf)n and and m.ec tha., Id,rh.ec SI00,M)1.r,ash uwh ta.lur, \.ah,.,J Im 1.w.al Rcpnwiu,thm Federal 1 or Ilml): \landard Farm-I.I I Standard Form 1.11.Rev.09-12-97 INSTRUCTIONS FOR COMPLETION OF E`CHIBIT H. DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing Pursuant to title 31 U.S.C. section 1352. The filing of a form is required for such payment or a¢reement to make payment to lobbying entity for influencing or attempting to influence an officer or emplovee of any agency. a Member of Congress an offiicer 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. _) Identif'v 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 chance 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. ldentifv 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. >) 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. i f'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 I). If known. enter the full Catalog of Federal Domestic .Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 41) Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e._., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, «rant 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 i. 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 difTerent from 10 (a). Enter Last Name, First Name and Middle Initial (MI). I I) Enter the amount of compensation paid or reasonabl' expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12)Check the appropriate box(es). Check all boxes that apply. if payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. I3)Check the appropriate box(es). Check all boxes that apply. If other, specify nature. 14) Provide a specific and detailed description of the services that the lobbvist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparaton and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s) or emplovee(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 su_eestions for reducing this burden. to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington. D.C. 20503. By my signature on this proposal 1 cerifv, under penalty of perjury under the laws of the State of California, that the foregoing questionnaire and statements of Public Contract Code Sections 10162, 10232 and 10285.1 are true and correct and that the bidder has complied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5, Title 2 of the California .Administrative Code). rzHlarr I FEDERAL LOBBYING RESTRICTIONS Section 1352, Title 31, United States Code prohibits Federal funds from being expended by the recipient or any lower tier subrecipient of a Federal-aid contract to pay for any person for influencing or attempting to influence a Federal agency or Congress in connection with the awarding of anv Federal-aid contract, the making of anv Federal grant or loan, or the entering into of am cooperative agreement. If any funds other than Federal funds have been paid for the same purposes in connection with this Federal-aid contract, the recipient shall submit an executed certification and, if required, submit a completed disclosure form as part of the bid documents. A certification for Federal-aid contracts regarding payment of funds to lobby Congress or a Federal agency is included in the Proposal. Standard Form - LLL, "Disclosure of' Lobbying Activities," with instructions for completion of the Standard Form is also included in the Proposal. Signing the Proposal shall constitute signature of the Certification. The above referenced certification and disclosure of lobbvinu, activities shall be included in each subcontract and anv lower-tier contracts exceeding $100,000. All disclosure rams. but not certifications. shall be forwarded from tier to tier until received by the Engineer. The Contractor, subcontractors and anv lower-tier contractors shall file a disclosure form at the end of each calendar quarter in which there occurs any event that requires disclosure or that materially affects the accuracy of the information contained in anv disclosure form previously filed by the Contractor, subcontractors and any lower-tier contractors. An event that materially affects the accuracy of the information reported includes: I) A cumulative increase if 525,000 or more in the amount paid or expected to be paid for innuencing or attempting to influence a covered Federal action; or 2) A change in the person(s) or individual(s) influencing or attempting to influence a covered Federal action; or 3) A change in the offfcer(s), employees(s), or Mentber(s) contacted to influence or attempt to influence a covered Federal Action. Bid Bond Bid Bond Number CSBA-15505 CONTRACTOR: SURETY: (2\1ame,legal rratut and ada'"n) (rVame,*I rratur ref.prinapcl place of"butinev) Geier;General Engineering,Inc. The Ohio Casualty Insurance Company 9277 Archibald Avenue 790'rhe City Drive South,Suite 200 Rancho Cucamonga,CA 91730 Orange,CA 92868 OWNER: This document has important legal (Name,legal rtatnr and addrru) consequences.Consultation with City of Huntington Beach An attorney is encouraged with respect 2000 Main Street its completion or modification. Huntngton 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 PROJECI': Residential Curb Ramp Project,CC No. 1620 Project Number,if any: 1620 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,thew 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)enms 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 gaud 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 nor apply to any extension exceeding sixty(60)days in the aggregate beyond the time for acceptance of bids specified in the bid documents,and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty(60)days. If this Bond is issued in connection with a subcontractors bid to a Contractor,the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project,any provision in This Bond conflicting with said statutory or legal requirement shall be deemed deleted here from and provisions conforming to such statutory or other legal requirement shall be dcemed incorporated herein.When so hirtushed,the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. Signed and sealed this 26 day of October.2020 y / Gcnury General Engineering Inc Sp Q A 7��crse� (Prinapn!) (SeaQ (Ivan",) (Iit/eJ — r�r�l The Ohio Casualty Insurance Company (Sunk) . (Sea9 (lflaneu) Melissa Ann Vaccaro (I r/e)Dwight Reilly,Attorney-in-Fact By arrangement with the American Institute of Architects, the National Association of Surety Bond Producers (NASBP)lwww.nasbo.orel makes this form document available to its members, affiliates,and associates in Microsoft word format for use in the regular course of surety business.NASBP vouches that t 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. 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 10/26/2020 before me, Melissa Ann Vaccaro. Notary Public (insert name and title of the officer) personally appeared Dwight Reilly who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. meussAANrvAccARo COMM.22241394 n Notary Public-California x ORANGE COUNTY ` :•'yCn nin.Expires NPy 12,2022A Signature (Seal) �_. Melissa Ann Vaccaro This Power of Attorney limits the ads of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Bond No.CSHA-I»D. Liberty Mutual Insurance Company Mutual. The Ohio Casualty Insurance Company Certificate No: 8202806-969561 SURETY West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duty organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duty organized under the laws of the Slate of Massachusetts,and West American Insurance Company is a corporation duty organized under the laws of the Slate of Indiana(herein collectively called[he'Companies),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Amuo Ayala,Daniel Huckabav,Frank dlorones,R-Nappi,Dwight Reilly,Shaunna Rozelle Ostrom,Ben Soong,Michacl D.Soong all of the aly of Oranec state of CA each individually if there be more than one named,its we and lawful attorney-in-fact to make, execute,seal,acknowledge and deliver,for and on its behalf as surety and as its ad and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the President and attested by the secretary of the Companies in thew own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 3lst day of Dccembcr 2019 Liberty Mutual Insurance Company `W9VR `�Y WSVn lNSU¢ The Ohio Casualty Insurance Company „JP�Prm�f-4C hJPc°✓W. Yf `r roe+O4rT 1'n West American Insurance Company m J 3 om vi a f+ -m David M.Carey,Assistant Secretary n :o m State of PENNSYLVANIA ss e aY Canty of MONTGOMERY tO c On this 31si day of December 2019 before me personally appeared David M.Carey,who ackr avledged himself to be the Assistant Secretary of Liberty Mutual Insurance m Company,Tate Ohio Casualty Company,and West American Insurance Company,and that he,as such,being authorized so to do,execute the foregoing instrument for the purposes m W therein contained by signing on behalf of the corporations by himself as a duly authorized officer.ad E — IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at King of Prussia,Pennsylvania,on the day and year first above written. e do n p0 N N P4�r < . . OOMMONWFALTM OF PENHSriVANN J� Q p .vnurY 9aa1 � O C p a) CP i°reaa P.O ,Ndvy Py°Ie T e m upprw Moron Tvp...M--a e«wy By: LGwz/-1 F P MY O°m^NQ'E.,vaf Ma A 1e.2011 O Teresa Pastella,Notary Public rpa o m m wrw uo r This Power of Attorney a made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, liberty Mutual= o � Insurance Company,and'West American Insurance Company which resolutions are now h full force and effed reading as follows: ex e—Q ARTICLE IV-OFFICERS:Section 12.Paver of Attorney. -o no Any officer or other official of the Corporation authorized la that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the-�a President may prescribe,shall appoint such attorneys-In-tact as may be necessary to ad in behalf of the Corporation to make,execute,seal,acknowledge and deliver as surety o m ep any and all undertakings,bonds,remignizances and other surety oblgatims. Such aaaneysin-fact subject to the limitations set forth in their respective powers of attorney,shag t o t: have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such E N Z 0 instruments shag be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attomeym-tact under the,^ro provisions of;his aside may be revved al any time by the Board,the Chairman,the President a by the officer a officers granting such paver a authority. o 6 ARTICLE XIII-Execution of Contracts:Section 5.Surely Bonds and undertakings. oU m Any officer of the Company authorized for that purpose in writing by the diairman a the president,and subject to such limitations as the chairman a the president may prescribe, shag appoint such attorneys-in-fact as may be necessary to act in behalf of the Company to make,execute,seal, acknowledge and deliver as surety any and all undertakings, bonds,recognizances and other surety obligations.Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney,shag have lug power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation-The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such mornevs-in- fad as may be necessary to act an behalf of the Company la make,execute.seal,acknowledge and deliver as surety any and all undertakings,bonds,rec gnizances and other surety obligations. Authorization-By unanimous consent of the Canpamys Board of Directors,the Company consents that famirmle a mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bands,shall be valid and binding upon the Company with the same face and effect as though manually affixed. I,Renee C. Jewellyn,the undensgned,Assistant Secretary,The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company,and West American Insurance Company do hereby canary that the original power of attorney of which the foregoing is a fug,true and correct copy of the Paver of Attorney executed by said Companies,is in full face and effect and has not been revoked. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 26Ih day of October 2020 c) (90 rSY W9V1NSUR9J oaroy. TL `P'`orr°P� yc 30 6 m ¢ i "ern /1919 ns 1991 o ` l �y��Nx�r.+�Jr '4a.nr aBy gN2 }ea s3M . }�,a Renee C.Llewellyn,Assistant Secretary u S-12e]]LM.iC OGC rcAIC a nu Co lung ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of San Bernardino On i o /16 ho before me, Nicole Dye, Notary Public (insert name and title of the officer) personally appeared Brenton Gentry who proved to me on the basis of satisfactory evidence to be the person Ss) whose name(s) is/ subscribed to the within instrument and acknowledged to me that he/s,1�6/th,ey-executed the same in his/ter/thqdauthorized capacity(ies), and that by his/Kr/tl it 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. NICoIE DYE Notary Poblic-California WITNESS my hand and official seal. �" San Bernardino county Commission 0 2325135 My Comm.E.pires M 20,2024 Signature (Seal) I S�' N DI Sea(e ! 17rC �i eSZ�h! pl) A � "S RFMp ecoje - GC ICZ Opt, w-1k City of Huntington Beach n. 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov Office of the City Clerk » na+ Robin Estanislau, City Clerk April 23, 2021 Hardy & Harper, Inc. 32 Rancho Circle Lake Forest, CA 92630 RE: Residential Curb Ramp Project— CC No. 1620 Enclosed please find your original bid bond for CC-1620. Sincerely, Robin Estanislau, CIVIC City Clerk RE:ds Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand SECTION A NOTICE INVITING SEALED BIDS for the construction of RESIDENTIAL CURB RANIP PRO.IECI' CC No. 16211 in the CITY OF HUNTINCI'ON IIFACFI PUBLIC NOTICE IS 1,11EREBY GIVEN that the CITY OF HUNTINGTON IIEACIL as AGENCY. invites sealed bids for the above stated projects and will receive such bids in the office of the City Clerk. Second I'loon. 2000 Nlain Street. Huntington Beach. California 92648, up to the hour of 2:00 PNI on October 27, 2020. Bids will be publicly opened in the Council Chambers Unless otherwise posted. Copies of the Plans. Specifications. and contract documents are available font the Office of the Director of Public `,Yorks. 2000 Main Street. Huntington Beach. CA 92648. upon payment of a S10.00 nonrefundable Icc if'picked up. or payment of it S30.00 nonrefundable fce i1'sent by UPS ground delivery (bidder shall pay additional costs for special delivery). Plans. Specifications. and contract documents can be downloaded free on AGENCY websitc at: httn:/hvww.hUntinetonheachca.�,oy/eowernmenUdeparunents/public works/Bids/ Open website. then click on "Current Advertised Pro.jccts" tah. This is a Davis-Bacon project and the Federal Regulations will be enforced. Any contract entered into pursuant to this notice will incorporate the provisions of the Federal Labor Standards. which are on file at the office of the Director of Public Works. 2000 \lain Street. Huntington Beach. CA 92648. The AGENCY will deduct 5% retention from all progress payments. 'file Contractor may substitute an escrow holder surety of equal value to the retention in accordance with the provisions ofthe Public Contract Code. Section 10263. The Contractor shall be beneficial otwncr ofthe surety and shall receive any interest thereon. The AGENCY hereby affirmatively ensures that minority business enterprises will be afforded full opportunity to submit bids in response to this notice and will not be discriminated against on the basis of race, color. national origin. ancestry, sex, or rclieion in any consideration Icadims to the award of contract. No bid shall be considered unless it is prepared on the approved Proposal forms in conformance with the Instructions to Bidders as determined by the AGENCY. The bid must be accompanied by a certified check. cashier's check, or bidder's bond made payable to the AGENCY for an amount no less than 10% of the amount bid. "fhe successful bidder shall be licensed in accordance with provisions of the Business and Professions Code and shall possess a State Contractor's License Class A at the time of award. The successful Cont actor and his subcontractors will be required to possess business licenses from the AGENCY. All extension of unit prices will be subject to verification by the AGLNCI'. fit case ofa variation bet vecn the unit price and the cuension. the unit price will govern. Project Description: This project will provide the construction ol' curb access ramps and truncated domes to existing ramps throughout the city. These locations are prioritized from a list compiled by Public Works staff, based on requirements for the upcoming residential pavement management project and public requests. The proposed locations are listed in the Appendix along with Contractor guidelines and provisions to meet all Federal requirements. The contract shall allow the Contractor 60 working days to complete the contract. The ['reject Disadvantage 13usincss Enterprises (D13E) goal is 9% The AGENCI' reserves the right to reject any or all bids. to waive any irregularity and to take all bids under advisement for a maximum period of 60 days. BY ORDER of the CITY COUNCIL of the CITY OF I IUNTINGfON BEACH. CALIFORNIA. the 29th day of Junc 2020, by Resolution No. 2020-39. Attest: /s/ Robin IalanlSlaU CITY CLLRK OF T11L' CITY Oh HUNTING FON BEACH SECTION C PROPOSAL for the construction of RESIDENTIAL CURB RAMP PROJECT CC No. 1620 in the CITY OF IIUNTINGTON BEACH TO "rHE HONORABLE, tNIAYOR AND i11EtNIBERS OF TIIIE COUNCIL OF HUNTINGTON 13EACII: In compliance with the Noticc Inviting Scaled Bids, the undersigned hereb 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 Iat,inccr of the City of I hintington 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 I Iuntington Beach. and to enter into a contract at the following prices. The undersigned aerces to complete the work within 60 working days. starting from the (laic of the Notice to Procced. BIDDER declares that this proposal is hascd upon careful examination of the work site, plans. specifications. Instructions to Bidders and all other contract documents. If this proposal is accepted for award. BI DDI R agrees to enter into a contract with AGI.:NC1' at the unit and/or lump SLIM 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 TI IF. RIGHT TO DI3LF1'17 .ANY ITFM FROM THI7 CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses. taxes, royalties. Ices. etc.. and will be guaranteed for a period ol'sixty days from the bid opening date. Ifat such time the contract is not awarded, the AGENCY will reject all bids and will re-advertise the project. In the case of discrepancies in the amounts bid. unit prices shall govern over extended amounts, and words shall govern over f icures. C-t If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find Bidder's Bond in the amount of 10% which said amount is not less than 10%of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond for_% ", as the case may be) Any standard Surety Bid Bond form is acceptable. Bidder shall signify receipt of all Addenda here. if any: Addenda No. Date Receiwd Bidd 's SignatqW 1 10/20/2020 Michael Mu - Vice President C-z SECTION C PROJECT BID — SCHEDULE A CURB RAMP PROJECT,CC 1620 BID ITEMS Item Description Quantity Unit Unit Cost Total Cost No. r� (Extension) 1 Mobilization 1 LS $a $ 25T 2 Prepare Storm Water Pollution Prevention Plan(SWPPP) 1 LS $ _ $ 3 Install&Maintain Construction BMPs 1 LS $ $ Q Horizontal Curb Cut Curb Access Ramp per Caltrans Std Plan A88A using horizontal curb cutting machine as shown on Curb Ramp Detail 1 in Appendix H of Specifications (Item 109 includes all appurtenances. curb&gutter depressed curb sawcut sidewalk domes retaining curb etc ) EA $ Construct Curb Access Ramp per Caltrans Std Plan A88A as 5 shown on Curb Ramp Detail 1 in Appendix H of Specifications 17 (Item includes all appurtenances. curb&gutter, depressed curb, sawcut. sidewalk. domes. retaining curb, slot pave.etc.) EA $ }I N3�! $ Horizontal Curb Cut Curb Access Ramp per Caltrans Std Plan A88A using horizontal curb cutting machine as shown on 6 Curb Ramp Detail 2 in Appendix H of Specifications (Item 2 includes all appurtenances. curb&gutter depressed curb. sawcut sidewalk domes retaining curb,etc I EA $ VD S 25 2 Horizontal Curb Cut Curb Access Ramp per Caltrans Std Plan A88A using horizontal curb cutting machine as shown on 7 Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances. curb&gutter. depressed curb. sawcut. sidewalk. domes retaining curb etc ) 30 EA Construct Curb Access Ramp per Caltrans Std Plan A88A as 6 shown on Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances curb&gutter, depressed curb sawcut sidewalk. domes. retaining curb, slot pave, etc ) 8 EA 9 Install truncated domes to existing Curb Ramp 10 EA ICU t0 Install 4" PVC Sleeve for Street Assembly Sign per City of HB Std Plan 401 10 EA S 50 A $ 500•CX) t1 Remove and replace existing sidewalk per City of HB Std Plan 207 (Allowance) 1,000 SF Remove and replaces existing 6' or 8' Curb and Gutter per 12 HB Stcl Plan 205(Item includes all appurtenances. slot pave. etc I (Allowance) 300 IF S 50-00 $ I4 OW SUB-TOTAL BID AMOUNT (SCHEDULE A) c-z.l SECTION C PROJECT BID—SCHEDULE A CURB RAMP PROJECT, CC 1620 SUB-TOTAL BID AMOUNT IN WORDS' Jqo mlmljyl ty)(K ilhoVsary fnur Uy)&IA vcntvi �x s bltars 0 CCU CQin Note. All extensions of unit prices will be subject to verification by Owner In case verification is required between the unit price and the extension. the unit price will govern The Owner reserves the right to reject any or all proposals and bid items In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract ('-2.2 SECTION C PROJECT ADDITIVE BID-SCHEDULE B CURB RAMP PROJECT,CC 1620 DID ITEMS Item Description Quantity Unit Unit Cost Total Cost No. (Extension) Horizontal Curb Cut Curb Access Ramp per Caltrans Std Plan A88A using horizontal curb cutting machine as shown on 1 Curb Ramp Detail 1 in Appendix H of Specifications (Item 40 includes all appurtenances, curb&gutter. depressed curb. sawcut, sidewalk domes retaining curb, etc I FA $ $ Construct Curb Access Ramp per Caltrans Std. Plan A88A as 2 shown on Curt) Ramp Detail 1 in Appendix H of Specifications 3 (Item includes all appurtenances, curb&gutter depressed curb, sawcut, sidewalk domes. retaining curb. slot pave.etc ) EA $ $ S Horizontal Curb Cut Curb Access Ramp per Caltrans Sid Plan A88A using horizontal curt)cutting machine as shown on 3 3 Curb Ramp Detail 2 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter depressed curb. ^� sawcut sidewalk. domes. retaining Curb. etc) EA $ l0 $ mil, Horizontal Curb Cut Curb Access Ramp per Caltrans Sid Plan A88A using horizontal curb cutting machine as shown on 4 Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances curb&gutter. depressed curb. sawcut sidewalk domes, retaining curb. etc ) 17 EA $ Ono bnl_W1 O Construct Curb Access Ramp per Caltrans Std Plan A88A as 6 shown on Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances. curb&gutter, depressed curb sawcut sidewalk, domes, retaining curb. slot pave. etc) 9 EA 6 Install truncated domes to existing Curb Ramp 9 EA $ 310•00 $ 3 7 Remove and replace existing sidewalk per City of HB Std Plan 207 (Allowance) 400 SF $ �$•� $ -I�Q Remove and replaces existing 6'or 8- Curb and Gutter per 8 HB Std Plan 205(Item includes all appurtenances, slot pave. etc) (Allowance) 100 LF $Pam' p0 $6 = SUB-TOTAL ADITIVE BID AMOUNT (SCHEDULE B) S� l� l (21•CU SUB-TOTAL ADDITIVE BID AMOUNT IN WORDS V-arr V)0RJ.red +� ,SPven +V\,0JsarA ana. Ylundred +wP,ntu -hKiu doha,rs and ?'m Ctnts Note All extensions of unit prices will be subject to verification by Owner In case verification is required between the unit price and the extension the unit price will govern The Owner reserves the right to reject any or all proposals and bid items In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract (-2.3 SECTION C PROJECT BID SCHEDULE TOTALS RESIDENTIAL CURB RAMP PROJECT CC 1618 Sub-Total Bid - Schedule A IT('A-410 . 00 Sub-Total Additive Bid - Schedule B ti1�I I b2.00 TOTAL BID AMOUNT, BASIS OF AWARD (Schedules A+B) 43U Imo$. fL TOTAL BID AMOUNT IN WORDS Ono, miwcn Cwr hunnred +i�Irhn tv�r>ssand Rve h�t�clre�t q�na. Flap rich u ar\A aw rents Notes All extensions of unit prices will be subject to verification by Owner In case verification is required between the unit price and the extension, the unit price will govern. The Owner reserves the right to reject any or all proposals and bid items In addition. the City reserves the right to include or remove Bid Schedule B in the award of the contract ( -2A 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 S10,000, Hhichecer is greater, and the portion of the work to he done by such subcontractor. Bid Name and Address of State Class DIR PWC Dollar % of Item(s) Subcontractor License Regisiraliun a Amount Contract .Number CL SUNWj VVIOVS Coma 1'olnOriQ M' Co l5`d231 l5 IOo0oo�1�¢b 81 ,0� b °�e rona, CA "IM16S By submission of this proposal, the Bidder certifies: I. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID declare under penalty of perjury under the laws of t�g�,$[�ttd' alifornia that the foregoing is true and correct and that this declaration is executed o tJ LO Z t Lake Forest CA Date City State Michael Murray being first duly swom, deposes and says that he or she is Vice President of Hardy & Haroer. Inc. the party making the foregoing bid that the bid is not made in the interest of,or on the behalf of,any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true;and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof,or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization. bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Hardy & Harper, Inc. Name of Bidder S1gnat i �M�qhael Murray - Vice President 32 Rancho Circl6 Lake Forest, CA 92630 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 RESIDENTIAL CURB RAMP PROJECT, (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: .4 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. Contractor By�/ Michael Murfay - Vice President Title Date: 1 0/23/2020 C-S DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162. the Bidder shall complete. Under penalty of perjury% the following questionnaire. QUESTIONNAIRE Has the Bidder. am• 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 X 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 Cxlstittrte 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 workers 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. Contractor 13y Michael Mu/Y - ice President Tide Date: 1 O/23/2020 Cn BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Hardy & Harper, Inc. Bidder Name 32 Rancho Circle Business Address lake Forest, CA 92630 C lty. State Zip ( 7141444-1851 ablanchard@hardyandharper.com Telepphone Number Email Address 215952; A, C-8 & C12 State Contractor's License No. and Class 03/13/63 Original Date Issued 12/31/2021 Expiration Date The work site was inspected by Mike Amundson of our office on 10/23/2020, 201— The following are persons, firms, and corporations having a principal interest in this proposal: Dan T. Maas - President Michael Murray - Vice President Steve Kirschner - Vice President Tanner Hambright - Vice President Kristen S. Paulino - Corporate 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. Hardy & Harper, Inc. Comp• � Name 'w", P)" Sig azure er ichael Murray - Vice President C-a Printed or I'yped Signature NOTARY CERTIFICATE Subscribed and sworn to before the this day of . 201 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 truthfIdness, accuracy. or validity of that document. State of, ) County of,- On before me. tMonth. Day. and Year Insert Name and Title of Notary personally appeared Name(s) of Signer(s) who proved to me on the basis of'satisfactory evidence to be the person(s) whose name(s) is/arc Subscribed to the within instrument and acknowledged to me that he/slid/thev executed the same in his/her/their authorized capacitv(ics). 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. cxccutcd the instrument. I certify under PENALTY OF PERJURY under the lays of the State of' California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature Signature of Notary Public (PLACE NOTARY SEAL ABOVE) C-9 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 0 1 L31 0 IC) before me, Ashlie Blanchard _T We Here Insert Name and Title of the Officer personally appeared 1lJI (�� mvt Name( dif Signe ) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies),and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. 1 Signature Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑Corporate Officer — Tr*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 k5907 Bidder's Project History For the purposes of this project. the bidder shall provide project history of similar work. specifically refercncing the construction of jDescribe specific work and experience necessary for project. For example, "Demolition of existing concrete ADA ramps and construction of new ADA compliant curb ramps. Work included additional curb and ¢utter construction to ensure surface water floe around corner. All ramps met Caltrans reouirements set forth in Standard Plan A88A-1 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: I Please see attached - Hardy & Harper, Inc. References. Name and Address of public A,,encv Name and Telephone No. of Project i4tanager: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Nance and Address of Public Auency \flume and Telephone No. of Project iNlanagcr: Contact Amount l ype of Work Dane Completed provide additional project description to show similar work: Name and Address of Public Aeencv Name and Telephone No. of'Project Manager: Contract Amount Type of'Work Date Completed Provide additional project description to show similar work: Gm Bidder's Critical Staff Listed below are the names of the bidders proposed Construction 1'roject iNlanaeer. 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 yeas. "These projects do not have to be under the employment of the bidder of this project. Bidders are enciwra,ed submit supplemental relevant project history in addition to the projects listed herein. I Please see attached resumes. Name of proposed Project iNlanaoer Telephone No. oi'proposed project \Manager: Project Namc & Contract AIM1Unt 'I ype of'Work Date Completed project Name & Contract Amount Type of'Work Date Completed Project Name & Contract Amount Type of Work Date Completed Name of proposed Superintendent Telephone No. of proposed Superintendent: Project Name & Contract Amount Type of Work Date Completed Project Namc & Contract Amount Type of Work Date Completed 1'roject Namc & Contract Amount Type of\Vork Date Completed GII PUBLIC WORKS REFERENCES Attachment 2017/2019 Owner/Agency Contact Project (Amount & Completion Date) City of Jurupa Valley Mike Myers T.R.I.P Pavement Rehab. 8930 Limonite Ave (951) 332-6464 Phase I Juru a Valley, CA 92509 mm ers uru avalle .or $1,254,012.21 03/17 City of Newport Beach Frank Tran MacArthur Blvd Pavement 100 Civic Center Drive (949) 644-3340 Rehabilitation Newport Beach, CA 92660 ftran new rtbeachca, ov $2,142,045.66 3/17 City of Rancho Cucamonga Romeo M. David Red Hill Park Pedestrian Trail 10500 Civic Center Drive (909) 477-2740 Renovation Project Rancho Cucamonga, CA 91730 Romeo.David0cityoftc.us $171,888.70 3/17 City of Signal Hill Anthony Caraveo Willow Street Improvement 2175 Cherry Ave (562) 989-7352 Project Signal Hill, CA 90755 acaraveotcbcitvofsignalhill.oro $922,100.43 6/17 City of Laguna Hills Frank Tran Arterial Pavement Mngmt. 24035 El Toro Rd (949) 644-3340 Project Street Rehabilitation La una Hills ftran new rtbeachca. ov $1,375,406.90 6/17 City of Highland John Egan West Highland Bikeways 27215 Base Line (909) 890-1255 Infrastructure & Pavement Imprv. Highland, CA 92346 waanCEterscinc.corn $2,678,788.77 7/17 City of Irvine Brian Brown Yale Ave Rehabilitation Irvine One Civic Center Plaza (949) 724-6000 Center Drive Bid No. 17-1160 Irvine, CA 92623 bbrown(ftityofirvine.or $2,453,343.83 7/17 City of Pasadena Tony An Preventative Maintenance of 100 N. Garfield Ave (626) 744-7403 Street 2016 Pasadena, CA 91109 tanacitvofoasadena.net $945,932.59 8/17 City of Ontario Miguel Sotomayor ATP Cycle I Safe Routes to 303 East B Street (909) 395-2108 School Sidewalk Imprv. Ontario, CA 91764 msotoma or ontanoca. ov $824,850.88 10/17 City of Inglewood Hunter Nguyen Streets & Alleys Rehabilitation One Manchester Blvd (310) 412-5333 Project Inglewood, CA 90301 hhunter ci ofin lewood or $2,639,330.06 11/17 PUBLIC WORKS REFERENCES Attachment 2017/2019 Owner/Agency Contact Project (Amount & Completion Date) City of Covina Chris Marcarello Grand Ave. Street 125 E. College (626) 384-5490 Rehabilitation Fed Project Covina, CA 91723 ema)covinaca go v NO. :STPL-5118(020) $3,030,000.00 5/18 City of Rancho Palos Verdes Ron Dragoo Residential St. Rehab. Project 30940 Hawthorn Blvd. (310)544-5252 Rancho Palos Verdes, CA 90275 akwolekWcf.ca.aov $2,227,000.00 5/18 City of Downey Edwin. Norris CIP No. 18-02 Residential St. 11111 Brookshire Ave (562) 904-7110 Pavement Rehab Project Downey, CA 90241 enorris dowse caor $1,808,000.00 03/1c City of Dana point Matthew Sinacori Arterial Roadway Resurface & 33282 Golden Lantern (949) 248-3500 Pavement Preservation Project Dana Point, Ca 92629 msinacon dana int.or $3,993,000.00 1/18 City of Fountain Valley Fatana Temory Resurface & Rehab. Of Euclid 10200 Slater Ave. (714)593-4433 Street from Slater Ave. to Fountain Valley, CA 92708 fatana.Temorv(dfountianvallev.ora Warner ave. No. TI-271 $1 ,077,000.00 9/18 City of Pomona Public Works Major Street Improvements 505 South Garey Ave. (909)620-2261 Pomona, CA 91766 Dwengineenngaci.Pomona.ca us $3,839,000.00 8/18 City of Lancaster Luis Garibay 2018 Sidewalk, Curb & Gutter 44933 Fern Ave. (661)723-6110 Repairs Lancaster, CA 93534 I arbiba o oflancaster.or $1.976.000.00 12/18 City of Tustin Mario Medina FY 2017-18 Roadway Rehab. & 300 Centennial way (949)394-8955 Sidewalk Repair Project Tustin,CA 92780 mmedinaCatustinca.org $1,575,125.00 10118 City of Vernon Daniel Wall Downey Road Improvements 4305 S. Santa fe Ave. (323) 583-8811 x305 Vernon, CA 90058 PublicWorksBids i.vernon.ca.us $2,584,000.00 1/17 City of Diamond Bar Jason Williams Residential &Collector Road 21810 Copley Drive (909)839-7050 Rehab. Project PUBLIC WORKS REFERENCES Attachment 2017/2019 (Diamond Bar. CA 91765 Jwilkams(&diamondbarca.00v $1,551.000.00 121111 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 5300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 httpJ/www.dir.ca.gov/DLSE/Public Works/SB854FactSheet-6.30.14.pdf DIR's Contractor Registration Link—Call (844) 522-6734 https://efiIing.dir.ca.gov/PWCR/ActionServlet?action=displayP W CRegistrationForm DIR's Contractor Registration searchable database: https://efiling.dir.ca.gov/PWCR/Search.action I am aware and will comply with the provisions of Labor Code Section 1771.I la)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. C for Y ablanchard@ rdyandharper.com Email Michael Murray - Vice President Title Date: 10/23/2020 PWC Registration #: 1000OM76 C-12 10127/20, 8:13 AM Contractor Information Registration History Legal Entity Name Effective Date Expiration Date HARDY& HARPER, INC. Legal Entity Type 6/15/2018 6/30/2019 Corporation Status 5/9/2017 6/30/2018 Active Registration Number 6/8/2016 6/30/2017 1000000076 Registration effective date 6/19/2015 6/30/2016 7/1/2020 Registration expiration date 7/2/2014 6/30/2015 6130/2021 Mailing Address 7/1/2019 6/30/2020 32 Rancho Circle Lake Forest 92630 CA United 5... Physical Address 7/1/2020 6/30/2021 32 Rancho Circle Lake Forest 92630 CA United 5... Email Address Trade Name/DBA License Number(s) CSLB:215952 CSLB:215952 Legal Entity Information Corporation Number: C0443071 Federal Employment Identification Number: President Name: Daniel T Maas Vice President Name: STEVEN M KIRSCHNER Treasurer Name: Secretary Name: KRISTEN S PAULINO CEO Name: DANIEL T MAAS Agent of Service Name: DANIEL T MAAS Agent of Service Mailing Address: 32 Rancho Circle Lake Forest 92630 CA United States of America https://cadir.secure.force.com/ContractorSearch/PrintRegDetaiIs Page 1 of 2 10/27/20, 8:13 AM Workers Compensation Do you lease employees No through Professional Employer Organization (PEO)?: Please provide your current workers compensation insurance information below: PEO PEO PEO PEO InformationName Phone Email Insured by Carrier Policy Holder Name:HARDY & HARPER, INC.Insurance Carrier: FEDERAL INSURANCE COMPANYPolicy Number:54310019Inception date:9/30/2019 Expiration Date:9/30/2020 https://cadir.secure.torce.com/ContractorSearch/PrintRegOelails Page 2 of 2 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: Michael Murray - Vice President Contact Phone: 714-444-1851 Signed: Date: 10/ 3 202 *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-13 DISADVANTAGED BUSINESS ENTERPRISE (DBE) This Prgject is subject to Part 200.321. Tide 2. Code of Federal Regulations entitled "Contracting With Small and Minority Businesses. Women's Business Enterprises, and Labor Surplus Area Firms." The Regulations in their entirely are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in Part 200.321, Title 2 CPR, shall be encouraged to participate in the performance of Contracts Financed in whole or in part with federal funds.The Contractor should ensure that D13Es,as dclmcd in Part 200.121. -title 2 CPR, have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps.as set forth in Part 200.121,Tide 2 CPR. for this assurance. The Contractor shall not discriminate on the basis 01'race. colo1% national origin. or sex in the award and performance of subcontracts. Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be full\, informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project, although there is no specific goal for DBL participation. C-IJ FXI-1113IT 13 DBE INFORIMATION — GOOD FAITH EFFORTS Federal-aid Project No. CC No. 1620 Bid Opening Date 10/27/2020 The City of Huntington Beach established a Disadvantagcd Business L'nterprise (DBF) goal of 9% for this Project. '['he 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. '['his 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. c.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 arc listed in the Section entitled '`Submission of DBE Commitment" of the Special Provisions: A. '['he names and dates of each publication in which a rcducst for D13L participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement P_lease_see_attached. 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 certainly whether the DBEI*s were interested (please attach copies ofsolicitations. telephone records. fax confirmations. ctc.): Names of DBEs Solicited Date of Initial Follow Up Agethods Solicitation and Dates _P_lease_see_attached_ C-ts C. The items of- work which the bidder made available to D13E firms includim,. where appropriate, any breaking clown of the contract work items(including those items normally performed by the bidder with its own forces) into economically feasible units to tacilitate D13E participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate D13E participation was made available to DBE lirnts. Items of Work Bidder Normally Breakdown of Amount PCI'CCnla$e Performs Item Items (S) of (w,") Contract PIease_see_attached 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 D131- it the selected first is not a DBL': Names. addresses and phone numbers of* rejected DBEs and the reasons for the bidder's rejection ofthe DB13s: -P_lease_see_attached. Names. addresses and phone ntnttbers of'firms selected for the work above: Please see attached. E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance. Mid any technical assistance or information related to the plans. specifications and requirements for the work which was provided to DBEs: Please see attached. C-16 F. Efforts made to assist interested DBE's in obtaining necessary equipment. supplies. materials or related assistance or services. CXCIUding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: Please see attached. G. The nanus of agencies, organizations or groups contacted to provide assistance in contacting. recruiting and using IMF firms (please attach copies of requests to agencies and any responses received, i.e., lists. Internet page download, etc.): Name of Agency/Organization N-Icthod/Date of Contact Results Please see attached. H. Am additional data to support a demonstration of'good faith efTorts (use additional sheets if necessary): Please see attached. NOTE: USE. ADDITIONAL ShIFFTS OF PAPIi,R IF NECESSARY, C-17 IF A SOLE OWNER OR SOLI. CONTRACTOR SIGN HERE: (I) Name under which business is conducted N/A (2) Signature (given and sumamC) ol'proprictor (3) Place of Business (Street and Number) City and State (4) /_ip Code Telephone No. (5) E-Agail IF A PARTNIF.,RSIIIP. SIGN IIL`RE: (1) NamC wider which business is conduCtecl N/A (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business (Street and Number) CitV and State (4) /_ip Cocle Telephone No. (5) E-Mail C-I8 IF A CORPORATION, SIGN HERE: (1) Name under which business is conducted Hardy & Harper, Inc. ('-) at/ay Michael MurVice President (Title) Impress Corporate Seal here (3) Incorporated under the la"s of the Suite cif California (4) Place of Business 32 Rancho Circle (Street and Number) City and State Lake Forest, CA (5) Zip Code 92630 "telephone No. 714-444-1851 (6) E-Mail ablanchard@hardyandharper.com NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED C-19 List below names of president, vice president, secretary and assistant secretary, if a corporation; if a partnership, list names of all general partners and managing partners: Please see attached. t 1" ¢-tiaree4.1 I n(..,' C� j Dirct d.h an DW T Mw6 - yraotflt MiCkwl Mv" —V.r- fdtlntr rtrtmbr+dYlt "V.�. 1�ri en cUutnD G20 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 Ltih' !'!'L'CLC tC Mnk A rotary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certfcate is attached,and not the truthfulness,accuracy,or validity of that document. State of California ) County of Orange ) On >, 23 t 2 0 Z O before me, Ashlie Blanchard Date Here Insert Name and Title of the Officer personally appeared 1 eA r wr( Namei4 of Signjo 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 Cafifomia that the foregoing paragraph is true and correct. _ WITNESS my hand and official seal. ar Signature Signature of Notary Public r„3 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 EXHIBIT- C LOCAL AGENCY BIDDER DBE COMMITMENT(CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY LOCATION PROJECT DESCRIPTION TOTAL CONTRACT AMOUNT S BID DATE BIDDER'S NAME CONTRACT DBE GOAL: CONTRACT TEM OF WORK AND DESCRIPTION BE CERT NO NAME OF EACH DBE DOLLAR AMOUNT ITEM NO )R SERVICES TO BE AND EXPIRATION (Must be certified on the dare bids DOE UBC'ONTRACTED OR MATERIAL: DATE me opened- include DBE.address O BE PROVIDED for conbacted If the arid phone number) adder Is a DBE) For Local Agency to Complete: I offal Claimed DBF S Local Agency Contract Number Panuipannn Federal-aid Project Number o� 0 Federal Share Contract Award Date Local Agency certifies that all DBE cenitwaltons hare been%critied and information is complete and accurate 7 4-444-1851 [kite (Area Code)TO No Prim Nance Signature Date Michael Murray - Vice President Local Agency Representause Person to Contact (Please Type or Print) I Area Code)Telephone Number Local,s peru} Redder f)RF lloeutrrwtron Canvaasl INP fi�4 U91 C-21 PLEASE NOTE.: This information nun be submitted with your bid. If it is nol, and you are the apparent low bidder or the second or third low bidder, h must he submitted and received as specified in the Special Provisions. Failure to submit the required IME commitment will he grounds for finding the bid nonresponsive The form requires specific information regarding Be construction contract: Local Agency. Locrnion. Project Description. "Dotal Contract Amount, Rid Date. Bidder's Name. and Contract DHE Goal. "fhe Form has a column Or 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 D13E shall provide a certification number to the Contractor and expiration date. Enter the DBE primc"s and subcontractors" certification numbers.l"hc form has a column for Be Names of DBE contractors to perform Be work (who must be certified on the date bids are opened and include the DBE address and phone number). INIPORTAN"I': Identil:y all Dl3E Finns participating in the project regardless of tier. Names of the First=fier DEL= Subcontractors and their respective itcm(s) of work listed should be consistent. where applicable, with the names and items of work in the "List of"Suhcontactors" submitted with your hid. ']'here is a column for the DBE participation dollar amount. Enter the Total Claimed D13E Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. or I owxo of item is not to be performed or furnished by the D13E. describe exact portion of' time to be performed or furnished by the D13E.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (constnwdon contractsy to determine how to count the participation of"DBE firms. L'xhibit 15-G must he signed and dated by the person bidding. Also list a phone number in the space provided and print the name ofthe 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. CO2 ExI1113IT D EQUAL- EMPLOYMENT OI'I'ON'I'UNI"I'Y CER-l'IFICA'I'ION The bidder Hardy & Harper, Inc. [proposed subcontractor hereby certifies that he/she/it has_x_, has not_ participated in a previous contract or suhcontract subject to the Equal Opportmity clauses, as required by L=.cccutive Orders 10925. 1 1 1 Id. or 11246. and that. where required, he/she/it has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency. or the former President's Committee on 1=,qual Lmploymcnt Opportunity. all reports due under the applicable filling requirements. Note: The above certification is required by the Fqual 1-inployment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (I )), and nwst 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 liom the equal opportunity clause are set forth in 41 CPR 60-I.5. (Generally only contracts or subconuacts of SI0.000 or under are exempt.) Currently. Standard Form 100 (GI-0-1) is the only report required by the I SCCUII\'e Orders or their implementing regulations. (ceoc. ov/anpluycrs/ceolsurvey/indes.ciin) Proposed prime contractors and subcontractors Who have participated in a previous contract or subcontract suhjcct to the f SCenllv'e Orders and have not filed the required reports should note that 41 CPR 60-1.7(b) (1) prevents the award of contracts and suhcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director. Office of Federal Contract Compliance. U.S. Department of Labor. Signature: fi�vDate: 10/23/2020 print Name: Micha I Murr Title: Vice President C-23 EXHIBIT E NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) [NAME OF CONTRACT] To the City of Huntington Beach In conformance with Title 23 United States Code Section 112 and California Public Contract Code 7106 the bidder declares that the bid is not made in the interest of,or on behalf of,any undisclosed person,partnership,company,association,organization,or corporation;that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid,and has not directly or indirectly colluded,conspired,connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement. communication, or conference with anyone to fix the bid price of the bidder or any other bidder. or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true; and. further, that the bidder has not,directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. By signing the Proposal, the Bidder has also signed this Noncollusion Affidavit. Bidders are cautioned that making a false Certification may subject the Bidder to criminal prosecution. Signature: /W/WDate:1 0/23/2020 Print Name: Mieha Murra Title: Vice President C-24 EXHIBIT F DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The Bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated with Bidder in the capacity of owner, partner, director,officer, manager: • is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agency; • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending: and • has not been indicted, convicted, or had a civil judgment rendered against him/her by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency,and dates of action. Note: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Signature: Date: 10/23/2020 Print Name: Micha I Mur ay Title: Vice Presi ent ('_25 EXHIBIT G NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: 1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment,or modification of any Federal contract,grant, loan,or cooperative agreement. 2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities." in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31. U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100.000 and that all such subrecipients shall certify and disclose accordingly. Signature: AIN Date: 10/23/2020 Print Name: Mich el Mu ay Title: Vice President EXHIBIT H C-26 DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1332 I. Type of Federal Action: 1 Smlw of Fedenl Action: 3. Report Type: FAIa contract as t d/olleNapplication ® a initial h grant b minal award b material change cooperative agreement c "-award J loan For Material('lunge(fitly: c ,an guarantee Year quarter f loan ursurarmce date of 14,t rcpon a. Name and Address of Reporting Eality S. If Reporting EUity in No.a is Srbawardet. Enter Name and Address of Prime: ® Prime Subawardec Tier .ifin....n N/A fonere%monal Dislricl,ifkmwn Congressional District,if kn.w,m 6. Federal Deparlmenn Agency; 1. Federal Proeranr Nome Description: N/A CFDA Number.it applicable N. Federal kelion Nunrher,d known 9. Award Amount,if kmusm N/A la. a.Name and,Sddrns of Lobby Eaten Is. ladividuals Performing Sinks, (including 111 irdn'idual,lust name.first name.MI) address it different from No IOa) (last name,first name.MI I N/A (attach Continuation Sheetlsl if r cssanI 11. %mount of Pa,n rrel luhedk all that appls) 13. I,1.of Pa,nenl(rherk all Vial apply 5 ❑ Actual plmmed a 'Clam,,ou b e- mc fee I:. Form of Pavement lahteh aB that spiel)(: c commission a cash d cmlingent fee N/A b in-kind. specify nature a deferred ,aloe f olher,specif, IJ. Brief Description uf%eniccy Performed or to be performed and Days)oftier%ke,includinc ulficrnal.empins eels(.or mrmberlsl coma,red,for Pa,ment ludicaled in Item 11: Hardy & Harper, Inc. has not contributed any funds to this project 1 attach l i ��n ShecrlsUl riecesvnm IC (batinulioa Sheens)attached: S el ❑ No ❑ 16. Informatim requested through this ton is authorized b, file 31 ll S C Section 1352 This disclosure of lobtiymg rcharice Signattuc was played by the tier above witert his vensactio was made or entered into This disclosure is required pursuant to 31 U S C Pnm Name Michael rra 1352 Th.s informaio will be repined to Cogress semiannually and will be available tine public m i,ecum Am Title Vice President pervm Nice tails o file the required disclosure shall be subject �/23/2t) it) d p a ciscnaln of not less than SIO.00II and non more than Telcplonc No 714-444-1 85 t l i.nc 20 Slia1,000 for each such failure Authmved for I mal RepnrJucOun F,drral(x Only: Standard Rxm I I Standard Form LLL Rev D9.12-97 C-27 INSTRUCTIONS FOR COi\-IPLETION OF EXHIBIT I L DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall he completed b,v the reporting entity. whether suhawardce 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 influcnce an officer or employee of any agency. a Nlember of Congress an ofliccr or employee of' Congress or an employee of a iblcmbcr of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the foam is inadequate Complete all items that apply for both the initial filing and material chance report. Reler to the implementing guidance published by the Oflicc of'Managemem and Budget tier additional information. I) Identif - 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) Identif, the status of the covered Federal action. 3) Identif\- the appropriate classification of this report. If this is a l'ollow-up report causal by a material change to the inl'ormation previously reported, enter the \,car and quarter in which the change occurred. Enter the (late of the last. prmously submitted report by this reporting entity for this covered Federal action. 4) Enter the f ill name. address, city. state and zip code of- the reporting entity. Include Congressional District if known. Check the appropriate classification ol'the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identif', the tier of'the aibawardec.e.g., the first subawORICC OI the prime is the first tier. SabawardS include but are not limited to StbcontraCIS. subgrants and contract awards under grants. 5) If the or_anization filin the report in Item 4 checks "Subawarcice" then enter the tiill name, address. city, state and zip code ofthe prime Federal recipient. Include Congressional District. if known. G) Enter the name ol'thc 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 I). 11' known, enter the full Catalog ol' 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 (c.g.. Request for Proposal (RIP) numbr, Invitation for laid (I1-13) number, grant announcement mnnber, the contract grant. or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RPP-DI -90-001." 9) For a covered Federal ❑ction where there has been an award or loan commitment by the Federal agency, enter the Federal amount ol'thc award/loan commitments fix the prime entity identified in item 4 or 5. 10)(a) Enter the full name. address. city. state and zip code of the lobbyim',entity engaged b_v the reporting entity identified in item 4 to intluenecd the covered Federal action. (b) Enter the ILll names of the individual(s) perfonning services and include full address if different from 10 (a). Enter Last Name. first Name and Middle Initial (NII). I I) Enter the amount of compensation paid or reasonable expected to be paid by the reporting emit, (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. ll* this is a material change report. enter the cumulati\,c amount of payment made or planned to be made. C-28 12)Chcck the appropriate box(cs). Chuck all boxes that apply. If payment is made through an in-kind contribution, speciry the nature and value of the in-kind payment. 13)Check the appropriate box(es). Check all boxes that apply. II other. specilA, nature. 14) Provide a specific and detailed description of the services that the lohbyist has performed of- will be expected to perform and the datc(s) of anq services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identit'ythe Federal officer(s) or employec(s) contacted or the officer(s) employec(s) or Member(s) of Coneress 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. includim, time fir rcviewina instruction, Sam-Ching existing (lata sources, gathering and maintaining the data needed, and completing mid reviewing the collection of information. Scnd comments regarding the burden estimate or env other aspect of' this collection or information, inchiding suggestions for reducing this burden, to the Office of i\Management and 13u(IIct. Paperwork Reduction Project (0348-0046), Washim,ton. D.C. 20503. 13v my si"nanire on this proposal I certirV. under penalty of perjury under the lays of the State of California. that the foregoing qucstionnairc and statements 01' Public Contract Code Sections 10162. 10232 and 10285.1 Me true and correct and that the bidder has complied with the requirements 01' Section 8103 of' the Fair Employment and Housing Commission Regulations (Chapter 5. Title 2 of the California Administrative Code). C-29 LxI I111IT I FEDERAL LOBBYING: RE.S 1'RICFIONS Section 1352. Title 31. United States Code prohibits Federal funds from being upended by the recipient or any lower tier subrecipient of a Federal-aid contract to pay for any person for influencing or attempting to intlucncc a Federal agency or Congress in connection with the awarding of any Federal-aid contract. the making of any Federal grant or loan, or the entering into of any cooperative agreement. I f any funds other than Federal funds have been paid for the same purposes in connection with this Federal-aid contract. the recipient shall submit an esccutcd certification and, il'required, submit a completed disclosure form as part of the bid documents. A certification fur Fcderal-aid contracts regarding p:n•mcnt of Bolds to lobby Congress or a Federal agency is included in the Proposal. titWldat'd 1:01-111 - I,L,L.. "Disclosure of Lobbying Activitics." with instructions for completion ol'the Stanelard Form is also included in the Proposal. Signing the Proposal shall constitute signature ofthc Certification. The above referenced certification and disclosure of lobbying activities shall be included in each subcontract and anv lower-tier contracts exceeding $100.000. All disclosure forms, but not certifications, shall be forwarded from tier to tier until received by the L'-nuineer. The Contractor, subcontractors and anv lower-tier contractors shall file a disclosure form at the end of each calendar quarter in which there occurs any event that requires disclosure or that materially affects the accuracy ofthc information contained in any disclosure form previously filed by the Contractor. subcontractors and ally lower-tier contractors. An event that materially allects the accuracy ofthe information reported includes: I) A cumulative increase if$25.000 or more in the amount paid or expected to be paid for influencing or attenlptimt to influence a covered Federal action: or 2) A change in the person(s) or individual(s) influencing or attempting to intlucncc a coycred Federal action: or 3) A change in the officer(s), cnlployces(s), or Nlember(s) contacted to intlucncc or attempt to intlucncc a coycred Fccleral Action. C-30 City of Huntington Beach Public Works Department 2000 Main Street Tel (714) 536-5431 . Fax (714) 374-1573 ADDENDUM NUMBER ONE For RESIDENTIAL CURB RAMP PROJECT in the CITY OF HUNTINGTON BEACH OCTOBER 20, 2020 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) SHEET At OF PROJECT SPECIFICATIONS Bids will be received from 1 00 PM to 2 00 PM only on the bid due date (10/27/2020) outside of the City Hall main entrance at 2000 Main St in Huntington Beach Staff will be present during this hour to receive bids only Mailed bids are still accepted but must be received before the bid submission deadline It in encouraged that bidders arrive earlier than normal to drop off bids to avoid a late delivery Bids will be opened outside of City Hall immediately after 2 00 PM Bidders are welcome to stay and attend the opening Social distancing measures shall be observed and masks will be required for all in attendance This update to the Notice Inviting Sealed Bids shall supersede all other bid delivery information noted on the project documents A revised NISB is now included with the project documents This is to acknowledge receipt and review of Addendum Number One, dated October 20, 2020 Hardy & Harper, Inc. Company Name BY Ichael y - Vice President 10/20/2020 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. i Bid Bond Bid Bond Number. CSBA-15462 CONTRACTOR: SUR El-Y: (M me, legal rtatur and addmsr) (Name,legal status and principal plart of bmsiness) I lardy&Harper, Inc. Fidelity and Deposit Company of Mandand 32 Rancho Circle 777 South Figueroa Street,Suite 3900 I nke Forest,CA 92630 Los Angeles,CA 90017 OWNER: This document has important legal (.Name,legal status and ade"jr) consequences. Consultation with City of I luntvngton Beach An attorney is encouraged with respect 2000 Main Street its completion or modification. I lunungton Beach,CA 92648 Any singular reference to Contractor,Surety,Owner or other parry shall be considered Plural where applicable. BOND AMOUNT: Ten Percent(100/.)of Amount Bid PROJ F_CI': Residential Curb Ramp Project,CC No. 1620 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,exennoa,administrators,successors and assigns,jointly and severally,as provided herein.The conditions of this Bond are such that if the Owner accepts[he 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[he 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 fill force and effect.The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid.Waiver of notice by the Surety shall not apply to any extension exceeding sixty(60)days in the aggregate beyond the time for acceptance of bids specified in the bid documents,and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty(60)days. If this Bond is issued in connection with a subcontractors bid to a Contractor,the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. \C'hen this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project,any provision tin[his Bond conflicting with said staturory 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 hnmishcd,the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. Signed and sealed this zLday of October 2020 /AI[�y\/It/•t/� ,(/]0 /,tlt',. Hardy 3c�per. Inc. / (lE%irnurJ �SL 11e ���r�� C\ Fdcf a Z- an f"la land (Suety) (sear (Witnerr) Melissa Ann Vaccaro (L•i/e)Dwight Reilly,Attorney-in-Fact By arrangement with the American Institute of Architects, the National Association of Surety Bond Producers(NASBP)(www.nasbp.orp)makes this form document available to its members, affiliates, and associates in Microsoft Word format for use in the regular course of surety business.NASSP vouches that t the original text of this document conforms exactly to the text in AIA Document P310-2010, Bid Bond. Subsequent modifications may be made to the original tent of this document by users,so careful review of its wording and consultation with an attorney are encouraged before its completion, execution or acceptance. 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 10/21/2020 before me, Melissa Ann Vaccaro, Notary Public (insert name and title of the officer) personally appeared Dwight Reilly who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. nlEuss Na vaccARo N COML7.77 2 24 1394 n '�Ns< ,' • Notary Public-California y �, ORANGE COUNTY n ��VV My Camm.Exoi^s 1Aay]2.7.0221 Signature �:CCf7� (Seal) Melissa Ann Vaccaro Band No.CSBA-15462 "ZURICH AMERICA:N INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETYCOMPANY FIDELITY AND DEPOSIT COMPANY OFMARYLAN'D 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 CObIPANY,a corporation of the State of Illinois,and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Illinois(herein collectively called the "Companies"), by Robert D. Murray, Vice President, in pursuance of authority granted by Article V, Section 8, of the By-Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof,do hereby nominate, constitute, and appoint Daniel HUCKABAY, Dwight REILLY, Arturo AYALA, Shaunna ROZELLF, OSFROM, Frank MORONES, Ben SfONC, Michael D. STONC and R.:NAPPI,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 mid 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 "ZUR1CH AIN161CAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPA,xIY at its office in Owings Mills, M:wland., 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 hisfher names and affixed the Corporate Seals of the said "ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANI', and FIDELITY AND DEPOSIT COMPANY OF MARYLAND,this Lith clay of January,A.D. 2020. m; og nr ,.FTEST: ZURICH AJIERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND By:Robert D.Morrov \Vice President J Bv:Dawn E. Brown Secretary Slate of Marvland County of Baltimore On this ISth day of January,A.D. 2020.before the subscriber,a Notary Public of the State of Marvland,duly commissioned and qualified, Robert D. Nlurr2v. Vice President and Daa'n E. Rrowm,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 Nvom,deposeth and suth,that heishe 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 mid Corporations. - IN rESTID10NY WHEREOF,I have hereunto set my hand and affixed my Official Seal the day and,year first above written. , n) 4 v u Constance A.Dunn,Votary Public My Commission Expires:July 9,2023 rump. 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 to ��_� Z�2 u before me, Ashlie Blanchard Date O'Here Insert Name and Title of the Officer personally appeared 1 u I rrwrf Name( of S ner() who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies),and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and offici✓allsseal. (/ ractary'uUilccal:r;.;ai❑ Signature_ i `i:-73.-t OP.kP!GE COIr!7Y Signature of Notary Public Aly Ccnm.Egire;Mau;?,2)"<3!� 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 t1L1,1' Z. nco-19rt , It lv" 32 lrwho urclf, c.a�e Fur-�st, �+� g2t�3o UAI P C iy of 1i-Jrbn Z oo MCO(1 S� rlunti roc Scalccl (did �i: C,r NO Irmo 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 23, 2021 Horizons Construction Co. Int'l, Inc. 432 W. Meats Ave. Orange, CA 92865 RE: Residential Curb Ramp Project—CC No. 1620 Enclosed please find your original bid bond for CC-1620. Sincerely, 4&�444 Robin Estanislau, CIVIC City Clerk RE:ds Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand SECTION C PROPOSAL for the construction of RESIDENTIAL CURB RAMP PROJECT CC No. 1620 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 60 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans. specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award,BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc.. and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded,the AGENCY will reject all bids and will re-advertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may,at the AGENCYY'S_option, be considered null and void. Accompanying this proposal of bid.find in the amount of 10 7. 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 "Bidders Bond for 10% ", as the case may be) Any standard Surety Bid Bond forth is acceptable. Bidder shall signify receipt of all Addenda here, if any: Addenda Na. Date Received Bidder's.S' atare O1 10/20/2020 c -2 SECTION C PROJECT BID—SCHEDULE A CURB RAMP PROJECT,CC 1620 BID ITEMS Item Description 0A 07 No. 1E:teman), 1 Mobilizaticn 1 LS $ $/10 2 Prepare Storm Water Pollution Prevention Plan (SWPPP) 1 LS 3 Install &Maintain Construction BMPs 1 LS $ $ 10,-X.JU Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb Cutting machine as shown on 1� 4 Curb Ramp Detail 1 in Appendix H of Specifications (Item incudes all appurtenances curb&gutter depressed curb c� sawcut. sidewalk domes retaining curb etc ) EA $ SJo $ Construct Curb Access Ramp per Caltrans Std Plan A88A as shown on Curb Ramp Detail 1 in Appendix H of Specifications 17 S (Item includes all appurtenances. curb&gutter depressed curb. sawcut. sidewalk, domes retaining curb slot pave, etc.) EA Horizontal Curb Cut Curb Access Ramp per Caltrans Std Plan A88A using horizontal curb cutting machine as shown on 6 Curb Ramp Detail 2 in Appendix H of Specifications (Item 2 includes all appurtenances curb&gutter, depressed curb. sawcut, sidewalk domes. retaining curt. etc) EA Horizontal Curb Cut Curb Access Ramp per Caltrans Std Plan A88A using horizontal curb cutting machine as shown on 7 Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances. curb & gutter depressed curb. sawcut, sidewalk. domes retaining curb. etc) 30 EA O Construct Curb Access Ramp per Caltrans Sod Plan A88A as 6 shown on Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances. curb&gutter depressed curb. sawcut sidewalk. domes retaining curb slot pave. etc.) 8 EA 9 Install truncated domes to existing Curb Ramp 10 FA $'1 y 2 $a 10 Install 4' PVC Sleeve for Street Assembly Sign per City of HB Slid Plan 401 10 EA $�24 $ 2-LI 0 Remove and replace existing sidewalk per City of HB Std Plan 207 (Allowance) 1,000 SF 11 $ Ls-—144 $ Remove and replaces existing 6' or 8' Curb and Gutter per Q 12 HB Sid Plan 205(Item includes all appurtenances. slot pave. etc) (Allowance) 300 LF $ O� $ t' `1 ) f VJ SUB-TOTAL BID AMOUNT(SCHEDULE A) $ C-2.1 SECTION C PROJECT BID—SCHEDULE A CURB RAMP PROJECT,CC 1620 SUB-TOTAL BID AMOUNT IN WORDS: (AR3 Oo'S Note: All extensions of unit prices will be subject to verification by Owner In case verification is required between the unit price and the extension. the unit price will govern The Owner reserves the right to reject any or all proposals and bid items. In addition. the City reserves the right to include or remove Bid Schedule B in the award of the contract. c -2.2 SECTION C PROJECT ADDITIVE BID —SCHEDULE B CURB RAMP PROJECT, CC 1620 BID ITEMS m Description Quantity Unit I Unit Cost Total Cost e (Extension) Horizontal Curb Cut Curb Access Ramp per Caltrans SIC, Plan A88A using horizontal curb cutting machine as shown on 1 Curb Ramp Detail 1 in Appendix H of Specifications (Item 40 includes all appurtenances, curb&gutter,depressed curb, sawcut, sidewalk, domes, retaining curb, etc.) EA Construct Curb Access Ramp per Caltrans Std. Plan A88A as 3 2 shown on Curb Ramp Detail 1 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter, depressed curb, sawcut.sidewalk. domes,retaining curb. slot pave,etc.) EA Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curo cutting machine as shown on 3 Curt)Ramp Detail 2 in Appendix H of Specifications (Item 3 includes all appurtenances, curb&gutter, depressed curb, sawcut, s+dawalK, domes, retaining curb, etc.) EA $ $ 0 Horzontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 4 Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter, depressed curb, sawcut,sidewalk, domes, retaining curb,etc.) 17 EA Construct Curb Access Ramp per Caltrans Std. Plan A8aA as 5 shown on Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter, depressed curb, sawcut, sidewalk, domes, retaining curb, slot pave,etc.) 9 EA $ $42___�9 30 6 Install truncated domes to existing Curb Ramp 9 EA $ 7 Remove and replace existing sidewalk per City of HB Std. Plan207 (Allowance) 400 SF $1D.b $ Remove and replaces existing 6`or 8'Curb and Gutter per 8 HB Sid. Plan 205(Item includes ail appurtenances, slot pave, G etc.). (Allowance) 100 tF $ n.u7 $4q SUB-TOTAL ADITIVE BID AMOUNT (SCHEDULE B) $ SUB-TOTAL ADDITIVE BID AMOUNT IN WORDS: Note: All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern. The Owner reserves the right to reject any or all proposals and bid items. In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract. C-2.3 SECTION C PROJECT BID SCHEDULE TOTALS RESIDENTIAL CURB RAMP PROJECT CC 1618 Sub-Total Bid - Schedule A �51 tSi7.� Sub-Total Additive Bid - Schedule B TOTAL BID AMOUNT, BASIS OF AWARD (Schedules A+B) 29, AgD&OO TOTAL BID AMOUNT IN WORDS: .J e — r Notes. All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern The Owner reserves the right to reject any or all proposals and bid items In addition the City reserves the right to include or remove Bid Schedule B in the award of the contract c •2.4 LIST OF SUBCONTRACTORS In accordance with Government Code Section 1104. 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' thetotal 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 D/R PWC Dollar % of ltem(.ti) Subcontractor License Registration# I Amount Contract Number By submission of this proposal. the Bidder certifies: I. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listine. 2. That the AGENCY will be fumished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 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 RESIDENTIAL CURB RAMP PROJECT, (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. liorizons Construction Co. Int ' 10 Inc. Contractor - dX B. n Kotrash Vice President I it!c Date: 10/26/2020 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162. the Bidder shall complete. under penalty of perjury, the following questionnaire. QUESTIONNAIRE: Flas 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 0 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 workers compensation or to undertake self- insurance in accordance with the provisions of that code, and 1 will comply with such provisions before commencing the performance of the work of this contract. Horizons Construction Co. Int ' 1 . Inc . Contractor B% Ki r Vice President I itic Date: 10/26/2020 C BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Hnrizong Construction Co . Int ' 1. Inc . Bidder Name 432 W. Meats Avenue Business Address Orange CA 92865 City. State Zip ( 714 )626-0000 bidding@horizonscci . com Telephone dumber Email Address 825022 A B C2 , C8 , C12 , C20 , C21 & C36 State Contractor's License No. and Class 09/25 /2003 Original Date Issued 09/30/2021 Expiration Date The work site was inspected by F.YI C bXQ of our office on OC tnbBr IS , 20f1_O. The following are persons, firms, and corporations having a principal interest in this proposal: Hatem Ibrahim. President Kinan Kotrash. Vice President The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Horizons Construction Tnt�l . Inc , Company Name Signature of Bidder C-8 xinan Knrrash . Vice President Printed or Typed Signature NOTARY CERTIFICATE Subscribed and swom to before me this 26 day of October . 2020 . 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. Stateof California ) County of Orange ) On ontober 26 2020 before me,)�Q711jP) k7 afrer0l WAry YL)(�IL'i Month, Day,and Year Inserts Name and Title of Notary personally appeared K� 1' ul VQ '►ya4l Name($of Signerj4 who proved to me on the basis of satisfactory evidence to be the persorvq whose name(*) is/am subscribed to the within instrument and acknowledged to me that he/sheHlwy executed the same in his/la�authorized capacity(49 ,and that by his/herMteir signatureo on the instrument the persono,or the entity upon behalf of which the persons)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. Ya2MIN BABAEAA VALDES WITNESS my hand and official seal. Notary P,.Enc Cadorma E Orange County i Commission r 2241343 • Ny Comm.Eapv.Jen 2. 2022 Signatin Sig ate of Notary Pu lic (PLACE NOTARY SEAL ABOVE) C-9 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on ,,,,.,, „.at Orange ,CAA Date Citv Stole xi nan Kntrash _. being first duly sworn, deposes and says that he or she is Vi eo Ares i dent ofHorizons Construction Co. Int'1. Inc the party making the foregoing bid that the bid is not made in the interest of,or on the behalf of,any undisclosed person. partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham:that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner. directly or indirectly, sought by agreement. communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract.that all statements contained in the bid are true;and, further.that the bidder has not,directly or indirectly, submitted his or her bid price or any breakdown thereof,or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Horizons Constrnetion Co Intl , Inc. Name of Bidder Signature of 422 W. Meats Ave. Orange. CA 92865 Address of Bidder C4 Kinan Kotrash Vice President Printed or Typed Signature NOTARY CERTIFICATE Subscribed and sworn to before me this L day of�'�. 20X 11 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document, to which this certificate is attached, and not the truthfulness, accuracy,or validity of that document. Stateof California ) County of Orange ) On nc toper 96, 2020 before me, X,1-7mtn -Pr7YVTO Month, Day, and Year Insert Name and Title of Notary personally appeared t"l �1'1gw ' `c fra4_�,, Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the personof whose name(4 isEaoe subscribed to the within instrument and acknowledged to me that he/she*vey executed the same in h isAwr4heir authorized capacity(ies),and that by hi&%*Wdhwr signaturoslon the instrument the personsA. or the entity upon behalf of which the persono)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. YANIM BARRERA VALDES WITNESS my hand and official seal 4ou•v o-o.¢•aotorme _ t�°' i.' county ! Commitswn i 2241142 UP,,"Jun 2.2022 Signature *Sigreotary Public (PLACE NOTARY SEAL ABOVE) C-9 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, "Demolition of existing concrete ADA ramps and construction of new ADA compliant curb ramps. Work included additional curb and gutter construction to ensure surface water flow around corner. All ramps met Caltrans requirements set forth in Standard Plan A88A"I Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. Listed below are the names. address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: County of San Bernardino L 825 E. 3rd Street , San Bernardino, CA 92415 Name and Address of Public Agency Name and Telephone No. of Project Manager. Larry white 909-387-7924 $511, 282 . 00 Ada improvements to concrete cross -amps 05/2019 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: North Bloomington ADA Ramps City of Anaheim ?. 400 E . Vermont Ave, Anaheim, CA 92805 Name and Address of Public Agcncy Name and Telephone No. of Project Manager: Lorenzo Rea 714 -765-6893 $441 , 802 . 50 Remove & replace nidewalk 0 / 020 Contract Amount "type of Work Date Completed Provide additional project description to show similar work: Arterial Sidewalk removal and reconstruction City of Orange �• 300 E . Chapman Ave Orange CA 92865 Name and Address of Public Agency Name and Telephone No. of Project Manager: youiehi Nakagawa 714 -744 -5572 $656 , 406 . 87 Curb and gutter. 07 /2020 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Annual Concrete Replacement at Various locations C-10 Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager, and Superintendent. For each of these critical positions. please list at least three projects for which the critical staff has performed similar work within the last five years. These projects do not have to be under the employment of the bidder of this project. Bidders are encourar*ed submit supplemental relevant project history in addition to the projects listed herein. I. )aM Name of proposed Project Manager Telephone No. of proposed Project Manager: Iy lUz�p -Cccr) If 550, b 5 z Oramccouin"JA (`ern lf rd Oc.M 4riFS IMp �D12019 Project Name ktontract Am nt Type of Work Date Completed %,21zv7-1 o00 C i ET-) (Me fif ' p�i�l li nte,(l ) Q �20�P) Project Name & ntract . mount Type of W6 k Date Com leted �3fw0 v>�jL�i 04f 2010 Yl�� n�Y . Project Name & Contract Amount }.pe of Work U Date Completed z. M i 1(,e Sand-Or C, Name of proposed Superintendent I 'Telephone No. of proposed Superintend /ent: ZtO — no0a S�eL .6--�4 oct-t d Vf SO m Q , Project Name & Contract Amount Type of Work Date Completed ,�CL +Kcu,/m `(Ze<( yy\- Project Name & Contract Amount Type of Work Date Completed �)-e0) iilacI±d (4PSUry\�L Project Name & Contract Amount Type of Work Date Completed C-II Mike C. Sanders 2820 Antares Drive Riverside, CA 92503 951-722-6029 Mikesanders1010@gmail.com Job Objective: • Over 35 years experience as a builder, crew leader, foreman, and supervisor. Well known in the industry for my workmanship, knowledge and dependability. Skills: • Built and poured concrete structures including catch basins, manholes,junction structures, pump stations, box culverts, headwalls and flood channels, curb and gutter, sidewalk and flatwork. Experience running heavy equipment such as loaders and backhoes. Proficient at reading plans and have knowledge of multiple County Specifications for same. Currently a member of the Cement Masons Union Local 600. Experience: • Harry H Joh Const. Paramount CA 562-630-3348 Position: Job Foreman Supervisor Oversaw a crew of 10-14 people installing storm drain pipe and catch basins. Replaced curb and gutter and supervised the installation of pervious concrete. Responsible for material calculation and ordering of same. Arranged for inspections as needed per City plans and specs. • Covarrubias Bros Const. Murrieta, CA 951-600-1751 Position: Foreman Built, pour and strip concrete structures. Also assist the pipeline division raising manholes, laying storm drain, sewer, water and electrical conduit and have done some paving. Supervised multiple crews, scheduling jobs, ordering materials and inspections • LNA Storm Drain Const. Chino Hills CA 909-393-149 Position: Foreman Built, pour and strip concrete structures. Also assisted the pipeline division raising manholes, laying storm drain, sewer,water and electrical conduit and have done some paving. Supervised multiple crews, scheduling jobs, ordering materials and inspections • James A Shirley Const. Yucca Valley, Ca 760-228-0447 Position: Foreman Built, pour and strip concrete structures. Also assisted the pipeline division raising manholes, laying storm drain, sewer, water and electrical conduit and have done some paving. • California Structures Blue Jay, CA (closed) Position: Foreman Built, pour and strip concrete structures • R Dugan Const Mira Loma CA 951-360-7531 Position : Foreman Duties were to build, pour and strip concrete structures. Supervised multiple crews • Kip Inc. Murrieta, CA 951-698-7890 Position: Foreman Duties were to build, pour and strip concrete structures. Also assisted the pipeline division raising manholes, laying storm drain, sewer, water and some paving. "references upon request' CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771.1(a)), passed by the California State Senate on June 20,2014.established a new public works Contractor Registration Program,which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July I through June 30 state fiscal year) with the California Department of Industrial Relations(DIR).Currently the annual non-refundable registration fee for Contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 httpJ/www.dir.ca.gov/DLSE/Public W orks/SB854F&ctShect-6.30.14.pdf DIR's Contractor Registration Link—Call (844) 522-6734 https://efiling.dir.ca.gov/P W CR/ActionServiet?action=displayP WCRcgistrationForm D1R's Contractor Registration searchable database: https://cfiling.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. ruction Co . I , Inc. Contra By an Kotrash biddingghorizonscci . com Email Vice reaidPnt Title Date: 10/26/2020 PWC Registration #: 1000011n17 C-12 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24. Code of Federal Regulations, Part 1350 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): K •K• 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: Horizons Construction Co . Int ' 1 . Inc . Contact Person: Kinan Kotrash Contact Phone: 714 -626 aadw - Signed: Date: *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub- contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Pre%ious non-compliance w ith Section 3 could result in disqualification. ( -13 EXI-llBff A DISADVANTAGED BUSINESS ENTERPRISE (DBE) This Project is subject to Part 200.321. Title 2. Code of Federal Regulations entitled "Contracting with Small and Minority Businesses. Women's Business Enterprises. and Labor Surplus Area Firms." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in Part 200321. Title 2 CFR. shall be encouraged to participate in the performance of Contracts financed in whole or in part with federal funds.The Contractor should ensure that DBEs.as defined in Part 200321. Title 2 CPR, have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps.as set forth in Part 200321.Title 2 CFR. for this assurance. The Contractor shall not discriminate on the basis of race, color. national origin. or sex in the award and performance of subcontracts. Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project. although there is no specific goal for DBE participation. C-14 EXHIBIT B DBE INFORMATION—GOOD DDjFAITH EFFORTS Federal-aid Project No. CG- 6 181 Bid Opening Date 1L-4jiCe Y The City of Huntington Beach established a Disadvantaged Business Enterprise(DBE)goal of 9% 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 ('COP WO" A&WS 10 /(o /2&zo B. The names and dates of written notices sent to certified DBEs soliciting bids for this Project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested(please attach copies of solicitations,telephone records. fax confirmations,etc.): Names of DBEs Solicited Date of Initial Follow Up Methods Solicitation and Dates t}13 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 (S) of (Y/N) Contract Oa O o� D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidders 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 bidders rejection of the DBEs: Fei V`+ COKsh'w(', Ice.+ ? Irretid 64 c 1c kU Names,addresses and p one 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: �sw! S c jr c A �Vwr C-16 F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: 7 sr,� 1;�G i..ai ' � jz' or 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 oytOl���+u ILr✓1 /U It, 1v2u H. Any additional data to support a demonstration of good faith efforts(use additional sheets if necessary): r A NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. C-17 0/10.121120 CangrG:m.e Vea.:4fi mn Fax Confinn:aions or Rc,idemial Curb Ramps - Project CC 1618 Compan) Name. Fax Shoats Attempts Time Sent (310) 515- Failure I G fi C EQUIPMENT CORPORATION 5046 (805 Success I) 830- 10/16/2020 at 07:33 All Source Ingincerin" 1856 PNI (760) 510- Success I t0/16/2020 at 07:41 TTP-US 8559 PM (888) 401- FallUI'C 1 ELEVATING SALES CORP. 1669 (714) 953- Success I 10/16/2020 at 07:41 ONIi"I'I\MI lfl'll-ITY SAI_I S, INC 5710 111%11 (661) 424- Failure I RUSSELL W \\ F.ISSE 9O8S (619) 498- Success 1 10/16/2020 at 07:41 PedVct Construction 1060 (619) 593 Failure I TIALI3F..RT CON'STRUC.TION CO INC' 352-1 (951) 240_ 10/16/2020 at 07:41 SF\M CONSTRUCTORS IV'( 3419 Success I 131\1 (818)450- Success I 10/16/2020 at 07:41 DVBF LOW VOLTAGE SYSTEMS INC 2577 PM (714) 754- Success 1 10/16/2020 at 07:42 COAST FLOORS INCG455 P\M (714) 479_ 10/16/2020 at 07:42 Global Environmcntul Network [tic Success Success I PM \MO\'TGO\MFRI CONSTRUCTION SERVICI-S (019) 546- Failure I INC 8.182 (909) 620- Failure I A1MFRICAI_ SOLUTIONS 4454 (71-1) 455- Failure 1 BRrAS"1 FCII C'ON"I'RACI\G INC.' 7086 (SSS1 351i- 10/16/2020 at 07:42 Gsj Utility Supply ,\ Service 1250 Success I P\M (-i6O) S59_ 10/16/2020 at 07:42 Flia_D BRO"I'I II RS COIN'S"I'I.UC I'1O\' 3500 Success I PNI (323) 939_ Success I 10/16/2020 at 07:42 All Area Services Inc 9262 PM GI'I"TIV'S ENVIRONNIENTAL S ENGINEERING. (949) 472- Failurc I 1 IN,C. OS17 (619) 561- 1ll/16/2020 at 07:42 \1�lDCO yes; Success I P\1 (619) 550- Failure I VALOR CONSTRUCTORS INC 7036 (310) 329_ 10/I6/2020 at 07:-42 LOS AA'CiLII-GS ('il_/ASS COMPANY INC Success I y10 4\I (949) 215- 10/16/2020 at 07:42 IN'I_AA'IJ I I.00RIA'i I t,ON"I RAC I'OI:S INC 5891 Succe>s I PNI 71•11 844 10/16/2020 at 07:42 Glacier l_aholator{cs lu", 143 9 � JucccsS I P\I _ \Monaco AMeclianical. Inc. (32 3) 939- Success 1 10/16/2020 at 07:42 v2 luryr/hcww'cnmpli:rnccn...cn.nl.ulnun/Icucr�'un:innauun�bJn>' I 175/'1119 Comp]wcc Ne,,Adnun 9262 PNI (i 14) 731- Failure I Reilly Elechic Cu 0303 (760) 720- Failure I I' 12 �1U1_I.IG:AN INC" 1955 (9.19) '36- Success I 10/16/2020 w 07:42 ON TARGE"F F-.LECTRIC IN(: s,Ob P\i (805) 92S Failu e I BROWN'S ELECfRICAI. 8578 (S IS) 537- Failure I NEP'fUNE PLUMBING CO 1429 ,1, Impaw..w...mph"', lc tic......uruceion..n t05_ IF A SOLE.. OWNER OR SOLE CONTRACTOR SIGN HERE: (I) Name under which business is conducted (2) Signature (given and surname) of proprietor (3) Place ol`Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail IF A PARTNERSHIP. SIGN HERE: /�N I �1 (1) Name under which business is conducted (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone NO. (5) E-Mail C-is IF A CORPORATION. SIGN HERE: (1) Name under which business is conducted Ho i zone rnnatruntinn rn_ Tnt 1, Inc. (2) (Signature) Kinan Kot Vice President (Title) Impress Corporate Seal here (3) Incorporated under the laws of the State of ra1 i forni a (4) Place of Business 432 W. Meats Avenue (Street and \umhcr) City and State Orange CA (5) ZipCode 92865 Telephone No.714-626-0000 (6) E-Mail bi ddi na@hari 7.onHCCi com NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED C-19 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other offices completing this certificate verifies onh the identih of the lndi%idual who signed the document to �%hich this certificate is attached, and not the truthfulnc%.. accuracc, or calidit% of that document. State of CALIFORNIA County of ORANGE On October 26, 2020 before me YAZMIN BARRERA VALDES, NOTARY PUBLIC _ 1 Personally appeared KINAN KOTRASH who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/aFe subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/heF/theiF authorized capacity Oes), and that by his/heFftheiF 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 seat. J Signature of Notary OPTIONAL Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ® CORPORATE OFFICER ❑ LIMITED ❑ PARTNER(S) ❑ ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: Horizons Construction Co. Int'I, Inc. NAME OF PERSON(S) OR ENTITY (IES) List below names of president, vice president. secretary and assistant secretan_�. if a corporation: if a partnership, list names of all general partners and managing partners: Hatem Ibrahim, President Kinan Kotrash, Vice President K'maN Kotrusl� SeC�>'-�,7r� C-20 EXHIBIT C LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS THE REVERSE SIDE OF THIS FORM LOCAL AGENCY Ithd (- 'n htlr,�� (/-"-LOCATION PROJECTDESCRIP'nON FZCS14eritial POMP PvQ/I'G+ TOTAL CONTRACT AMOUNTS r. 1:2 �Srb 00 BID DATE 10 BIDDER'S NAME L-lpYiznnS Cons ur ff m ro. -T-1i i"/ . rm__� CONTRACT DBE COAL: r a ONTRACT TEM OF WORK AND DESCRIPTI0111IDBECERT NO iAME OF EACH DBEDOLLARAMOUNT M NO SERVICES TO B NO EXPIRATION lMum be certified on the datc bv&DR[ UBCONTRACTED OR MATERI DATE or opened- mclude DBE addresizi O BE PROVIDED(err corVat-d rT trid pharc marshes) rider is a DBE) For Local Agency to Complete: Tool C41mad DBE S 16 7. Gff !mal.Agency Contract Number Pantctpatda !cdc:Ward Roth Number edeml Share _ t onttaci Award Date oral Agency clfnfics that all DBE ccrttia:atans have been verified and tiornnmfmn is complete and accurate s,gm ors I ��n�,_� (AneaCodel?el No Print Nrune Signature Date <VYIP) ICOfVn I k I ocal Agency Repr stenmlrvc Person to Contact (Please Type or Rini ,Am Code)I elephor a Number kcal Agency Bidder DBE Cae.nitnwn(Cmreoe Corso,,. (Pfau 626 M) C-21 EXHIBIT D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Hnri Iona ( mina ni ion n- Tn ' 1 _Tnc - [proposed subcontractor .] hereby certifies that he/she/it has_, has not_, participated in a previous contract or subcontract subject to the Equal Opportunity clauses, as required by Executive Orders 10925, 11114, or l 1246. and that, where required, he/she/it has filed with the Joint Reporting Committee.the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10.000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. (eeoc.gov/employers/ceoisurvey/index.cfm) Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance. U.S. Department of Labor. Signature: Date: 10/9.6/2 0 9 0 Print Name: Kinan Kotrash Title: Vice President C-23 EXHIBIT E NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) [NAME OF CONTRACT] To the City of Huntington Beach In conformance with Title 23 United States Code Section 112 and California Public Contract Code 7106 the bidder declares that the bid is not made in the interest of,or on behalf of,any undisclosed person, partnership,company,association.organization,or corporation;that the bid is genuine and not collusive or sham: that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid,and has not directly or indirectly colluded,conspired,connived. or agreed with any bidder or anyone else to put in a sham bid or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price. or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract:that all statements contained in the bid are true;and, further, that the bidder has not,directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid. and will not pay, any fee to any corporation, partnership, company association, organization, bid depository,or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. By signing the Proposal, the Bidder has also signed this Noncollusion Affidavit. Bidders are cautioned that making a false Certification may subject the Bidder to criminal prosecution. Signature: - Date: 10/26/2020 Print Name: Kinan Kotrash Title: Vice President C-24 EXHIBIT F DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49.CODE OF FEDERAL REGULATIONS, PART 29 The Bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated with Bidder in the capacity of owner, partner, director, officer, manager: • is not currently under suspension,debarment, voluntary exclusion, or determination of ineligibility by any Federal agency: • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years: • does not have a proposed debarment pending. and • has not been indicted,convicted, or had a civil judgment rendered against him/her by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Note: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Signature: XA Date: 10/2 6/2 02 0 Print Name: Kinan Kotrash Title: Vice President C-zs EXHIBIT G NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief,that: 1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency. a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan,the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment,or modification of any Federal contract,grant,loan.or cooperative agreement. 2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL. "Disclosure of Lobbying Activities." in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10.000 and not more than S100.000 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 Sl00.000 and that all such subrecipients shall certify and disclose accordingly. Signature: Date: 10/2 6/2 02 0 Print ?game: Title: vice President EXHIBIT H C-26 DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT To 31 U.S.C. 1352 I. Ts pe of Federal Aeldoo: t Stain et Federal Acdow I Report Type: a contract ®a.l+ld;'otTer/appltcanon F a metal b grant It initial award b mineral change c coopa nsc ugrccri c pal-award d loon For Material Ckmage Only: e Icon Fuarennn year quaoruc f Irian ineurancc time of Iasi report J. Namr and \ddress of Reporting Vail y S. If RepMfq Entity In Na.4 is Smbmwardte. Eater Nagar mad Addr ral of Print: ❑ P lm ❑Subawarda Ilrf If klwwn ( nngr<ssinnat❑istnct. Inc%n Coagreriomal District.If kno vn 6. Federal Deliarnnent \genq: 7, Federal Program NmaWDeseriptim: CFDA Naatber.Ifappltcable A. Federal \rGun NumM•gdkMs'n 9. Aveiro!Anatol,if kro%n 10. A.Name and \ddress of I nbb. Falit-v ► to lMduah Performing Son im (including _.d n:ro • '+t came,MI) address dJi!lect•.I :hurt\n gal flag name,lint n:emr \I:I latach Continuation Shee0sl lfuccessary) IL \mouri I'as mfnl loner k nil that all 13. Type of Polygonal itketk all fkal apply) S \.tual planned a returcr b one-lime fee 12. Form of P.,"lent Ic heck all that appl, a cammrsswn B ,.,..•. d contingent fee b m"kind, ,gcciN rsnurc a deferred 'slue f other,specify 16. Brief Description of Son ices Performed or to he performed mod Ilatelsl of Service,including officegak emploseel al,or mrmlrerlsl contacted,for Pa)meat ladicaled in Item 11: f atach Conlmuanort Sheet(s)If noccssarl) IS. (bntinuatftw Sbeetisl attached: Its No IC Infonrauon requested through this form is authorized tor Title 31 U S C- Section 1352 rhos disclosure of lobbying reIINMe SI®ature %u placed by the tier above%hen his transactim was mode or entered info This diwIceoc is required pursuing to 31 U.S.C. Print Name. 16 11TYM 1352 This Infomutwn will be reported to Congress �•�r ,Q`^ semiann ually and will be available for pub Im lic pectwn Any Title CKA , person%ho fails to file the required dwieaoe shell be Aubyw (�, to a civil penalty of rid less then$10.000 and not tope than Telephone No.. � I4`{G Z(o ID S 10D.000 for each such faillur. Authorized for Local Reproduce m Federal Use Only: Sgtdard Form-L1. Standard Form LLL Ric 09.12.97 C-27 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431 , Fax (714) 374-1573 ADDENDUM NUMBER ONE For RESIDENTIAL CURB RAMP PROJECT in the CITY OF HUNTINGTON BEACH OCTOBER 20, 2020 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) SHEET Al OF PROJECT SPECIFICATIONS Bids will be received from 1 00 PM to 2 00 PM only on the bid due date(10/27/2020)outside of the City Hall main entrance at 2000 Main St in Huntington Beach Staff will be present during this hour to receive bids only Mailed bids are still accepted but must be received before the bid submission deadline It in encouraged that bidders arrive earlier than normal to drop off bids to avoid a late delivery Bids will be opened outside of City Hall immediately after 2 00 PM Bidders are welcome to stay and attend the opening Social distancing measures shall be Observed and masks will be required for all in attendance This update to the Notice Inviting Sealed Bids shall supersede all other bid delivery information noted on the project documents A revised NISB is now included with the project documents This is to acknowledge receipt and review of Addendum Number One, dated October 20, 2020 /' Hor; 7-onG construction Co- Tnt ' 1 . Inc . Company Name By tCtt1GY1 tYC�Sh ( �, d October 26 2020 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal OLD REPUBLIC SURETY COMPANY BOND NO.: HORCO-884 BID BOND KNOW ALL MEN BY THESE PRESENT'S: That we. HORIZONS CONSTRUCTION COMPANY INTERNATIONAL, INC. (hereinafter called the Principal), and OLD REPUBLIC SURETY COMPANY, a corporation organized and doing business under and by virtue of the laws of the State of WISCONSIN, and duly licensed for the purpose of making, guaranteeing or becoming sole surety upon bonds or undertakings required or authorized by the laws of the State of CALIFORNIA, as Surety, are held and firmly bound unto CITY OF HUNfINGTON BEACH, (hereinafter called the obligee) in the sum equal to 10% of the accompanying bid of the Principal, not, however, in excess of TEN PERCENT OF THE TOTAL AMOUNT BID Dollars (10% OF BID AMOUNT), for the payment of which, well and truly to be made, we hereby bind ourselves and our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCI-1 THAT WHEREAS, the above bounden Principal as aforesaid, is about to hand in and submit to the obligee a bid for RESIDENTIAL CURB RAMP PROJECT. JOB/BID NO.: CC NO. 1620, in accordance with the plans and specifications filed in the office of the obligee and under the notice inviting proposals therefore. NOW, THEREFORE, if the bid or proposal of said principal shall be accepted, and the contract for such work be awarded to the principal thereupon by the said obligee, and said principal shall enter into a contract and bond for the completion of said work as required by law, then this obligation to be null and void, otherwise to be and remain in full force and effect. IN WITNESS WHEREOF, said principal and said Surety have caused these presents to be duly signed and sealed this 23RD day of OCTOBER, 2020. HORIZONS CONSTRUCTION 1 ANY INTERNATIONAL. INC. 13 V: OLD RMBLIC SkJRETY CQMPANY BY: _ RANDY POI-IN, - Attomey in-Pact OLD REPUBLIC SURETY COMPANY- # # POWER OF ATTORNEY KNOW ALL MEN BY TFIESE PRFSENTS: That OLD REPUBLIC SURETY COMPANY,a Wisconsin stock insurance corporation,does make,constitute and. appoint: - RANDY$POHN,MATTHEW R.DOBYNS,HAMILTON KENNEY,ASHLEY M.SPOHN,OF SANTA ANA,CA its trio and lawful Attomey(s)-in-Fact,with full power and authority, for and on behalf of the company as surety,to execute and deliver and affix the seal of the company thereto(if a seal is required),bonds,undertakings,recognirances or other written obligations in the nature thereof, (other than hail bonds,bunk depository bonds,mortgage deficiency bunds,mortgage guaranty bonds,guarantees of installment paper and note guaranty bonds,scl Kinairance workers , compensation builds.guarmtceing payment of benefits,asgeslos abatement contract bonds,waste management bonds,hsiaalous waste remediatioobunds ' or black lung bonds), as follows: - ALL WRIThE'N INSTRUMENTS - - and to bind OLD REPUBLIC SURETY COMPANY thereby,and all of the ucts of said Aitomeys-in-Fact,pursuant to these presents,are ratified and confirmed. This appointment is made under and by authority of the board of directors at a special meeting held on February 18: 1982. This Power of Attomey is signed and scaled by facsimile under and by the authority of the following resolutions adopted by the board of directors of the OLD REPUBLIC SURETY COMPANY on February 18, 1982. RESOLVED that;the president,any vice-president,or assistant vice president,in conjunction with the secrctary or any assistant secretary,may appoint attomeys-in-fact or agents with authority as defined or limited in the instrumeni'evidennng the appointntcmt in each case,for and'on behalf of the company to execute and deliver and affix the seal of the company to bonds;undertakings,rccogni'rances,and'suretyship obligations of all kinds;and said officers may relnovp any such uttomcy-in-fact or agent and revoke any Power of Attorney previously granted to such person. - RESOLVED FURTHER,that any bond-undertaking recogniiumce,or suretyship obligation shall be valid and binding upon the Company (i)when signed by the presidem,any vicdpresidentor assistant vice president,and attested and sealed(if a seal be required)by any secretary or assistani . . secretary:or - . " (it)when signed by the president,any vice president or assistant vice president,ucretary,or assistant secretary,and counlersignal andsealed(if a seal be required)by a duly authorized altomey-in-fact or agent;or (iii)when duly executed and sealed(if a seal be required)by one or more attomeys-in-fact or agents pursuant to and within the limits ofthc authority evidenced by the Power of Attorney issued bylhe company to such person or'persons. / _ RESOLVED FURTHER,that the signature of any authorized officer and the seal c f the company may be affixed by facsimile to any Power of Attorney or certification there of authorizing the execution and delivery of any bond,undertaking,reeogm7Anec,comber suretyship obligations of the company; and such signature and seal when so used shall have the smile force and effect as though manually affixed. IN WITNESS W HFREOF,OI-D REPUBLIC SURETY COMPANY has caused these pre8enls,to be signed by its proper officer,and its corporate seal to be affix cd this '• 26TH. day of MAY,2020, '. I " w OLD REPUBLIC SURETY COMPANY - �• ��... //./ram/J//i Assistant Secretary jo SEAL'}-r - h STATE OF WISCONSIN,COUNTY OF WAUKESFIA-SS `�..:..+"'' President 26TH y ,personally came before me,. Alan Pavlic and On this ��� day of MAY,2020 - < Karen J Haffner ,to me known to be the individuals andofficers of the OLD REPUBLIC SURETY COMPANY who executed the above instrument,and they each acknowledged the execution of the same,and being by me duly swom,did severally depose and say; that they am the said officers of the.. corporation aforesaid,and that the seal affixed to the above instrument is the seal of the corporation,and that said corporate seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority of the board of directors of said corporation. - - Notary Public' My cornrnission expires: 9/282022 CERTIFICATE - _ ``. r (Expiration of notary commission does not invalidate this Instrument) I,the undersigned,assistant secmlary of the OLD REPUBLIC SURETY COMPANY,a Wisconsin corporation,CERTIFY that the foregoing and attached Power of Attorney remains in full force and has not been revoked;and furthermore,that the Resolutions of the board of directors set forth in the Power of Attomey,are now in force. 74J097 ,.,e`�� Signed and sealed at the City of Brookfield;Wl this 23 rd'. dayof..00tOber 2020 - 4 9t SEAL Assistant Secretary R.S.BONDING&INS AGENCY INC 22851-W r AORs 012020 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 n On 1� (�( � before me, ERIKA GUIDO, NOTARY PUBLIC, personally appeared RANDY SPOHN © who proved to me on the basis of satisfactory evidence to be the persons) whose nameN is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/heF/theiF authorized capacity (ies), and that by his/heF/the' 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 ERIKAGUIDO 6 California that the foregoing paragraph is true and correct. V COMM.#2190052 e 5 , NOTARY PUBLIC CALIFORNIA o WITNESS my h nd and official seal. N � r ORANGE COUNTY5,2021 Il: SMy Comm.ezq es May nature of N fri OP,TIID _ Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER ❑ PARTNER(S) ❑ LIMITED ® ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: _ NAME OF PERSON(S) OR ENTITY(IES) ( \ la: Horizons Construction ~` ✓' '` Co. Intl Inc. 432 W. Meats Ave. Orange, CA 92865 City of f-luntington Beach t �v City Hall 2000 Main St. HLI11tington Beach, CA Project: Residential Curb Ramp Project No.: CC No. 1620 Due Date: 10/27/2020Due Time: 02:0011M City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ISO. �ti<�w•huntingtonbeachca.gov Office of the City Clerk Robin Estanislau, City Clerk April 23, 2021 Kalban, Inc. 26450 Ruether Avenue, Unit 201 Santa Clarita, CA 91350 RE: Residential Curb Ramp Project — CC No. 1620 Enclosed please find your original bid bond for CC-1620. Sincerely, G� Robin Estanislau, CIVIC City Clerk RE:ds Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand SECTION C PROPOSAL for the construction of' RESIDENTIAL CUR13 RAMP PROJECT CC No. 1620 in the CITY OF HUNTINGTON BEACH TO THE; HONORABLE MAYOR AND MEMBERS OF THE. COUNCIL. OF IIUNTINGTON 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 60 working days. starting from the date of the Notice to Proceed. 131DDER 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\vork satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM TI-117 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 ol'sixty days from the bid opening date. If at such time the contract is not awarded. the AGENCY will reject all bids and will re-advertise the project. In the case of discrepancies in the amounts bid. unit prices shall govern over extended amounts, zinc] words shall govern over figures. C-t 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 fid O^ej in the amount of w ,O �hich 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_r/u ", as the case may be) Any standard Surety Bid Bond form is acceptable. Bidder shall signify receipt of all Addenda here, if any: tddeuda No. Date Recehrd Bidder's Signature 9-13- ZOZO ( -2 SECTION C PROJECT BID—SCHEDULE A CURB RAMP PROJECT,CC 1620 BID ITEMS Item Description Quay ity Unit Unit Cost Total Cost Na (Extension) 1 Mobilization 1 I_S $104000 $ (�,000 _ 2 Prepare Storm Water Pollution Prevention Plan(SWPPP) 1 LS $ZXVY 3 Install&Maintain Construction BMPs 1 LS $ $ y000 u Horizontal Curb Cut Curb Access Ramp per Caltrans Std Plan A88A using horizontal curb cutting machine as shown on 4 Curb Ramp Detail 1 in Appendix H of Specifications (Item 109 includes all appurtenances. curb&gutter, depressed curb, sawcut, sidewalk domes retaining curb etc) EA S U00 $ 0 00" Construct Curb Access Ramp per Caltrans Sid Plan A88A as 5 shown on Curb Ramp Detail 1 in Appendix H of Specifications 17 (Item includes all appurtenances. curb&gutter, depressed curb. sawcut. sidewalk, domes, retaining curb, slot pave, etc) EA $S700 $ 19 0 Horizontal Curb Cut Curb Access Ramp per Caltrans Std Plan A88A using horizontal curb cutting machine as shown on 6 Curb Ramp Detail 2 in Appendix H of Specifications (Item 2 includes all appurtenances, curb&gutter, depressed curb, e sawcut, sidewalk domes, retaining curb etc) EA $YL00 $ 96, 400't Horizontal Curb Cut Curb Access Ramp per Caltrans Sid Plan A88A using horizontal curb cutting machine as shown on 7 Curb Ramp Detail 3 in Appendix H of Specifications (Item Includes all appurtenances, curb& gutter. depressed curb sawcut, sidewalk, domes retaining curb. etc ) 30 EA $ 4c00 $ 174000-' Construct Curb Access Ramp per Caltrans Std Plan A88A as 8 shown on Curb Ramp Detail 3 in Appendix H of Specifications (Item Includes all appurtenances. curb&gutter depressed curb, sawcut. sidewalk, domes retaining curb slot pave. etc) 8 EA $ 5�]QO $ `154;00. 9 Install truncated domes to existing Curb Ramp 10 EA $ y00 22 $ Y,000 10 Install 4" PVC Sleeve for Street Assembly Sign per City of HB Sid Plan 401 10 EA $ iS0 $ "o ffi 11 Remove and replace existing sidewalk per City of HB Std o Plan 207 (Allowance) 1,000 SF Remove and replaces existing 6" or 8' Curb and Gutter per 12 HB Std Plan 205(Item includes all appurtenances slot pave etc) (Allowance) 300 LF SUB-TOTAL BID AMOUNT(SCHEDULE A) $ 81 9r 100 ep C-2.1 SECTION C PROJECT BID—SCHEDULE A CURB RAMP PROJECT, CC 1620 SUB-TOTAL BID AMOUNT IN WORDS: ._..Area ForfYeiwl T70wa. 4 ore hueoLed Colic, Note All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern The Owner reserves the right to reject any or all proposals and bid items In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract. C-2.2 SECTION C PROJECT ADDITIVE BID—SCHEDULE B CURB RAMP PROJECT,CC 1620 BID ITEMS Item Description Quantity Unit Unit Cost Total Cost No. (Extension) Honzontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 1 Curb Ramp Detail 1 in Appendix H of Specifications (Item 40 includes all appurtenances. curb&gutter, depressed curb. •o sawcul. sidewalk. domes retaining curb. etc.) EA $ 00 — $ ray+ poo" Construct Curb Access Ramp per Caltrans Std Plan A88A as 2 shown on Curb Ramp Detail 1 in Appendix H of Specifications 3 (Item includes all appurtenances. curb&gutter. depressed 29 curb, sawcut sidewalk domes retaining curb, slot pave. etc ) EA $ 5700 $ 7 00 Horizontal Curb Cut Curb Access Ramp per Caltrans Sid Plan A88A using horizontal curb cutting machine as shown on 3 Curb Ramp Detail 2 in Appendix H of Specifications (Item 3 includes all appurtenances, curb& gutter depressed curb, sawcut. sidewalk, domes retaining curb, etc) EA $!160 0 ER $ 13.800 Horizontal Curb Cut Curb Access Ramp per Caltrans Sid Plan A88A using horizontal curb cutting machine as shown on 4 Y b 90 e 0 0 4 Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances. curb&gutter. depressed curb, O.P. sawcut, sidewalk, domes, retaining curb. etc) 17 EA $ $'*HN7A2 Construct Curb Access Ramp per Caltrans Std Plan A88A as 5)DO oo g 100°P 6 shown on Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances. curb& gutter, depressed O.V. 0. P. curb sawcut sidewalk domes retaining curb. slot pave. etc J 9 EA $ f $ &"per 6 Install truncated domes to existing Curb Ramp 9 EA $ 002 $ 36002-0 7 Remove and replace existing sidewalk per City of HB Sid Plan 207 (Allowance) 400 sF $4 ° $ J6L)C> Remove and replaces existing 6"or 8"Curb and Gutter per 8 HB Sid Plan 205(Item includes all appurtenances slot pave etc ) (Allowance) 100 LF $ ]S $ 2i00sl? SUB-TOTAL ADITIVE BID AMOUNT (SCHEDULE B) $ 35!4 100-0 SUB-TOTAL ADDITIVE BID AMOUNT IN WORDS. -th"I H.an'ily.t 1'-ct.aZ' n.Ssc Yh#,,ane� om a Wwg.4-/ Note All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern The Owner reserves the right to reject any or all proposals and bid items In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract ( -2.3 SECTION C PROJECT BID SCHEDULE TOTALS RESIDENTIAL CURB RAMP PROJECT CC 1618 Sub-Total Bid - Schedule A A`i y' wo 00 Sub-Total Additive Bid - Schedule B 359� (pp 00 TOTAL BID AMOUNT, BASIS OF AWARD (Schedules A+B) 11206 20., ev TOTAL BID AMOUNT IN WORDS' One m (I on Two tfupa/ of P;qk r t6outan4 fwo dollaa Notes All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern The Owner reserves the right to reject any or all proposals and bid items. In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract C-2.4 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104. the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000. whichever is greater, and the portion of the work to be done by such subcontractor. Bid Name and Address of Slate Class DIR PWC Dollar % of Items) Subcontractor License Registration a Amount Contract 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 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 g2�E- fat SwrM Clw,'r4. , Dare City Stare ✓>U � being first�duly� S'wor�n, deposes and says that he or she is VrGp r'CS, of 1=GLl.YXNr, V the party making the foregoing bid that the bid is not made in the interest of,or on the behalf of,any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true:and, further,that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository,or to any member or agent thereof to effectuate a collusive or sham bid. K•rw►,, IMc Name \\of Bidder � ' h � L, Signature oT Bidden Zt.NSo Rmerh r A& jllit Santa Ci a k&,� A 4030 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 RESIDENTIAL CURB RAMP PROJECT, (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 he 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. KA(LI. T.r Contractor L� A.,.r,( Poole [IN yirG Fi[rl,4inr I itic Date: 10-17—2010 C-S 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 E 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. am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers compensation or to undertake self- insurance in accordance with the provisions of that code, and 1 will comply with such provisions before commencing the performance of the work of this contract. Contractor Dar,.( Roole R� V.rs,dem k I itic Date: 10-27-2020 C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Kalbw"/ Lie Bidder Name 26Y50 K"riy.- Ak tIMIi- 30/ Business Address iAV 0. c/..tr� CA 41jS0 City. State Zip ( I it ) 5W—(00-5 KafkP""Oc®ytl,tt.n Telephone Number Email Address 50755o Clast A State Contractor's License No. and Class March 017 Original Date Issued 3/;1/z021 Expiration Date ,/ �, t,, The work site was inspected by4 nnG6 !n C/ /"� O— of our office on . 2014. The following are persons, firms, and corporations having a principal interest in this proposal: Pefgak A+al iiesJ/mt T �'b.t SaxIM.'► 1}rwswir a'n tt6 Saw./not Off.'ct� 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. tea/iwn F Lt. Company Name Signature of Bidder C-t: Printed or Typed Signature NOTARY t CERTIFICATE Subscribed and sworn to before me thist!day of , R10 v 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 CA ) County of 1o5 On /(J — 7-1 -to 2,0 before me. /*Irky�(�r�.�/y[Q �✓Qf°t��i�la Month, Day, and Year �,/ Insert Name and Title of otary personally appeared � (/v Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies),and that by his/her/their signature(s)on the instrument the person(s),or the entity upon behalf of which the person(s) acted, executed the instrument. 1 certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Man twMCHAEL uwiarrCE Nehry Publ,-C&I, r, WITNESS my hand and official seal. LMAf ek,Cm sy COmm w,02196ISO My Comm.EvIon Mry 2.W21 r Signat Signature of Notary Public (PLACE NOTARY SEAL ABOVE) C-9 Bidder's Project History I-'or the purposes of this project, the bidder shall provide project history of similar work. specifically referencing the construction of (Describe specific work and experience necessan for project. For example, "Demolition of existing concrete ADA ramps and construction of ne% ADA compliant curb ramps Work included additional curb and gutter construction to ensure surface water flew around corner. All ramps met Caltrans requirements set forth in Standard Plan ASSA"I Bidders are encouraged to submit supplemental relevant project histon 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: I. C;y, #{ Rebmk Z73 Ear Olrvt A,Y.; 8...-6■..k CA 41Soz Name and Address of Public Agency Name and Telephone No. of Project Manager: A.(.». Salf;%; CRIA) 2IA- JSoO $214,000 RawtR PCt_ n)1- 241 Contract Amount Type of Work Date Completed Provide additional ro ect description to how similar w k� 2. C%fy of Alhr.,&, Ill Jr /.:Ir SI•f Alkg—lvr , CA 011201 Name and Address of Public Agency Name and Telephone No. of Project Manager: Rol,, r yT• (6Z0- 570- Sony 7opr 600 R a...t R PrC ort-Zola Contract Amount Type of Work Date Completed Provide additional pr 'ect d scription to show similar work: (-„tsr� xe-c 3. �; . t ho o CA 9r7)I Name and Address of Public Age cy Name and Telephone No. of Project Manager: gory, Cj sl (aot) Yn- zyyn 'LSogoo R" R P(-r OG-zrl4 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: C-Ill SS 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. y Name of proposed Project Manager Telephone No. of proposed Project Manager: (911) 501Hor5 $23f,ooc TipirR S.rrt rwav wr "'eat R...rR frc 01-2of9 Project Name & Contract Amount Type of Work Date Completed ,,,Ali. Fek i,,%"Kw 14Jag,aoe Rwdl 811 04-20I Project Name & Contract Amount Type of Work Date Completed FY 2oi4-l1 ADA ArrLa Raq# T .pr.m~nAr 1(50.0r6, 9-4AI Pre 06-2O!1 Project Name & Contract Amount Type of Work Date Completed Z• Nike Nova, Name of proposed Superintendent Telephone No. of proposed Superintendent: M is) So f- lot ? TL-r1 S+r..# fwv�,.,,,.w.,.r.I /r.t«f tZI&OO R...,tR Pce 01-101Y Project Name & Contract�Amoouuf! Type of Work Date Completed Allr.. Rdk.6d,-A aaa tlo7oq uo kB.R VCc o+-ZOi1 P ero� ct Name & Contract Amount Type of Work Date Completed FY ZOIVII ADA A"4rr Raw IIATnwrym-f ;csnoaoo gift Pcc D[-4011 Project Name & Contract Amount Type of Work Date Completed C-11 CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771.1(a)), passed by the California State Senate on June 20,2014,established a new public works Contractor Registration Program,which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July I through June 30 state fiscal year) with the California Department of Industrial Relations(DIR).Currently the annual non-refundable registration fee for Contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 http://www.dir.ca.gov/DLSEtPublic Works/SB854FactSheet_6.30.14.pdf DIR's Contractor Registration Link—Call (844) 522-6734 https://efiling.dir.ca.gov/PWCR/ActionServlet?action=displayP WCRegistrationFortn 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. ka! 7nc Contractor \ Dar/d By k4a,m jou®a.l. co,a Email VAe Pr r,A+n,, iitic Date:0-Z7-Yo 10 PWC Registration #: I00000z711 C-12 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992. SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low-Income Persons The bidder, under penalty of perjury,certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer,or manager(initial the applicable selections): Will ensure that 10%of all new hires as a result of this project shall meet all requirements of Section 3 ofCFR 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: Kati*"'Inc Contact Person: MaffMw 1.AWrellre Contact Phone: tt i Signed: 1A I �— Date: 10-27-1010 *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 disoualifiestion. (-13 fiXI-11131T A DISADVANTAGED 13USINESS ENTERPRISE (DBE) This I'rgjcct is subject to part 200.321. Title 2. Code of Federal Regulations entitled "Contracting with Small and Minority Businesses. Women's Business Enterprises. and Labor Surplus Area Firms." '['he Rcgulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs). as defined in Part 200.321. "Title 2 CFR. shall be encouraged to participate in the performance of Contracts financed in whole or in part with I'cdcral funcls.The Contractor should ensure that DBEs, as defined in fart 200.321. Title 2 CPR, have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps,as set forth in Part 200.321.Title 2 CFR. fir this assurance. The Contractor shall not discriminate on the basis of race, color. national origin. or sex in the award and performance of subcontracts. Failure to carry out the requirements of'this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project, although there is no specific goal for DBE participation. C-14 LXHIBfi B DBE INFORMATION—GOOD FAITH EFFORTS Federal-aid Project No. 16 10 Bid Opening Date 10-37-2020 The City of Huntington Beach established a Disadvantaged Business Enterprise (DBE)goal of 9% 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 SBz AkptW B. The names and dates of written notices sent to certified DBEs soliciting bids for this Project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested(please attach copies of solicitations,telephone records, fax confirmations,etc.): Names of DBEs Solicited Date of Initial Follow Up Methods Solicitation and Dates 52 U-s- -26- 7o c-ts 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 (S) of (YIN) Contract 4RE 'A e� TV A11 D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidders 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: sew Alm — dye �l�f Names,addresses and phone numbers of firms selected for the work above: �n n '- 1"b E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: ) C-16 F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purc*ses or leases from the prime contractor or its affiliate: Sew ! +- i�M /Li - ,Zw upti- I r AF—V 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 A enc /O anization Method/Date of Contact Results H. Any additional data to a demonstration of good faith efforts(use additional sheets if recess �2 t NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. C-17 ('13LEBRATINGr 30 YEARS AS A SMALL FAMILY BUSINESS 'PHI: DAILY REPORTER Connecting California contractors to construction bidding leads 8041 Tallon Way.Antelope CA 95843 candspublishingpgmail.com 916,729,5432 Proof of _ 1 Publication Packet IN THIS Pal'KET GOOD FAITH EFFORT AFFIRMATIVE ACTION OUTREACH SERVICE INCLUDES: Proof of Publication Statements one • Web posting for each newspaper in which your ad • daily/Weekly publishing in TOR ran with documentation stating the • TOR Plus Posting dates and publications in which your ad . Emailing over 13,500 contractors weekly ran., company names of weekly and . Signed proof of publication for each newspaper daily email blasts, and your invoice. These Proofs of Publication . Free logo placements Statements are provided for you to use Social Media outreach . with your bid package to document All included in one price your compliance with federal and state outreach requirements. THE DAILY REPORTER PLUS THE DAILY REPORTER The Daily Reporter Founded in 1994. The Dade Reporter is a recogniml mmont}-focused i NlBUWl3FJSBE/DBEiDVBE)neespaper On-line at www.TheDailyReporternet Publisher: C&S Publishing PROOF OF PUBLICATION STATEMENT for The Daily Reporter Electronic Newspaper The Daily Reporter newspaper is certified as both a Trade newspaper and also as a Focus paper. It is published in three editions. a North (California) State edition, a Southern (Califomia) edition and a Statewide (California) Water edition. Advertisements are published continually in all three editions and/or a selection of the three newspapers from the date approved until the bid date. Ads are also published online at www.TheDailyReporter.net. Ads are also sent out via Twitter, Facebook and Instagram. Ads are emailed directly to approximately 13,000 DBE/DVBE/SBE/ MBEPABE/013E firms - list updated and expanded in July, 2019. The following pages will include but not limited to all efforts made by C&S Publishing via The Daily Reporter C&S Publishing was founded in 1989 and is a family-owned and operated small business, DBE, S WBE and SMSE. CERTIFICATION 1 am over the age of eighteen. a citizen of the United States. and a resident of Sacramento County I am not a party to or otherwise interested in the attached matter. I am the principal clerk of the publisher. C&S Publishing. whc produces The Daily Reporter Electronic Newspaper. The The Daily Reporter Electronic Newspaper is published in the County of Sacramento The notice, a printed copy of which is attached as Exhibit A, was set in type not smaller than nonpareil and was preceded bywords describing the general character and terms of the notice printed in a black face type not smaller than nonpareil. Exhibit A was published in the The Daily Reporter online at www.thedailyreporter.net from )0 - 0�3 - '� to ko "C::'I-? ' "I:::: Exhibit Awas published in the The Daily Reporter(Northern edition) Electronic Newspaperfrom Exhibit A was published in the The Daily Reporter (Water State Wide edition) Electronic Newspaper from Q declare under penalty of perjury that the forgoing is true and correct and that the at- tached advertisement, Exhibit A, was affixed to this Proof of Publication by my own hand. Executed on to -off G . 20 0� at Sacramento, California Cath e Wo O er, Da1ty Reporter Good Faith-Effortort Affirmative Action Outreach :ompliance Op ortunitic-s SOLTEK , PACIFIC C O N a T R U C T r n N Invitation to Bid Soltek Pacific Construction is requesting Bids from certified DVBE.WBE, MBE,SBE.WOSB,SLBE. ELBE and Section 3 Business Subcontractors and Suppliers for ALL TRADES & MATERIALS on the: Project No S-16013 CHILDREN'S PARK IMPROVEMENTS Bid Date—Tuesday November 3, 2020 before 2:00 PM Assistance is available from Softek in obtaining necessary equipment. supplies, or materials. Assistance is available from Soltek in obtaining bonding. lines of credit or insurance. Soltek is actively pursuing SLBEELBE subcontractorsNendors for trades including the following divisions 03concrete. 04-masonry, 05- metals. 06-synthetic decking, 07-thermal & moisture protection. 08-openings. 09-finishes. 10-specialties. 11- equipment. 12-furnishings. 13-water feature. 22-plumbing. 23-HVAC. 26-electrical. 32-extedor improvements Bids to be submitted via fax at 619-296-4314 or email at Below is the direct link to view the plans and specs on our website or through planetbids available at no cost. By submitting a bid.the Subcontractor represents that it has reviewed the standard subcontract and consents to its use without modification and agrees to execute SPC's standard AGC subcontract with SPC's standard Attachment A thru N if awarded by SPC Any listing of Subcontractor pursuant to Public Contract Code Section 4100 et seq is expressly contingent upon Subcontractors acceptance to Soltek Pacific Construction Contact Jason Aviles Phone: (619)296-6247 Fax: (619) 296-4314 An Equal Opportunity Employer Request For Quotes From Certified DVBEIDBE/MBE/SBE/WBE Subcontractors and Suppliers for: RESIDENTIAL CURB RAMP PROJECT Location City of Huntington Beach Bid Date and Time: 10-27-2020 2:00 PM Trades/Services Requested:Asphalt/Paving Work Concrete Suppliers Trucking Survey Traffic Control Systems Equipment Suppliers Truncated Domes Minor Concrete Excavation NPDES Compliance Kalban, Inc. Address 26450 Ruether Ave#201 Santa Clar ta. CA 91350 Email Address. Contact Person Matthew Lawrence License Number 507550 An Equal Opportunity Employer Daily Roporter October23,2020 www.TheDailyReporter.net THE DAILY REPORTER PROOF OF PUBLICATION STATEMENT Contacted agencies via WEEKLY email The following information is provided by C&S Publishing, listing qualifiing construction agencies contacted via email in an attempt to fullfill requirements listed as: Names of agencies and dates on which they were contacted to provide assistance in contacting, recruiting. and using firms. I am overthe age of eighteen, a citizen of the United States. and a resident of Sacramento County. I am not a party to or otherwise interested in the attached matter. The notice, a printed copy of which is attached as Exhibit A. was set in type not smaller than nonpareil and was preceded by words describing the general character and terms of the notice printed in a black face type not smaller than nonpareil. declare under penalty of perjury that the forgoing is true and correct and that the attached advertisement, Exhibit A, was affixed to this Proof of Publication by my own hand. Number of agencies contacted �q,2) Executed on �, 20-Q:2 at Sacramento, California Cat ine Wood Owner, The Daily Reporter Publisher, GSPS News - Northern Edition THE DAILY REPORTER Weekly Email Sent I0-26-2020 Email Address axtcretcI00per"-nta aiKit,corn INF(Ya,DUNRIl 'RVICFS.COM j.w%=s naucslcchscsawn F.D.WOLF'd.ICLOIID.COM BARBARAI.IBGLL dCONKLINBRO&COM ROY_1_MOREN(Ya.11OTMAIL.COM dsgcaelro dgtnml am pauc_icxx,nntlting d:gmad.00en bids a enlammpcx)ls.wm IASON aMORASFQ(J[PM[ENT.CoM RIGO.BARA IASa YAI IOO.COM ello.capitalciteg'glgmail.lam sckxtncll a echotimprolcclion.com avc%twnrrwcstconcomkuuction.wm cstimatinga scanderatmwm PLANDRE'a SYNERGYCOMPANIES.ORG boot s'araweng.am BRIANW a`WII.I.IAMSON-CONSTRUCTION.COM FALCONSERVICES2016'aGMAIL.COM gltvardo'agllocnailting.axn gape:rihcrc diacabling olutinns ccm jfracrrachamlmonhard%%=corn mmtchcltmma'aiirandlubc.axn uwdk.g'afnmtiemct.nct 4wrewe a magnci te.pecialtres.am LUC KY1BA'a AOL.0 OM tvemU adaxlech wm wra mail2had am ranvantes a ne 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GENERAL ENGINEERING CONSTRUCTION 26450 Ruether Ave., #201., Santa Clarita, CA 91350 Phone: 818-504-1066 Fax: 818-504-1067 License No #507550—A kalbaninc@aol com 10-15-2020 Written Notice of Intent to Bid K.-\LBAN,INC.is bidding the following project as a prime contractor. Included in this listing are the portions of work that we have allocated to be lid on by available subcontracting firms,including DBIi/\fBE/D\BF./\CBE firms. Residential Curb Ramp Project City of Huntington Beach 2000 Main Street,Huntington Beach, CA Bid Opening 10-27-2020 2:00 PM The work,in general,consists of Removal and Reconstruction of,PCC Sidewalk.,PCC Curb and Gutter,parkway improvements,Curb Ramps,Survey Work,and other related work. The following categories of work have been allocated for reception of quotes from\fBE/\CBE/D\BE/SBE/DBE and Section 3 businesses: Requesting Asphalt/Paving Work Concrete Suppliers Trucking Survey Traffic Control Systems Equipment Suppliers Truncated Domes Minor Concrete Excavation NPDES Compliance If you are an interested DBE/MBE/DVBE/WBE sub contractor,KAI.BAN INC. can pro-6de information about the plans, specifications and requirements for the selected subcontracting work. KALBAN, INC. requests that your company submit a proposal for the sub-work allocated. Please be advised that KAI.BAN, INC.,when applicable can assist interested Section 3 subcontractors in obtaining bonds,lines of credit or insurance. If you have any questions about this project,please feel free to contact our Section 3/DBE/NIBE/WBE/DNBE administrator Matthew Lawrence at kalbaninc@aol.com. "lhank you for your time. BROADCAST REPORT TIME 10/15/2020 11: 08 NAME KALBAN INC FAX 8185041067 TEL 8185041065 SER. H BR0J4J528374 PAGES) 01 DATE TIME FAX NO. /NAME DURATION PAGE(S) RESULT COMMENT 10/15 10:36 8188820509 15 01 OK 10/15 10:37 8587934495 16 01 OK ECM 10/15 10:38 9518489812 16 01 OK 10/15 10:39 6194476540 14 01 OK ECM 10/15 10:40 6269625055 16 01 OK ECM 10/15 10:40 3106310155 15 01 OK ECM 10/15 10:42 7148930945 17 01 OK 10/15 10:44 3237548558 00 00 BUSY 10/15 10:45 8053062498 18 01 OK ECM 10/15 10:46 8006599196 14 01 OK ECM 10/15 10:47 5308947767 22 01 OK ECM 10/15 11:07 9094448311 00 00 BUSY 10/15 11:08 5626333180 00 00 BUSY BUSY: BUSY/NO RESPONSE NG POOR LINE CONDITION CV COVERPAGE KALBAN, INC. GENERAL ENGINEERING CONSTRUCTION 26450 Ruether Ave., #201., Santa Clarita, CA 91350 Phone: 818-504-1065 Fax: 818-504-1067 License No.#507550—A kalbaninc@aol.com 10-26-2020 Written Notice of Intent to Bid- Follow Up KALR:AN, INC. iS bidding die f011oWing projen :r a prime contractor. Included in this listing arc the portions of cork that sac have allocated to be bid on be available subonmacting firms,including DIi13/AIItl3/DCl31i:/AC'131 firms. Residential Curb Ramp Project Cite of Huntington Beach 2000 Main Street, Huntington Beach, CA Bid Opening 10-27-2020 2:00 PM 'hhe work.in general,consists of llenun-al and Reconstrucion of, PCC Sidewalk, PCC Curb and Guner,parkway improvement,,,Curb Ramps,Survey\Cork,and other reh tcd %vork. The follmming ouegories of work 6ayc been allocated for reception of quotes from :A(lil::/APB];/DA'lll3/Slild/DRIi and Suction 3 busincs>cs: RcqucSting Asphalt/Pacing Work Concrete Suppliers Trucking Survey Traffic Control Systems Equipment Suppliers Truncated Domes Nhnor Concrete Excavation NPDES Compliance If you arc an interested sub contactor, KAI_BAN INC. can provide information aboul the plans, specifications and requirements for the selected subcontracting work. KAI_B AN, INC. requests that Your c011111anY SUbmil a proposal for the sub-work allocated. Please he advised tint KAIMAN, INC:., when applicable can assist interested Section 3 subcontractors in obtaining bonds, lines of Crerljr or insurance. If You have -mY questions about this project, please fCel free to conrnct our SCCjoll 3/1-)lili:/I\IIiE/\\ 131=/I�VBI:: administrator Matthew Lawrence at kalbanine a aol.com. "]'hank Aou for tour time. BROADCAST REPORT TIME 10/24/2020 13: 58 NAME KALBAN INC FAX 8185041067 TEL 8185041065 SER. k BR0J4J528374 PAGE(S) 01 DATE TIME FAX NO./NAME DURATION PAGE(S) RESULT COMMENT 10/24 13: 25 8188820509 15 01 OK 10/24 13: 26 8587934495 16 01 OK ECM 10/24 13: 27 9518489812 16 01 OK 10/24 13: 28 6194476540 14 01 OK ECM 10/24 13: 29 6269625055 32 01 OK ECM 10/24 13: 30 3106310155 15 01 OK ECM 10/24 13:32 7148930945 26 01 OK 10/24 13: 33 3237548558 00 00 BUSY 10/24 13:36 8053062489 00 00 BUSY 10/24 13:36 8006599196 25 01 OK ECM 10/24 13: 37 5308947767 27 01 OK ECM 10/24 13:57 9094448311 00 00 BUSY 10/24 13:58 5626333180 00 00 BUSY BUSY: BUSY/NO RESPONSE NG POOR LINE CONDITION CV COVERPAGE NALBAN,INC. Gemual Eryurenrrry Caotngryn :eaSCer..A+,aA..s.Ie.c.a r:mm susanlws Fac e,edw.,lxr 2019 UDBEJDBEISWBEISMBEIDVBE CONTACT LIST CLASS RACE 6 GENDER CERTIFIED LISTING p(Gwltwtgr:uw[ puLPEfa POd[Sa pyplrRna t�M E DBE .E 1CN PIM aaCE G[IIpEN I'll,lro CAyEIIC C r rsr CATI1,Eo PO a[1PdrlE ctauer:ta EmaJ AOvnu Cemolnion enC GUOin Inc Iyiv Y wmu..Uerm Y. % % BWk Female Cl. ll.. loll. a I.A.eeCOenweMprpEayl CeCIIN's Na.,eervl a Inc. nl Y L, l IlRl Al,CA VAR /' . % ACauUYYI F—Il, Cl. CA., ... YA Tol. 1.1. eyurylnr(ECrrpYvautelYa^rv8 Crva CMY16.Y[u,u.1 VRW.NC. .IE,[CUA e.'n"Y} % Cau(JYen Fenub CI+IP.a IAvtr rb,Y.69 Crnt E u nl InC. rl2l elu I.—CA eFa rt % % __ Nvuve AmeMan Famab 11. 1 CAN, . _ Ueao{esMpbLW nel DpninrwL Cnnstr lion Coin IM, Y4perra CA eITC % RCloo. Mv4 CTmMII� Cl,dl— 6M/bn 6MW'YG ar1EfO r!1(Eamn.r ,Con. DrlsCdl Elecrn4l 1'.v.Ill,A heel % BI l Mak C,wlll ]r4NIgN Gra_YC Ea ME eM Develo en,I.C. .111 % Komi. MNe 040064 Ca.gfs..pr AAT— a tramvel�{eaRkerglev conr Global 9.0 Seabn Inc. crs0—CA.' % A A AYao Paalc Mek CANT I".. ".. loll. yye(UblrYpmseabq tum F..La�WM1 eTr! alla':+nn A+ [n epwru VDu % % % BIRc Femak CInW co Jte4pb vo Tlol lolo=o NIA Paru[u Ind. .ro,e P.a Fr•Ycewr C.00A % % Avon Pwlc MMe CTj�_ CANT Y+eA:wn SGAISYm Mllpr(elgmnvran PleCon PlNucts LTD oin CA aYIb CeeA+,4arw 111 Moe CANT oll2l.I ..Z. loll. CW.1CauWrWalrrYa fan ROT Elenrk •.1 Wt n.D WHIT lm [Ipa+ % BlaCic MO. Clollro wWfru 1.111 lll,lMtl C..can Santos E,tavallng,Inc, MCA YLn fvA.ml % % Illsnnc LYb ratlM CANT ll1W AlA YOp]M MJ IMmvs currem a o1 Mdpd019 Cr..cw.r+.a. u+e+n r6a.axs. I+ura.�r+.erw.vrr.0 r+v rr�e+,r�r'..rrtir�u+.r.w..ro-w IF A SOLE OWNER OR SOLE CONTRACTOR SIGN HERE: (1) Name under which business is conducted (2) Signature (given and surname)of proprietor (3) Place of Business (Street and Number) City and State (4) Zip Code Telephonq No. (5) E-Mail II IF A PARTNERSHIP, SIGN HERE: (1) Name under which business is conducted (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business (Street and Nu bar) City and State V 7-j (4) Zip Code Telephone No. (5) E-Mail C-IS IF A CORPORATION, SIGN HERE: (1) Name under which business is conducted ko I bn.o 1 h C (2) � �-- (Signature) Vi rc Aoa (Title) Impress Corporate Seal here (3) Incorporated under the laws of the State of 1z fNwnj! . (4) Place of Business 7Gaei Rattho - AvA ♦ 10/ (Street and Number) City and State Sow m. C(o.rN CA (5) Zip Code 41fS0 Telephone No. (3110 SM-lots (6) E-Mail k4(b.w.hc4D nut.tow NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED C-19 List below names of president,vice president, secretary and assistant secretary, if a corporation; if a partnership, list names of all general partners and managing partners: De•13?k Pwrsl PM"A'st} Pa,1 POa'C Wee YrrioVotf OCA Iye.Aa.r feces roar PhrO+StAICN/— c-20 EXHIBIT C VOCAL AGENCY BIDDER DBE COMMITMENT(CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE EE R �VEERRSE SIDE OF THIS FORM I o CAL AGENCY C � f7 �J'�T/V' An LOCATION L `L �"LA3 PROJECT DESCRIPTION -czjofts S I rYTAL CONTRACT AMOUNTS I ZOS Zaptf 111DDATE lO -L2 —w+47 IIDDEWS NAME. hrGj ( I INTRACT DBE GOAL: —17 nNTRA(-T ITEM OF WORK AND DESCRIPTION BE CERT NO NAME OF EACH DBF Ix d.I.P.R AAIut NI 1 PM NO 1R SERVICES TO BEANDEXPIRATION (Must be certrtied on the date biJ Dot UIICONTRACTED OR MATERIAL. DATE tre opened• Include DBII addres TO BF PROVIaED for contracted if dir ind plwne number) iddcr is a D 77 For Local Agency to Complete: Taal Claimed DBE S G I(cal Agtncl Contract Number Partieipwon I ederad-aid Pmjcet Number u a I edcral Shure �mtrwi A%wd(late I(cal Agenn curdles that all DBI. vm iwuors hart been wri ied ant llormahon Is complete and accurate �] Signature of Bidder Dart (Area Code)Tel N„ Print Name Signature Dolt /41*4 7! yy Local Agenc) Repeescnwn a Peron to Canuct (Pdtase Type or Print) (Arta Codel Telephone Number _ Local Ageaty Bidda DBE Cmaauoaa 1Cmmurom l'annacnl IRe, 62609) l -_2 1 ]'LEASE NOTE: This information may be submitted with pour bid. If it is not, and you are the apparent low hidder or the second or third loNs, bidder, it must be submitted and received as specified in the Special Provisions. Failure to submit the required D13E 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. Bidders Name. and Contract DBE Goal. The form has a column for the Contract Item Nmllber and Item of Work and Description or Services to be Subcontracted or Materials to he provided by D131is. Prim contractors shall indicate all work to be performed by DBIis including, if the prime is a DBE, work performed by its own forces. it'a DBE. The 1)f31; shall provide a certification number to the Contractor and expiration date. Enter the DBE primes and subcontractors' certification numbers.The form has a column for the Names of D13E contractors to perform the work (who must be certified on the (fate bids are opened and include the D13E address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless oftier. 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 vour bid. '['here is a column for the DBF 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 DBF. describe exact portion of time to be performed or furnished by the DBE.) See Section -Disadvantaged Business Enterprise (1)131 ).'- of the Special Provisions (construction contracts). to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award. Federal-aid Project Number. Federal Share. Contract Award Date fields and verify that all information is complete and accurate before signing and filing C-22 EXHIBIT D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder (4 km jnc (proposed subcontractor ] hereby certifies that he/she/it has , has not_, participated in a previous contract or subcontract subject to the Equal Opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he/she/it has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently,Standard Form 100(EEO-1) is the only report required by the Executive Orders or their implementing regulations. (eeoc.gov/employers/eeolsurvey/index.cfm) Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Signature: Date: 10-z7-zoa0 Print Name: Owr,'d Poole Title: Vice rear.InrF C-23 V DISCLOSURE OF LOBBYING ACTIVITIES III I I FlIIS FORM TO DISCLOSE LOBBYING ACTIVITIES f URS NT TO 31 U.S.C. 1352 1. Type of Federal:\elloo: 2. Stains of Federal Action: 3. eport Type: ❑a.contract ❑a,laid/offer application a.initial h.grant b.initial award h.material change C.cewperatise agreement c.post-award d.loan For Material Change Onh: c.loan guarantee )car quarter f loan insurance date of la,i rclam /. %ame and Address of Reporting Entity 5. If Repo Ing Entity In No.q Is Suban ardee, Enter ame and \ddress of Prime: Prlmc Suhaward" Ter if known Congressional Dhgri<I,ifkm.wn ngressionA Ilhtrict.dknown h. Federal DepartmenUAgnscy: 7. Federal Program\ame/Descripfion: CF'D.A Number,It applicable X. Federal \clion Number.it known- 9• Award Amount.dknown: 10. a.%ame and.\title",of Lobby Eftdry b. Indisiduah Performing Senior I including (It imhsulual,last name,first name.MI) address if different from No. 10a) (Iasi name,first name MI) (attach Conti/I.onts)if neces<an-I I I. \mount of Pat merit Icheck all that apply) / 13. Type of Pay ment Ichrak all that apph 1 Actual pla)lsled a.retainer b.one-lime fee 12. Form of B Payment(check all that apply): c.commission a.cash d.contingent fee b.in-kind; specify: nature c defcrri ,aloe f other.specify 14. R-Irf Deserlpflon of See,I"%Performed or to he performed and Dates)of Seniee,Including offici emplm rem.or memherl•l contacted,for Payment Indicated in Item 11: (attach Continuation Shcct(s)if ncccssxry) 15. Continuation SheeOs)attached: Yes O No 16. Information requested through this forth is authorized by Title 31 U.S.C. Section 1152- This disclosure of lobbying reliance Signature was placed by the tier above when his transaction was trade or entered into.This disclosure is required pursuant to 31 U.S.C. PnnLNatie: _ 1152. This informarliom will he reported to Congress semiannually and will be available for public inspection. Any frtic', person who faih to file the required dI<dnsure shall be subject to a civil penalty of not less than 510,000 and not more than Telephone No.: _ Date' SI00.000 for each such failure. Authorized for Loxal Reproduction Federal Uu Only: Standard Form-LLL Mandate!Form LLL Rev.09-12-97 C-27 INSTRUCTIONS FOR COMPLETION OF EXHIBIT 1-1. 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 I352. 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 il9anagement 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) ldentify 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 entitv 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 subacvar(lm 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. G) Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example. Department of' Transportation. United States Coast Guard. 7) Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants. cooperative agreements. loans and loan commitments. S) Enter the most appropriate Federal identifying number available for the Federal action identification in item I (e.g., Request for Proposal (RFP) number. Invitation for Bid (IFB) number, grant announcement number. the contract grant. or loan aNvard number, the application/proposal control number assigned by the Federal agency). Include prefixes, c.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 >. 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). I I)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 madc (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 madc. C-2s 12)Check the appropriate box(es). Check al I boxes that apply. If payment is made through an in-kind contribution, specify the nature and value ol'the in-kin(I payment. 13)Chcck the appropriate box(es). Chcck all boxes that apply. If other. specify nature. 14) Provide it specific all([ detailed description of the services that the lobbyist has performed or will be expected to perform and the tlate(q of any services rendered. Include all preparatory and related activity not just Mile spent in actual contact with Federal officials. ldcntify the Federal officer(s) or employce(s) contacted or the officer(s) employce(s) or Nlember(s) of Congress that were contacted. 15)Check whether or not a continuation shect(s) is attached. I6)Thc certifving official shall sign and date the form, print his/hcr name title and tcicphane 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 continents regarding the burden estimate or any other aspect of this collection of information. ncluding suggestions for reducing this burden, to the Office of klanagcmcnt and Budget. Paperwork Reduction Project (0348-0046). Washington. D.C. 20503. By my signature on this proposal I certify, under penalty of perjury under the laws of the State of California, that the foregoing questionnaire and statements of Public Contract Code Sections 10162. 10232 and 10295.1 are true and correct and that the bidder has complied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5. Title 2 of the California Administrative Code). C-29 EXHIBIT I FEDERAL LOBBYING RESTRICTIONS Section 1352, Title 31. United States Code prohibits Federal funds from being expended by the recipient or any lower tier subrecipient of a Federal-aid contract to pay for any person for nfluencin; or attempting to influence a Federal agency or Congress in connection with the awarding of any Federal-aid contract, the making of any Federal grant or loan, or the entering into of any cooperative agreement. I f any funds other than Federal funds have been paid for the same purposes in connection with this Federal-aid contract, the recipient shall submit an executed certification and, if required, submit a completed disclosure form as part of the bid clocuments. A certification for Federal aid contracts regarding payment of funds to lobby Congress or a Federal agcncv is included in the Proposal. Standard Form - LI_L, "Disclosure of Lobbying Activities." with instructions for completion of the Standard Form is also included in the Proposal. Signing the Proposal shall constitute signature of the Certification. The above referenced certification and disclosure of lobbying activities shall be included in each subcontract and any lower-tier contracts exceeding 5100,000. All disclosure forms, but not certifications. shall be forwarded from tier to tier until received by the Engineer. The Contractor, subcontractors and any lower-tier contractors shall file a disclosure form at the end of each calendar quarter in which there occurs any event that requires disclosure or that materially affects the accuracy of the information contained in any disclosure form previously filed by the Contractor, subcontractors and anv lower-tier contractors. An event that materially affects the accuracy of the information reported includes: I) A Cnttttllative increase if 525,000 or more in the amount paid or expected to be paid lot- influcncin21 or attempting to influence a covered Federal actiont or 2) A change in the person(s) or individual(s) influencing or attempting to inlucnce a covered Federal action: or 3) A change in the officer(s), cmployees(s), or Member(s) contacted to influence or attempt to influence a covered Federal Action. C-30 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431 , Fax (714) 374-1573 ADDENDUM NUMBER ONE For RESIDENTIAL CURB RAMP PROJECT in the CITY OF HUNTINGTON BEACH OCTOBER 20, 2020 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) SHEET Al OF PROJECT SPECIFICATIONS Bids will be received from 1 00 PM to 2.00 PM only on the bid due date (10127/2020)outside of the City Hall main entrance at 2000 Main St.in Huntington Beach. Staff will be present during this hour to receive bids only.Mailed bids are still accepted but must be received before the bid submission deadline. It in encouraged that bidders arrive earlier than normal to drop off bids to avoid a late delivery. Bids will be opened outside of City Hall immediately after 200 PM. Bidders are welcome to stay and attend the opening. Social distancing measures shall be observed and masks will be required for all in attendance- This update to the Notice Inviting Sealed Bids shall supersede all other bid delivery information noted on the project documents. A revised NIS8 is now included with the project documents. This is to acknowledge receipt and review of Addendum Number One, dated October 20, 2020 --Karr Company Name By j0-27-2020 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. Z. R F. Z. BID BOND ® Everest Reinsurance Company Everest National Insurance Company ❑ Everest National Insurance Company 461 rAvenue-4^Pow Nov York,N.Y.10017 KNOW ALL MEN BY THESE PRESENTS: That we Kalban, Inc. (hereinafter called the Principal), and Everest Reinsurance Company, a corporation duly organized and existing under the laws of the State of Delaware , (hereinafter called the Surety), are held and firmly bound unto City of Huntington Beacb (hereinafter called the Obligee) in the sum of Ten Percent of the Total Bid Amount Dollars ($ 10%) , lawful money of the United States of America, for the payment of which, well and truly be made, we, the said Principal and the said Surety, bind ourselves, our heirs, administrators, executors, successors and assigns, jointly and severally, firmly by these presents. Whereas,the Principal has submitted a bid for Residential Curb Ramp Project-CC No. 1620. Now, Therefore, If the Obligee shall accept the bid of the Principal within the period specified therein, or if no period be specified, within sixty (60) days after opening, 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 fumished in the prosecution thereof, then this obligation is to be void; otherwise the Principal and Surety will pay unto the Obligee the difference in money between the amount of the bid of said Principal and the amount for which the Obligee legally contracts with another parry to perform the work if the latter amount be in excess of the former, but in event shall liability hereunder exceed the penal sum hereof. Signed, sealed and delivered this 19th day of October, 2020. Kalban,Inc. (Principal) (Seal) (WFn-ess) By R �7//�ctlle ' V7� /J✓pt. /�r Everest Reinsurance Company t (Surety) (Seal) 1 t �A. .Peluffo, ary Publi/ (Witness) By William Ctt= ,..Alto ey-in-Fart Jh Z_VE R ESN. POWER OF ATTORNEY EVEREST REINSURANCE COMPANY DELAWARE KNOW ALL PERSONS BY THESE PRESENTS: That Everest Reinsurance Company, a corporation of the State of Delaware (`Company') having its principal office located at 477 Martinsville Road, Liberty Comer, New Jersey 07938, do hereby nominate, constitute,and appoint: William Syrkin,Rebecca Haas-Bates,Megan Hike,Richard Adair,Sergio Bechara is true and lawful Attorney(s)-in-fact to make,execute,attest seal and deliver for and on its beha0,as surety,and as its act and deed, where required,any and all bonds and undertakings in the nature thereof,for the penal sum of no one of which is in any event to exceed UNLIMITED,reserving for itself the lull power of substitution and revocation. Such bands and undertakings,when duly executed by the aforesaid Attorney(s)-in-fact shall be binding upon the Company as fully and to the same extent as if such bonds and undertakings were signed by the President and Secretary of the Company and sealed with its corporate seal. This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Board of Directors of Company('Board')on the 28th day of July 2016: RESOLVED, that the President, any Executive Vice President, and any Senior Vice President and Anthony Romano are hereby appointed by the Board as authorized 10 make, execute, seal and deliver for and on behalf of the Company, any and all bonds, undertakings, contracts or obligations in surety or msurety with others and that the Secretary or any Assistant Secretary of the Company be and that each of them hereby is authorized to attest to the execution of any such bonds, undertakings, contracts or obligations in surety or co-surety and attach thereto the corporate seal of the Company. RESOLVED, FURTHER, that the President, any Executive Vice President and any Senior Vice President and Anthony Romano are hereby authorized to execute powers of attorney qualifying the attorney named in the given power of attorney to execute,on behalf of the Company, bonds and undertakings in surety or co-surety with others,and that the Secretary or any Assistant Secretary of Me Company be,and that each of them is hereby authorized to attest the execution of any such paver of attorney, and to attach thereto Me corporate seal of the Company. RESOLVED,FURTHER, that the signature of such officers named in the preceding resolutions and the corporate seal of the Company may be affixed to such powers of attorney or to any certificate relating thereto by facsimile, and any such power of attorney or certificate bearing such facsimtle signatures or facsimile seal shall be thereafter valid and binding upon the Company with respect to any bond,undertaking,contract or obligation in surety or co-surely with others to which it is attached. IN WITNESS WHEREOF, Everest Reinsurance Company has caused their corporate seals to be affixed hereto,and these presents to be signed by their duly authorized officers this 28th day of July 2015. ¢`09Jragca Everest Reinsurance Company ( SEAL 3v v•, 1991 t d 1 • Attest Nicole Chase,Assistant Secretary By:Anthony Romano.Vice President On this 28M day of July 2016,before me personally came Anthony Romano,known to me,who,being duty sworn,did execute the above instrument;that he knows the seal of said Company; that the seal affixed to the aforesaid instrument is such corporate seal and was affixed thereto;and that he executed said instrument by like order. LINDA ROBINS Notary Public,Slate of Now York No 01 R06239736 Qualified in Queens County Term Expires April 25,2023 Linda Robins,Notary Public IN WITNESS WHEREOF,I have hereunto set my hand and affixed the seal of said Company,at the Liberty Comer,this t 9th day of October 20 20 ES 00 01 04 16 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 e�xrrr-r.+�_rr.Ff.�4`a.( `.u^GTVC,$S.FS.P:cw"t1�Cd",dcc.cs9'ceilSSeTL`f,CCA^6c'.tw"C,GGLfd`S-w:f�`LfiE['.cTSd A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy, or validity of that document. State of California ) County of Los Angeles ) On October 19, 2020 before me, A. M. Peluffo, Notary Public Date Here Insert Name and Title of the Officer personally appeared William Syrkin Namer9Jvof Signer who proved to me on the basis of satisfactory evidence to be the person) whose name( is/at\ subscribed to the within instrument and acknowledged to me that he/31Zg/they executed the same in his/her/their authorized capacity(&&, and that by hisAzu/(her signature(gon the instrument the person(s� or the entity upon behalf of which the personN acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. A. M. PELUFFO COMM. #2259366 z •"'g Notary Public California � /� z Las Angeles County � Signature-----+' Fg-z-� M Comm.Ex Tres Oct. 12,2022 Signature o Notary filic 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: William Syrkin Signer's Name: ❑Corporate Officer — Title(s): C Corporate Officer — Title(s): • Partner — ❑ Limited ❑General G Partner — n Limited ❑General ❑Individual IX Attorney in Fact ❑Individual ❑Attorney in Fact ❑Trustee ❑Guardian or Conservator ❑Trustee ❑ Guardian or Conservator ❑Other: ❑ Other: Signer Is Representing: Everest Reinsurance Signer Is Representing: Company 02014 National Notary Association • www.NationaiNotary.org • 1-800-US NOTARY(1-800-876-6827) Item 45907 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 f ) County of W 1 �yo<Q5 On 0 before me, 1 rl L ( ✓YE✓1�Q /Vo kA41 l� Date �� / �� Here Insert Name and Title of the Officer personally appeared V' >(J/ Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. _ MpTTHEWMICHAELLAwRENCE WITNESS my hand and official seal. Notary Public-California § Los isles 21961 2 ounty CommlSsiona2196150 Signatur 'XIMy Comm.E.pires May 0,2021 Signatu 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: a 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: ©2016 National Notary Association • www.NationaiNotary.org • 1-800-US NOTARY(1-800-876-6827) Item #5907 K-lbwn+ Inc 16150 of t,14r Ave ! Unrr Z01 Sun is Cl>••'k,CA -��JSO 4 I C +� Of Nunr/�ro� 8�ach P.csidranl+l Cp.b ZooO Ma%� Sr. � 1 F+unti�ron Bmrh� CA 42648 Dale: ro-z�-zozv City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ xvNvw.huntingtonbeachca.gov Office of the City Clerk Robin Estanislau, City Clerk April 23, 2021 Nobest Incorporated 7600 Acacia Avenue Garden Grove, CA 92841 RE: Residential Curb Ramp Project— CC No. 1620 Enclosed please find your original bid bond for CC-1620. Sincerely, '&�d4 Robin Estanislau, CIVIC City Clerk RE:ds Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand j SECTION C PROPOSAL for the construction of RESIDENTIAL CURB RAMP PROJECT CC No. 1620 in the CITY OF HUN"IINGTON 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 60 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, 131DDER 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 Linder 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 hump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will re-advertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find 6 -dG ei' 5' tf in the amount of I Cj 1 which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond for_% ", as the case may be) Any standard Surety Bid Bond form is acceptable. Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's Si nature C-2 1 SECTION C PROJECT BID — SCHEDULE A CURB RAMP PROJECT, CC 1620 BID ITEMS Item _ _ Description' _ 'Quantity] Unit Cost Total Cost .(Extension) 1 Mobilization — - — -- 1 LS S jb�'CL�.`� $ iC'000. = 1 2 Prepare Storm Water Pollution Prevention Plan (SWPPP) 1 7 3 Install&Maintain Construction BMPs 1 LS $ r�,��, a $ /Q CV0 Horizontal Curb Cut Curb Access Ramp per Caltrans Std- Plan A88A using horizontal curb cutting machine as shown on 4 Curb Ramp Detail 1 in Appendix H of Specifications (Item 109 includes all appurtenances,curb&gutter,depressed curb, n. n sawcut, sidewalk, domes, retaining curb, etc.) EA $ a,7�.�Q $ ���y SS0. Construct Curb Access Ramp per Caltrans Std. Plan A88A as 5 shown on Curb Ramp Detail 1 in Appendix H of Specifications 17 (Item includes all appurtenances,curb&gutter, depressed EA I o curb, sawcut, sidewalk, domes, retaining curb, slot pave, etc.) $ $ Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 6 Curb Ramp Detail 2 in Appendix H of Specifications (Item 2 includes all appurtenances, curb&gutter, depressed curb, L_2� sawcut, sidewalk, domes, retaining curb, etc.) EA Horizontal Curb Cut Curb Access Ramp per Caltrans Std. Plan A88A using horizontal curb cutting machine as shown on 7 Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter,depressed curb, ,, �7 14 sawcut,sidewalk,domes, retaining curb, etc.) 30 EA Construct Curb Access Ramp per Caltrans Sid. Plan A88A as 8 shown on Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances,curb&gutter, depressed /'// CL yO curb, sawcut, sidewalk, domes, retaining curb, slot pave, etc.) 8 EA $� 9 Install truncated domes to existing Curb Ramp 10 EA 10 Install 4"PVC Sleeve for Street Assembly Sign per City of HB Sid. Plan 401 10 EA 11 Remove and replace existing sidewalk per City of HS Std. Plan 207. (Allowance) 1,000 SF Remove and replaces existing 6"or 8"Curb and Gutter per 12 HB Sid. Plan 205(Item includes all appurtenances, slot pave, etc.). (Allowance) 300 LF $ So• $ 1l0` 00Q SUB-TOTAL BID AMOUNT (SCHEDULE A) $ � pICIr C-2.1 k � SECTION C PROJECT BID — SCHEDULE A CURB RANIP PROJECT, CC 1620 SUB-TOTAL BID AMOUNT IN WORDS: t.< l/�ec�-m1� �U,.✓r T���nuv/ tr,-yr���1�/ �t'�a7 ��«,s A;: ,d2 red �Caf Note: All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern. The Owner reserves the right to reject any or all proposals and bid items. In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract. C-2 2 ' SECTION C PROJECT ADDITIVE BID — SCHEDULE B CURB RAMP PROJECT, CC 1620 BID ITEMS Dcscnptioh Quantity Unit • Unit Cost Total Cos[ N0. - - - ' (Eztensiop) Horizontal Curb Cut Curb Access Ramp per Caltrans Sid. Plan A88A using horizontal curb cutting machine as shown on I Curb Ramp Detail 1 in Appendix H of Specifications (Item 40 includes all appurtenances, curb& gutter, depressed curb, sawcut, sidewalk,domes, retaining curb,etc.) EA $ ,�/ 7�t-I $ /18 � U0 Construct Curb Access Ramp per Caltrans Sid. Plan A88A as 2 shown on Curb Ramp Detail 1 in Appendix H of Specifications 3 h_ (Item includes all appurtenances,curb&gutter, depressed curb, sawcut, sidewalk,domes, retaining curb, slot pave, etc.) EA $ 6 `'�4. $ /�/ 6V• Horizontal Curb Cut Curb Access Ramp per Caltrans Sid. Plan A88A using horizontal curb cutting machine as shown on 3 Curb Ramp Detail 2 in Appendix H of Specifications (Item 3 includes all appurtenances,curb&gutter, depressed curb, /? �"'1 �' I `) L sawcut, sidewalk,domes, retaining curb,etc.) EA $ �j $ 'ter` �•� Horizontal Curb Cut Curb Access Ramp per Caltrans Sid. Plan A88A using horizontal curb cutting machine as shown on 4 Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter, depressed curb, So/�1•"n a" sawcut, sidewalk,domes,retaining curb, etc.) 17 EA $ .!, I��. $ � Construct Curb Access Ramp per Caltrans Std. Plan A88A as 5 shown on Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter, depressed /_ 4� Cr S curb, sawcut, sidewalk,domes,retaining curb, slot pave, etc.) 9 EA 1.I 6 Install truncated domes to existing Curb Ramp 9 EA 7 Remove and replace existing sidewalk per City of HB Std. R Plan 207. (Allowance) 400 SF $ _ $ 3 %t 60 Remove and replaces existing 6"or 8"Curb and Gutter per 8 HB Sid. Plan 205(Item includes all appurtenances, slot pave, etc.). (Allowance) 100 LF $ ��• r $ Ji SUB-TOTAL ADITIVE BID AMOUNT (SCHEDULE B) $ 2cz /So• SUB-TOTAL ADDITIVE BID AMOUNT IN WORDS: Note: All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern. The Owner reserves the right to reject any or all proposals and bid items. In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract. C-2.3 t SECTION C PROJECT BID SCHEDULE TOTALS RESIDENTIAL CURB RAMP PROJECT CC 1618 Sub-Total Bid - Schedule A / a Sub-Total Additive Bid - Schedule B ("qi TOTAL BID AMOUNT, BASIS OF AWARD (Schedules A+B) LIJ 4 a TOTAL BID AMOUNT IN WORDS: L�J Notes: All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern. The Owner reserves the right to reject any or all proposals and bid items. In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract. G2.J LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who wilt 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 Nanre and Address of State Ctass DIR PWC Dollar % of Itetn(s) .Subcontractor License Registration k Amount Contract Number By submission of this proposal. the Bidder certifies: I. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing-. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID I declare under penalty of perjury tinder the laws of the State of California that the foregoing i.� true and correct and that this declaration is executed on 0 II Date City State L4i lt/ being first duly sworn, deposes and says that he or she is f I P Sr G r is t of_/yp ^PS t Z ni - 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 hidder, 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. ;Nlameof Bidder ue of B de Address of Bidder C•a CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 :r�rar�s�rescccr.�:rsr�e�rarr�cccc�K- �rsc-.cs:cc 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 D --9 7 " Z� before me, Kay E. Anderson/Notary Public Date Here Insert Name and Title of the Officer personally appeared Larry Nodland Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(af whose name is/W4 subscribed to the within instrument and acknowledged to me that he/spd/tpejr executed the same in his/hef tWr authorized capacity(jpB), and that by his/horAperr signatureoron the instrument the personssj' or the entity upon behalf of which the persongacted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. KAY E.ANDERSON WITNESS my hand and official seal. Notary Public-Callfomia -I. Orange County _ Commission s 22o5w A1yCWW.Expl,esm11S.2021 Signature +Jture 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(les) Claimed by Signer(s) Signer's Name: Larry Nodland Signer's Name: L Corporate Officer — Title(s): President ❑Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑General ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑Attorney in Fact ❑ Individual ❑Attorney in Fact ❑Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other: ❑ Other: Signer Is Representing: Signer Is Representing: �.'V'�3LZYv'4Z�2L4�7i.CT'.S�LL41 :4va<.'S:C•Q.Ri'4i4 ' `S.�4sGT.�.`L4SiCILL.Z'LA7SiC?':�i5�-T,iLR 02016 National Notary Association • www,NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item #5907 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the RESIDENTIAL CURB RAMP PROJECT, (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 temi "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 famiGtrr with the operation to be performed and the hazards involved." The undersigned also promised and agrees that all such work shall be perfonmed 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. t4/0b-e5r Tr,(_ Contractor By r>F VDL. Title Date: C-i DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162. the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE I[as 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? Cl Yes YNo If the answer is yes, explain the circumstances in the space provided. Nl)�' 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. Nob(2z; f T(. Contractor By Title Date: C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: AI&OpO r Bidder Name Moo 4 Ck<,a ASP. Business Address C-01-Ae„ G rove Cc, ql� Yj City, State Zip fy > M3 "fele hone Number Email ddress 'sy6,aa A State Contractor's License No. and Class �— 7� Original Date Issued -7- 3/ - as Expiration Date The work site was inspected by �BW,S of our office on 0C4ebef '�2 , 2QO. The following are persons. firms, and corporations having a principal interest in this proposal: 1'7 (rr NC 1_Qnd- 1"Asafet- R IUoolla.7r 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. Yt/uliJ'S'r �{�t Company Name Signature'6, Bidder C-8 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 srxrrcres;er�rcceserrr•M•,,• ,�•.cecse�r�sc¢ac .ercrcrxrr_rcamca� 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 0 ) County of Orange ) On Z 7 --ZD before me, Kay E. Anderson/Notary Public Date Here Insert Name and Title of the Officer personally appeared Larry Nodland Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(af whose nameW is/W subscribed to the within instrument and acknowledged to me that he/syd/they executed the same in his/hetltfyefr authorized capacity(, and that by his/hoA/ err signatureoron the instrument the persons' or the entity upon behalf of which the person(,sj'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. KAY E.ANDERSON Notary Public-Czli'ornia _ Orange County ,y,[/) Cornmlivon 12205144 — Signature '� \0.'� LQ—,.Q— M*CWm Eaoi,e Jun5.20211 Sign ture 6f 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: Larry Nodland Signer's Name: A Corporate Officer — Title(s): President ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑General ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑Attorney in Fact ❑ Individual ❑Attorney in Fact ❑Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other: ❑ Other: Signer Is Representing: Signer Is Representing: 02016 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item #5907 Printed or Typed Signature NOTARY CERTIFICATE Subscribed and swom to before me this _day of 201_ 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 ) County of ) On before me, Month, Day, and Year Insert Name and Title of Notary personally appeared Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. 1 cenifv under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature Signature of Notary Public (PLACE NOTARY SEAL ABOVE) C-9 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, "Demolition of existing concrete ADA ramps and construction of new ADA compliant curb ramps. Work included additional curb and putter construction to ensure surface water flow around corner. All ramps met Caltrans requirements set forth in Standard Plan A88A"I Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: I. SPe 4 N�� �� SR fYI �� %�o•�� A i Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 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-10 NOBEST INCORPORATED REFERENCE LIST Page I No. I Project Name/Number: Concrete Replacement Program Project Description: Remove & Replace Curb & Gutter, Sidewalk, Drivewav, and Ramp Approximate Construction Dates: From: 3/2018 To: 8/2018 Agency Name: Cite of Newport Beach Contact Person: Mike Sinacori Telephone: (949) 644-3342 Original Contract Amount: $784,000 Final Contract Amount: S 855.000 No. 2 Project Name/Number. Heil Avenue & Indianapolis Street rehabilitation Project Description: Remove& Replace Curb& Gutter. Sidewalks. Driveways,and Cross Gutter Approximate Construction Dates: From: 7/2018 To: 1/2019 Agency Name: City of Huntington Beach Contact Person: John P. Telephone: (714) 536-5431 Original Contract Amount: $476.832 Final Contract Amount: S 539.000 NOBEST REFERENCE LIST Page 2 \to. 3 Project NameNumber. Annual Concrete Maintenance Program Project Description: R& R Concrete Sidewalks Curb& Gutter, Drive Approaches, and Curb Ramps Approximate Construction Dates: From: 2/2013 To: Present Agency Name: City of Huntington Beach Contact Person: Dereck Livermore Telephone: (714) 960-8861 Original Contract Amount: $500,000 Final Contract Amount: S In Progress_ No. 4 Project Name/Number: Replacement of Allev. ADA Ramps & Sidewalk Project Description: Remove& Replace Sidewalks. Alley Pavement, Curb Ramps, and Curb & Gutter Approximate Construction Dates: From: 8/2019 To: 9/2019 Agency Name: City of Los Alamitos Contact Person: Dave Hunt Telephone: (714) 296-5836 Original Contract Amount: S121.060 Final Contract Amount: S 123.000 NOBEST REFERENCE LIST Page 3 No. 5 Project Name/Number: CIP Project Phase 5 Residential Street Rehabilitation Project Description: Remove & Replace Sidewalk Curb Ramos. Curb & Gutter, and Cross Gutter Approximate Construction Dates: From: 7/2019 To: Present Agency Name: Cite of La Mirada Contact Person: Eric VillaRarcia Telephone: (562) 902-2373 Original Contract Amount: $1.734,839 Final Contract Amount: $ In Progress No. 6 Project Name/Number: Street Preservations Local Citywide Project Description: Remove and Replace Sidewalk Curb&Gutter Driveways Curb Ramps.and Allevs Approximate Constnuction Dates: From: 10/2018 To: 1/2019 Agency Name: City of Pomona Contact Person: Matt Pilarz Telephone: (909) 620-3652 Original Contract Amount: S603.406 Final Contract Amount: S 486.000 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 perfonned similar work within the last five years. These projects do not have to be under the employment of the bidder of this project. Bidders are encouraged submit supplemental relevant project history in addition to,the projects listed herein. I . MIKCFy /, 6�:-Oj Name of proposed Project Manager Telephone No. of proposed Project Manager: 71 `f C'r i y /� ��TJ-rJ�"►-a+✓ j3��J;� 6 �2a7�5 Project Na ie & Contract Amount Type of Work / Date Completed t,$� S 32 �Oo _ , /Z t i�. Gv�eL, r t h L- A OZ- 1 xf:,Pt A-n/ A'Fb4/S � H 1 T • ���T�q i N mp" JsL�-C f� ! t/Z 19 Project Contract Amount Type of Work � L� ,�atDate Completed Project Nat e & Contract Amount Type of Work Date Completed Name of proposed Superintendent q Telephone �lo. of proposed Superintendent: ,stqrntE- /d n A v U Project Name & Contract Amount Type of Work Date Completed Project Name & Contract Amount Type of Work Date Completed J� A � Project Name & Contract Amount Type of Work Date Completed C-II CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771.1(a)), passed by the California State Senate on June 20, 2014, established a new public works Contractor Registration Program,which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July I through June 30 state fiscal year) with the California Department of Industrial Relations (DIR). Currently the annual non-refundable registration fee for Contractors is S300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on S13 854 http://www.clir.ca.gov/Di-S L'/PublicWorks/SB8541-actSheet_630.14.pdf DIR's Contractor Registration Link— Call (S44) 522-6734 https://efil ing.dir.ca.gov/PWCRJActioiiServict?action=displayPWCRegistrationForm DIR's Contractor Registration searchable database: littps:HeFiiIing.dir.ca.aov/PWCR/Searcli.action 1 am aware and will comply with the provisions of Labor Code Section 1771.1(a) which states: "A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725.5. It is not a violation of this section for an unregistered contractor to submit a bid that is authorized by Section 7029.1 of the Business and Professions Code or by Section I0164 or 201035 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//Clhea f- Sk r . Contractor By LA Email p1-Ps'?re//t- Date: 10 27 20 Title PWC Registration #: I�Cti�'i15aQ C-12 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1965 AS AMMENDED IN 19922 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 1965; 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: /blob,0y f 1- it Contact Person: 4 „ Aide 50n Contact Phone: 7t Signed: Date: IC' a7- 2C *Note: The above certification is required by the epartment of Housing and Urban Development (24 CPR 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 1965 Housing and Urban Development Act, as amended in 1992 (I-IUD)- Previous non-compliance with Section 3 could result in disqualification. C-13 EXHIBIT A DISADVANTAGED BUSINESS ENTERPRISE (DBE) This Project is subject to Part 200.321. Title 2, Code of Federal Regulations entitled "Contracting with Small and Minority Businesses, Women's Business Enterprises, and Labor Surplus Area Firms." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in Part 200.321, Title 2 CFR, shall be encouraged to participate in the performance of Contracts financed in whole or in part with federal finds.The Contractor should ensure that DBEs,as defined in Part 200.321, Title 2 CFR, have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps, as set forth in Part 20032 t,Title 2 CFR, for this assurance. The Contractor shall not discriminate on the basis of race, color, stational origin, or sex in the award and performance of subcontracts. Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project, although there is no specific goal for DBE participation. G14 EXHIBIT B DBE INFORMATION—GOOOD FAITH EFFORTS Federal-aid Project No. ,061Ul�14U 0.1 i V) V11 0 Bid Opening Date IO -2-710 The City of Huntington Beach-established a Disadvantaged Business Enterprise(DBE)goal of 9% 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" fonn 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 detennines 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 tr�lsty a- 1 Ze. - T -...Agv l�larrs B. The names and dates of written notices sent to certified DBEs soliciting bids for this Project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested (please attach copies of solicitations,telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods Solicitation and Dates VLA1J+_ ;rw 10.23.2o On10 , 10•Z"1.20 C-15 C. The items of work which the bidder made available to DBE Finns 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 Finns. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items ($) of (Y/N) Contract D. The names, addresses and phone numbers of rejected DBE fines, the reasons for the bidder's rejection of the DBEs, the-fines selected for that work (please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected Ern is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs; N/A Names, addresses and phone numbers of firnis 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: t\1 C-16 F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: _�QNF 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 SHEE"fs OF PAPER IF NECESSARY. C-17 IF A SOLE OWNER OR SOLE CONTRACTOR SIGN HERE: (1) Name under which business is conducted tJ/At (2) Signature(given and surname) of proprietor (3) Place of Business (Street and Number) City and State (4) 'Lip Code Telephone No. (5) E-Mail IF A PARTNERSHIP. SIGN HERE: (1) Name under which business is conducted (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail C-18 fl- A CORPORATION, SIGN HERE: ^/ r (1) Name under which business is conducted !�/d ke? f In r. (2) 1 /� (Si ,/P C e�P pj (Title) / Impress Corporate Seal here (3) Incorporated under the laws of the/State of 4 ( '.4a/n %9 (4) Place of lusiness 7E4/G ! [ 4r"q A r/X. (Street and Number) City and State G arcJe 6roLl 'IF C 4 (5) Zip Code q 2 �q( Telephone No. (6) E-Mail �n156�-Si' _ NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED C-19 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 :cdocrer.�.csccsrcr�e��,zrc�oct.ex�:�n�cr_cccaracecs�crsoceer�as,�crcrrrsscscrrs;rss�ssr<.zer_rz 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 /0— 27 ,2-o?' before me, Kay E. Anderson/Notary Public Date Here insert Name and Title of the Officer personally appeared Larry Nodland Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(K whose name is/9.4 subscribed to the within instrument and acknowledged to me that he/sy>d/tbeQ executed the same in his/het9tWr authorized capacity(, and that by his/119rAJ elr signatureisron the instrument the personal or the entity upon behalf of which the personXacted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. KAY E.ANDERSON WITNESS my hand and official seal. Notary Public-California a Orange County — LM (pmmlSsion+7KI5144 M tbmm.P� a luns.zozl Signature Sig+tSe 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: Larry Nodland Signer's Name: A Corporate Officer — Title(s): President ❑Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑General ❑ Partner — ❑ Limited ❑General ❑ Individual ❑Attorney in Fact ❑ Individual ❑Attorney in Fact ❑Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other: ❑ Other: Signer Is Representing: Signer Is Representing: .T.�.CR'vCi.�Z�`Ci,�4�:LZ'S:4tiG`LZ`V'4'LZ�[7L'C7.ZYT7+:��4..tiL 'r:LTk4YiLS 020116 National Notary Association -www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 List below names of president, vice president, secretary and assistant secretary, if a corporation. if a partnership, list names of all general partners and managing partners: L.urry lUo`�l"'� - PrPs,�P,�F /�' rP4soi AP Il ONP/f �UD��n nc� " SP(./P fGly C-20 EXHIBIT C LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON TILE REVERSE SIDE OF THIS FORTY[ LOCAL AGENCY:�.1'a'yp qu,& wLOCATION: PROJECT DESCRIPTION:JJJ .�C �,(d 10 A;SA 0[A Cb— TOTAL CONTRACT AMOUNT:S -12 S OCO OX.1 rY••�-'T`��T "U--- _- BID DATE:_ o , _— BIDDER'S NAME:—N o e* r VK. • ---___—____ — CONTRACT DBE GOAL: 0 CONTRACT ITEM OF WORK AND DESCRIPT10N DBE CERT NO, 4AME OF EACH DII LLAR AMOUNT TRM NO. R SERVICES TO B AND EXPIRATION (Most be certified ou the date bi BE SUBCONTRACTED OR MATE MATERMLS DATE we opened-ivdude DBE ad re O BE PROVIDED(or contracted it tit, and phone number) idder is a DBE) L-51_ - �c.c..alYra�on_ __o_Ro��- s_YYuckr �PoGv_ - - - -- -- -- p 310�ccwaoGt For Local Agency to Complele: T'owl Claimed DBE 111 n��f Lxal Agency Conb:rct Nnmhcr Partiaipvtion Falenl-aid Project Number. Federal Share: Contract Award Date: Loral Agency certifies that all DBE certifications have been verified and infornwtion is complete end accurate. _ rc of Bi r Date ( rca Code)7e1.No. Print Name Signamrt Date 1-[—.Y,1�T5t_I Local Agency Representative e. n to Comma (Please Type or Print) (Arco Cale)Telephone Number: ..._- La i Agcnq Bi:Ida DBF.Cornnut9(at(Ca vnw,w.fConal u) file• NInU9) C-21 PLEASE NOTE: This information may be submitted with ,your bid. If it is not, and you are the apparent low bidder or the second or third low bidder, it must be submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific inforniation regarding the construction contract: Local Agency, Location, Project Description, 'Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date. Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier. Names of the First-Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE-.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts), to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award, Federal-aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. C-22 EXHIBIT D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder pbGg { S(1[r [proposed subcontractor t ] hereby certifies that he/she/it has , has not_, participated in a previous contract or subcontract subject to the Equal Opportunity clauses, as required by Executive Orders 10925, 1 1 114,or 11246, and that, where required,he/she/it has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Cotmnittee 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) (I)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause arc set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently,Standard Form 100(EEO-1) is the only report required by the Executive Orders or their implementing regulations. (eeoc.gov/eniployers/ecoIsurvey/index.cfin) 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 conhacts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Signature: / Date: (41 a 0 _ Print Name: Lqp// /, �ah Title: / (25 C-2J EXHIBIT E NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) [NAME OF CONTRACT] R��iu7t���1Y GU R � �A�Y 7 J� ��p f� e--T To the City of Huntington Beach In conformance with Title 23 United States Code Section 112 and California Public Contract Code 7106 the bidder declares that the bid is not made in the interest of,or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any nnanner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof', or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association; organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. 13y signing the Proposal, the Bidder has also signed this Noncollusion Affidavit. Bidders are cautioned that making a false Certification may subject the Bidder to criminal prosecution. Signature: Q f 41 p� J tc: lU Print Name. G0')1G/1w Title: C-24 EXHIBIT F DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The Bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated with Bidder in the capacity of owner, partner, director, officer, manager: is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agency; has not been suspended, debars d, 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 hinm/her by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award. but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Note: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signatu of this Certification. Signature: ate: I - JZT;Q Print Name: �o,,/ G��Qn� Title: C-25 EXHIBIT G N'ONLOBBVING 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 empfoyee 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 tails to file the required certification shall be subject to a civil penalty of not less than S10,000 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 S 100,000 and that all such subrecipients shall tify and disclose accordingly. Signature: ate: IO-a7-?G Print Name: l 0)(GnG Title: / !P S.dP I/ f EXHIBIT H C-26 DISCLOSURE OF LOBBYING AC'PIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 I. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ❑o.contract ❑a.bid/offcdapplicalion ❑ a.initial b.grant b.initial Award b.material change C.cooperative agreement c.post-sward it.loan par Material Change Only: C.loan gtsarnntee year quarter f.loan insurance data of last report a. Name mud Address of Reporting Entity 5. If Reporting Entity In No.A Is Subawardee, Enter Name and Address of Prime. Prime SobowaNee Tier if known Congresslonal District,it known Congrcesumal District,if knowo 6. Federal DeparlmenciAgency: 7. Federal Program Name/Descriptlon: CFDA Number,if eppiieablc 8. Federal Action Number,ifknuwn: 9. Award Amount,it known: W. A.Name and Address of Lobby Entity b. Individuals Periarmhtg Servlce, (including (If individual,last name,first name,of I) address if different Imm No. IN) (p t sun m(�l�0stnany MI) - 1 _ Datuciauv 11afm S: t(s ihmcn T)f f(hl N IT I I. Amount of Payment(check a0 that apply) 13. Type of Payment(check all that apply) S Actual planed a.roarer h.one-time fee 12. Farm of Payment(check all that apply): C.cummission Bn.cash - -- d.contingent fee b. in-kind: specify: name_,,,_ a deferred value C.other,specify, Is. Brief Description of Services Performed or to be performed and Oate(s)of5ervlee,Including oMcer(,),employee(s),or member(s)contacted,for Payment Indicated In Item 11: (attach Continuation Sheet(,)if necessary) 15. Condnuation Sheet(,)oltached: Yes No 16. Information requested through this forth is authorized by Title 31 U.S.C. Section 1352.This diseosur, of lobbying reliance Signature: was placed by the der above when his transaction was made ra entered into.Thu disclosure is required pursuant m 31 U.S.C. Print Name:_ 1352. This bnfomation will be reported to Congress Q �• acadeonually and will be available for public inspeninn Any Title: person who fails m 0k the required disclosure shall be subject QQ 11 a to a civil penalty of not less dam S10,000 sad not more than Telephone No.: �•�SSp7 Dmea�1_ $100,000 for each such failure. Authorized I'nr Local Reproduction Federal Use Only: SandsN Fona-LEI. Standard Form LLL Rev.09-12-97 C-27 INSTRUCTIONS FOR COMPLETION OF EXHIBIT H. DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial tiling 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 narne, 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, subgrunts and contract awards under grant%. 5) If the organization Filing the report in Item 4 checks "Subnwardee" 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 conuuitmem. 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 I). 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, Imitation for Bid (IFB) number, grant amtouncement 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 conmutment 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 (ivll). 1 1)Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned'). Check all boxes that apply, if this is a material change report, enter the cumulative amount of payment made or plamted to be made. C-28 t 2)Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13)Check the appropriate box(es).Check all boxes that apply.If other, specify nature. 14)Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s) or ernployee(s) contacted or the officer(s) employee(s) or Meniber(s) of Congress that were contacted. 15)Check whether or not a continuation sheet(s) is attached. 16)The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. By my signature on this proposal I certify, under penalty of perjury under the taws of the State of California, that the foregoing questionnaire and statements of Public Contract Code Sections 10162, I0232 and I0285.1 are true and correct and that the bidder has complied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5, Title 2 of the California Administrative Code). C-29 EXHIBIT I FEDERAL LOBBYING RESTRICTIONS Section 1352, Title 31, United States Code prohibits Federal funds from being expended by the recipient or any lower tier subrecipient of a Federal-aid contract to pay for any person for influencing or attempting to influence a Federal agency or Congress in connection with the awarding of any Federal-aid contract, the making of any Federal grant or loan, or the entering into of any cooperative agreement. If any funds other than Federal funds have been paid for the same purposes in connection with this Federal-aid contract, the recipient shall submit an executed certification and, if required, submit a completed disclosure form as part of the bid documents. A certification for Federal-aid contracts regarding payment of finds to lobby Congress or a Federal agency is included in the Proposal. Standard Fonn - LLL, "Disclosure of Lobbying Activities," with instructions for completion of the Standard Form is also included in the Proposal. Signing the Proposal shall constitute signature of the Certification. The above referenced certification and disclosure of lobbying activities shall be included in each subcontract and any lower-tier contracts exceeding $100,000. All disclosure forms, but not certifications, shall be forwarded from tier to tier until received by the Engineer. The Contractor, subcontractors and any lower-tier contractors shall file a disclosure form at the end of each calendar quarter in which there occurs any event that requires disclosure or that materially affects the accuracy of the information contained in any disclosure form previously filed by the Contractor, subcontractors and any lower-tier contractors. An event that materially aft'ects the accuracy of the information reported includes: 1) A cumulative increase if$25,000 or more in the amount paid or expected to be paid for influencing or attempting to influence a covered Federal action; or 2) A change in the person(s) or individual(s) influencing or attempting to influence a covered Federal action; or 3) A change in the officer(s), employees(s), or Member(s) contacted to influence or attempt to influence a covered Federal Action. C-30 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For RESIDENTIAL CURB RAMP PROJECT in the CITY OF HUNTINGTON BEACH OCTOBER 20, 2020 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) SHEET Al OF PROJECT SPECIFICATIONS Bids will be received from 1:00 PM to 2:00 PM only on the bid due date(10/27/2020)outside of the City Hall main entrance at 2000 Main St. in Huntington Beach. Staff will be present during this hour to receive bids only.Mailed bids are still accepted but must be received before the bid submission deadline. It in encouraged that bidders arrive earlier than normal to drop off bids to avoid a late delivery. Bids will be opened outside of City Hall immediately after 2:00 PM. Bidders are welcome to stay and attend the opening. Social distancing measures shall be observed and masks will be required for all in attendance.This update to the Notice Inviting Sealed Bids shall supersede all other bid delivery information noted on the project documents.A revised NISB is now included with the project documents. This is to acknowledge receipt and review of Addendum Number One, dated October 20, 2020 Company Name By /p - 2'7 -- �O Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. Bid Bond Bid Bond Number.CSBA-15366 CONI'RACI'OR: SURF-M (iVame,!,gal narur and a&;"sr) dram,,legol uarur and prinnpal pG.n of banner;) Nobest Incorporated Merchants Bonding Company(Mum:d) 7600 Acacia Avc. 6700 Westown Parkway Garden Grove,CA 92841 West Des Moines,IA 50266 OWNER: This document has important legal (i\tame,!,gal rmrur and addnrr) consequences.Consultation with City of Huntington Beach An attorney is encouraged with respect 2060 Main Street its completion or modification. 1-luntington 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: Residential Curb Ramp Project,CC No. 1620 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 tirne 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 terns 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 hi 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 hi good faith contract with another parry to perform the work covered by said bid,then this obligation shall be null and void,otherwise to remain in full force and effect.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 Contactor,the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contactor. \Vhen 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 stamtory or other legal requirement shall be deemed incorporated herein.When so furnished,the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. Signed and sealed this 13�day of October 2020 Nobest Inco om rated 114-�'- /J (Ptinnpa9 0119 Metthttms Bo ding Company(Mciwal a NO (Sra.'f (Wint,rr) Melissa Ann Vaccaro (Title)-Dwight Reilly,Attorney-ut-Fact By arrangement with the American Institute of Architects, the National Association of Surety Bond Producers(NASBP)(www.nasbo.orz) makes this form document available to its members,affiliates,and associates in Microsoft Word format for use in the regular course of surety business.NASBP vouches that the original [ex[ of this document conforms exactly to the text in AIA Document A3142010, Bid Bond. Subsequent modifications may be made to the original teat of this document by users,so careful review of its wording and consultation with an attorney are encouraged before its completion, execution or acceptance. ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange ) On 1 0/1 312 0 20 before me, Melissa Ann Vaccaro Notary Public (insert name and title of the officer) personally appeared Dwight Reilly who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. MEussnANNvaceaRo /., COr.1 .#2241394 .� :=;n;. Notary Public-California 'd4..�N. 1 ORANGE COUNTY \(�/ - i ` �\ \ ( ( ) +,ty Camm.EzPiies MaY 12,2022 Signature � \ J 1r'., r\�V\ �CL !`l� Seal Melissa Ann Vaccaro MERCHANT Bond No.CSBA-15366 BONDING COMPANY,. POWER OF ATTORNEY Know All Persons By These Presents,that MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,INC., both being corporations of the State of Iowa(herein collectively called the'Companiesl do hereby make,constitute and appoint,individually, Arturo Ayala;Ben Stong; Daniel Huckabay; Dwight Reilly; Frank Morones;Michael D Stang;R Nappi;Shaunna Rozetle Ostrom their We and lawful Attomey(s}in-Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments 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. This Power-of-Attorney is granted and is signed and sealed by facsimile under and by authority of the following By-Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors of Merchants National Bonding, Inc.,on October 16, 2015, 'The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys-in-Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings,recagnizances,contracts of indemnity and other writings obligatory in the nature thereof.- 'The signature of any authorized officer and the seal of the Company may be affixes by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company,and such signature and seal when so used shall have the same force and effect as though manually fixed' In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and aut hority hereby given to the Attomey-in-Fact includes any and all consents for the release of retained percentages andlor final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consend ng to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its hand. In connection with obligations in favor of the Kentucky Department of Highways only,it is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner- Department of Highways of The Commonwealth of Kentucky at least thirty(30)days prior to the modification or revocation. In Witness Whereof,the Companies have caused this instrument to be signed and sealed this 111h day of February 2020 ;apt\ONq<e, 41' G POO .:�•vQ0\N�..�q�ijp, MERCHANTS BONDING COMPANY(MUTUAL) : Z 0 MERCHANTS NATIONAL BONDING. INC. ot— Z: 1933 c: By =;d �.; ;may . dc. resident STATE OF IOWA "" ...... COUNTY OF DALLAS ss. On;his 1 tth day of February 2020 , before me appeared Larry Taylor, to me personally known, who being by me duly swam did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument are the Corporate Seals of the Companies;and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. �Pµ1, P POLLY MASON . Commission Number750576 My Commission Expires V y P January 07, 2023 Notary Public (Expiration of rotary's commission does not invalidate this instrument) I,William Warner,Jr.,Secretary of MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING, INC.,do hereby certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies,which is still in full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 13th day of October 2020 kx pia 0? '4l':Z: •m�'�0 PO'yq�9�<: L�/.[% y . :2 '2• • a' 1933 C; Severary 2003 POA 0018 /1/201 ""' CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 s�f [`�G`fu�f,CS.FY.cCss.Lc�c'dry��G�Cs.�,Bf.L°C,Ps,�C 4c'.�Tdd:Y',LCcPdSa�rr=cuv.r{:c'�.g�.i-Cs 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 I T 2_7_ ZD before me, Kay E. Anderson/Notary Public Date Here Insert Name and Title of the Officer personally appeared Larry Nodland and Robert Nodland 11 Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s)X/are subscribed to the within instrument and acknowledged to me that MI5 e they executed the same in pig//their authorized capacity(ies), and that by.x�/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. NotafyPubfic ERS KAYE.ANDEASON WITNESS my hand and official seal. California Orange County Commission a 22051" My Comm.Expires Jul 15,2021 Signature Sign ure ot 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: Larry Nodland Signer's Name: Robert Nodland 11 99 Corporate Officer — Title(s):President A Corporate Officer — Title(s): Secretary ❑ 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: �xz.�.�c.�c;5.z�:R.s:.c.s:c:yescacgz�.�:�c.�c-�„<cr�c.�cx:,c.�.s:ccz:�z�,�t:sz;�cs;c>�z:�z;�c„z.s:�.w:�,•L:c.c..-7:zt�c:aay.:cY�s 02016 National Notary Association • www.NationaiNotary.org • 1-800-US NOTARY(1-800-876-6827) Item #5907 7 NO BEST, INCORPORATED P.O. BOX 874 nn` tiL� WESTMINSTER, CA 92684-0874 "Y rot : 111�s,"��Pr,�,nl Ccri� Iri k W26 C 7y /jc" VJ, ., rl�'r� v G ,+�' City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ wNviv.huntingtonbeachca.gov Fe.I sit Office of the City Clerk Robin Gstanislau, City Clerk April 23, 2021 Vido Samarzich, Inc. 6829 Billings Place Rancho Cucamonga, CA 91701 RE: Residential Curb Ramp Project — CC No. 1620 Enclosed please find your original bid bond for CC-1620. Sincerely, RobinEstanislau, CIVIC City Clerk RE:ds Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand SECTION C PROPOSAL for the construction of RESIDENTIAL CURB RAMP PROJECT CC No. 1620 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 Frigincer of the Cite 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 60 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 rn-m FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties. fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will re-advertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts. and words shall govern over figures. GI 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 Bidders Bond in the amount of 10%of bid 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 Recelrvd Id er's Si nature c-z SECTION C PROJECT BID—SCHEDULE A CURB RAMP PROJECT,CC 1620 BID ITEMS Item Description Quantity Unit Unit Cost Total Cost No. (Extension) 1 Mobilization 1 LS $30 dOs.oe $ 30 p0e.00 2 Prepare Storm Water Pollution Prevention Plan(SWPPP) 1 LS $V000. 60 SIS;DOO. o 0 3 Install&Maintain Construction BMPs 1 LS $!qow.eD $ 16,000. 00 Horizontal Curb Cut Curb Access Ramp per Caltrans Sid Plan A88A using horzontal curb cutting machine as shown on 4 Curb Ramp Detail 1 in Appendix H of Specifications (Item 109 100.00 S s sy "I'llot-010 includes all appurtenances, curb&gutter, depressed curb. sawcut. sidewalk. domes. retaining curb,etc.) EA S $ Construct Curb Access Ramp per Caltrans Std. Plan AMA as 17 6 shown on Curb Ramp Detail 1 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter, depressed curb, sawcut, sidewalk,domes, retaining curb, slot pave,etc.) EA $ S,Loo.00 S $Y)400'OD Horizontal Curb Cut Curb Access Ramp per Caltrans Sid Plan A88A using horizontal curb cutting machine as shown on 9 Curb Ramp Detail 2 in Appendix H of Specifications (Item 2 includes all appurtenances, curb&gutter,depressed curb. QQO o e $ 9�(r00.ID sawcut. sidewalk,domes, retaining curb,etc.) EA $ 41 Horizontal Curb Cut Curb Access Ramp per Caltrans Std Plan A88A using horizontal curb cutting machine as shown on 7 Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter, depressed curb, sawcut, sidewalk, domes, retaining curb, etc) 30 EA $ 'trBoa# $ 1941 0i0.0-0 Construct Curb Access Ramp per Caltrans Std Plan A88A as 6 shown on Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter, depressed curb, sawcut, sidewalk, domes. retaining curb, slot pave. etc.) 8 EA S S,Lo0.00 $ 9Ii I'a0.00 9 Install truncated domes to existing Curb Ramp 10 EA S brio.00 S 6, 000. op 10 Install 4"PVC Sleeve for Street Assembly Sign per City of HB Sid Plan 401 10 EA S 300.Oe $ 0oo,70 11 Remove and replace existing sidewalk per City of HB Sid, Plan 207 (Allowance) 1,000 SF S )0. 00 $ lOrOOV- 00 Remove and replaces existing 6'or 8'Curb and Gutter per 12 HB Std. Plan 205(Item includes all appurtenances slot pave, etc.) (Allowance) 300 LF $ 80•00 $ ZIt. OD0.00 SUB-TOTAL BID AMOUNT(SCHEDULE A) _ 4 3 Z S06- 00 C-2.1 SECTION C PROJECT BID-SCHEDULE A CURB RAMP PROJECT,CC 1620 SUB-TOTAL BID AMOUNT IN WORDS: ✓S >/. n/t�C N✓�pn,�D rr1, 2,y s,E✓Eni TYIo✓�A�v� Fr✓E HuronEO I>0t-t &J Note. All extensions of unit prices will be subject to verification by Owner In case verification is required between the unit price and the extension, the unit price will govern. The Owner reserves the right to reject any or all proposals and bid items. In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract. C-2.2 SECTION C PROJECT ADDITIVE BID-SCHEDULE B CURB RAMP PROJECT,CC 1620 BID ITEMS Item Description Quantity Unit Unit Cost Total Cost No. I (Extension) Horizontal Curb Cut Curb Access Ramp per Caltrans Sid Plan A88A using horizontal curb cutting machine as shown on I Curb Ramp Detail 1 In Appendix H of Specifications (Item 40 S,1IO.00 Z Os�� otV-00 includes all appurtenances. curb&gutter, depressed curb, sawcut, sidewalk,domes, retaining curb, etc) EA $ $ Construct Curb Access Ramp per Cattrans Std. Plan A88A as 3 2 shown on Curb Ramp Detail 1 in Appendix H of Specifications (Item includes all appurtenances. curb&gutter,depressed curb, sawcut. sidewalk,domes, retaining curb, slot pave, etc) FA $S�zao.00 $ IS boo o0 Horizontal Curb Cut Curb Access Ramp per Caltrans Sid. Plan A88A using horizontal curb cutting machine as shown on s Curb Ramp Detail 2 in Appendix H of Specifications (Item 3 includes all appurtenances,curb&gutter, depressed curb, atrwcut,sidewalk,domes, retaining curb,etc.) EA $y,800.00 $ Iyr 400.00 Horizontal Curb Cut Curb Access Ramp per Caltrans Slid. Plan A88A using horizontal curb cutting machine as shown on 4 Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter, depressed curb, sawcul, sidewalk, domes, retaining curb,etc) 17 EA $41110v-00 $ S1111000.00 Construct Curb Access Ramp per Cattrans SW Plan AMA as & shown on Curb Ramp Detail 3 in Appendix H of Specifications (Item includes all appurtenances, curb&gutter,depressed curb, sawcut. sidewalk, domes, retaining curb, slot pave,etc.) 9 EA $ 20V.00 $ '16, $00.00 6 Install truncated domes to existing Curb Ramp 9 EA $ 600.00 $ S�y00.OD Remove and replace existing sidewalk per City of HB Sid. Plan 207. (Allowance) 400 SF $ 10.00 $ YJ 000. 00 Remove and replaces existing 6'or 8'Curb and Gutter per 8 HB Std. Plan 205(Item includes all appurtenances. slot pave. etc.). (Allowance) 100 LF $ 8o•0V $ S 000, 00 SUB-TOTAL ADITIVE BID AMOUNT(SCHEDULES) $ 37 DO.00 SUB-TOTAL ADDITIVE BID AMOUNTWIRD"? HRCE �.vO H (1 'T'HovSArJO E16k7 Nunron.ED Pou.QItl, Nple: All extensions of unit prices will be subject to verification by Owner. In case verification is required between the unit price and the extension, the unit price will govern. The Owner reserves the right to reject any or all proposals and bid items. In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract. C-2.3 SECTION C PROJECT BID SCHEDULE TOTALS RESIDENTIAL CURB RAMP PROJECT CC 1618 Sub-Total Bid - Schedule A 9 3� s00' 00 Sub-Total Additive Bid - Schedule B 0-11111— Meow 379, Woo - OD TOTAL BID AMOUNT, BASIS OF AWARD )Schedules A+B) , 3 ) ? 300. DO TOTAL BID AMOUNT IN WORDS NafMW pro S G vErJ TF�nI �•�- V. . F� 1- o u) o rJ D N✓n/f�I� E p 170L1�/Z 711 Notes. All extensions of unit prices will be subject to verification by Owner In case verification is required between the unit price and the extension, the unit price will govern The Owner reserves the right to reject any or all proposals and bid items. In addition, the City reserves the right to include or remove Bid Schedule B in the award of the contract. C-2.d 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 S10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Bid Name and Address of State Clan DIR PWC Dollar % of Item(s) Subcontractor License Registration a Amount Contract Number J.S. Aft" SL'AA opt- Poi✓T H-8 t AJV SjereYr-,b, t-Pc. LS1133 LS 1600003/0o S&t4a [4o6 OMMY@ TaEE LA t / 0 r SOMA,40S, 917I By submission of this proposal, the Bidder certifies: I. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on 1oa7no20 ,at Covina CA Date City State Vido L. Samarzich being first duly sworn, deposes and says that he or she is Vice President of Vido Samarzich, Inc. the party making the foregoing bid that the bid is not made in the interest of,or on the behalf of,any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true;and, further,that the bidder has not,directly or indirectly, submitted his or her bid price or any breakdown thereof,or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Vido Samarzich, Inc. 1 Name/of Bidder `/t i I , Wo L Srrwzi h-Vw P soft Slgnatu ABidder 6829 Billings Place, Rancho Cucamonga, CA 91701 Address of Bidder C4 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 RESIDENTIAL CURB RAMP PROJECT, (I)(wexit) 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. Vido Samarzich, Inc. Contractor V By Vice President Title 1)atr: 10/27/2020 C-s DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162. the Bidder shall complete. tinder 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 m \o If the answer is yes. explain the circumstances in the space provided. Note. This questionnaire constitutes a part of the Proposal. and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 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 1 will comply with such provisions before commencing the performance of the work of this contract. Vido Samarzich, Inc. Contractor Zj �/I By Vice President Title Date: 10/27/2020 Ca BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Vido Samarzich, Inc. Bidder Name 6829 Billings Place Business Address Rancho Cucamonga CA 91701 City. State Zip ( 909 ) 987-6377 vidosam@yahoo.com Telephone Number Email Address 433210 Class A State Contractor's License No. and Class 12/31/1982 Original Date Issued 12/31/2020 Expiration Date The work site was inspected by Vido L. Samarzich of our office on October 14, 2020 .49+—. The following are persons, firms, and corporations having a principal interest in this proposal: Vido Samarzich. Inc. Vido Samarzich - President The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Vido Samarzich, Inc. Comp y Nam ij Signature of BiUd C-8 Vido L. Samarzich Printed or Typed Signature NOTARY CERTIFICATE 116:M1, Subscribed and swom to before me this 14th day of October a9l-..2020 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document, to which this certificate is attached, and not the truthfulness, accuracy,or validity of that document. State of California ) County of Los Angeles ) On October 14, 2020 before me, Desmond G. Warren, Notary Public Month, Day, and Year Insert Name and Title of Notary personally appeared Vido L. Samarzich NameKof SigneW who proved to me on the basis of satisfactory evidence to be the personVy-Avhose nameoyis/pf subscribed to the within instrument and acknowledged to me that he/she/ipay executed the same in his/ber/jwir authorized capacity(es),and that by his/bef7tberf signaturej,*yon the instrument the personal, or the entity upon behalf of which the personal 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. casom o wuaaw car maasU 0"nuc_cwo"s ww.a.C'M"y wow.c�w..ro c.gym, Signature Signature 6f Notary Public (PLACE NOTARY SEAL ABOVE) C-9 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, "Demolition of existing concrete ADA ramps and construction of new ADA compliant curb ramps. Work included additional curb and gutter construction to ensure surface water flow around corner. All ramps met Caltrans requirements set forth in Standard Plan A88A"I Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. Listed below are the names. address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: I. SEE ATTACHED INFORMATION 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: ?. SEE ATTACHED INFORMATION 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. SEE ATTACHED INFORMATION 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-10 VIDO SAMARZICH, INC. General Engineering Contractor No. 4332I0A 6829 BILLINGS PLACE, RANCHO CUCAMONGA, CALIFORNIA 91701 TELEPHONE 909-987-6377 FAX 909-987-8988 COMPLETED CONSTRUCTION PROJECT REFERENCES 1. Project Name: Sidewalk Gap Closure Project Owner: City of Palm Springs Phone Number: (760) 323-8253 s8744 Engineer/Contact: Mr. Donn Uyeno Contract Amount: $1.267.000.00 Date of Completion: 2020 2. Project Name: Misc Storm Drain Improvements - 335 S. Hale Ave Owner: City of Fullerton Phone Number: (714) 738-6853 Engineer/Contact: Mr. David Grantham Contract Amount: $200.000.00 Date of Completion: 2020 3. Project Name: Misc Storm Drain Improvements — Knepp Ave Owner: Cite of Fullerton Phone Number: (714) 738-6853 Engineer/Contact: Mr. David Grantham Contract Amount: $304.000.00 Date of Completion: 2019 4. Project Name: Local Street Curb Ramp Improvements Owner: City of Santa Ana Phone Number: (714) 552-5336 Engineer/Contact: Mr. Gerardo Lechuga Contract Amount: $577.000.00 Date of Completion: 2019 5. Project Name: 3"' Ave Pavement Rehabilitation and Water Improvements Owner: City of tJpland Phone Number: (909) 291-2946 Engineer/Contact: Mr. Bob Critchfield Contract Amount: $2.800.000.00 Date of Completion: 2019 Page I of 7 VIDO SAMARZICH, INC. General Engineering Contractor No.433210A 6829 BILLINGS PLACE, RANCHO CUCAMONGA, CALIFORNIA 91701 TELEPHONE 909-987-6377 FAX 909-987-8988 6. Project Name: 91" Street Pavement Rehabilitation and Water Improvements Owner: City of Upland Phone Number: (909) 291-2946 Engineer/Contact: Mr. Bob Critchfield Contract Amount: $2.600.000.00 Date of Completion: 2019 7. Project Name: La Palma Ave Sidewalk Improvements Owner: Citv of Anaheim Phone Number: (714) 765-5052 Engineer/Contact: Mr. Joel Jordan Contract Amount: S479.000.00 Date of Completion: 2019 8. Project Name: Wilshire Avenue Bicycle Blvd Improvements Owner: City of Fullerton Phone Number: (714) 738-6853 Engineer/Contact: Mr. David Grantham Contract Amount: $2.100.000.00 Date of Completion: 2019 9. Project Name: FY 17-18 ADA Access Ramp Improvements at Various Locations Owner: City of Rancho Cucamonga Phone Number: (909) 774-4070 Engineer/Contact: Mr. Romeo David Contract Amount: $975.000.00 Date of Completion: 2018 10. Project Name: Wilshire Avenue Water and Sewer Improvement Project Owner: City of Fullerton Phone Number: (714) 738-6895 Engineer/Contact: Mr. Gar Huang Contract Amount: S550.000.00 Date of Completion: 2018 11. Project Name: Elm/Malden Area Street. Sewer and Water Improvements Owner: Citv of Fullerton Phone Number: (714) 773-0049 Engineer/Contact: Mr. Joseph Hernandez Contract Amount: $2.200,000.00 Date of Completion: 2018 Page 2 of 7 VIDO SAMARZICH, INC. General Engineering Contractor No. 433210A 6829 BILLINGS PLACE. RANCHO CUCAMONGA. CALIFORNIA 91701 TELEPHONE 909-987-6377 FAX 909-987-8988 12. Project Name: Anaheim Hills Road Water Main Replacement Owner: Cite of Anaheim Phone Number: (714) 863-8020 Engineer/Contact: Mr. Luis Tapia Contract Amount: $600.000.00 Date of Completion: 2018 13. Project Name: CDBG ADA Wheelchair Access Ramp Replacement at Various Locations Owner: City of Orange Phone Number: (714) 744-5566 Engineer/Contact: Mr. Matthew Lorenzen Contract Amount: $204.300.00 Date of Completion: 2018 14. Project Name: 2017 Citywide Curb Ramp Improvements Owner: City of Laguna Beach Phone Number: (949) 497-0741 Engineer/Contact: Mr. Tri Nguyen Contract Amount: $285.000.00 Completion Date: 2017 15. Project Name: Safe Routes to School Improvements. Phase 3 Owner: City of Glendale Phone Number: (818) 402-0225 Engineer/Contact: Mr. Gary Edsall Contract Amount: $908.000.00 Date of Completion: 2017 16. Project Name: Heim Ave at Canal St Storm Drain Improvements Owner: City of Orange Phone Number: (714) 744-5566 Engineer/Contact: Mr. Matthew Lorenzen Contract Amount: $99,000.00 Date of Completion: 2017 17. Project Name: Citywide Sidewalk Repair Project PY I5-16 Owner: City of Santa Monica Phone Number: (951) 522-4505 Engineer/Contact: Mr. Craig Wheeler Contract Amount: $878.000.00 Date of Completion: 2017 Page 3 of 7 VIDO SAMARZICH, INC. General Engineering Contractor No.433210A 6829 BILLINGS PLACE, RANCHO CUCAMONGA. CALIFORNIA 91701 TELEPHONE 909-987-6377 FAX 909-987-8988 18. Project Name: FY 16/17 Curb Access Ramp Installation Project Owner: City of I-luntington Beach Phone Number: (714) 536-5259 Engineer/Contact: Mr. Joe Fuentes Contract Amount: $679,000.00 Date of Completion: 2017 19. Project Name: Comstock Avenue Water Main Improvements Owner: Citv of Whittier Phone Number: (562) 567-9302 Engineer/Contact: Mr. Carl Hassel Contract Amount: S578.000.00 Date of Completion: 2017 20. Project Name: Monterey Road Street Improvements Owner: City of South Pasadena Phone Number: (626) 590-0570 Engineer/Contact: Mr. Alex Chou Contract Amount: S1.550.000.00 Date of Completion: 2017 21. Project Name: Fletcher Avenue Reconstruction Owner: City of South Pasadena Phone Number: (702) 204-4025 Engineer/Contact: Mr. Mark Peterson Contract Amount: S878.000.00 Date of Completion: 2016 22. Project Name: Patterson Street Reconstruction Owner: City of Fullerton Phone Number: (714) 732-9060 Engineer/Contact: Mr. Pete Acosta Contract Amount: S675.000.00 Date of Completion: 2016 23. Project Name: Magnolia/Bolsa Intersection Widening Owner: City of Westminster Phone Number: (714) 548-3464 Engineer/Contact: Ms. Theresa Tran Contract Amount: S975.000.00 Date of Completion: 2016 Page 4 of 7 VIDO SAMARZICH, INC. General Engineering Contractor No.433210 A 6829 BILLINGS PLACE, RANCHO CUCAMONGA, CALIFORNIA 91701 TELEPHONE 909-987-6377 FAX 909-987-8988 24. Project Name: 2015 Water Main Improvements Owner: City of Westminster Phone Number: (714) 548-3456 Engineer/Contact: Mr. Tuan Pham Contract Amount: $1.100.000.00 Date of Completion: 2016 25. Project Name: Red Hill Lake Modernization Owner: City of Rancho Cucamonga Phone Number: (909) 477-2740 Engineer/Contact: Mr. Romeo David Contract Amount: $300.000.00 Date of Completion: 2016 26. Project Name: 2015 Concrete Improvements Owner: City of Inglewood Phone Number: (714) 468-7319 Engineer/Contact: Mr. Hunter Nguyen Contract Amount: $425.000.00 Date of Completion: 2015 27. Project Name: EI Centro Avenue Rehabilitation Owner: City of South Pasadena Phone Number: (626) 590-0570 Engineer/Contact: Mr. Ales Chou Contract Amount: $1,100,000.00 Date of Completion: 2015 28. Project Name: Concrete 13us Pads Owner: City of Rancho Cucamonga Phone Number: (714) 548-3456 Engineer/Contact: Curt Billings Contract Amount: $175.000.00 Date of Completion: 2015 29. Project Name: ADA Wheelchair Ramps Owner: City of'Orange Phone Number: (714) 744-5566 Engineer/Contact: Mr. Matthew Lorenzen Contract Amount: $275,000.00 Date of Completion: 2015 Page 5 of 7 VIDO SAMARZICH, INC. General Engineering Contractor No.433210 A 6829 BILLINGS PLACE, RANCHO CUCAMONGA, CALIFORNIA 91701 TELEPHONE 909-987-6377 FAX 909-987-8988 30. Project Name: 2014 Water Improvement Owner: Citv of Westminster Phone Number: (714) 548-3456 Engineer/Contact: Mr. Tuan Pham Contract Amount: $1.100.000.00 Date of Completion: 2015 31. Project Name: ADA Sidewalk Improvement Owner: City of Artesia Phone Number: (951) 314-6984 Engineer/Contact: Mr. Chuck Burkhardt Contract Amount: $200.000.00 Date of Completion: 2014 32. Project Name. YLHS Park Bryant Cross Feeder Pipeline Owner: Yorba Linda Water District Phone Number: (714) 701-3104 Engineer/Contact: Mr. Joe Polimino Contract Amount: $675.000.00 Date of Completion: 2013 33. Project Name: County Road Storm Drain Owner: City of Pomona Phone Number: (909) 322-7471 Engineer/Contact: Mr. Dave Barron Contract Amount: S570.000.00 Date of Completion: 2013 34. Project Name: Adams Square Park Owner: City of Glendale Phone Number: (818) 548-2864 Engineer/Contact: Mr. Hagop Kassabian Contract Amount: $1.100,000.00 Date of Completion: 2010 35. Project Name: Various Public Work Purchase Orders and Contracts 2000-2013 Owner: City of Pasadena Phone Number: (626) 484-5640 Engineer/Contact: Mr. Dale Torstenbo - dtorstenbo@cityofpasadena.net Contract Amount: $2.500.000.00 Date of Completion: 2000-2013 Page 6 of 7 VIDO SAMARZICH, INC. General Engineering Contractor No.433210A 6829 BILLINGS PLACE, RANCHO CUCAMONGA, CALIFORNIA 91701 TELEPHONE 909-987-6377 FAX 909-987-8988 -16. Project Name: Misc Park Improvements From 2000-2010 Owner: City of Glendale Engineer/Contact: George 13alteria — (951) 201-2710 Peter Vicrheilig— pvierheiIig a ci.glendale.ca.us Contract Amount: $3.500.000.00 Date of Completion: 2000-2010 Page 7 ol'7 Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager. and Superintendent. For each of these critical positions, please list at least three projects for which the critical staff has performed similar work within the last five years. These projects do not have to be under the employment of the bidder of this project. Bidders are encouraged submit supplemental relevant project history in addition to the projects listed herein. I, Vido L. Samarzich Name of proposed Project Manager Telephone No. of proposed Project Manager: (909) 987-6377 Sidewalk Gap Closure Project- $1,267,000- Concrete Work 2020 Project Name & Contract Amount Type of Work Date Completed Local Street Curb Ramp Improvements- $577.000- Concrete Work 2019 Project Name & Contract Amount Type of Work Date Completed 3rd Ave Pavement Rehabilitation & Water Improvements - $2,800,000 - Street Rehabilitation - 2019 Project Name & Contract Amount Type of Work Date Completed ?. Joe Hewko Name of proposed Superintendent Telephone No. of proposed Superintendent: (909) 987-6377 Sidewalk Gap Closure Project- $1,267,000- Concrete Work 2020 Project Name & Contract Amount Type of Work Date Completed Local Street Curb Ramp Improvements - $577,000 - Concrete Work 2019 Project Name & Contract Amount Type of Work Date Completed 3rd Ave Pavement Rehabilitation & Water Improvements - $2,800,000 - Street Rehabilitation - 2019 Project Name & Contract Amount Type of Work Date Completed C-II CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771.1(a)), passed by the California State Senate on June 20,2014,established a new public works Contractor Registration Program,which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July I through June 30 state fiscal year) with the California Department of Industrial Relations(DIR).Currently the annual non-refundable registration fee for Contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 http://www.dir.ca.gov/DLSE/Public Works/SB854FactSheet_6.30.14.pdf DIR's Contractor Registration Link—Call (844) 522-6734 https://efiIing.dir.ca.gov/P WCR/ActionServlet?action=displayPWCRegistrationForm DIR's Contractor Registration searchable database: https://efiling.dir.ca.gov/PWCR/Scarch.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. Vido Samarzic , Inc. Cont r I ' V By vidosam@yahoo.com Email Vice President Title Date: 10/27/2020 PWC Registration k: 1000013213 C-12 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135• Economic Opportunities for Low and Very Low-Income Persons The bidder, under penalty of perjury,certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager(initial the applicable selections): Will ensure that 10%of all new hires as a result of this project shall meet all requirements of Section 3 ofCFR Part 135 of the HUD Act of // 1%8; or Will hire no new employees in conjunction with this project. Will award 10%of its sub-contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub-contracts related to this project. Contractor Vido Samarzich, Inc. Contact Person: Vido L. Samarzich Contact Phone: (909) 67-63 7 Signed Date 10/27/202 '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-comnliancc %ith Section 3 could result in disqualification. ( -u EXHIBITA DISADVANTAGED 13USINESS ENTERPRISE (DBE) This Project is subject to Part 200.321. Title 2. Code of Federal Regulations entitled "Contracting with Small and Minority Businesses. Women's Business Enterprises. and Labor Surplus Area Finis." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs). as defined in Part 200.321. Title 2 CPR, shall be encouraged to participate in the performance of Contracts financed in whole or in part with lederal funds.The Contractor should ensure that DBEs.as defined in Part 200.321, Title 2 CPR. have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps.as set forth in Part 200.321.Title 2 CFR, for this assurance. The Contractor shall not discriminate on the basis of race. color, national origin, or sex in the award and perfonance of subcontracts. Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain D13E participation in this project, although there is no specific goal for DBE participation. C-14 EXHIBIT B DBE INFORMATION—GOOD FAITH EFFORTS Federal-aid Project No. Bid Opening Date a to The City of Huntington Beach established a Disadvantaged Business Enterprise(DBE)goal of 9°/u 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 WE tT ' (e DAL B. The names and dates of written notices sent to certified DBEs soliciting bids for this Project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested(please attach copies of solicitations,telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods Solicitation and Dates C-15 C. The items of work which the bidder made available to DBE firms including, where appropriate,any breaking down of the contract work items(including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidders 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 (S) of (YIN) Contract n4 A D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved),and the price difference for each DBE if the selected firth is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidders 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: A/ a C-16 F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: rJA 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 rj1A H. Any additional data to support a demonstration of good faith efforts(use additional sheets if necessary): / n/A NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. C-17 IP A SOLE OWNER OR SOLE CONTRACTOR SIGN IIERI : (I) Name under which business is conducted (2) Signature (given and surname) of proprietor (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail IF A PARTNERSHIP. SIGN 1-IERE: (I) Name under which business is conducted (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business (Street and Number) Citv and State (4) Zip Code Telephone No. (5) E-Mail C-I8 IF A CORPORATION, SIGN HERE: (1) Name under which business is conducted Vido Sarnarzich, Inc. (2) (Sign ) Vice President (Title) Impress Corporate Seal here (3) Incorporated under the laws of the State of California (4) Place of Business 6829 Billings Place (Street and Number) City and State Rancho Cucamonga, CA (5) Zip Code 91701 Telephone No. (909) 987-6377 (6) E-Mail vidosam@yahoo.com NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED C-19 ACKNOWLEDGMENT notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached. and not the truthfulness, accuracy. or validity of that document. State of California County of Los Angeles On October 14, 2020 before me. Desmond G. Warren, Notary Public (insert name and title of the officer) personally appeared Vido L. Samarzich who proved to me on the basis of satisfactory evidence to be the person(ewhose nameK s/aje subscribed to the within instrument and acknowledged to me that he/$helt4ey,executed the same in his/Fier/weir authorized capacityUpar and that by his/beVtkif signature(pf'on the instrument the person;sr' or the entity upon behalf of which the personal 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 DESWNDD.WARREN WITNESS my hand and official seal ° COMM 67190531 Nary WOYc Cadwma a, Riy.rry Canty Nf Ca Eq AV 5 2021 � wwr Signature (Seal) List below names of president. vice president. secretary and assistant secretary. if a corporation: if a partnership, list names ofall general partners and managing partners: Vido Samarzich President Vido L. Samarzich Vice President Monika Samarzich Secretary C-20 EXHIBIT D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Vido Samareicn. Inc. [proposed subcontractor ] hereby certifies that he/she/it has V , has not, participated in a previous contract or subcontract subject to the Equal Opportunity clauses, as required by Executive Orders 10925. 1 11 14, or 11246, and that, where required, he/she/it has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently, Standard Form 100(EEO-I)is the only report required by the Executive Orders or their implementing regulations. (ecoc.gov/employers/ecolsurvey/index.cfm) Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Signature: Date: 10/27/2020 Print Name: Vido L. Samarzich Title: Vice President C-u EXHIBIT E NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) [NAME OF CONTRACT) - Residential Curb Ramp Project, CC1620 To the City of Huntington Beach In conformance with Title 23 United States Code Section 112 and California Public Contract Code 7106 the bidder declares that the bid is not made in the interest of,or on behalf of,any undisclosed person,partnership,company,association,organization,or corporation;that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid,and has not directly or indirectly colluded,conspired,connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true:and, further,that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof,or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. By signing the Proposal, the Bidder has also signed this Noncollusion Affidavit. Bidders are cautioned that making a false Certification may subject the Bidder to criminal prosecution. Signature: I J�/ - Date: 1 0/2 712 0 2 0 Print Name: Vido L. Samarzich Title: Vice President C-24 • EXHIBIT F DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS, PART 29 The Bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated with Bidder in the capacity of owner, partner, director, officer, manager: • is not currently under suspension,debarment. voluntary exclusion,or determination of ineligibility by any Federal agency; • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted,convicted, or had a civil judgment rendered against him/her by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Note: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Signature: Date: 10/27/2020 Print Name: Vido L. Samarzich Title: Vice President C-25 EXHIBIT G NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: 1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement. and the extension, continuation, renewal. amendment,or modification of any Federal contract,grant, loan,or cooperative agreement. 2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31. U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10.000 and not more than 5100,000 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 S 100,000 and that all such subrecipients shall certify and disclose accordingly. Signature: JDate: 10/27/2020 Print Name: Vido L. Samarzich 1 itle: Vice President EXHIBIT H C-26 a DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBY(\G AC I I%I I IFS PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Sutter of Federal Action: 3. Rgmn Type: a contract Da lhdfofTevapphcation ❑a maul h grant b mrtul award In material change c cooperator agreement c post-award d loan For%lal"I O hhngc Only: e loan guarantee I Lan insurance date�,t Ia'l"[MrtI J. Name and %ddrns of Reporting I mity 5. If Reponmg)nt(N in No.J is Nubawardee. F rater Name and Wdress of Prime P...ni. El s,tuwmdee 1 icr if known <ongrnsional District,if known Congre,momil Monet,tl A,ioi,r b. Federal Depanmen( Sgencs: 7. Federal Program Name/Itc criptiun: CFDA Namber,if applicable S. Federal %clion Number.d known 9. Award Aarank if known 10. a,Name and Address of[Abby Entity 0. Individuals Performing Sei vkn (including (If undo idual.last name,first name.MI) address if Menem from No l0a) past name.first name,MI) lavach Continuation Shectls)dnecessan I I I. %mount of Pa.�norm(cheek all that apph 1 13. 1,prof Payment(check all that apph I 5 Actual L-]planned a retainer b one-time fee 12. Form of e Payormoot(ebeck all that apph 1: c commission a cash d contingent fee b in-kind. speiits nature a deferred saluc f other.specds 14. Grief lyewription of Sen ices Performed or to be performed and Datns)of Sen kr,including oMcensl,employetlsk or memberlsl contacted.for Pasmrnt Indicated in Item 11: lauach Continuation Shecos)d necessan) IA Continuative Sheers)attached: Ies ❑ No 16. Information requested through this torn is authorrzed by Title 31 U S C Section 1352 This disclosure of lobby%mg reliance Signature li!— was placed by the tier above when his transaction was made or r entered into rhos disclosure is required pursuant to 31 U S C Print Name Vido L. S8R1821Ch 1352 This information will be reported to Congress semunnua0y and will be asadable for public inspection Am file ViCb Phi gident person who fails to file the required disclosure shall be subject to a cts it penaln of not less than$10.000 and not more than Telephone No (909)987.6377 Date 1027/2020 SIOOOX)for each such failure Authorised for Local Reproduction Federal 1 ve Only: Standard Form-LLI. Standard Form I.LL.Res 09-12-97 C-27 INSTRUCTIONS FOR COMPLETION OF EXHIBff H. DISCLOSURE OF LOBBYING ACTIVITII=S 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 iNlember 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 Hill 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 tiling the report in Item 4 checks "Subawardcc" then enter the full name, address, city, state and zip code ofthe 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 (RI'P) number. Imitation 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-90-00I." 9) For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitments 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 individuai(s) performing services and include full address if different from 10 (a). Enter Last Name. First Namc and Middle Initial (MI). 1 1)Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. C-28 12)Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13)Check the appropriate box(es). Check all boxes that apply. Ifother, 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 oflicials. Identify the Federal officer(s) or employee(s) contacted or the officer(s) employce(s) or Mentber(s) of Congress that were contacted. 15)Check whether or not a continuation sheet(s) is attached. 16)The certifying official shall sign and date the form. print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response. including time for reviewing instruction. searching existing data sources. gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information. including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0046). Washington. D.C. 20503. By my signature on this proposal I certify. under penalty of perjury under the laws of the State of California. that the foregoing questionnaire and statements of Public Contract Code Sections 10162. 10232 and 10295.1 are true and correct and that the bidder has complied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5. Title 2 of the California Administrative Code). C-29 FXI-III31T I FEDERAL LOBBYING RESTRICTIONS Section 1352. Title 31. United States Code prohibits Federal funds from being expended by the recipient or any lower tier subrccipient of a Federal-aid contract to pay for any person for influencing or attempting to influence a Federal agency or Congress in connection with the awarding of any Federal-aid contract, the making of any Federal grant or loan, or the entering into ofany cooperative agreement. I f any funds other than Federal funds have been paid for the same purposes in connection with this Federal-aid contract, the recipient shall submit an executed certification and, if required, submit a completed disclosure form as part of the bid documents. A certification for Federal-aid contracts regarding payment of funds to lobby Congress or a Federal agency is included in the Proposal. Standard Form - LLL. `'Disclosure of Lobbying Activities." with instructions for completion of the Standard Form is also included in the Proposal. Signing the Proposal shall constitute signature of the Certification. The above referenced certification and disclosure of lobbying activities shall be included in each subcontract and any lower-tier contracts exceeding $100.000. All disclosure forms. but not certifications, shall be forwarded from tier to tier until received by the Engineer. The Contractor, subcontractors and any lower-tier contractors shall file a disclosure form at the end of each calendar quarter in which there occurs any event that requires disclosure or that materially affects the accuracy of the information contained in anv disclosure form previously filed by the Contractor. subcontractors and any lower-tier contractors. An event that materially affects the accuracy ofthe infornation reported includes: I ) A cumulative increase if$25.000 or more in the amount paid or expected to be paid for influencing or attempting to influence a covered Federal action: or 2) A change in the person(s)or individual(s) influencing or attempting to influence a covered Federal action: or 3) A change in the officcr(s). employces(s), or Mcmber(s) contacted to influence or attempt to influence a covered Federal Action. C-30 • City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For RESIDENTIAL CURB RAMP PROJECT in the CITY OF HUNTINGTON BEACH OCTOBER 20, 2020 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1 j SHEET Al OF PROJECT SPECIFICATIONS Bids will be received from 1:00 PM to 2:00 PM only on the bid due date(10/27/2020)outside of the City Hall main entrance at 2000 Main St. in Huntington Beach. Staff will be present during this hour to receive bids only. Mailed bids are still accepted but must be received before the bid submission deadline. It in encouraged that bidders arrive earlier than normal to drop off bids to avoid a late delivery. Bids will be opened outside of City Hall immediately after 2:00 PM. Bidders are welcome to stay and attend the opening. Social distancing measures shall be observed and masks will be required for all in attendance.This update to the Notice Inviting Sealed Bids shall supersede all other bid delivery information noted on the project documents.A revised NISB is now included with the project documents. This is to acknowledge receipt and review of Addendum Number One, dated October 20, 2020 Vido Samarzich, Inc. Company Name By 10/20/2020 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. OLD REPUBLIC SURETY COMPANY BOND NO: VIDSA-2101 BID BOND KNOW ALL MEN BY THESE PRESENTS: That we, VIDO SAMARZICH, INC., (hereinafter called the Principal), and OLD REPUBLIC SURETY COMPANY , a corporation organized and doing business under and by virtue of the laws of the State of WISCONSIN, and duly licensed for the purpose of making, guaranteeing or becoming sole surety upon bonds or undertakings required or authorized by the laws of the State of CALIFORNIA, as Surety, are held and firmly bound unto CITY OF HUNTINGTON BEACH, hereinafter called the obligee) in the sum equal to 10% of the accompanying bid of the Principal, not, however, in excess of TEN PERCENT OF THE TOTAL AMOUNT OF THE BID Dollars (10% OF THE BID AMOUNT), for the payment of which, well and truly to be made, we hereby bind ourselves and our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT WHEREAS, the above bounden Principal as aforesaid, is about to hand in and submit to the obligee a bid for the RESIDENTIAL CURB RAMP PROJECT, CC NO. 1620, in accordance with the plans and specifications filed in the office of the obligee and under the notice inviting proposals therefore. NOW, THEREFORE, if the bid or proposal of said principal shall be accepted, and the contract for such work be awarded to the principal thereupon by the said obligee, and said principal shall enter into a contract and bond for the completion of said work as required by law, then this obligation to be null and void, otherwise to be and remain in full force and effect. IN WITNESS WHEREOF, said principal and said Surety have caused these presents to be duly signed and sealed this 15T"day of OCrOBER, 2020. VIDO 9AMAR2?ICH NC. BY: I /'J I, I —/ OLD REPUBLIC SURETY COMPANY BY: �j GGC2 /Z-i� _ MA HEW R. DOBYNS, Attorney-in-Fact OID''REPUBLIC SURETY COMPANY t f \•,\ \� r j y 1- J - POWER OF ATTORNEY\\ io � r, a _ - r • i i KNOK ALLNIEN BY THESE-PRESEN'rS:,That OLD REPUBLIC SURETY COMPANY,.Wisconsin stock insurance coiporation, 'appoint: does make;constitute and� � ' - - - .RANDY SPOHN,MATTHEW R.DOBYNS,HAMILTON KENNEY,ASHLEY M.SPOHN,OF SANTA ANA,CA ' 'Its tine and lawful Attorney(s)m-Fact,with full powe and authority; for and on behalf of the company as solely,to execute and deliver and affix the seal of the company thereto(if a seal is required),bonds,undertakings,recognimirces or other written obligations in the nature thereof, (other than ball bonds,bank depository bonds,mortgage deficiency bonds,mortgage gu.n mty lwnds.guarantees of.installment and note guaranty bonds,sell`-inSumncc�workcrs -�t - compensati6 bondsguarinmciog payment of beneliu,asbestos'abalement contract Grads.waste neiriage lent bonds,h wa',r ous waste rcmedialion bonds br black lung bonds). ''as follows: )' i ' ALL WRITTEN INSTRUMENTS - OLD REPUBLIC SURETY COMP YNY Hereby,arld all of the acts of said ARome)s-in-act,pursuant to these presents,arc ratified and con firmed:bind firmed: r This appointment is made under and by authority ofthc board ofdircctors at a special meeting held-mi February 18,1982. This Power of Auomcy is signed and s scaled by facsimile under and by the authority of thefollowing resolutions adopted by the board of directors of the OLD REPUBLIC SURETY COMPANY on / I February 18. 1982. 'RESOLVED that;ttie prutdrni zany vlte-president or assistant xtcc pruident,in conjunction with the secretary or any assistant secrets mta"mrys,In-fact o[a enis with aoNont ry my appoint \ g y as defined or limited in the inswment evidencing the appointment in each case,for and on behalf of the company to 'execute and delivei and affix the se lof the company to bonds,undertakings,recogmzzh'cm.and surtyship obligations ofall kinds;and said officers may rtmove':--c ' any suthSitomey-in-fact or agent and revoke any Power of Attorney previously granted to such person. RESOLVED FURTHER;that any bond,ondenakmg,recognizance,or suretyship obligation shall be valid and binding upon the Company (i)when Signed by die praidcnt any vicdpresidrnt or assistem vice president,and atimied and scaicd(if a seal be required)by tiny secretary or as'sismnt secretary-or A 1 ' - h p' v v, , e 1 r1 (it)when signrd by the president,any vice president or assistant vice president,secretary or assistant secretary,and countersigned andscaled(ifa seal be required)by a duly authorized attomey-m-fact or agent or (iii)when duly,executed and sealed(if a seal be required)by one or,more uttomcys-in-fact or agents pursuant to and within the limits otihe authority ' - a evidenced by the Power of Auomcy Issued by the company to•such person orpersons.RESOLVED FURTHER that the signature ofany authorized officerrand the seal of the ebmpanymay be affixed by facsimile to any Powerro(Attomn'or t -certification there ofauthorizing the execution and delivery ofany band,undo iakmgk recognizance,or other suretyship obligations of thecompan`y; and such signature and seal when so used shall have the same force and effect as though manually affixed. IN W ITN ESS WHEREOF;OLD REPUBLIC SURETY COMPANY has caused these presents to be signed by its proper oliicer,and Its corporate seal to be .'r 'affixed this ' . •'2ST14 dayoP APRIL.'2020 x OLD REPUBLIC SUR ETi'COSI PANV ' ASSlstanl Sceew,y lv� STATE OF WISCONSIN,COUNTY OF WAUKLSHA-SS "' ;,r..A`� President �a On Ihls• 28TH`? day"I'"APRIC;20n0 personally camebefore me,� - Alan Pavlic end Kart+r 1 H fT rn ? ,to me known to be the Individuals and officers of the OLD REPUBLIC SURETY COMPANY who executed the above `�Jnsumncm and they each acknowledged the execution of the same,ind being by me duty iwom,did severally depose and say; that they are the said oHiceis of the - corporation aforesaid,and that the seal affixed to the above instrument is the seal of the corpomt ion,and that said corpomtc seal and their signatures as such officers ,\were duly affixed and subscribed to the said instrument by the authority of the board of directors ofsaid corporation v1 Notary Public / - �... ee lily commission capirti: 928l2022 CERTIFICATE ` t1 (Expirallon of notary commission does not invalidate this Instrument) I,the undersigned,assistant secretary of the OLD REPUBLIC SURETY COMPANY a Wisconsin corporation.CGRTiF;Y that the foregoing and attached Power frce. racy remains in full force and has not been revok o ed:and furthermore.that the Resolutions of the board of w indirectors set forth in the Power of Attorney,an:no forte. 74-7097 1 +"c su,,N Signed and sealed at the City of Brookfield,WI,this 15 tll- day of'—QC C7bP.0 2020 S SEAL . Assistant Secretary R.S.BONDING&INS AGENCY INC t } IB51-W POAORS01:020 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verities only the identity of U1e individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validih, of that document. State of CALIFORNIA County of ORANGE On October 15th, 2020 before me, ASHLEY MARIE SPOHN. NOTARY PUBLIC personally appeared MATTHEW R. DOBYNS who proved to me on the basis of satisfactory evidence to be the person() 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(5) on the _ instrument the person(5), or the entity upon behalf of which the persons) AEHIE'r I:AH.RIE SPOHN acted, executed the instrument. vMK k 2188665 -d I:OiAP,Y PUBLIC CALIFORNIA O I certify under PENALTY OF PERJURY under the laws of the State of 3 d� ORANGE COUNTY i California that the foregoing h is true and correct. 9I MyMMM.ex�ires Mar.27,2G'_J1 9 9 paragraph ra 9 P l' WITNESS my hand and official seal. Ig tature of Notary 920-IF MIME Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER ❑ PARTNER(S) ❑ LIMITED _ ® ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: _ NAME OF PERSON(S) OR ENTITY(IES) � c o a Q o � ow H < wo co co Q x op P n V Z Q °' P P C U w Q � Q I� cD M O Q U w Z U I o O PI Z U Z Q JO O J rC� P Z W I 00 K W