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PTM General Engineering Services Inc. - 2022-10-04
RECEIVED BY: CITY CLERK RECEIPT COPY p Return DUPLICATE to L..4)(1.41 ��-✓ 1`�C A.1' V1 City Clerk's Office (Name) after signing/dating (Date) CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: City Treasurer FROM: City Clerk DATE: lr-?5/21// SUBJECT: Bond Acceptance I have received the bonds for PT 1 1 CPA N c.Pr-I L S '_14 6 e—SI five • (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. I-153249 Li 3 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 I G/UL1 f.2C'12— (Council Approval Date) CC No. Agenda Item No. MSC No. City Clerk Vault No. t 'c7l)• 0 Other No. SIRE System ID No. (G b2LIL' g:/forms/bond transmittal to treasurer IS) CITY OF HUNTINGTON BEACH o INTERDEPARTMENTAL COMMUNICATION DATE: 3/21/2024 TO: THOSE LISTED HEREON FROM: Keegan Olds, PW Capital Projects Administrator SUBJECT: Retention Release Payment - PO#29681-OJ Supplier#33132 Co.#873 Utica Avenue Bicycle Boulevard, Project#CC-1499 Fed: 5181(191) Contractor's Name: PTM General Engineering Services Inc. Address: 5942 Acorn Street City, State and Zip Code: Riverside, CA 92504-1057 Phone Number: 951-722-5678 City Business License Number: (City Lic#Here) Notice of Completion (Date by City Clerk): 2/13/2024 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. D e hau Vu, Director of Public Works I certify that there are no outstanding invoices on file. 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. 5/2/zrpi Date Robin Estanislau, City Clerk SiTif 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 Recorded in Official Records, Orange County Hugh Nguyen, Clerk-Recorder II I II I II III I I I III I II I I II IIIMII N O FEE * $ R 0 0 1 4 7 8 3 2 1 1 $ * PLEASE COMPLETE THIS INFORMATION 2024000030853 9:37 am 02/13124 RECORDING REQUESTED BY: 90 CR-SC06 N12 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:Keegan Olds 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 PTM General Engineering Services Inc.,who was the company thereon for doing the following work to-wit: Utica Avenue Bicycle Boulevard,Protect#CC-1499 Fed:6181(191) That said work was completed 09/29/2023 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 09/29/2023,per City Council Resolution NO.2003-70 adopted October 6,2003. That upon said contract Great American Insurance Company,was surety for the bond given by the said company as required by This document is solely for the official business of the City of Huntington Beach,as contemplated under Government Code Section 27383 and should be recorded free of charge. "27 1( Director of Public Works or City Engineer / ate j City of Huntington Beach,California STATE OF CALIFORNIA) County of Orange )ss: City of Huntington Beach I,the undersigned,say:I am an Agent of the City of Huntington Beaph,owner in fee,in the foregoing NOTICE OF COMPLETION. I have read said NOTICE OF COMPLETION and know the contents thereof;the same 1s 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 Coun This document is solely the official business of j the City of Huntington Beach,as contemplated / f j under Government code section 27383 and Di c or of Public Works or City Engi er 'D to 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) • • • • ISSUED IN TWO (2) ORIGINAL COPIES BOND NUMBER 4532043 • PREMIUM IS INCLUDED IN PERFORMANCE BOND MAINTENANCE BOND KNOW ALL PERSONS BY THESE PRESENTS: That PTM GENERAL ENGINEERING SERVICES,INC. (contractor's name) 5942 ACORN ST., RIVERSIDE, CA 92504 (contractor's street address,city and state-and zip code) as Principal(hereinafter called Contractor),and: GREAT AMERICAN INSURANCE COMPANY (surety's name) 750 THE CITY DR.SOUTH#470,ORANGE,CA 92868 (surety's street.address,city and state and zip code) • a corporation organized-and existing under the-laws of the State of CALIFORNIA with its principal office in the City.of CINCINNATI as-Surety(hereinafter called Surety),are held firmly bound unto CITY.OF HUNTINGTON BEACH as Obligee (hereinafter called Owner), in the amount of FIVE HUNDRED AND THREE THOUSAND TWO HUNDRED NINETY SEVEN 00/100 Dollars ($ 503,297.00 ), 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,firmly by these presents, WHEREAS,Surety is a duly.admitted surety insurer under the laws Of-the State Of California;and Surety is certified and listed in the U,S, Department of the Treasury Circular 570;and able to provide proof of bonding limitation shown in said circular is sufficient to provide bonds in the amount required-by said Contract;and Surety has provided financial strength ratings from reputable companies,such as from AM. Best, Moody's, Standard • &Poor's,to validate that Surety has.positive ratings of being secure or stable;and Surety is registered andlisted with the California Department of Insurance;and- Contractor has by.written agreement dated. OCTOBER 24TH ,2022,entered into a contract with Owner for the I ITICA AVFNI IF RICYCI F Rot II FVARf PROJFCT#CC-1499 in accordance with drawings and specifications prepared by WILLIAM JANUSZ which contract is by reference:made a part hereof(hereinafter referred to as the Contract);and . The Contract.provides that:the principal will guarantee, for-a period of one:year, the-work performed as part of'the Contract-from and against all defects in materials and workmanship;-and The Contract also provides that the Contractor shall secure Contractor's obligations during the one-year period with a • bond executed by a surety duly admitted in the state of-California;and The Contract has been completed;and the Owner, Contractor and Surety:agree that the commencement date for this Guarantee.and Bond shall:be SEPTEMBER 29TH ,2023,- 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 Owner's written notice of default, either: (a) remedy the-default, or-(b) shall promptly complete the Contract in accordance with its terms and conditions. Surety shall save the Owner harmless from any claims,judgments, liens or losses.arising from the Surety's failure to • either remedy the default or to complete-the Contract in accordance with its terms and conditions in a timely manner. • 15-4584/118138 1 Whenever the Principal shall be, and declared by the Owner to be in default under the Contract, which shall include without limitation, any breach or default of the Contract, then, after written notice from the Owner to the Surety, as provided for below,the Surety 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 damages for which the surety may be liable hereunder, provided, however, that the procedure by which the Surety undertakes to discharge its obligations under this Bond shall be subject to the advance written approval of the Owner. Within thirty (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 state the date of commencement of its cure or remedy of the Principal's default(s) or its performance of the Contract. The Surety's obligations for cure or remedy, include but are not limited to: correction of defective work and completion of the Contract, additional legal, design professional and delay costs arising from Surety's actions or failure to act; and liquidated damages (or if no liquidated damages are specified in the Contract, actual damages caused by delayed performance or non-performance by the Principal). The Surety shall give prompt written notice to the Owner upon completion of the cure or remedy of the Principal's default(s)of its performance of the Contract. If the Surety does issue its Notice of Election and does not proceed to cure or remedy the Principal's default(s) of its performance of the Work within thirty(30) days after receipt of a written notice from Owner, Surety shall be deemed to be in default on this bond,and the Owner shall be entitled to enforce any remedy available to Owner. No right of action shall accrue on this bond to or for the use of any person or corporation other than the owner named herein or the successors of Owner. Signed and sealed this 9TH day of FEBRUARY , 20 24 Principal Raised Corporate Seal PTM GENERA ENGINEERING SERVICES,INC. [MUST BE AFFIXED] (Contractor Name) y: (Seal) Principal Raised Corporate Seal rp� � d��� [MUST BE AFFIXED] 11/01 f C.TZD (Title) GREAT AMERICAN INSURANCE COMPANY (Surety Name) By: (Seal) BRITTON CHRISTIANSEN,ATTORNEY-in-FACT APPROVED AS RM: B ' NOTES: chael E. Ga es, City Attorney 1. Acknowledgments must be completed and returned L as part of the bond. 2. Raised Corporate Seals are mandatory. 3. Please attach Power of Attorney. 15-4584/118138 2 GREAT AMERICAN INSURANCE COMPANY® Administrative Office: 301 E 4TH STREET • CINCINNATI,OHIO 45202 • 513-369-5000 • FAX 513-723-2740 The number of persons authorized by this power of attorney is not more than FOUR No.0 20974 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the GREAT AMERICAN INSURANCE COMPANY,a corporation organized and existing under and by virtue of the laws of the State of Ohio.does hereby nominate.constitute and appoint the person or persons named below.each individually if more than one is named,its true and lawful attorney-in-fact,for it and in its name,place and stead to execute on behalf of the said Company.as surety,any and all bonds. undertakings and contracts of suretyship,or other written obligations in the nature thereof;provided that the liability of the said Company on any such bond. undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below. Name Address Limit of Power PHILIP E.VEGA ALL OF ALL KEVIN VEGA COVINA,CALIFORNIA $100,000,000 BRITTON CHRISTIANSEN MYRNA F.SMITH This Power of Attorney revokes all previous powers issued on behalf of the attorneys)-in-fact named above. iN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 7TH day of FEBRUARY 2020 . Attest GREAT AMERICAN INSU NCE COMPANY W• ttjA e. 3 �s,hsuq, Assistant Secretary Divisional Senior Vice President STATE OF OHIO,COUNTY OF HAMiLTON-ss: MARK VICARIO(877-377-2405) On this 7TH day of FEBRUARY , 2020 .before me personally appeared MARK VICA RIO,tome knosn, being duly sworn.deposes and says that he resides in Cincinnati.Ohio,that he is a Divisional Senior Vice President of the Bond Division of Great American Insurance Company,the Company described in and which executed the above instrument;that he knows the seal of the said Company;that the seal affixed to the said instrument is such corporate seal;that it was so affixed by authority of his office under the By-Laws of said Company,and that he signed his name thereto by like authority. Susan A.Kohorst Notary Public,St*of OM AA-4.6 cr.-rt- a . .. My Co mission Expires 05-16-2M0 This Power ofAttorney is granted by authority of the following resolutions adopted by the Board of Directors of Great American Insurance Company by unanimous written consent dated June 9,2008. RESOLVED: That the Divisional President.the several Divisional Senior Vice Presidents,Divisional Vice Presidents and Divisonal Assistant Vice Presidents,or any one of them.be and hereby is authorized,from time to time.to appoint one or more Attorneys-in-Fact to execute on behalf of the Company, as surety;any and all bonds,undertakings and contracts of suretyship,or other written obligations in the nature thereof,to prescribe their respective duties and the respective limits of their authority:and to revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the Company may be affixed by facsimile to any power of attorney or certificate of either given for the execution of any bona undertaking,contract of suretyship, or other written obligation in the nature thereof such signature and seal when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company,to be valid and binding upon the Company with the same force and effect as though manually affixed CERTIFICATION I,STEPHEN C.BERAHA,Assistant Secretary of Great American insurance Company.do hereby certify that the foregoing Power ofAttorney and the Resolutions of the Board of Directors of June 9,2008 have not been revoked and are now in full force and effect. Signed and sealed this 9TH day of FEBRUARY . 2024 . Q ...., F •9 e 3 Assistant Secretary S1029AG(07/18) CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of SAN LUIS OBISPO FEB 0 9 2024 McKENZIE SALAZAR, NOTARY PUBLIC On before me, Date Here Insert Name and Title of the Officer personally appeared BRITTON CHRISTIANSEN 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. MCKENZIE SALAZAR ir?,„ Notary Public-California WITNESS my hand and official seal. `= W ^ San Luis Obispo County >_ I Commission#2459004 1 My Comm.Expires Aug 13,2027 Signature 1-Yt)c Signature of tary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) • Signer's Name: Signer's Name: ❑ Corporate Officer — Title(s): ❑Corporate Officer — Title(s): ❑ Partner — ❑Limited ❑ General 0 Partner — ❑Limited ❑General ❑ Individual ❑Attorney in Fact ❑Individual ❑Attorney in Fact El Trustee 0 Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other: ❑ Other: Signer Is Representing: Signer Is Representing: r�^.WsW^ y y Yr r ©2014 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 i CLEAR CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§1189 r r. .-' �. .� "^;:'_"Wiz'�` c"r_6i^_f��.c'�,^, ��fVelS�..St'zC-`.C'1'c,�.f`.,.t�+`,r✓,.'47,1`..,e-eSFf �rC:c_C;c'T.G".c�!!rY`S. A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California ) County of Riverside ) on 2/12/2024 before me, Yee Ping Leung, Notary Public Date Here Insert Name and Title of the Officer Personally appeared Elizabeth H. Mendoza Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(ifY whose name(seris/art subscribed to the within instrument and acknowledged to me that k /s#e/fey executed the same in higher/their authorized capacity(ipa),andthatbyhi(/her/tIrsignature(slontheinstrumenttheperson( 4',orthe entity upon behalf of which the person(y)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. ,,5')' ='?YEE PING LEUNG WITNESS my hand and official seal. `_ a1` 1 COMM # 2416239, z�- RIVERSIDE County c F ?� I� California Notary Pubii Signature s .P Cornm Exp Sept. 16, 2026: Signsldf Notary P lic 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)OtherThan Named Above Capacity(ies) Claimed by Signer(s) Signer's Name Signer's Name 0 Corporate Officer—Title(s) O Corporate Officer—Title(s) O Partner O Limited O General O Partner 0 Limited OGeneral O Individual O Attorney in Fact O Individual LO_ Attorney in Fact O Trustee O Guardian or Conservator 0 Trustee O Guardian or Conservator O Other O Other Signer Is Representing Signer Is Representing ice.,• e.#t- Cr'a" 'i; :inn..ct �'`.r-^%^fj^,rn,..;:;...er�+—n—, +-c1�a^""rrws�-n2`.{,.cv2i�["".s^f�.e"(^Est' ,F^NA.Y :e"[`i^f>??t�^\^.2 ©2014 National NotaryAssociation • www.NationalNotary.org•1-800-US NOTARY(1-800-876-6827) Item#5907 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: CC-1499 Project: Utica Avenue Bicycle Boulevard from Main Street to Beach Boulevard in the City of Huntington Beach The undersigned contractor on the above-referenced project("Project")hereby certifies that all laborers,mechanics, apprentices,trainees, watchmen and guards employed by him or by any subcontractor performing work under the contract for the Project have been paid pursuant to the minimum wage and bona fide fringe benefit requirements specified for each particular classification of work, as set forth in the wage-rate determinations of the State of California, Department of Industrial Relations,and/or the United States.Department of Labor. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this 20th day of February ,20 24 , at Riverside ,California. PTM General Engineering Services,Inc. (Contractor Name) APPROVED FORM By: , �, Mlhaa1 E. Gates Cfty Attorney 1 CONTRACTOR'S CERTIFICATE EIizabeth H.Mendoza , state and certify that: (Name of Declarant) 1. PTM General Engineering Services,Inc. is the general contractor to the City of Huntington Beach("City") on Contract No. CC-1499 (the"Contract") for the construction of the public work of improvement entitled: Utica Avenue Bicycle Boulevard.from Main Street to Beach Boulevard in the City of Huntington Beach (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 cr claims that are the subject of a Notice to Withhold filed pursuant to the Civil Code of the State of California(list all disputed claims; if none, write"NONE"). NONE I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at Riverside, California on this 22nd a}i of February ,20 24 • cSi .. eoDeclarant) APPROVED A,TOIORL Michae-. Gates v f Cityorney 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: CC-1499 Project: Utica Avenue Bicycle Boulevard from Main Street to Beach Boulevard in the City of Huntington Beach 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, arid 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 20th day of February , 20 24 , at Riverside , California. PTM General Engineering Services,Inc. (Contractor Name) Al-PROVED AS14 F R,MM By: �.�'1 Mi el E. Gates City Attorney 1 • OWNER CONSENT OF SURETY ARCHITECT TO FINAL PAYMENT CONTRACTOR l(n1 Conforms with the American Institute of sutu'1'Y I^l Architects, AIA Document G707 OTHER ri I'O OWNER: ARCHITECT'S PROJECT NO.: (Nurse and address) CITY OF HUNTINGTON BEACH 2000 MAIN ST.#5 CONTRACT FOR: PROJECT NO.#CC-1499 HUNTINGTON BEACH,CA 92648 PROJECT: CONTRACT DATED: 10/24/2022 (Nnnre and address) UTICA AVENUE BICYCLE BOULEVARD,PROJECT#CC-1499 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the (Insert name and address of Surety) GREAT AMERICAN INSURANCE COMPANY 750 THE CITY DR.SOUTH#470 ORANGE,CA 92868 , SURETY, on bond of Olsen name and address of C untructur) PTM GENERAL ENGINEERING SERVICES,INC. 5942 ACORN ST. RIVERSIDE,CA 92504 ,CONTRACTOR, hereby approves of the linal payment to the Contractor,and agrees that final payment to the Contractor shall not relieve the Surety of any ill'its obligations to (ft/sot/it/wand address a/'Uu,ned CITY OF HUNTINGTON BEACH 2000 MAIN ST.#5 HUNTINGTON BEACH,CA 92648 ,OWNER, as set forth in said Surety's bond. IN WITNESS WHEREOF,the Surety has hereunto set its hand on this date: 03/11/2024 (Insert in writing the mwrdr Jalluwcd by the auner'ir time and year.) GREAT AMERICAN INSURANCE COMPANY (Sorely) .'gnats 411POfaut ,Anzed representative) Attest: (Seal): BRITTON CHRISTIANSEN,ATTORNEY-in-FACT (Printed name and title) S-2134IGEEF 10/01 FRP Power of Attorney KNOW ALL MEN BY THESE PRESENTS THAT: Nationwide Mutual Insurance Company,an Ohio corporation hereinafter referred to severally as the"Company"and collectively as"the Companies"does hereby make,constitute and appoint: BRITTON CHRISTIANSEN;KEVIN VEGA;PHILIP E VEGA; each in their individual capacity,its true and lawful attorney-in-fact,with full power and authority to sign,seal,and execute on its behalf any and all bonds and undertakings,and other obligatory instruments of similar nature,in penalties not exceeding the sum of UNLIMITED and to bind the Company thereby,as fully and to the same extent as if such instruments were signed by the duly authorized officers of the Company;and all acts of said Attorney pursuant to the authority given are hereby ratified and confirmed. This power of attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the board of directors of the Company: "RESOLVED,that the president,or any vice president be,and each hereby is,authorized and empowered to appoint attorneys-in-fact of the Company, and to authorize them to execute and deliver on behalf of the Company any and all bonds,forms,applications,memorandums,undertakings, recognizances,transfers,contracts of indemnity,policies,contracts guaranteeing the fidelity of persons holding positions of public or private trust,and other writings obligatory in nature that the business of the Company may require;and to modify or revoke,with or without cause,any such appointment or authority;provided,however,that the authority granted hereby shall in no way limit the,authority of other duly authorized agents to sign and countersign any of said documents on behalf of the Company." "RESOLVED FURTHER,that such attorneys-in-fact shall have full power and authority to execute and deliver any and all such documents and to bind the Company subject to the terms and limitations of the power of attorney issued to them,and to affix the seal of the Company thereto;provided,however,that said seal shall not be necessary for the validity of any such documents." This power of attorney is signed and sealed under and by the following bylaws duly adopted by the board of directors of the Company. Execution of Instruments.Any vice president,any assistant secretary or any assistant treasurer shall have the power and authority to sign or attest all approved documents,instruments,contracts,or other papers in connection with the operation of the business of the company in addition to the chairman of the board,the chief executive officer,president,treasurer or secretary;provided,however,the signature of any of them may be printed,engraved,or stamped on any approved document,contract,instrument,or other papers of the Company. IN WITNESS WHEREOF,the Company has caused this instrument to be sealed and duly attested by the signature of its officer the 20th day of August,2021. 470 Antonio C.Albanese,Vice President of Nationwide Mutual Insurance Company ACKNOWLEDGMENT ` STATE OF NEW YORK COUNTY OF NEW YORK:ss • On this 20th day of August,2021,before me came the above-named officer for the Company aforesaid,to me personally known to be the officer described in and who executed the preceding /,;SEAL ;' instrument,and he acknowledged the execution of the same,and being by me duly "'' "";• sworn,deposes and says,that he is the officer of the Company aforesaid,that the seal affixed hereto is the corporate seal of said Company,and the said corporate seal and his signature were 1111,111.70 duly affixed and subscribed to said instrument by the authority and direction of said Company. Stephanie Rubino McArthur igetetetA4aCkait,ite• f Notary Public,State of New York No,02MC6270117 Qualified in New York County Notary Public Commission_ Expires October 19,2024 My Commission Expires October 19,2024 CERTIFICATE I,Laura B.Guy,Assistant Secretary of the Company,do hereby certify that the foregoing is a full,true and correct copy of the original power of attorney issued by the Company;that the resolution included therein is a true and correct transcript from the minutes of the meetings of the boards of directors and the same"has not been revoked or amended in any manner;that said Antonio C.Albanese was on the date of the execution of the foregoing power of attorney the duly elected officer of the Company,and the corporate seal and his signature as officer were duly affixed and subscribed to the said instrument by the authority of said board of directors;and the foregoing power of attorney is still in full force and effect. • IN WITNESS WHEREOF,I have hereunto subscribed my name as Assistant Secretary,and affixed the corporate seal of said Company this I1TH.day of MARCH 2024irc j� 4A SJ ^i Assistant Secretary BDJ 1(08-21)00 . • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of SAN LUIS OBISPO On MAR 1 1 2024 before me, McKENZIE SALAZAR, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared BRITTON CHRISTIANSEN 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. Nott.ffila; nia San Luis Obispo County f. WITNESS my hand and official seal. f• Commission#2459004 My Comm.Expires Aug 13,2027 Signature -VIZ Signature o 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: 0 Corporate Officer — Title(s): 0 Corporate Officer — Title(s): 0 Partner — 0 Limited 0 General 0 Partner — 0 Limited 0 General 0 Individual U Attorney in Fact 0 Individual 0 Attorney in Fact 0 Trustee 0 Guardian or Conservator 0 Trustee 0 Guardian or Conservator 0 Other: 0 Other: Signer Is Representing: Signer Is Representing: (ev_AWM..MAry_4( W, Y Y Y ©2014 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 RECEIVED BY: CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office (Name) after signing/dating (Date) CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION ag TO: City Treasurer FROM: City Clerk DATE: l0/o2Se.2-1/ SUBJECT: Bond Acceptance I have received the bonds for Pfl./l al(pltJ 2•I P7 .VI• �, / (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. Li 532-0 3 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 I{2/0/4 )2D2,Z (Council Approval Date) CC No. Agenda-% No. MSC No. City Clerk Vault No. •1000- 50 Other No. SIRE System ID No. Ntil g:/forms/bond transmittal to treasurer Recorded in Official Records, Orange County Hugh Nguyen, Clerk-Recorder II I I II III II II III III II II II1 NO FEE * $ R 0 0 1 4 7 8 3 2 1 1 $ * PLEASE COMPLETE THIS INFORMATION 2024000030853 9:37 am 02113/24 RECORDING REQUESTED BY: 90 CR-SC06 N12 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:Keegan Olds 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 PTM General Engineering Services Inc.,who was the company thereon for doing the following work to-wit: Utica Avenue Bicycle Boulevard,Project#CC-1499 Fed:5181(191) That said work was completed 09/29/2023 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 09/29/2023,per City Council Resolution Nb.2003-70 adopted October 6,2003. That upon said contract Great American Insurance Company,was surety for the bond given by the said company as required by This document is solely for the official business of the City of Huntington Beach,as contemplated under Government Code Section 27383 and should be recorded free of charge. • Director of Public Works or City Engineer ate City of Huntington Beach,California STATE OF CALIFORNIA) County of Orange )ss: City of Huntington Beach I,the undersigned,say:I am an Agent of the City of Huntington Beaph,owner in fee,in the foregoing NOTICE OF COMPLETION. I have read said NOTICE OF COMPLETION and know the contents thereof;the same is true of my knowledge. I declare under penalty of perjury that the foregoing Is true and correct,and that said NOTICE OF COMPLETION was duly and regularly ordered to be recorded in the Office of the County Recorder of Orange Count This document Is solely the official business of 11 the City of Huntington Beach,as contemplated O`'7 under Government code section 27383 and Di c or of Public Works or City Engi er D to 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) PLEASE COMPLETE THIS INFORMATION RECORDING REQUESTED BY: WHEN RECORDED MAIL TO: CITY OF HUNTINGTON BEACH PUBLIC WORKS DEPARTMENT Attn: Keegan Olds 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 PTM General Engineering Services Inc.,who was the company thereon for doing the following work to-wit: Utica Avenue Bicycle Boulevard, Project#CC-1499 Fed:5181(191) That said work was completed 09/29/2023 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 09/29/2023,per City Council Resolution No. 2003-70 adopted October 6,2003. That upon said contract Great American Insurance Company,was surety for the bond given by the said company as required by This document is solely for the official business of the City of Huntington Beach, as contemplated under Government Code Section 27383 and should be recorded free of charge. 4_,...—, ___, jt_ . Director of Public Works or City Engineer atPJ e / City of Huntington Beach, California STATE OF CALIFORNIA) County of Orange )ss: City of Huntington Beach ) I,the undersigned,say: I am an Agent of the City of Huntington Beach,owner in fee,in the foregoing NOTICE OF COMPLETION. I have read said NOTICE OF COMPLETION and know the contents thereof;the same is true of my knowledge. I declare under penalty of perjury that the foregoing is true and correct, and that said NOTICE OF COMPLETION was duly and regularly ordered to be recorded in the Office of the County Recorder of Orange Count This document is solely the official business of 14 the City of Huntington Beach, as contemplated /// under Government code section 27383 and Dir c or of Public Works or City Engi er/' D to 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) FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND PTM General Engineering Services, Inc. FOR Utica Avenue Bicycle Boulevard, CC-1499 THIS AGREEMENT ("Agreement") made and entered into by and between the City of Huntington Beach, a municipal corporation of the State of California, hereinafter referred to as "CITY," and PTM General Engineering Services, Inc. California corporation, a , hereinafter referred to as "CONTRACTOR." WHEREAS, CITY has solicited bids for a public works project, hereinafter referred to as "PROJECT," more fully described as Utica Avenue Bicycle Boulevard, CC-1499 in the City of Huntington Beach; and CONTRACTOR has been selected to perform said services, NOW, THEREFORE, in consideration of the promises and agreements hereinafter made and exchanged, the parties covenant and agree as follows: I. STATEMENT OF WORK; ACCEPTANCE OF RISK CONTRACTOR shall complete and construct the PROJECT pursuant to this Agreement and the Contract Documents (as hereinafter defined) and furnish, at its own cost and expense, all labor, plans, tools, equipment, supplies, transportation, utilities and all other items, services and facilities necessary to complete and construct the PROJECT in a good and workmanlike manner. CONTRACTOR agrees to fully assume the risk of all loss or damage arising out of the nature of the PROJECT, during its progress or prior to acceptance by CITY, from the action 1 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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; B. Bonds covering the work herein agreed upon; 2 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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 Works Construction, published by Builders'News, Inc., 10801 National Boulevard, Los Angeles, CA 90064, and all amendments thereto, written and promulgated by the Southern California chapter of the American Public Works Association and the Southern California District Associated General Contractors of the California Joint Cooperative Committee as specified in the particular Plans, Specifications, Special Provisions and Addenda applicable to the Project; E. Bid documents including the Notice Inviting Bids, the Special Instructions to Bidders,the CONTRACTOR's proposal, (attached as Exhibit"A"),and, the Federal Requirements from FHWA 1273 (attached as Exhibit"B");and F. The particular Plans, Specifications, Special Provisions and Addenda applicable to the PROJECT. Anything mentioned in the Specifications and not indicated in the Plans or indicated in the Plans and not mentioned in the Specifications, shall be of like effect as if indicated and mentioned in both. In case of a discrepancy between any Plans, Specifications, Special provisions, or Addenda, the matter shall be immediately submitted by CONTRACTOR to the Department of Public Works of CITY (hereinafter referred to as "DPW"), and CONTRACTOR shall not attempt to resolve or 3 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 adjust the discrepancy without the decision of DPW, save only at its own risk and expense. Should there be any conflict between the terms of this Agreement and the bid or proposal of CONTRACTOR, then this Agreement shall control and nothing herein shall be considered as an acceptance of the terms of the bid or proposal which is in conflict herewith. 3. COMPENSATION CITY agrees to pay and CONTRACTOR agrees to accept as full compensation for the faithful performance of this Agreement, subject to any additions or deductions made under the provisions of this Agreement or the Contract Documents, a sum not to exceed Four Hundred Ninety-Three Thousand,Five Hundred Eighty-Nine 493 589 Dollars ($ ), as set forth in the Contract Documents, to be paid as provided in this Agreement. 4. COMMENCEMENT OF PROJECT CONTRACTOR agrees to commence the PROJECT within ten (10) working days after the Notice To Proceed is issued and diligently prosecute the PROJECT to completion within Fifty (50) consecutive working days from the day the Notice to Proceed is issued by CITY, excluding delays provided for in this Agreement. 5. TIME OF THE ESSENCE The parties hereto recognize and agree that time is of the essence in the performance of this Agreement and each and every provision of the Contract Documents. CONTRACTOR shall prepare and obtain approval as required by the Contract Documents for all shop drawings, details and samples, and do all other things necessary and incidental to the prosecution of its work in conformance with the progress schedule set forth in the Contract Documents. CONTRACTOR shall coordinate its work with the work of all other 4 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 contractors, subcontractors, and CITY forces working on the PROJECT in a manner that will facilitate the efficient completion of the PROJECT and in accordance with the terms and provisions of this Agreement. CITY shall have complete control of the premises on which the work is to be performed and shall have the right to decide the time and order in which the various portions of the work shall be performed and the priority of the work of other contractors, subcontractors and CITY forces and, in general, all matters concerning the timely and orderly conduct of the work of CONTRACTOR on the premises. 6. CHANGES CONTRACTOR shall adhere strictly to the plans and specifications set forth in the Contract Documents unless a change therefrom is authorized in writing by DPW. CONTRACTOR agrees to make any and all changes, furnish materials and perform all work necessary within the scope of the PROJECT as DPW may require in writing. Under no condition shall CONTRACTOR make any changes without the prior written order or acceptance of DPW, and CITY shall not pay any extra charges made by CONTRACTOR that have not been agreed upon in writing by DPW. When directed to change the work, CONTRACTOR shall submit immediately to DPW a written cost proposal reflecting the effect of the change. Should DPW not agree to such cost proposal, the work shall be performed according to the changes ordered in writing by DPW and the proper cost thereof shall be negotiated by the parties upon cost and pricing data submitted by CONTRACTOR; thereupon, CITY will promptly issue an adjusted change order to CONTRACTOR and the Agreement price will be adjusted upward or downward accordingly. 7. NOTICE TO PROCEED No work, services, material, or equipment shall be performed or furnished under this Agreement unless and until a Notice to Proceed has been given to CONTRACTOR by CITY. 5 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 CITY does not warrant that the work will be available on the date the Notice to Proceed is issued. In the event of a delay in commencement of the work due to unavailability of the job site, for any reason,relief to CONTRACTOR shall be limited to a time extension equal to the delay due to such unavailability. 8. BONDS Only bonds issued by California admitted sureties will be accepted. CONTRACTOR shall, prior to its performance of this Agreement, furnish the following two (2) bonds approved by the City Attorney: One in the amount of one hundred percent (100%) of the Agreement price to guarantee the CONTRACTOR's faithful performance of the work, and one in the amount of one hundred percent of the Agreement price to guarantee payment of all claims for labor and materials furnished. In addition, CONTRACTOR shall submit to CITY a bond in the amount of one hundred percent(100%) of the final Agreement price, including all change orders,to warrant such performance for a period of one (1) year after CITY's acceptance thereof within ten (10) days of filing of the Notice of Completion. 9. WARRANTIES CONTRACTOR unconditionally guarantees all work done under this Agreement including, but not limited to, any workmanship, installation, fabrication, material or structural facilities constructed. CONTRACTOR, within ten (10) days after notice by CITY of any defect in the work, shall have the option to make appropriate repairs or replace the defective item or items. Upon expiration of such ten- (10) day period, CITY may then make appropriate repair or replacement at CONTRACTOR's risk and own cost and expense. 6 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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 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 7 SFF:1 7-5732/158097/CalTrans-Federal Contract 6/17 beyond the control and without the fault or negligence of CONTRACTOR, including, but not limited to, acts of God or of the public enemy, fire, floods, epidemics, quarantine restrictions, strikes, unsuitable weather, or delays of subcontractors due to such causes. CONTRACTOR shall, within fifteen (15) days from the beginning of any such delay(unless CITY shall grant a further period of time), notify CITY 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 CITY shall be conclusive on the parties hereto. Should CONTRACTOR be delayed in the prosecution or completion of the work by the act, neglect or default of CITY, or should CONTRACTOR be delayed by waiting for materials required by this Agreement to be furnished by CITY, or by damage caused by fire or other casualty at the job site for which CONTRACTOR is not responsible, or by the combined action of the workers, in no way caused by or resulting from default or collusion on the part of CONTRACTOR, or in the event of a lockout by CITY, then the time herein fixed for the completion of the work shall be extended by the number of days CONTRACTOR has thus been delayed,but no allowance or extension shall be made unless a claim therefor is presented in writing to CITY within fifteen (15) days of the commencement of such delay. No claims for additional compensation or damages for delays, irrespective of the cause thereof, and including without limitation the furnishing of materials by CITY or delays by other contractors or subcontractors, will be allowed and an extension of time for completion shall be the sole remedy of CONTRACTOR. 8 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 12. DEMANDS FOR ADDITIONAL TIME OR MONEY A. Definitions. (1) "Change Order"means a document signed by the CONTRACTOR and CITY which authorizes an addition, deletion or revision in the work, or an adjustment in the Compensation under Section 3, or the Completion Time specified at Section 4. (2) "Demand"means a written demand for a Change Order by the CONTRACTOR for any of the following: (a) A time extension; (b) Payment of money or damages arising from work done by, or on behalf of, the CONTRACTOR pursuant to this Agreement and payment of which is not expressly permitted pursuant to Section 3 of this Agreement; (c) Payment of an amount the CITY disputes; (d) Any disputes and other matters relating to the acceptability of the work performed or the interpretation of the Contract Documents; (e) A request for a time extension or additional payment based upon differing site conditions, such as subsurface or latent physical conditions at the job site differing materially from those indicated in this Agreement or the Contract Documents, or unknown 9 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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 the Contractor has submitted a Demand to the DPW (or its written designee). All Demands shall be submitted promptly, but in no event later than thirty(30)days after the occurrence of the event giving rise to the Demand. The Demand shall be in writing and include all documents necessary to substantiate the Demand. The DPW shall act on the Demand within fifteen (15) days after receipt, including by requesting additional information from the CONTRACTOR to determine whether to approve the Change Order the Demand seeks. The DPW shall act on the Demand within fifteen (15) days after receipt of the additional information or within a period of time no greater than the time the CONTRACTOR took to produce the additional information requested, whichever is greater. 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 DPW may promptly investigate the conditions. E. If the CONTRACTOR disputes the DPW's written response on the Demand, or the DPW fails to respond within the time prescribed, the CONTRACTOR may so 10 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 notify the DPW, in writing, either within fifteen (15) days of receipt of the DPW's response or within fifteen (15) days of the DPW's failure to respond within the time prescribed, respectively, and request an informal conference to meet and confer for settlement of the Demand. Upon the CONTRACTOR's request, the DPW shall schedule a meet and confer conference within thirty (30) days to seek to resolve. F. CITY and CONTRACTOR shall execute appropriate Change Orders covering changes to the time or price by executing the Change Order by mutual agreement. If the CITY and CONTRACTOR are unable to reach a mutual agreement, then the City Engineer shall issue a written decision on the claim within a reasonable time. G. Following the meet and confer conference, if the Demand remains in dispute, the CONTRACTOR may file a claim with the CITY as provided in Chapter 1 (commencing with Section 900) and Chapter 2 (commencing with Section 910)of Part 3 of Division 3.6 of Title l of the Government Code. For purposes of those provisions, the running of the period of time within which a claim must be filed shall be tolled from the time the time the CONTRACTOR submits his or her Demand until the Demand is denied as a result of the meet and confer process, including any period of time utilized by the meet and confer process. 13. VARIATIONS IN ESTIMATED QUANTITIES The quantities listed in the bid schedule will not govern final payment. Payment to CONTRACTOR will be made only for the actual quantities of Agreement items used in construction of the PROJECT, in accordance with the plans and specifications. Upon completion of the PROJECT, if the actual quantities used are either more than or less than the quantities listed in the bid schedule, the bid price shall prevail subject to the provisions of this Section. DPW may, at its sole discretion, when warranted by the facts and circumstances, order an equitable 11 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 adjustment, upwards or downwards, in payment to CONTRACTOR where the actual quantities used in construction of the PROJECT are in variation to the quantities listed in the bid schedule. No claim by CONTRACTOR for an equitable adjustment in price or time for completion shall be allowed if asserted after final payment under this Agreement. If the quantity variation is such as to cause an increase in the time necessary for completion, DPW shall ascertain the facts and circumstances and make such adjustment for extending the completion date as in its sole judgment the findings warrant. 14. PROGRESS PAYMENTS Each month DPW will make an estimate in writing of the work performed by CONTRACTOR and the value thereof. From each progress estimate, five percent (5%) will be deducted and retained by CITY and the remainder of the progress estimate, less the amount of all previous payments since commencement of the work, will be paid to CONTRACTOR. When CONTRACTOR has, in the judgment of DPW, faithfully executed fifty percent (50%) or more of the value of the work as determined from the bid schedule, and if DPW finds that satisfactory progress has been and is being made, CONTRACTOR may be paid such sum as will bring the payments of each month up to one hundred percent (100%) of the value of the work completed since the commencement of the PROJECT,as determined in its sole discretion by DPW, less all previous payments and less all previous retained amounts. CITY's final payment to CONTRACTOR, if unencumbered, or any part thereof unencumbered, shall be made thirty-five (35) days after the acceptance of the work and the filing of a Notice of Completion by CITY. Provided, however, that in the event of a dispute between CITY and CONTRACTOR, CITY may withhold from the final payment an amount not to exceed 150 percent of the value of any disputed amount of work. Payments shall be made on demands 12 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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 CITY its affidavit stating that all workers and persons employed, all firms supplying materials and all subcontractors working upon the PROJECT have been paid in full and that there are no claims outstanding against the PROJECT for either labor or material, except certain items, if any,to be set forth in CONTRACTOR's affidavit covering disputed claims, or items in connection with Notices to Withhold, which have been filed under the provisions of the statutes of the State of California. 17. WAIVER OF CLAIMS The acceptance by CONTRACTOR of the payment of the final certificate shall constitute a waiver of all claims against CITY under or arising out of this Agreement. 13 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 18. INDEMNIFICATION, DEFENSE, HOLD HARMLESS CONTRACTOR hereby agrees to protect, defend, indemnify and hold harmless CITY, its officers, elected or appointed officials, employees, agents, and volunteers from and against any and all claims, damages, losses, expenses, judgments, demands, defense costs, and consequential damage or liability of any kind or nature, however caused, including those resulting from death or injury to CONTRACTOR's employees and damage to CONTRACTOR's property, arising directly or indirectly out of the obligations or operations herein undertaken by CONTRACTOR, caused in whole or in part by any negligent act or omission of the CONTRACTOR, any subcontractors, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, including but not limited to concurrent active or passive negligence, except where caused by the active negligence, sole negligence, or willful misconduct of the CITY, its officers, elected or appointed officials, employees, agents, and volunteers. CONTRACTOR will conduct all defense at its sole cost and expense and CITY shall approve selection of CONTRACTOR's counsel. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by CONTRACTOR. 19. WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY INSURANCE Pursuant to California Labor Code Section 1861, CONTRACTOR acknowledges awareness of Section 3700 et seq. of this Code, which requires every employer to be insured against liability for workers' compensation; CONTRACTOR covenants that it will comply with such provisions prior to commencing performance of the work hereunder. 14 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 CONTRACTOR shall maintain workers' compensation and employer's liability insurance in an amount of not less than the State statutory limits. CONTRACTOR shall require all subcontractors to provide such workers' compensation and employer's liability insurance for all of the subcontractors' employees. CONTRACTOR shall furnish to CITY a certificate of waiver of subrogation under the terms of the workers' compensation and employer's liability insurance and CONTRACTOR shall similarly require all subcontractors to waive subrogation. 20. INSURANCE In addition to the workers' compensation and employer's liability insurance and CONTRACTOR's covenant to defend, hold harmless and indemnify CITY, CONTRACTOR shall obtain and furnish to CITY, a policy of general public liability insurance, including motor vehicle coverage covering the PROJECT. This policy shall indemnify CONTRACTOR, its officers, employees and agents while acting within the scope of their duties, against any and all claims arising out or in connection with the PROJECT, and shall provide coverage in not less than the following amount: combined single limit bodily injury and property damage, including products/completed operations liability and blanket contractual liability, of One Million Dollars ($1,000,000) per occurrence. If coverage is provided under a form which includes a designated general aggregate limit,the aggregate limit must be no less than One Million Dollars($1,000,000) for this PROJECT. This policy shall name CITY, its officers, elected or appointed officials, employees, agents, and volunteers as (the "Additionally Insured Parties") as Additional Insureds, and shall specifically provide that any other insurance coverage which may be applicable to the PROJECT shall be deemed excess coverage and that CONTRACTOR's insurance shall be primary and non-contributory with any other valid and collectible insurance or self-insurance available to 15 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 the Additionally Insured Parties. Any available insurance proceeds in excess of the minimum coverage amount specified herein shall be available to the Additionally Insured Parties. All coverage available to CONTRACTOR shall also be available to the Additionally Insured Parties. Under no circumstances shall said above-mentioned insurance contain a self-insured retention without the express written consent of CITY; however, an insurance policy "deductible" of $5,000.00 is permitted. CONTRACTOR shall be responsible for causing all Subcontractors to maintain the same types and limits of insurance coverage as that required of CONTRACTOR by this Agreement. 21. CERTIFICATES OF INSURANCE; ADDITIONAL INSURED ENDORSEMENTS Prior to commencing performance of the work hereunder, CONTRACTOR shall furnish to CITY certificates of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverages as required by this Agreement; the certificates shall: 1. provide the name and policy number of each carrier and policy; 2. state that the policy is currently in force; and 3. promise to provide that such policies will not be canceled or modified without thirty (30) days' prior written notice of CITY. CONTRACTOR shall maintain the foregoing insurance coverages in force until the work under this Agreement is fully completed and accepted by CITY. The requirement for carrying the foregoing insurance coverages shall not derogate from the provisions for indemnification of CITY by CONTRACTOR under the Agreement. CITY or its representative shall at all times have the right to demand the original or a copy of all the 16 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 policies of insurance. CONTRACTOR shall pay, in a prompt and timely manner, the premiums on all insurance hereinabove required. CONTRACTOR shall provide a separate copy of the additional insured endorsement to each of CONTRACTOR's insurance policies, naming CITY, its officers, elected and appointed officials, employees, agents and volunteers as Additional Insureds, to the City Attorney for approval prior to any payment hereunder. 22. DISADVANTAGED BUSINESS ENTERPRISES. CONTRACTOR shall not discriminate on the basis of race, color, national origin, or sex in the performance of this Agreement. CONTRACTOR shall carry out applicable requirements of Part 26 of Title 49 of the Code of Federal Regulations in the award and administration of this Agreement, which has received funding assistance from the United States Department of Transportation. Failure by CONTRACTOR to carry out these requirements is a material breach of this Agreement, which may result in the termination of this Agreement or such other remedy as the CITY deems appropriate. 23. CALIFORNIA PREVAILING WAGE LAW. A. The CITY has ascertained from the Director of Industrial Relations of the State of California the general prevailing rate of per diem wages and the general prevailing rate for legal holiday and overtime work in the locality in which the work is to be performed for each craft or type of work needed to execute this Agreement, and the same has been set forth by resolution on file in the office of the City Clerk of CITY. CONTRACTOR and any subcontractor under it shall pay not less than said prevailing wage rates to all workers employed on this public works Agreement, as required by California Labor Code Sections 1771 and 1774. In accordance 17 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 with the provisions of Section 3700 of the California Labor Code, CONTRACTOR agrees to secure payment of compensation to every employee. B. Pursuant to this Agreement and in accordance with Section 1774 and 1775 of the California Labor Code, CONTRACTOR shall, as penalty to CITY, forfeit twenty-five dollars ($25) for each calendar day or portion thereof for each worker paid (either by CONTRACTOR or any of its subcontractors) less than the prevailing wage rate established for that particular craft or type of work. 24. CALIFORNIA EIGHT-HOUR LAW A. California Labor Code, Sections 1810 et seq, shall apply to the performance of this Agreement; thereunder, not more than eight (8) hours shall constitute one day's work and CONTRACTOR and each subcontractor employed by its hereunder, shall not require more than eight(8) hours of labor per day or forty (40) hours per week from any one person employed by it hereunder, except as stipulated in California Labor Code Section 1815. CONTRACTOR and each subcontractor employed by it hereunder shall, in accordance with California Labor Code Section 1812, keep an accurate record, open to inspection at all reasonable hours, showing the name and actual hours worked each calendar day and each calendar week by each worker employed in connection with the PROJECT. 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. 18 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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. 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. 28. FEDERAL PARTICIPATION Because the United States of America is providing funding for the PROJECT, CONTRACTOR shall comply with the following Federal Statutes and Regulations: A. Attached at Exhibit "B" is FHWA Form 1273, which describes required Federal contract provisions which CONTRACTOR shall perform. Additionally, CONTRACTOR shall incorporate Form 1273 into each of CONTRACTOR's subcontracts for the PROJECT, and further require each subcontractor to incorporate Form 1273 in any lower tier subcontract or purchase order. 19 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 B. Pursuant to the Federal Cargo Preference Act (46 CFR Part 381), the CONTRACTOR agrees: (1) To utilize privately owned United States-flag commercial vessels to ship at least 50 percent of the gross tonnage (computed separately for dry bulk carriers, dry cargo liners, and tankers) involved, whenever shipping any equipment, material, or commodities pursuant to this Agreement,to the extent such vessels are available at fair and reasonable rates for United States-flag commercial vessels. (2) To furnish within 20 days following the date of loading for shipments originating within the United States or within 30 working days following the date of loading for shipments originating outside the United States, a legible copy of a rated, `on-board' commercial ocean bill-of-lading in English for each shipment of cargo described in paragraph (B) (1) of this Section to both the Contracting Officer (through the prime contractor in the case of subcontractor bills-of-lading) and to the Division of National Cargo, Office of Market Development, Maritime Administration, Washington, DC 20590. CONTRACTOR shall incorporate Section 28(B) of this Agreement into. each subcontract, and further require each subcontractor to incorporate Section 27(B) of this Agreement in in any lower tier subcontract or purchase order. C. Pursuant to the Buy America Act, CONTRACTOR agrees: (1) Furnish steel and iron materials to be incorporated in the PROJECT that was melted and manufactured in the United States except: a. Foreign pig iron and processed, pelletized, and reduced iron ore may be used in the domestic production of the steel and iron materials 20 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 b. If the total combined cost of the materials does not exceed the greater of 0.1 percent of the total bid or$2,500, materials produced outside the United States may be used if authorized (2) Furnish steel and iron materials to be incorporated into the work with certificates of compliance and certified mill test reports. Mill test reports must indicate where the steel and iron were melted and manufactured. (3) To incorporate Section 28(C) of this Agreement into each subcontract and further require each subcontractor to incorporate Section 28(C) into any lower tier subcontract or purchase order. D. Pursuant to Section 402 of the Vietnam Era Veterans Readjustment Act of 1974 (38 USC Section 219 et seq.), CONTRACTOR agrees: (1) To prohibit job discrimination and require affirmative action to comply and advance in employment to (1) qualified Vietnam veterans during the first four (4) years after their discharge, and(2)qualified disabled veterans throughout their working life if they have a thirty percent(30%) or more disability. (2) To incorporate Section 28(D) of this Agreement into each subcontract and further require each subcontractor to incorporate Section 28(C)into any lower tier subcontract or purchase order. 29. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT. A. CONTRACTOR stipulates that all facilities to be utilized in the performance of this Agreement were not listed, on the date of Agreement award, on the United 21 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 States Environmental Protection Agency (EPA) List of Violating Facilities, pursuant to 40 CFR 15.20. B. The CONTRACTOR agrees to comply with all of the requirements of Section 306 of the Clean Air Act and section 508 of the Federal Water Pollution Control Act and all regulations and guidelines listed thereunder. C. The CONTRACTOR shall promptly notify the CITY of the receipt of any communication from the Director, Office of Federal Activities, EPA, indicating that a facility to be utilized pursuant to this Agreement is under consideration to be listed on the EPA List of Violating Facilities. D. The CONTRACTOR agrees to include or cause to be included the requirements of paragraph (a) thorough (d) of this section in every nonexempt subcontract, and further agrees to take such action as the Government may direct as a means of enforcing such requirements. 30. NOTICE OF THIRD-PARTY CLAIM Pursuant to Public Contracts Code §9202, CITY shall provide notice to CONTRACTOR of receipt of any claim filed with CITY or a court of competent jurisdiction which arises out of performance of this agreement within ten(10)days of receipt of such claim or claims. 31. DEFAULT AND TERMINATION If CONTRACTOR fails or refuses to prosecute the work hereunder with diligence, or fails to complete the work within the time specified, or is adjudged bankrupt or makes an assignment for the benefit of creditors or becomes insolvent, or violates any provision of this Agreement or the Contract Documents, CITY may give CONTRACTOR notice in writing of its intention to terminate this Agreement. Unless the violation is cured within ten (10)days after such 22 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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 32 and any damages shall be assessed as set forth in Section 32. 32. TERMINATION FOR CONVENIENCE CITY may terminate this Agreement for convenience at any time with or without cause,and whether or not PROJECT is fully complete upon seven (7)calendar days written notice to CONTRACTOR. In the event of termination, under this Section CITY shall pay CONTRACTOR for value of work in place on the PROJECT through the termination period less all such payments already made. In case of such termination for convenience,the CONTRACTOR shall be entitled to receive payment for work executed, and costs incurred by reason of such termination. In no event shall CONTRACTOR be entitled to recover overhead, profit or CONTRACTOR's fee on work not performed. Such payment by CITY shall be CONTRACTOR's sole and exclusive remedy for termination by CITY for its convenience and CITY shall have no further obligation to CONTRACTOR. 33. 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, 23 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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. 34. 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. 35. 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. 36. STOP NOTICES; RECOVERY OF ADMINISTRATIVE COSTS CITY shall be entitled to all reasonable administrative costs and necessary disbursements arising out of the processing of Stop Notices, Notices to Withhold, or any similar legal document. This obligation shall be provided for in the labor and materials payment bond required of CONTRACTOR. CITY may charge an administrative fee of One Hundred Dollars ($100)for every Stop Notice filed in excess of two(2),regardless of whether or not CITY is named in an action to enforce such stop notices. CITY may set off any unreimbursed cost or expense so incurred against any sum or sums owed by CITY to CONTRACTOR under this Agreement. 37. 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; 24 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 provided that CITY and CONTRACTOR, by notice given hereunder, may designate different addresses to which subsequent notices, certificates or other communications will be sent: TO CITY: TO CONTRACTOR: City of Huntington Beach PTM General Engineering Services, Inc. ATTN: Keegan Olds Attn: Elizabeth H. Mendoza de Mcrae 2000 Main Street 5942 Acorn Street Huntington Beach, CA 92648 Riverside, CA 92504 38. 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. 39. IMMIGRATION CONTRACTOR shall be responsible for full compliance with the immigration and naturalization laws of the United States and shall, in particular, comply with the provisions of the Immigration Reform and Control Act of 1978 (8 USC Section 1324a) regarding employment verification. 40. 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 25 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 CITY; and CITY shall not be liable for payment of any legal services expenses incurred by CONTRACTOR. 41. ATTORNEY'S FEES In the event suit is brought by either party to construe, interpret and/or enforce the terms and/or provisions of this Agreement or to secure the performance hereof, each party shall bear its own attorney's fees and the prevailing party shall not be entitled to recover its attorney's fees from the nonprevailing party. 42. INTERPRETATION OF THIS AGREEMENT The language of all parts of this Agreement shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any of the parties. If any provision of this Agreement is held by an arbitrator or court of competent jurisdiction to be unenforceable, void, illegal or invalid, such holding shall not invalidate or affect the remaining covenants and provisions of this Agreement. No covenant or provision shall be deemed dependent upon any other unless so expressly provided here. As used in this Agreement, the masculine or neuter gender and singular or plural number shall be deemed to include the other whenever the context so indicates or requires. Nothing contained herein shall be construed so as to require the commission of any act contrary to law, and wherever there is any conflict between any provision contained herein and any present or future statute, law, ordinance or regulation contrary to which the parties have no right to contract, then the latter shall prevail, and the provision of this Agreement which is hereby affected shall be curtailed and limited only to the extent necessary to bring it within the requirements of the law. 26 SFF:17-5732/I 58097/CalTrans-Federal Contract 6/17 43. GOVERNING LAW This Agreement shall be governed and construed in accordance with the laws of the State of California. 44. DUPLICATE ORIGINAL The original of this Agreement and one or more copies hereto have been prepared and signed in counterparts as duplicate originals, each of which so executed shall, irrespective of the date of its execution and delivery, be deemed an original. Each duplicate original shall be deemed an original instrument as against any party who has signed it. 45. CONSENT Where CITY's consent/approval is required under this Agreement, its consent/approval for one transaction or event shall not be deemed to be consent/approval to any subsequent occurrence of the same or any other transaction or event. 46. CALIFORNIA FAIR EMPLOYMENT AND HOUSING ACT CONTRACTOR agrees to comply with all requirements and utilize fair employment practices in accordance with California Government Code Sections 12900 et seq. 47. 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. 48. 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 27 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 unless in writing duly executed by both parties. The parties acknowledge and agree that they are entering into this Agreement freely and voluntarily following extensive arm's length negotiations, and that each has had the opportunity to consult with legal counsel prior to executing this Agreement. The parties also acknowledge and agree that no representations, inducements,promises, agreements or warranties, oral or otherwise, have been made by that party or anyone acting on that party's behalf, which are not embodied in this Agreement, and that that party has not executed this Agreement in reliance on any representation, inducement, promise, agreement, warranty, fact or circumstance not expressly set forth in this Agreement. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized officers on £tj,1 J£/1u, 2022. CONTRACTOR CITY OF HUNTINGTON BEACH, a municipal corporation of the State e-California s JI ' By: ~ Ma • Elizabeth McRae 9-6/411414-14) print name (*rim, ITS: (circle one)Chairm. 'residen ice President City Clerk /2/2 f22`� INITIA j i AND APPROVED: AND By: yr Director of P . is-': 1s Brian Mendoza R.NNZTE► ' ND 'PRO D: prin ame ITS: (circle one MD hief Financial Officer/Asst. +� Secretary-Treasurer City Ma a:��i APPROVED : ' '• F•RM: City Attorney 28 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 EXHIBIT A (Contractor's Proposal) 29 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 IxmBir A SECTION C PROPOSAL j• for the construction of UTICA AVENUE BICYCLE BOULEVARD from Main Street to Beach Boulevard 1 CC NO. 1499 FEDERAL AID PROJECT CML-5181(191) •• in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids,the undersigned hereby proposes and agrees to perform all the work therein described,and to furnish all labor,material,equipment and incident insurance necessary therefor,in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 50 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site,plans,specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of pae guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work,that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum • prices bid include all appurtenant expenses,taxes,royalties,fees,etc.,and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid,unit prices shall govern over extended amounts,and words shall govern over figures. C-1 If awarded the Contract,the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the • date of the AGENCY'S"_nolice 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 pption,be considered null and void. Bid bond for 10% of bid amount. Accompanying this proposal of bid,find m me 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: • v • g.2.34 2,1. • • • • • • ii C-2 . Project Bid Schedule , Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard • CC-1499 CML-5181(191) • — :,y,•'•.;Ct •.yt..{•, ,r,. a.J 'y"Nciir )��;r; •ar •.F':1' It`e' :U t'Prrc ,..: �E rided: It 'Yttn�1 i St!]71atC`. lllr, j; i..fo?:j;•as:' s '. el++!• ::._F;,. :,.fir .7•c.;a g:�� 1.Y,•:;!_ �;{:'#:•'6 . �4t� No• ` •:uantt • 1 1 L.S. Mobilization. $ ,161400 -- $ t 6q©o Pert.L.S. 1 L.S. , Furnish Project Traffic Control. $ 0 54 00' $ PSSI OU • Per L.S. 1 L,S. Preparation of projept Specific Storm Water Pollution Prevention Plan (5`0 p --" . 00 (SWPPP)• $ : .. $ ' Per L.S. ' 1 EA. Installation and naaimenence of BMP's ,per the approved SWPPP. 3004, 3 oa v '—` f $ $ Per L.S. n .__�. 21 LF Remove existing block wall and footing $ 3 5- �� • $ ' 31 `to 1 EA Construct concrete island $ 1a0 ptl #"'— $ 6 006 •'—• 7 40 LF Construct 8"median curb $ 441 � $ , P61.0..� 8 1,500 SF Remove and dispose existing A.C.and ,it t� ; j base material n' $ 9 130 LF •Remove and dispose of existing curb 1 /f 1a $ I f 33$ and gutter `�t 10 76 LF Construct 6"curb and gutter $ OF , $ ,l 11 33 LF Construct 6"curb $ tad. $ 1'q 7-— C-2.1 F . . . ' . - . • Project Bid Schedule . . i . . Utica Avenue Bicycle Boulevard Froro Main Street to Beach Boulevard . • . CC-1499 CML-5181(191) . • . _ . -.-0 '4.filii`'''' itiiiiiitea2::'5r::Y51,ii.sx.N.,vi;; -,..c.,,t:i.;ioitilek.,..... ..i..e:,..,...:,.-;,,',';‘,;,;.L'....,r,,,'.:'. ,1.,:.:- .p,.tm.,. .,,E).,;, .1,7,;,i.t,,EL.Ja..0.74,41,,..,.,.; ,p,,,c),;.i,Illvy.41.3.44 ip, .t11:;0•1'4',11 ,1:i!:',Z4:•%ig'.:1'.6.0•:"fir`ANNiMii;:', FrA-F.-gr iwaai;:::;:t•Kr::-(0%;,A4 4;4§.0. 0eS1..144.1f,v...t 12 1 LS Reconstruct existing improvements • $ ggigo-- $ ! 13 1 EA Adjust manhole to grade : $ 494160 ' Pt,OD -.... $ • • ,.. ..•: , • . 14 2 BA Finish.raw edge of wall with matching • .,_ -1.. -2,600 ..— . ' • existing material and color : $ ;' i. . • --.... c 15 113 SF Remove and dispose existing sidewalk di° go 1 —$ $ i I , 16 70 TONS Construct nevv 2"type M- 3-PO 64-10 (1/2")surface course over 4"class B- $ PG 70-10(3/4")base course over 1.0' C.M.B. . • I 1 17 100 TONS .Construct 1' crushed miscellaneous I I CO. ' $ i 8 aoe' • base _. _ ... 18 3 EA Construct Curb Access Ramp on . northwest,northeast and southeast q' 0 0 ' 4 q 90 : ;comers at Lake Street/Utica Ave pm $ $ . . . Caltrans Standard Plan No,RSP A88A Case A and Details on Sheets 3 and 4. (Item.includes all appurtenances,curb and gutter,depressed c-uxb,sidewalk, , domes,retaining curb, slot pave,etc.) - Per EA. • . . . C-2.2 4 1 Project Bid Schedule • Utica Avenue Bicycle Boulevard • Prom Main Street to Beach Boulevard • • CC-1499 ClvEL-5181(191) . ' 19 1 EA Construct Curb Access Ramp on southwest corner Lake St/Utica Aveper Caltrans StandardPlanNo.RSP A8SA 114140 — ?1,0 and Detail on Sheet 4(Item includes all $ • - $ . . a.ppurteriances,curb and gutter, depressed curb,sidewalk, domes, • retaining curb;slot pave,etc.) S • Per EA. • 20 1 L,S. Install traffic signal at the intersection .r"" • of Lake Street and Utica Avenue (excludes curb ramps and city furnished - equipment) gi(0 $ aV015-4i. S- I •• Per L.S. 21 1 L.S. Furnish and install signing and striping. • $ $ • C-2.3 Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) . . • Total Amount Bid Total Amount Bid in Figures: • • Total Amount Bid yiu Words: N leYie.,. ).(1141 4444 0;*---41/6 Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (also includes anchor bolts)to the contractor. The contractor is to pick up the materials, with its own labor, at the City Yard, 17371 Gothard Street. Contact traffic signal maintenance two working days in advance for pick up at(714)536-5530, • C-2,4 ,wx c'r rF4ft.'.'1;wow;;; ;> .. • LIST OF SUBCONTRACTORS • tt I -- In accordance with Government Code Section 4104,the Bidder sha.l scr forth the name and business address' 1 ' ' ' 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$10,000,whichever is greater,and the portion of the work tube done by s't c t subcontractor. j �j ('� l�F8SQ.17f d� tU1 ,• Y �u?j sN r:' �" 443�i!mfii.r�J A. :„v ok"t `r .,k,: ogi9bCe b,4 �C l f�)tt811 t,;,!��7[LlRC D ie�s �ti �a„ c : u� � �. 1 llb s}tZt•(1ctOT� - • �,,i, %"1�4�� �� �$tS�' i: ,i .� r �' . S �t8'1. '31�11��1��,��0�+ � ` 'S'��lS L • '�, p� c 'f� �( 0a . . � u� era- : . ®I nAr .4t hµ; iii•tides" •MaoItric,fry w'P ' ► 4 ' • 6t4/4410" Pat,v/HI 404 rip � 1� `00 f0 $0a� + �,/' , • , , • 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 A I. NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID • I declare under penalty of perjury under the laws of the State of California that the foregoing is true and • correct and that this declaration is executed on 23rd ,at August, 2022 Riverside, CA • • Date City State • Elizabeth H. Mendoza de McRae , being first duly sworn, deposes and says that he or she is President/CFO ofPTM General Engineering Services, 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. PTM Genel Engineering Services, Inc. Ak Name o er ..beth H. Mendoza de McRae President/CFO S. •ature of t dder •corn St. Riverside, CA 92504 Address of Bidder C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the UTICA AVENUE BICYCLE BOULEVARD,(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. PTM G• eral En••i--ring Services, Inc. Contr.• or • Elizabeth H. Mendoza de McRae By President/CFO Title 08.23.2022 Date: C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162,the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder,any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? Cl Yes ( No If the answer is yes,explain the circumstances in the space provided. • Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 I . COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code,each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. PTM neral Engineering Services, Inc. Contrac Elizabeth H. Mendoza de McRae By President/CFO • Title 08.23.2022 Date: • C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: PTM General Engineering Services, Inc. Bidder Name 5942 Acorn St. Business Address Riverside, CA 92504 City, State Zip 951 )710.1000 elizabeth@ptm-eng.com Telephone Number Email Address 891265 Class A;C10 State Contractor's License No. and Class 02.2007 Original Date Issued 02.2023 Expiration Date The work site was inspected by Brian Mendoza of our office on 08.23 ,202_2. The following are persons, firms, and corporations having a principal interest in this proposal: Elizabeth H.Mendoza de McRae, President/CFO Brian Mendoza,Vice President/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. PTM General Engineering Services,lnc. Co ame ,L . Signature of Bidder Brian Mendoza,Vice President/Secretary Printed or Typed Signature C-8 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 ofLOS ANGELES On o •ol 3 before me, PHILIP VEGA, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared BRIAN MENDOZA Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/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 <yE,L°I;: PHILIP VELA is true and correct. Notary Public-California WITNESS my :nd a d official seal. Los Angeles County > Commission#2327592 �k,roa My Comm.Expires May 31,2024 Signature 4 iv-/ Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑Corporate Officer — Title(s): ❑Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Partner — ❑ Limited ❑General ❑ Individual ❑Attorney in Fact ❑ Individual ❑Attorney in Fact ❑Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other: ❑ Other: Signer Is Representing: Signer Is Representing: r�rr c ss y ^m:gews,..gwa ©2014 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 NOTARY CERTIFICATE Subscribed and sworn to before me this_day of , 202_ 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 Bidder's Project History • For the purposes of this project, the bidder shall provide project history of similar work, specifically referencing the construction of traffic signals,curb&gutter and sidewalk. 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. Caltrans 1727 30th St.MS43 Sacramento, CA 95816 Name and Address of Public Agency Mr. Dimitar Dimitrov R.E. 559.999.5733 • Name and Telephone No, of Project Manager: $1,296,296.00 Electrical monitoring stations in Kern County. 11/2020 • Contract Amount Type of Work. Date Completed ( Provide additional project description to show similar work: CDOT 06-0T0104 • 2 County of Riverside Transportation Agency • Name and Address of Public Agency • Name and Telephone No.of Project Manager:- Mr.Joel Jimenez, R.E. 951.955.1537 $442,224.00 T.S.and Lighting Project Gilman Springs and Bridge St. 12/2019 • Contract Amount Type of Work Date Completed Provide additional project description to show similar work; 3 Caltrans 1727 30th St. MS43 Sacramento,CA 95816 Name and Address of Public Agency • • Mr.Ryan Pham, R.E. 626.339.1601 • Name and Telephone No.of Project Manager: Electrical,Asphalt,and Concrete Work at Various Locations 02/2022 • 11,457,077.00 in Los Angeles and Ventura County 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, Brian Mendoza 1, Name of proposed Project Manager 951.722.5755 • Telephone No, of proposed Project Manager: CDOT 06-0T0104$1,296,296.00 Electrical Monitoring Stations 11/2020 • Completed Project Name&Contract Amount Type of Work Date Com p Riverside County T.S Ltg at Gilman and Bridge St. Electrical 12/2019 Completed Project Name&Contract Amount Type of Work Date Com P CDOT 07-340604 Electrical,Asphalt, 02/2022 • $11,457,077.00 Civil work in Ventura and Los Angeles County Completed Project Name &Contract Amount Type of Work Date Com p • Brian Mendoza 2. Name of proposed Superintendent 951.722.5755 Telephone No. of proposed Superintendent: Same as above • Completed Project Name&Contract Amount Type of Work Date Com p Same as above. • Project Name&Contract Amount Type of Work Date Completed Same as above. Project Name&Contract Amount Type of Work Date Completed • • C-11 . CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854(citing Labor Code Section 1771.1(a)),passed by the California State Senate on June 20, 2014, established a new public works Contractor Registration Program, which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July 1 through June 30 state fiscal year) with the California Department of Industrial Relations (DIR). Currently the annual non-refundable registration fee for Contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 http://www.dir.ca.gov/DLSE/PublicWorks/SB854FactSheet 6.30.14.pdf DIR's Contractor Registration Link—Call(844)522-6734 https://efiling.dir.ca.gov/P WCR/ActionServlet?action=displayP WCRegistrationForm DIR's Contractor Registration searchable database: https://efiling.dir.ca.gov/PWCR/Search.action I am aware and will comply with the provisions of Labor Code Section 1771.1(a)which states: "A contractor or subcontractor shall not be qualified to bid on,be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725.5.It is not a violation of this section for an unregistered contractor to submit a bid that is authorized by Section 7029.1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract Code,provided the contractor is registered to perform public work pursuant to Section 1725.5 at the time the contract is awarded." I furthermore will comply by providing proof of registration with DIR as the primary contractor, as well as for ALL subcontractors at the time of submitting the bid. PTM General E ineering Services, Inc. Contractor By elizabeth@ptm-eng.com Email Elizabeth H. Mendoza de McRae, President/CFO Title 08.23.2022 Date: PWC Registration#: 1000001433 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 I this project. Will award 10%of its sub-contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub-contracts related to this project. Contractor: PTM General Engineering Services, Inc. Contact P on: lizabeth H. Mendoza de McRae Contact Phone: 951.710.1000 Signed: Date: 08.23.2022 *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. PTM General Engineering Services Inc.will do what is necessary to comply. PTM does not anticipate any new hires. However, if for any reason it is necessary to hire new employees it will do as required. C-13 EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder X,proposed subcontractor XX has not participated in a previous ,hereby certifies that he has > p p contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. C-14 PUBLIC CONTRACT CODE I - PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby ! declares under penalty of perjury under the laws of the State of California that the bidder, has been XX has not been convicted within the preceding three years of any offenses referred to in that section,including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon,award of, or performance of,any public works contract,as defined in Public Contract Code Section 1101,with any public entity,as defined in Public Contract Code Section • 1100, including the Regents of the University of California or the Trustees of the California State • University. The term"bidder"is understood to include any partner,member,officer,director,responsible managing officer,or responsible managing employee thereof,as referred to in Section 10285.1. • Note: The bidder must place a checkmark after "has" or"has not" in one of the blank spaces provided. The above Statement is part f the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this` ement.Bidders are cautioned that making a false certification may subject the certifier to criminaiprosecu on. \Elizabeth H. Mendoza de McRae President/CFO 08.23.2022 • Signature Print Name Date PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury,the following questionnaire: Has the bidder,any officer of the bidder,or any employee of the bidder who has a proprietary interest in • the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal,state, or local government project because of a violation of law or a safety regulation? Yes XX No • If the answer is yes,explain the circumstances in the following space. C-15 PUBLIC CONTRACT CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232,the Contractor,hereby states under penalty of perjury,that no more than one final unappealable fording of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply • with an order of the National Labor Relations Board. • Note:The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosec ion. Elizabet H .Mendoza de McRae 08.23.2022 President/CFO I Signature Print Name Date C-16 Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY of Huntington Beach DEPARTMENT OF PUBLIC WORKS'. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of,any undisclosed person,partnership, company,association,organization,or corporation;that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded,conspired, connived,or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement,communication, or conference with anyone to fix the bid price of the bidder or any other bidder,or to fix any overhead,profit, or cost element of the bid price,or of that of any other bidder,or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true; and,further,that the bidder has not,directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto,or paid,and will not pay, any fee to any corporation, partnership,company association,organization,bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above No llusi Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereo also constitute signature of this Non-collusion Affidavit. Bidders are c ti ed that making a false certification may subject the certifier to criminal prosecutio Elizabeth H. Mendoza de McRae President/CFO 8.23.2022 Print Name Date C-17 DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS,PART 29 The bidder,under penalty of perjury, certifies that,except as noted below,he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: • is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any Federal agency; • has not been suspended,debarred,voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending;and • has not been indicted,convicted,or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification,insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above,indicate below to whom it applies,initiating agency,and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute sit+ .; e of this Certification. Elizabeth H. Mendoza de McRae 08.23.2022 President/CFO Sign. Print Name Date • C-18 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. fr Elizabeth H. Mendoza de McRae President/CFO 08.23.2022 Signa,, Print Name Date C-19 N/A=Not Applicable Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities EXHIBIT 10-Q 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: N/A a. contract N/A b. grant a. bid/offer/application ❑ a. initial b. initial award ❑ b. material change c. cooperative agreement d. loan c. post-award N/A 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: I I Prime n Subawardee N/A Tier ,if known N/A Congressional District,if known Congressional District,if known 6. Federal Department/Agency: 7. Federal Program Name/Description: N/A N/A CFDA Number,if applicable 8. Federal Action Number,if known: 9. Award Amount,if known: N/A N/A 10. Name and Address of Lobby Entity 11.Individuals Performing Services (If individual,last name,first name,MI) (including address if different from No. 10) N/A (last name,first name,MI) N/A (attach Continuation Sheet(s)if necessary) 12. Amount of Payment(check all that apply) 14. Type of Payment(check all that apply) $ N/A ❑ actual n planned a. retainer b. one-time fee N/A 13. Form of Payment(check all that apply): c. commission Aa. cash N/A d. contingent fee b. in-kind;specify:nature e deferred Value f. other,specify 15. 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 • (attach Continuation Sheet(s)if necessary) 16. Continuation Sheet(s)attached: Yes No 15 I 17.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: Elizabeth H. Mendoza de McRae 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any President/CFO person who fails to file the required disclosure shall be subject Title: to a civil penalty of not less than$10,000 and not more than 951.710.1000 08.23.2022 $100,000 for each such failure. Telephone No.: Date: Authorized for Local Reproduction Federal Use Only: Standard Form-LLL Standard Form LLL Rev.04-28-06 Distribution: Orig-Local Agency Project Files C-20 Page 1 LPP 13-01 May 8,2013 Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities INSTRUCTIONS FOR COMPLETING EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES • This disclosure form shall be completed by the reporting entity,whether subawardee or prime federal recipient at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C.Section 1352, The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information, 1. Identify the type of covered federal action for which lobbying activity is or has been secured to influence,the outcome of a covered federal action, 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which the change occurred. Enter the date of the last,previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name,address,city,state,and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to: subcontracts,subgrants,and contract awards under grants. 5. If the organization filing the report in Item 4 checks"Subawardee"then enter the full name,address,city,state,and zip code of the prime federal recipient. Include Congressional District,if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name,if known. For example,Department of Transportation,United States Coast Guard. 7, Enter the federal program name or description for the covered federal action(item 1). If known,enter the full Catalog of Federal Domestic Assistance(CFDA)number for grants,cooperative agreements,loans and loan commitments. 8, Enter the most appropriate federal identifying number available for the federal action identification in item I (e.g.,Request for Proposal(RFP)number,Invitation for Bid(IFB)number,grant announcement number,the contract grant.or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes,e.g.,"RFP-DE-90-001," 9. For a covered federal action where there has been an award or loan commitment by the Federal agency,enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5, 10. Enter the full name,address,city,state,and zip code of the lobbying entity engaged by the reporting entity identified in Item 4 to influence the covered federal action. 11, Enter the full names of the individual(s)perfonning services and include full address if different from 10(a). Enter Last Name, First Name and Middle Initial(M1). 12, 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. 13. Check all boxes that apply. If payment is made through an in-kind contribution,specify the nature and value of the in-kind payment. 14. Check all boxes that apply. If other,specify nature, 15. 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. 16. Check whether or not a continuation sheet(s)is attached. 17. The certifying official shall sign and date the form,and print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30-minutes per response,including time for reviewing instruction,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information, Send comments regarding the burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project(0348-0046),Washington,D.C.20503,SF- LLL-Instructions Rev.06-04 C-21 Page 2 LPP 13-01 May 8,2013 Local Assistance Procedures Manual Exhibit 15-G • Construction Contract DBE Commitment • i EXHIBIT 15-G CONSTRUCTION CONTRACT DBE COMMITMENT ; i • 6% • I 1.Local Agency: The City of Huntington Beach 2.Contract DBE Goal: - 1 1 3.Project Description: Utica Avenue Bicycle Boulevard ' I 4.Project Location: Utica Avenue(Main Street-Beach Blvd) ` j5.Bidder's Name: PTM General Engineering Services, Ines.Prime Certified DBE: fX 7.Bid Amount: "Z 3 t] • • { 8.Total Dollar Amount for ALL Subcontractors: 21 SSe -- -- 9.Total Number of ALL Subcontractors: 2 I• i ' 10.Bid 12.DBE 14.DBE Item 11.Description of Work,Service,or Materials Certification 13.DBE Contact Information Dollar Number Supplied Number (Must be certified on the date bids are opened) Amount t d42 1-vaffix. _► ai 35(i 1 o W C�or gviginmsi 7 5.2 • 1 0 - 1001. 1 c. 2 - tub r of-trria,� tac+�2 ptco-Yr 5-1- 1 s 2qu, .�--V( rn)h . 151 - q-2Z - 56 S • •. Puflio n of mob, c T/c j Fz Loca,Agency to Complete this Section upon Execution of Award t 21 i Local A enc Contract Number 1}i1 4,, I rl e., ',`' t !,, g y�.i4 lit..i•r 1 • b7-745z - 9" y I '" :t' 15,TOTAL CLAIMED DBE PARTICIPATION `^ t Mil:i �`4� rF�:±� '". ,.,' .,,F.;4,.. `22.•Fede�al:Afd Project F uinber'';a,-"IIV.i=',;: r , k 1,. ,;.•i i a,•i ,7 , {� � ,., 1t111 56 0 1 .�t-.;; lr ?ileti ` It!'-e4-�:i4 ° r!.1, b ' iki ti• Wyk F ! " 23 Bid Opening Date*� a, s . t i s * ti Y r 1 k r !.rk.i•:..:is`,T.ir.' i 11 51J iy q, ,,I,'9 I I 24,"ConfracfAward Date; c i,.ha ,. ? GI 1 r l•,ai..,-. Award Amount: Pill IMPORTANT: Identify all DBE firms being claimed for credit, s I 25. - regardless of tier.Names of the First Tier DBE Subcontractors and : ;�;-...:. ,;,;:,�• 4.,, "!;;,is;V ,,;�k.-s41-4 ;=et; ;SI;: ice.,:<;;'iaG 1, their r- •ective item(s)of work listed above must be consistent,where hilt;�;`Fi i 1r +'r` .;,;,ni 4: 1:4.1� ,,1 ft-:`:I! ., 't?t +.. , �d I`.l:h.r rt appli•= :with the names and items of the work In the Subcontractor . I Lopal Agency certifies that al�.DBE��rtifications are valid and information on List"s•. itted with your bid.Written confirmation of each listed DBE �v 1 this form ls'comrplete and accurate, (- j l+ '{ij1 h�`if k I w '1 C'i: I Kai iil; is requi 8.30.2022 1y 41i ;.%,..i +Lik 1lf`.� i Ir ;V i14rn rot n 1 + �-S7G' iti.:- kr,l Aq I'' . . r 1i '7 79 'a 3 t4 4m 26•:Local Agency Representptive s Sfignature ,',27 Dates t 5 i I I' 16 •-repare -Signature 17.Date ,�,ti z -s l•.:Nat 2,4 it ll tr al• i il414��it i;3. r�,may i ''i 5,7 tS 1.,i,sL §+'P ii"-jl e;•; lizab- • H. Mendoza de McRae 951.722.5678 tat 1 i '`t...r 4 t28 LocalAngency Representatives Name ' iJ;29 Phone ',4,0 ;ii'5 �t 18.Preparer's Name 19,Phone 1 13 4! 4, �a. �•t il- Ti., it's I g'�?;t 1.1 K a 't; ;{r' j.fii111j 7'',,,4i"ryit`A�I e 1,k_.ti., President/CFO I '� j '30.Local AgencyRepresentatiyesTitle,4rk,.,r y}.�,� Y'u;}p5'}1rFu-4,,,=._h, ', 20.Preparer'sTitle t DISTRIBUTION: 1.Original-Local Agency 2.Copy-Caltrans District Local Assistance Engineer(DLAE).Failure to submit to DLAE within 30 days of contract execution may result In de-obligation of federal funds on contract • 3.Include additional copy with award package. • ADA Notice: For Individuals with sensory disabilities,this document Is available In alternate formats. For Information call(916)654-6410 orTDD(916)654-3880 or write Records and Forms Management,1120 N Street,MS-89,Sacramento,CA 95814. Page l of 3 • C-22 January 2019 Local Assistance Procedures Manual Exhibit 15-H Proposer/Contractor Good Faith Effort EXHIBIT 15-H: PROPOSER/CONTRACTOR GOOD FAITH EFFORTS Cost Proposal Due Date PE/CE 08.23.2022 Federal-aid Project No(s), CML-5181(191) Bid Opening Date CON The City of Huntington Beach established a Disadvantaged Business Enterprise(DBE)goal of 6 00%for this contract.The information provided herein shows the required good faith efforts to meet or exceed the DBE contract goal. Proposers or bidders submit the following Information to document their good faith efforts within five(5)calendar days from cost proposal due date or bid opening. Proposers and bidders are recommended to submit the following information even if the Exhibit 10-01:Consultant Proposal DBE Commitments or Exhibit 15-G: Construction Contract DBE Commitment indicate that the proposer or bidder has met the DBE goal.This form protects the proposer's or 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. The following items are listed in the Section entitled"Submission of DBE Commitment"of the Special Provisions, please attach additional sheets as needed: 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 Prime DBE 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 Solicitation Follow Up Methods and Dates Prime DBE C-23 Page 1 of 3 May 2020 Local Assistance Procedures Manual Exhibit 15-H Proposer/Contractor Good Faith Effort C. The items of work made available to DBE firms including those unbundled contract work items into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation in order to meet or exceed the DBE contract goal. Items of Proposer or Bidder Breakdown of Amount Percentage Work Normally Performs Item Items ($) Of (Y/N) Contract 0.00% LPICk Ex �} 0.00% iPIC�C s: 0.00% Pick }, F3 0,00% D. The names, addresses and phone numbers of rejected DBE firms,the reasons for the bidder's rejection of the DBEs,the firms selected for that work(please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: Names, addresses and phone numbers of firms selected for the work above: E. Efforts (e.g.in advertisements and solicitations) made to assist interested DBEs in obtaining information related to the plans, specifications and requirements for the work which was provided to DBEs: C-24 Page 2 of 3 May 2020 • Local Assistance Procedures Manual Exhibit 15-H Proposer/Contractor Good Faith Effort F. Efforts(e.g.in advertisements and solicitations) made to assist interested DBEs in obtaining bonding, lines of credit or insurance, 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 Prime DBE H. Any additional data to support a demonstration of good faith efforts: C-25 Page 3 of 3 May 2020 „> z hs 7*^ igti.r�,... -,M:1,75i.:.ti:Jr1x v tg��> fir. ; 47Ra ,,,,.g' ;7"is4'tR.;:r i a. `4 iris, q �'.\''1::n'`Yi.:.MV....'!we.::'.Nri '',' •4i 1 /.t74 t.�.: ( .>� � *'T P .Mx:', .. F y.,. '� �:, '.;4�, ,:r%'g ,:a+ ..kt ;. ,r,,dt�eY�rr; ^I,r�.Pr.,c�. •''"l;,.tits�' a,a�,.,�Y�.'•>2;. ..six :.y,�;�:�.� :” ., .�J,N"�;. e •,•5,.:., ,!h�,x�i"X..,:as,: �', . 1. ..I. y,:'r�a'..-,�.>p., .^.rt?,,�.�,�'a�ire.,, :�1,. � .... �tdy,)is,ry ',+., .�'+ '±�Ff, a::"> >yvp�,,... .}r,.,.,-,, .1 r�• - . 7, Local Assistance Procedures Manual ' • - Exhibit 12-6 Bidders List of Subcontractors(DBE end Non-D5EI- ' • Exhibit 12-B: Bidder's List of Subcontractor (DBE and Non-DBE) -Part 4 ;Ali of March 1,2015 Contractors(and sub-contractors)wishing to bid on public works contracts must be registered with the State Division of Industrial Relations and oesttiried to bid on Public Works contracts,Please register at https;Awww.dir.ca.gov/Pubiic-Works/Contraotor. Reg istration.titml.The local agency'wlitverify registration of all contractors and subcontractors on publibworks projects at bid and thereafter annually to assure that yearly registration le maintained throughout the life of the project, In accordance With Title 49,Section 26.11 of the Code of Federal Regulations,and Section 4104 of the Public Contract Code of the State of California, as amended,the followin0 information is required for each sub-contractor wh o will perform work amounting to more than one half of one percent(0.5%) of the Total Ba.$e Bid dr$10,0DO{whichever is greater). . . . . FEDERAL PROJECT NUMBER; Photocopy thisform for additional flrms. • , • CML5181(181) Subcontractor Maine&Looenon Llna lien&Description 5Ubcontraot Pereentaga of Contractorilcenae Number OBE bts$Cert N,,,,,b, Annual Gross Racelpte Amount Bid Item (.YiN) SubtnctQd DM Rag Number ,. NAME f rti Ji a • g163g37 — 4�75-.4?�"7- re. minion blry,Suk _' J I v i ( C (f c$15 million bIPrhCVO.-bit' !' • id'iw 91+/tljl Aga dptrmIn tp�. __ r l L, ... worm jrcY_ L 14�4it 4$5!Millen m* lo • 41 aist e 2,14ae,.r • <ODlegion cly,jab .. ('t3typ,�AtQr il+t�:tlb,/ WO V.• k$15 melon y,, • i Pee rA Firm In l h�+`S ir 1•�+t� ,bars NAME ] =Si million <S5million _ K 0minion City,Side c$15 mt I •Age or Finn in NAME �/ L `Ssy'I m111ion i7I((.M'it�✓r� j/Lit1y/f' t7�t r ,�lbtgG' (QGl /. �jdl� ^ t SS minion �, it 4 SIB Million RR olty,Stele <51Bm1111on Cifri�W a popooli Age a Firm in to `"'��//ff�r yams NAME • IA St million c 55 mmien • c SlbMillion City,Stale 4515tnillion • Age of Firm in l .s. - year r NAME • <$tmillion , c$E mutton c$10 million Ole,Stale 1 —'� �` eiiSMillion r Aga or Firm in ' yews NAME . c$1 mggm - c a5 Million c g10 million City Stole <gt5million Aye of Firm In years c$1 million NAME c$5mllllm c 510 million •Ltty,Stara '� c'$15 million Aloof Firm in yaws c$i mii(Irpt NAME c 55 million .$10 million City,State i 515 million Apo!Firm in years Distribution—Original:LocalAgency rile;Copy:DLAE w/Award Package C-26 Page 1 of 2 September 2021 • 0 Local Assistance Procedures Manual exhibit12-B Bidder's List of Subcontractors(DBE and Non-DBE) . Exhibit 12-B: Bidder's List of Subcontractor (DBE and Non-DBE) -Part 2 In acCo rd an ce with Title49,Section 28 of the Code of Fed Aral Regulations,the Bidder shall list all subco n tractors whop rovidad a q note or bid but were noteelected to prtJcIpata as a subcontractor on this protect _ •• FEDERAL PROJECT NUMBER: Photocopy this form for Additional firms CML-5181(191) Suboontltotor Nam.bl,00aIet1 • LlneItione:Deacriplion SAoonutnr a Peamarof Got-1.7..l"I.eb Nrnber bYe) DBE CetNumbar. Annual Gross moots �ye subAoo�-ntmctat1 'DIIIR1Ra➢Number eY� l�bj .ia� W ,rrr��� y <$1mUUon �,/t�i� .M ����r�r Ssmiat v{'Wt� y�• 1eicK •+ r1kp r•. !.1' <BltlmIIII0 " r-y cay,suro64- 'T ` i <;>�mllllon rlI4-�41 4 y MaH,0 c: sn a1 '©l�.'" t t]['�alo 30�A'Jr ., Age ofFirm.m 1517 NAME ! / ..t$1 million /y�f �,I,,',.p //�,,,��,/ '�i�' �� I9®f /f_� / (� c$5miUfon k adVl�vac,4. G ( tt •'�-' m"O•? ' ) �r ! ' <S101nlllim city.Mate ��,'_,t to j J cZ"(f! 6 ' a395mtnroo > CIJYLvwcc.. 194E1J 61801 i Agog?�°�— •g lie."" - . I. waver— yw, 3 f +S1 moon •�'N�A^ME �/p�i // Y�9f' ��l! 5�q� • �,<�g5milrwn .+t-r �I(R+y,�Yl�tt RJr- f -'(1 ^ oiiommcm Clly.Slat• . ! 'IQ�4a'ki I • {` cIt15million /kWV itt. .. a�k3�� AaadFlmlm 0e0;1 ,1d;f . 0 A R re. /6t, 7. m. rah NAME I 53, <$lmillion e V d..„4.. Pt J��i �� l -�•"�/ `�f 6 )4,4$9million City.stale { y,_ <,,"15Atlllion �414.1.s.,,,f4--64 r I: WM:- 1ptJs+d if 3Q[-Y' Ag..rem ,..1-- NAME ..-•u 64461. _ '$1 million ``�/�, Q, "� `�� /� � SEmillion &t L+'4V ,690d, LAiv►. '+f r-v • r '4" `J J j 3117+ _ <y-lomgllorl ^� l,. et f j(�,� `YR1,.• c9ismlllial City,elate tQl fr /] yy�� •• 90"i71[. �' 1 ov ,s o�i820 DOOi? T>e AsedFsm in r'Bf�` years . �/ /, <Si million NAME '9 9-f dot *rile) ti5mnlion �( • oj� � `_ '_ /, „L� - 4$10milian city,std. /� (+17vte'/', p p.1r.^ 1 �y 1 4ti6mllllon 4.2445a... [.d1• 4 .lb i 1 00 D 6 f 3�j i ADeorear. In ta'f- rt t I// c Si million /? ,igp /►NAME , .rf /Ad: AA ��TVjb� a �c <$11SS 3m1bn City,Slate II a afFirm ion "� orb+i✓Jy(fly �'• + Ito 0/5•" r0vdoa0 204 .... Ago Firm In ta.�„ NAME ' ,,/. a Si million not d$5 million actchWiral' �"� i1QQ• it>,$? �J r''d<S10millien ily,Slate sfrege611/1, 11 D GJ/ r yMw ) 7 0 yowlc d1 million NAME 'L ,I1� 1413907 90 .e.$6mian ..�41 Yf/J�,,A�1,,L•(/�� 7[�� Jt7ptL(,A��l�� .Vry1� 7 � /(J - 4 rcytDmltllai .rp.is minion Clly, 1 U i.� d�jdvt?'' I COO 3?Va eyeerem it Lvi- - ',Pt .a, . Law . . _ Diatribe ion.-Original:Local Agency File;Copy:DLAE w/Award Package ' C-27 Page 2 of 2 • September 2021 Loco(AssistanOa Procedures Manual t xh'ib1t.12•B Bidders LIelofSubcodtra'ctar3(DBE and Nan-DBE) • — Exhibit 12-B; Biddot"s•List of Subcontractor (DBE and Non-DBE)-Part 2 In el:con:lab ce with"filie 48,gentle:1.28 Odle Code of Federal Rep uletion S,the Bid ri er sh alt listed;eubcontractors.who provided aquatopr bid but' 'Were not seIecteid to.pertjcipataseaaubcon trade ron this projecL, • FED llitALPPOJECTNUMNEtt. Photocopy this form for additional firms.. CML-61 a1(191) .SuboSidradtorHarlin&Loesgon • ;Inn Iteni'Abesenplton Bubaontraat. Parcartagsot COhtMrforLloanoo,Nlanb'd Dag ppE:GsrtNumbor Annul OrowRaoerpta Amount e1411rm • MN) Suboontr tad, vin Ray Number //NAME •''y� /'� ,r �yj�• r� 1yl' �S�m@Idn ratO city Stele,• y`, AI(315MIlllm /) / /, 6,Mf!3.Gt " la O Dn bp ADe m.ln +�'t"` V. 4d . 1 1f�1R.1L��� •li6S - <sfmuum �p�,J /�,, %�� ,y,, 1 • �,� per, �/j aSSmllnol! O/- 4fr"f•(.�Q/C� *5° r1 tykit t -e. 264.0?3 �L r ,.� <51Dmllllm • Gay,nt42 (Mad/ r�r�+'� _ —l! 4316TIIIlo7 A C 1A/N "IT Act (Q 4 O l4Jr' l _ ..� rev ritIn�ti'--. NAME ( a 51 mllltmn' 4 e5mlllton <ktomite •City,Slim e415m11 1 — .Ayedrtrm'yA . *tits WIMP - <ti5m51ito. 'SID'mlDlom ' .Clly.adle. • 4VETIOImn. AyadFlitn�h Part' IOW rbt meet NAME' - 4 osmium <51O mhtie1 bRy,Mato e S16 mldlmn • ;Or/Firm i11 . • year* NAME — — 49,1ni111m <86mtligi ' 4F'1bm511an any,Scale e.615mlllim Apso(FAm,N ' years - ` e a1 m111Wn NAME , i• L. ...SS natal City,Malt. .........- 1 4215A1s1 ApiorFiml In yews NAME ' e Pt rpillItn <i6 mlUrdt <slomillim Clty„Sieta <.416m1Ilio` Ags.d'FentIn , -yI ... 4 yy mllllan NAME <1;Sminian 4 5:IOtot lie Dlly,SI M' misinilllot Aflticf trm In L • years !Distribution-Original:Loos IAliency Pile;Copy;.DLAg WIAward Package C-27 Pape 2of2 Beptember2021 • N In H 2O N O • �, 0 w 67 O CUN W 0 d o ti 0 ,04 U 1 v a p a stF c m x a� m O o O a OO o°h U O E , E t c6U NNI.X. 4 t t `C � yN 0 ] 0 , C b CO H C al D 'o e, F h. m 0to m K m m € o g °� A ` w °w m o d aLi z o m E 0 C n C ¢ U $ 0 z Z .0 1 W , 8 a Is d o `0 P:iZ o N N 8 C G Q N c L.) 2 O c4 C -J tf K Q� W w.° d F- 1661 O0 CO v (6 CO m,p 0 O $ U O an CG o F E F- A a O a ed W �Uz � o LLO N 0 W F w 5 c b� a z c d 8 A Q my O E W m w _ N D C Z LL Is O .0 N o a Z w r •r.+ c4 J ,E y 0. a) 8- 0 3 M 41 y Z a N = A co y of O a) Z !. 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F- Q 0 3o • co0 _Z J 0 N O Q Local Assistance Procedures Manual Exhibit 17-F Final Report-Utilization of Disadvantaged Business Enterprises(DBE) and First-Tier Subcontractors INSTRUCTIONS—FINAL REPORT-UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES (DBE)AND FIRST-TIER SUBCONTRACTORS 1. Local Agency Contract Number-Enter the Local Agency contract number or identifier. 2. Federal-Aid Project Number-Enter the Federal-Aid Project Number. 3. Local Agency-Enter the name of the local or regional agency that is funding the contract. 4. Contract Completion Date-Enter the date the contract was completed. 5. Contractor/Consultant-Enter the contractor/consultant's firm name. 6.Business Address-Enter the contractor/consultant's business address. 7. Final Contract Amount-Enter the total final amount for the contract. 8. Contract Item Number-Enter contract item for work, services, or materials supplied provided.Not applicable for consultant contracts. 9.Description of Work,Services,or Materials Supplied -Enter description of work,services, or materials provided. Indicate all work to be performed by DBEs including work performed by the prime contractor/consultant's own forces, if the prime is a DBE. If 100%of the item is not to be performed or furnished by the DBE, describe the exact portion to be performed or furnished by the DBE. See LAPM Chapter 9 to determine how to count the participation of DBE firms. 10. Company Name and Business Address-Enter the name, address, and phone number of all subcontracted contractors/consultants.Also, enter the prime contractor/consultant's name and phone number, if the prime is a DBE. 11.DBE Certification Number-Enter the DBE's Certification Identification Number.Leave blank if subcontractor is not a DBE. 12. Contract Payments -Enter the subcontracted dollar amount of the work performed or service provided. Include the prime contractor/consultant if the prime is a DBE.The Non-DBE column is used to enter the dollar value of work performed by firms that are not certified DBE or for work after a DBE becomes decertified. 13.Date Work Completed-Enter the date the subcontractor/subconsultant's item work was completed. 14.Date of Final Payment-Enter the date when the prime contractor/consultant made the final payment to the subcontractor/subconsultant for the portion of work listed as being completed. 15. Original DBE Commitment Amount-Enter the"Total Claimed DBE Participation Dollars"from Exhibits 15-G or 10-02 for the contract. 16. Total-Enter the sum of the"Contract Payments"Non-DBE and DBE columns. 17. Contractor/Consultant Representative's Signature-The person completing the form on behalf of the contractor/consultant's firm must sign their name. 18. Contractor/Consultant Representative's Name-Enter the name of the person preparing and signing the form. 19.Phone-Enter the area code and telephone number of the person signing the form. 20.Date-Enter the date the form is signed by the contractor's preparer. 21. Local Agency Representative's Signature-A Local Agency Representative must sign their name to certify that the contracting records and on-site performance of the DBE(s)has been monitored. 22. Local Agency Representative's Name-Enter the name of the Local Agency Representative signing the form. 23.Phone-Enter the area code and telephone number of the person signing the form. 24.Date-Enter the date the form is signed by the Local Agency Representative, C-29 Page 2 of 2 July 23,2015 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For the UTICA AVENUE BICYCLE BOULEVARD PROJECT from Main Street to Beach Boulevard CC NO. 1499 in the CITY OF HUNTINGTON BEACH August 23, 2022 Notice To All Bidders: Please note the following clarification to the Project Specifications and Contract Documents: 1) Page viii, APPENDIX I, PART 1 and PART 2 is replaced with the following: PART 1 — FEDERAL & STATE REQUIREMENTS FOR FEDERAL-AID CONSTRUCTION PART 2— FEDERAL LABOR RATES PART 3—STATE LABOR RATES 2) FEDERAL LABOR RATES The Federal Labor Rates contained in Appendix I, Part 2 of the specifications for the: Utica Avenue Bicycle Boulevard Project, CC-1499 shall be replaced with the following attached documents: The Federal Labor Rates dated August 23, 2022. These rates shall be the labor rates in effect for the subject project. 3) STATE LABOR RATES The State Labor Rates contained in Appendix I, Part 3 of the specifications shall be replaced with the following attached document: State Labor Rates dated August 23, 2022 The State Labor Rates Dated August 23, 2022 shall by t' abor rates in effect for the subject project. This is to acknowledge receipt and review of Addendurri Number •• , •- ed above. PTM General Engineering Services, Inc. Elizabet' H. Mendoza de McRae , President / CFO Company Name t By 8.23.22 \ Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. For Addendum questions, please call Darren Sam at(714) 374-1619 within 3 days of posting. EXHIBIT B (Required Contract Provision For All Federal Aid Construction Contracts FHWA 1273) 30 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 Local Assistance Procedures Manual EXHIBIT B Exhibit 12-G Required Federal-Aid Contract Language FHWA-1273-- Revised May 1,2012 REQUIRED CONTRACT PROVISIONS FEDERAL-AID CONSTRUCTION CONTRACTS Page 31 January 2019 Local Assistance Procedures Manual EXHIBIT B Exhibit 12-G Required Federal-Aid Contract Language I. General II. NONDISCRIMINATION II. Nondiscrimination III. No segregated Facilities The provisions of this section related to 23 CFR Part 230 are applicable IV. Davis-Bacon and Related Act Provisions to all Federal-aid construction contracts and to all related construction V. Contract Work Hours and Safety Standards Act Provisions subcontracts of$10,000 or more. The provisions of 23 CFR Part 230 VI. Subletting or Assigning the Contract are not applicable to material supply,engineering,or architectural VII. Safety:Accident Prevention service contracts. VIII. False Statements Concerning Highway Projects In addition,the contractor and all subcontractors must comply with the IX. Implementation of Clean Air Act and Federal Water Pollution following policies:Executive Order 11246,41 CFR 60,29 CFR 1625- Control Act 1627,Title 23 USC Section 140,the Rehabilitation Act of 1973,as X. Compliance with Government wide Suspension and Debarment amended(29 USC 794),Title VI of the Civil Rights Act of 1964,as Requirements amended,and related regulations including 49 CFR Parts 21,26 and Xl. Certification Regarding Use of Contract Funds for Lobbying 27;and 23 CFR Parts 200,230,and 633. ATTACHMENTS The contractor and all subcontractors must comply with: the A.Employment and Materials Preference for Appalachian Development requirements of the Equal Opportunity Clause in 41 CFR 60-1.4(b)and, Highway System or Appalachian Local Access Road Contracts for all construction contracts exceeding$10,000,the Standard Federal (included in Appalachian contracts only) Equal Employment Opportunity Construction Contract Specifications in 41 CFR 60-4.3. I. GENERAL Note:The U.S.Department of Labor has exclusive authority to 1.Form FHWA-1273 must be physically incorporated in each determine compliance with Executive Order 11246 and the policies of the Secretary of Labor including 41 CFR 60,and 29 CFR 1625-1627. construction contract funded under Title 23(excluding emergency The contracting agency and the FHWA have the authority and the contracts solely intended for debris removal). The contractor(or responsibility to ensure compliance with Title 23 USC Section 140,the subcontractor)must insert this form in each subcontract and further Rehabilitation Act of 1973,as amended(29 USC 794),and Title VI of require its inclusion in all lower tier subcontracts(excluding purchase the Civil Rights Act of 1964,as amended,and related regulations orders,rental agreements and other agreements for supplies or including 49 CFR Parts 21,26 and 27;and 23 CFR Parts 200,230,and services). 633. The applicable requirements of Form FHWA-1273 are incorporated by The following provision is adopted from 23 CFR 230,Appendix A,with reference for work done under any purchase order,rental agreement or appropriate revisions to conform to the U.S.Department of Labor(US agreement for other services. The prime contractor shall be responsible DOL)and FHWA requirements. for compliance by any subcontractor,lower-tier subcontractor or service provider. 1.Equal Employment Opportunity:Equal employment opportunity Form FHWA-1273 must be included in all Federal-aid design-build (EEO)requirements not to discriminate and to take affirmative action to contracts,in all subcontracts and in lower tier subcontracts(excluding assure equal opportunity as set forth under laws,executive orders, subcontracts for design services,purchase orders,rental agreements rules,regulations(28 CFR 35,29 CFR 1630,29 CFR 1625-1627,41 and other agreements for supplies or services). The design-builder shall CFR 60 and 49 CFR 27)and orders of the Secretary of Labor as be responsible for compliance by any subcontractor,lower-tier modified by the provisions prescribed herein,and imposed pursuant to subcontractor or service provider. 23 U.S.C. 140 shall constitute the EEO and specific affirmative action standards for the contractor's project activities under this contract.The Contracting agencies may reference Form FHWA-1273 in bid proposal provisions of the Americans with Disabilities Act of 1990(42 U.S.C. or request for proposal documents,however,the Form FHWA-1273 12101 et seq.)set forth under 28 CFR 35 and 29 CFR 1630 are must be physically incorporated(not referenced)in all contracts, incorporated by reference in this contract.In the execution of this subcontracts and lower-tier subcontracts(excluding purchase orders, contract,the contractor agrees to comply with the following minimum rental agreements and other agreements for supplies or services related specific requirement activities of EEO: to a construction contract). a.The contractor will work with the contracting agency and the Federal 2.Subject to the applicability criteria noted in the following sections, Government to ensure that it has made every good faith effort to these contract provisions shall apply to all work performed on the provide equal opportunity with respect to all of its terms and contract by the contractor's own organization and with the assistance conditions of employment and in their review of activities under the of workers under the contractor's immediate superintendence and to contract. all work performed on the contract by piecework,station work,or by subcontract. b.The contractor will accept as its operating policy the following statement: 3. A breach of any of the stipulations contained in these Required Contract Provisions may be sufficient grounds for withholding of "It is the policy of this Company to assure that applicants are employed, progress payments,withholding of final payment,termination of the and that employees are treated during employment,without regard to contract,suspension/debarment or any other action determined to their race,religion,sex,color,national origin,age or disability. Such be appropriate by the contracting agency and FHWA. action shall include:employment,upgrading,demotion,or transfer; recruitment or recruitment advertising;layoff or termination;rates of pay 4.Selection of Labor:During the performance of this contract,the or other forms of compensation;and selection for training,including contractor shall not use convict labor for any purpose within the limits apprenticeship,pre-apprenticeship,and/or on-the-job training." of a construction project on a Federal-aid highway unless it is labor performed by convicts who are on parole,supervised release,or probation. The term Federal-aid highway does not include roadways functionally classified as local roads or rural minor collectors. FHWA-1273-- Revised May 1,2012 Page 32 January 2019 Local Assistance Procedures Manual EXHIBIT B Exhibit 12-G Required Federal-Aid Contract Language 2.EEO Officer:The contractor will designate and make known to the contracting officers and EEO Officer who will have the c.The contractor will encourage its present employees to refer responsibility for and must be capable of effectively administering minorities and women as applicants for employment. and promoting and active EEO program and who must be assigned Information and procedures with regard to referring such adequate authority and responsibility to do so. applicants will be discussed with employees. 5.Personnel Actions:Wages,working conditions,and employee 3. Dissemination of Policy:All members of the contractor's staff benefits shall be established and administered,and personnel who are authorized to hire,supervise,promote,and discharge actions of every type,including hiring,upgrading,promotion, employees,or who recommend such action,or who are transfer,demotion,layoff,and termination,shall be taken without substantially involved in such action,will be made fully cognizant of, regard to race,color,religion,sex,national origin,age or disability. and will implement,the contractor's EEO policy and contractual The following procedures shall be followed: responsibilities to provide EEO in each grade and classification of employment. To ensure that the above agreement will be met,the a.The contractor will conduct periodic inspections of project sites to following actions will be taken as a minimum: insure that working conditions and employee facilities do not indicate discriminatory treatment of project site personnel. a. Periodic meetings of supervisory and personnel office employees will be conducted before the start of work and then b.The contractor will periodically evaluate the spread of wages paid not less often than once every six months,at which time the within each classification to determine any evidence of contractor's EEO policy and its implementation will be reviewed discriminatory wage practices. and explained. The meetings will be conducted by the EEO Officer. c.The contractor will periodically review selected personnel actions b.All new supervisory or personnel office employees will be given in depth to determine whether there is evidence of discrimination. Where evidence is found,the contractor will promptly take a thorough indoctrination by the EEO Officer,covering all major aspects of the contractor's EEO obligations within thirty days corrective action. If the review indicates that the discrimination following their reporting for duty with the contractor. may extend beyond the actions reviewed,such corrective action shall include all affected persons. c.All personnel who are engaged in direct recruitment for the project will be instructed by the EEO Officer in the contractor's d.The contractor will promptly investigate all complaints of alleged procedures for locating and hiring minorities and women. discrimination made to the contractor in connection with its obligations under this contract,will attempt to resolve such d.Notices and posters setting forth the contractor's EEO policy will complaints,and will take appropriate corrective action within a be placed in areas readily accessible to employees,applicants reasonable time. If the investigation indicates that the for employment and potential employees. discrimination may affect persons other than the complainant, e.The contractor's EEO policy and the procedures to implement such corrective action shall include such other persons. Upon such policy will be brought to the attention of employees by completion of each investigation,the contractor will inform every means of meetings,employee handbooks,or other appropriate complainant of all of their avenues of appeal. means. 6.Training and Promotion: 4.Recruitment:When advertising for employees,the contractor a.The contractor will assist in locating,qualifying,and increasing will include in all advertisements for employees the notation:"An the skills of minorities and women who are applicants for Equal Opportunity Employer." All such advertisements will be employment or current employees. Such efforts should be aimed placed in publications having a large circulation among minorities at developing full journey level status employees in the type of and women in the area from which the project work force would trade or job classification involved. normally be derived. a.The contractor will, precluded by a valid bargaining b. Consistent with the contractor's work force requirements and as unlessysematic and direct recruitment permissible under Federal and State regulations,the contractor public and agreement,conducton employee referralican dire sources likely t throughh shall make full use of training programs,i.e.,apprenticeship,and on-the-job training programs for the geographical area of contract qualified minorities and women. To meet this requirement,the performance. In the event a special provision for training is contractor will identify sources of potential minority group provided under this contract,this subparagraph will be employees,and establish with such identified sources superseded as indicated in the special provision. The contracting procedures whereby minority and women applicants may be agency may reserve training positions for persons who receive referred to the contractor for employment consideration. welfare assistance in accordance with 23 U.S.C. 140(a). b. In the event the contractor has a valid bargaining agreement c.The contractor will advise employees and applicants for providing for exclusive hiring hall referrals,the contractor is employment of available training programs and entrance expected to observe the provisions of that agreement to the requirements for each. extent that the system meets the contractor's compliance with EEO contract provisions. Where implementation of such an d.The contractor will periodically review the training and promotion agreement has the effect of discriminating against minorities or potential of employees who are minorities and women and will women,or obligates the contractor to do the same,such encourage eligible employees to apply for such training and implementation violates Federal nondiscrimination provisions. promotion. Page 33 January 2019 Local Assistance Procedures Manual EXHIBIT B Exhibit 12-G Required Federal-Aid Contract Language FHWA-1273-- Revised May 1,2012 7.Unions:If the contractor relies in whole or in part upon unions as 10.Assurance Required by 49 CFR 26.13(b): a source of employees,the contractor will use good faith efforts to obtain the cooperation of such unions to increase opportunities for a.The requirements of 49 CFR Part 26 and the State DOT's U.S. minorities and women. Actions by the contractor,either directly or DOT-approved DBE program are incorporated by reference. through a contractor's association acting as agent,will include the procedures set forth below: b.The contractor or subcontractor shall not discriminate on the basis of race,color,national origin,or sex in the performance of a.The contractor will use good faith efforts to develop,in this contract. The contractor shall carry out applicable cooperation with the unions,joint training programs aimed requirements of 49 CFR Part 26 in the award and administration toward qualifying more minorities and women for membership of DOT-assisted contracts. Failure by the contractor to carry out in the unions and increasing the skills of minorities and women these requirements is a material breach of this contract,which so that they may qualify for higher paying employment. may result in the termination of this contract or such other remedy as the contracting agency deems appropriate. b.The contractor will use good faith efforts to incorporate an EEO clause into each union agreement to the end that such union 11.Records and Reports:The contractor shall keep such records will be contractually bound to refer applicants without regard to as necessary to document compliance with the EEO requirements. their race,color, religion,sex,national origin,age or disability. Such records shall be retained for a period of three years following the date of the final payment to the contractor for all contract work c.The contractor is to obtain information as to the referral and shall be available at reasonable times and places for inspection practices and policies of the labor union except that to the by authorized representatives of the contracting agency and the extent such information is within the exclusive possession of FHWA. the labor union and such labor union refuses to furnish such information to the contractor,the contractor shall so certify to a. The records kept by the contractor shall document the following: the contracting agency and shall set forth what efforts have been made to obtain such information. (1)The number and work hours of minority and non-minority group members and women employed in each work classification on d. In the event the union is unable to provide the contractor with a the project; reasonable flow of referrals within the time limit set forth in the collective bargaining agreement,the contractor will,through (2)The progress and efforts being made in cooperation with independent recruitment efforts,fill the employment vacancies unions,when applicable,to increase employment opportunities without regard to race,color,religion,sex,national origin,age for minorities and women;and or disability;making full efforts to obtain qualified and/or qualifiable minorities and women. The failure of a union to (3)The progress and efforts being made in locating,hiring,training, provide sufficient referrals(even though it is obligated to qualifying,and upgrading minorities and women. provide exclusive referrals under the terms of a collective bargaining agreement)does not relieve the contractor from the b.The contractors and subcontractors will submit an annual report requirements of this paragraph. In the event the union referral to the contracting agency each July for the duration of the practice prevents the contractor from meeting the obligations project,indicating the number of minority,women,and non- pursuant to Executive Order 11246,as amended,and these minority group employees currently engaged in each work special provisions,such contractor shall immediately notify the classification required by the contract work. This information is contracting agency. to be reported on Form FHWA-1391. The staffing data should represent the project work force on board in all or any part of the 8. Reasonable Accommodation for Applicants/Employees last payroll period preceding the end of July. If on-the-job with Disabilities: The contractor must be familiar with the training is being required by special provision,the contractor will requirements for and comply with the Americans with Disabilities be required to collect and report training data. The employment Act and all rules and regulations established there under. data should reflect the work force on board during all or any part Employers must provide reasonable accommodation in all of the last payroll period preceding the end of July. employment activities unless to do so would cause an undue hardship. III.NONSEGREGATED FACILITIES 9.Selection of Subcontractors,Procurement of Materials and This provision is applicable to all Federal-aid construction contracts Leasing of Equipment:The contractor shall not discriminate on and to all related construction subcontracts of$10,000 or more. the grounds of race,color,religion,sex,national origin,age or disability in the selection and retention of subcontractors,including The contractor must ensure that facilities provided for employees procurement of materials and leases of equipment. The contractor are provided in such a manner that segregation on the basis of shall take all necessary and reasonable steps to ensure race,color,religion,sex,or national origin cannot result. The nondiscrimination in the administration of this contract. contractor may neither require such segregated use by written or oral policies nor tolerate such use by employee custom. The a.The contractor shall notify all potential subcontractors and contractor's obligation extends further to ensure that its employees suppliers and lessors of their EEO obligations under this contract. are not assigned to perform their services at any location,under the contractor's control,where the facilities are segregated. The term b.The contractor will use good faith efforts to ensure subcontractor "facilities"includes waiting rooms,work areas,restaurants and compliance with their EEO obligations. other eating areas,time clocks,restrooms,washrooms,locker rooms,and other storage or dressing areas,parking lots,drinking fountains,recreation or entertainment areas,transportation,and housing provided for employees. The contractor shall provide separate or single-user restrooms and necessary dressing or sleeping areas to assure privacy between sexes. Page 34 January 2019 Local Assistance Procedures Manual EXHIBIT B Exhibit 12-G Required Federal-Aid Contract Language FHWA-1273-- Revised May 1,2012 IV. DAVIS-BACON AND RELATED ACT PROVISIONS (i)The work to be performed by the classification requested is not performed by a classification in the wage determination;and This section is applicable to all Federal-aid construction projects exceeding$2,000 and to all related subcontracts and lower-tier (ii)The classification is utilized in the area by the construction subcontracts(regardless of subcontract size). The requirements industry;and apply to all projects located within the right-of-way of a roadway that is functionally classified as Federal-aid highway. This excludes roadways functionally classified as local roads or rural minor (iii)The proposed wage rate,including any bona fide fringe benefits, collectors,which are exempt. Contracting agencies may elect to bears a reasonable relationship to the wage rates contained in apply these requirements to other projects. the wage determination. The following provisions are from the U.S.Department of Labor (2)If the contractor and the laborers and mechanics to be regulations in 29 CFR 5.5"Contract provisions and related matters" employed in the classification(if known),or their with minor revisions to conform to the FHWA-1273 format and representatives,and the contracting officer agree on the FHWA program requirements. classification and wage rate(including the amount designated for fringe benefits where appropriate),a report of the action 1. Minimum wages taken shall be sent by the contracting officer to the Administrator of the Wage and Hour Division,Employment Standards Administration,U.S.Department of Labor,Washington,DC a. All laborers and mechanics employed or working upon the site 20210.The Administrator,or an authorized representative,will of the work,will be paid unconditionally and not less often than approve,modify,or disapprove every additional classification once a week,and without subsequent deduction or rebate on any action within 30 days of receipt and so advise the contracting account(except such payroll deductions as are permitted by officer or will notify the contracting officer within the 30-day regulations issued by the Secretary of Labor under the Copeland period that additional time is necessary. Act(29 CFR part 3)),the full amount of wages and bona fide fringe benefits(or cash equivalents thereof)due at time of payment computed at rates not less than those contained in the wage (3)In the event the contractor,the laborers or mechanics to be determination of the Secretary of Labor which is attached hereto employed in the classification or their representatives,and the and made a part hereof,regardless of any contractual relationship contracting officer do not agree on the proposed classification which may be alleged to exist between the contractor and such and wage rate(including the amount designated for fringe laborers and mechanics. benefits,where appropriate),the contracting officer shall refer the questions,including the views of all interested parties and the recommendation of the contracting officer,to the Wage and Contributions made or costs reasonably anticipated for bona fide Hour Administrator for determination.The Wage and Hour fringe benefits under section 1(b)(2)of the Davis-Bacon Act on Administrator,or an authorized representative,will issue a behalf of laborers or mechanics are considered wages paid to such determination within 30 days of receipt and so advise the laborers or mechanics,subject to the provisions of paragraph 1.d. contracting officer or will notify the contracting officer within the of this section;also,regular contributions made or costs incurred for 30-day period that additional time is necessary. more than a weekly period(but not less often than quarterly)under plans,funds,or programs which cover the particular weekly period, (4)The wage rate(including fringe benefits where appropriate) are deemed to be constructively made or incurred during such determined pursuant to paragraphs 1.b.(2)or 1.b.(3)of this weekly period.Such laborers and mechanics shall be paid the section,shall be paid to all workers performing work in the appropriate wage rate and fringe benefits on the wage classification under this contract from the first day on which work determination for the classification of work actually performed, is performed in the classification. without regard to skill,except as provided in 29 CFR 5.5(a)(4). Laborers or mechanics performing work in more than one classification may be compensated at the rate specified for each c.Whenever the minimum wage rate prescribed in the contract for classification for the time actually worked therein: Provided,That a class of laborers or mechanics includes a fringe benefit which the employer's payroll records accurately set forth the time spent in is not expressed as an hourly rate,the contractor shall either each classification in which work is performed.The wage pay the benefit as stated in the wage determination or shall pay determination(including any additional classification and wage another bona fide fringe benefit or an hourly cash equivalent rates conformed under paragraph 1.b.of this section)and the thereof. Davis-Bacon poster(WH-1321)shall be posted at all times by the contractor and its subcontractors at the site of the work in a prominent and accessible place where it can be easily seen by the d. If the contractor does not make payments to a trustee or other workers. third person,the contractor may consider as part of the wages of any laborer or mechanic the amount of any costs reasonably anticipated in providing bona fide fringe benefits under a plan or b. (1)The contracting officer shall require that any class of program,Provided,That the Secretary of Labor has found,upon the laborers or mechanics,including helpers,which is not listed in the written request of the contractor,that the applicable standards of wage determination and which is to be employed under the contract the Davis-Bacon Act have been met.The Secretary of Labor may shall be classified in conformance with the wage determination.The require the contractor to set aside in a separate account assets for contracting officer shall approve an additional classification and the meeting of obligations under the plan or program. wage rate and fringe benefits therefore only when the following criteria have been met: Page 35 January 2019 Local Assistance Procedures Manual EXHIBIT B Exhibit 12-G Required Federal-Aid Contract Language FHWA-1273-- Revised May 1,2012 2. Withholding current address of each covered worker,and shall provide them upon request to the contracting agency for transmission to the The contracting agency shall upon its own action or upon written State DOT,the FHWA or the Wage and Hour Division of the request of an authorized representative of the Department of Labor, Department of Labor for purposes of an investigation or audit of withhold or cause to be withheld from the contractor under this compliance with prevailing wage requirements.It is not a violation contract,or any other Federal contract with the same prime of this section for a prime contractor to require a subcontractor to contractor,or any other federally-assisted contract subject to Davis- provide addresses and social security numbers to the prime Bacon prevailing wage requirements,which is held by the same contractor for its own records,without weekly submission to the prime contractor,so much of the accrued payments or advances as contracting agency. may be considered necessary to pay laborers and mechanics, including apprentices,trainees,and helpers,employed by the contractor or any subcontractor the full amount of wages required (2) Each payroll submitted shall be accompanied by a"Statement by the contract. In the event of failure to pay any laborer or of Compliance,"signed by the contractor or subcontractor or his mechanic,including any apprentice,trainee,or helper,employed or or her agent who pays or supervises the payment of the working on the site of the work,all or part of the wages required by persons employed under the contract and shall certify the the contract,the contracting agency may,after written notice to the following: contractor,take such action as may be necessary to cause the suspension of any further payment,advance,or guarantee of funds (i)That the payroll for the payroll period contains the information until such violations have ceased. required to be provided under§5.5(a)(3)(ii)of Regulations,29 CFR part 5,the appropriate information is being maintained 3. Payrolls and basic records under§5.5(a)(3)(i)of Regulations,29 CFR part 5,and that such information is correct and complete; a. Payrolls and basic records relating thereto shall be maintained by the contractor during the course of the work and preserved for a (ii)That each laborer or mechanic(including each helper, period of three years thereafter for all laborers and mechanics apprentice,and trainee)employed on the contract during the working at the site of the work.Such records shall contain the payroll period has been paid the full weekly wages earned, name,address,and social security number of each such worker, without rebate,either directly or indirectly,and that no his or her correct classification,hourly rates of wages paid deductions have been made either directly or indirectly from the (including rates of contributions or costs anticipated for bona fide full wages earned,other than permissible deductions as set fringe benefits or cash equivalents thereof of the types described in forth in Regulations,29 CFR part 3; section 1(b)(2)(B)of the Davis-Bacon Act),daily and weekly number of hours worked,deductions made and actual wages paid. (iii)That each laborer or mechanic has been paid not less than the Whenever the Secretary of Labor has found under 29 CFR applicable wage rates and fringe benefits or cash equivalents 5.5(a)(1)(iv)that the wages of any laborer or mechanic include the for the classification of work performed,as specified in the amount of any costs reasonably anticipated in providing benefits applicable wage determination incorporated into the contract. under a plan or program described in section 1(b)(2)(B)of the Davis-Bacon Act,the contractor shall maintain records which show that the commitment to provide such benefits is enforceable,that (3)The weekly submission of a properly executed certification set the plan or program is financially responsible,and that the plan or forth on the reverse side of Optional Form WH-347 shall program has been communicated in writing to the laborers or satisfy the requirement for submission of the"Statement of mechanics affected,and records which show the costs anticipated Compliance"required by paragraph 3.b.(2)of this section. or the actual cost incurred in providing such benefits.Contractors employing apprentices or trainees under approved programs shall (4)The falsification of any of the above certifications may subject maintain written evidence of the registration of apprenticeship the contractor or subcontractor to civil or criminal prosecution programs and certification of trainee programs,the registration of under section 1001 of title 18 and section 231 of title 31 of the the apprentices and trainees,and the ratios and wage rates United States Code. prescribed in the applicable programs. b. (1)The contractor shall submit weekly for each week in which c. requThe contractor or subcontractor shall make the records any contract work is performed a copy of all payrolls to the inspection, n,coring, traphnscription c.of this section authorized available for contracting agency. The payrolls submitted shall set out accurately iepresenta copying,or contracting eb cy,the to and completely all of the information required to be maintained representatives ortihes epaof rt f Labor,agency,the State DOT,the under 29 CFR 5.5(a)(3)(i),except that full social security numbers FHWA,representatives the to interview employees and us ingall wp rkin such and home addresses shall not be included on weekly transmittals. onthejob. fthetc intrac orrsbcontr during fails to submitworking hours Instead the payrolls shall only need to include an individually re the job.If d contractor them available, the to A the identifying number for each employee(e.g.,the last four digits of after writtenri records or ot the maket availe o, FHWA may, the employee's social security number).The required weekly payroll after te notice, ocontractor, action mayho contracting agency or o information may be submitted in any form desired.Optional Form the State DOT,takeins of anytion as be necessaryadvance, WH-347 is available for this purpose from the Wage and Hour guarsse the suspension Furthermore,f e failureer payment,submit therequiredor Division Web site at guarantee of funds. to the http Web ev/esa/whd/forms/wh347instr.htm or its successor records upon request or to make such records available may site.The prime contractor is responsible for the submission of be grounds for debarment action pursuant to 29 CFR 5.12. copies of payrolls by all subcontractors.Contractors and subcontractors shall maintain the full social security number and Page 36 January 2019 Local Assistance Procedures Manual EXHIBIT B Exhibit 12-G Required Federal-Aid Contract Language FHWA-1273-- Revised May 1,2012 4. Apprentices and trainees The ratio of trainees to journeymen on the job site shall not be greater than permitted under the plan approved by the Employment a.Apprentices(programs of the USDOL). and Training Administration. Apprentices will be permitted to work at less than the predetermined Every trainee must be paid at not less than the rate specified in the rate for the work they performed when they are employed pursuant approved program for the trainee's level of progress,expressed as to and individually registered in a bona fide apprenticeship program a percentage of the journeyman hourly rate specified in the registered with the U.S.Department of Labor,Employment and applicableeitsn acwacoerdance determination.pTrovisions shallf thebe paid efripro Training Administration,Office of Apprenticeship Training,Employer benefits in accordance with the provisions of trainee program. If and Labor Services,or with a State Apprenticeship Agency the trainee program does not mention fringe benefits,trainees shall recognized by the Office,or if a person is employed in his or her be paid the full amount of fringe benefits listed on the wage first 90 days of probationary employment as an apprentice in such determination unless the Administrator of the Wage and Hour an apprenticeship program,who is not individually registered in the Division determines that there is an apprenticeship program program,but who has been certified by the Office of Apprenticeship associated with the corresponding journeyman wage rate on the Training,Employer and Labor Services or a State Apprenticeship wage determination which provides for less than full fringe benefits Agency(where appropriate)to be eligible for probationary for apprentices.Any employee listed on the payroll at a trainee rate employment as an apprentice. who is not registered and participating in a training plan approved by the Employment and Training Administration shall be paid not less than the applicable wage rate on the wage determination for The allowable ratio of apprentices to journeymen on the job site in the classification of work actually performed.In addition,any trainee any craft classification shall not be greater than the ratio permitted performing work on the job site in excess of the ratio permitted to the contractor as to the entire work force under the registered under the registered program shall be paid not less than the program.Any worker listed on a payroll at an apprentice wage rate, applicable wage rate on the wage determination for the work who is not registered or otherwise employed as stated above,shall actually performed. be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed.In In the event the Employment and Training Administration withdraws addition,any apprentice performing work on the job site in excess approval of a training program,the contractor will no longer be of the ratio permitted under the registered program shall be paid not permitted to utilize trainees at less than the applicable less than the applicable wage rate on the wage determination for predetermined rate for the work performed until an acceptable the work actually performed.Where a contractor is performing program is approved. construction on a project in a locality other than that in which its program is registered,the ratios and wage rates(expressed in percentages of the journeyman's hourly rate)specified in the c.Equal employment opportunity.The utilization of apprentices, contractor's or subcontractor's registered program shall be trainees and journeymen under this part shall be in conformity observed. with the equal employment opportunity requirements of Executive Order 11246,as amended,and 29 CFR part 30. Every apprentice must be paid at not less than the rate specified in the registered program for the apprentice's level of progress, d.Apprentices and Trainees(programs of the U.S.DOT). expressed as a percentage of the journeymen hourly rate specified in the applicable wage determination.Apprentices shall be paid Apprentices and trainees working under apprenticeship and skill fringe benefits in accordance with the provisions of the training programs which have been certified by the Secretary of apprenticeship program.If the apprenticeship program does not Transportation as promoting EEO in connection with Federal-aid specify fringe benefits,apprentices must be paid the full amount of highway construction programs are not subject to the requirements fringe benefits listed on the wage determination for the applicable of paragraph 4 of this Section IV.The straight time hourly wage classification.If the Administrator determines that a different rates for apprentices and trainees under such programs will be practice prevails for the applicable apprentice classification,fringes established by the particular programs.The ratio of apprentices and shall be paid in accordance with that determination. trainees to journeymen shall not be greater than permitted by the terms of the particular program. In the event the Office of Apprenticeship Training,Employer and Labor Services,or a State Apprenticeship Agency recognized by 5.Compliance with Copeland Act requirements. The contractor the Office,withdraws approval of an apprenticeship program,the shall comply with the requirements of 29 CFR part 3,which are contractor will no longer be permitted to utilize apprentices at less incorporated by reference in this contract. than the applicable predetermined rate for the work performed until an acceptable program is approved. 6.Subcontracts. The contractor or subcontractor shall insert b.Trainees(programs of the USDOL). Form FHWA-1273 in any subcontracts and also require the subcontractors to include Form FHWA-1273 in any lower tier subcontracts.The prime contractor shall be responsible for the Except as provided in 29 CFR 5.16,trainees will not be permitted to compliance by any subcontractor or lower tier subcontractor with all work at less than the predetermined rate for the work performed the contract clauses in 29 CFR 5.5. unless they are employed pursuant to and individually registered in a program which has received prior approval,evidenced by formal 7.Contract termination:debarment. A breach of the contract certification by the U.S.Department of Labor,Employment and clauses in 29 CFR 5.5 may be grounds for termination of the Training Administration. contract,and for debarment as a contractor and a subcontractor as provided in 29 CFR 5.12. Page 37 January 2019 Local Assistance Procedures Manual EXHIBIT B Exhibit 12-G Required Federal-Aid Contract Language FHWA-1273--Revised May 1,2012 8.Compliance with Davis-Bacon and Related Act requirements. 3.Withholding for unpaid wages and liquidated damages.The All rulings and interpretations of the Davis-Bacon and Related Acts FHWA or the contacting agency shall upon its own action or upon contained in 29 CFR parts 1,3,and 5 are herein incorporated by written request of an authorized representative of the Department of reference in this contract. Labor withhold or cause to be withheld,from any moneys payable on account of work performed by the contractor or subcontractor 9.Disputes concerning labor standards.Disputes arising out of under any such contract or any other Federal contract with the same prime contractor,or any other federally-assisted contract the labor standards provisions of this contract shall not be subject to the general disputes clause of this contract.Such disputes shall be subject to the Contract Work Hours and Safety Standards Act, resolved in accordance with the procedures of the Department of which is held by the same prime contractor,such sums as may be Labor set forth in 29 CFR parts 5,6,and 7.Disputes within the determined to be necessary to satisfy any liabilities of such meaning of this clause include disputes between the contractor(or contractor or subcontractor for unpaid wages and liquidated any of its subcontractors)and the contracting agency,the U.S. damages as provided in the clause set forth in paragraph(2.)of this Department of Labor,or the employees or their representatives. section. 10.Certification of eligibility. 4.Subcontracts. The contractor or subcontractor shall insert in any subcontracts the clauses set forth in paragraph(1.)through(4.) of this section and also a clause requiring the subcontractors to a.By entering into this contract,the contractor certifies that neither include these clauses in any lower tier subcontracts.The prime it(nor he or she)nor any person or firm who has an interest in the contractor shall be responsible for compliance by any subcontractor contractor's firm is a person or firm ineligible to be awarded or lower tier subcontractor with the clauses set forth in paragraphs Government contracts by virtue of section 3(a)of the Davis- (1.)through(4.)of this section. Bacon Act or 29 CFR 5.12(a)(1). b.No part of this contract shall be subcontracted to any person or VI.SUBLETTING OR ASSIGNING THE CONTRACT firm ineligible for award of a Government contract by virtue of section 3(a)of the Davis-Bacon Act or 29 CFR 5.12(a)(1). This provision is applicable to all Federal-aid construction contracts on the National Highway System. c.The penalty for making false statements is prescribed in the U.S. 1.The contractor shall perform with its own organization contract Criminal Code,18 U.S.C. 1001. work amounting to not less than 30 percent(or a greater percentage if specified elsewhere in the contract)of the total V. CONTRACT WORK HOURS AND SAFETY STANDARDS original contract price,excluding any specialty items designated ACT by the contracting agency. Specialty items may be performed by subcontract and the amount of any such specialty items The following clauses apply to any Federal-aid construction contract performed may be deducted from the total original contract price in an amount in excess of$100,000 and subject to the overtime by theore contractor'sir'the amount of workrequired 3o .1b performed provisions of the Contract Work Hours and Safety Standards Act. by the own organization(23 CFR 635.116). These clauses shall be inserted in addition to the clauses required a. The term"perform work with its own organization"refers to by 29 CFR 5.5(a)or 29 CFR 4.6. As used in this paragraph,the workers employed or leased by the prime contractor,and terms laborers and mechanics include watchmen and guards. equipment owned or rented by the prime contractor,with or without operators. Such term does not include employees or 1.Overtime requirements. No contractor or subcontractor equipment of a subcontractor or lower tier subcontractor, contracting for any part of the contract work which may require or agents of the prime contractor,or any other assignees. The involve the employment of laborers or mechanics shall require or term may include payments for the costs of hiring leased permit any such laborer or mechanic in any workweek in which he employees from an employee leasing firm meeting all relevant or she is employed on such work to work in excess of forty hours in Federal and State regulatory requirements. Leased such workweek unless such laborer or mechanic receives employees may only be included in this term if the prime compensation at a rate not less than one and one-half times the contractor meets all of the following conditions: basic rate of pay for all hours worked in excess of forty hours in such workweek. (1)the prime contractor maintains control over the supervision of the day-to-day activities of the leased employees; (2)the prime contractor remains responsible for the quality of the 2.Violation;liability for unpaid wages;liquidated damages. In work of the leased employees; the event of any violation of the clause set forth in paragraph(1.)of (3)the prime contractor retains all power to accept or exclude this section,the contractor and any subcontractor responsible individual employees from work on the project;and therefor shall be liable for the unpaid wages.In addition,such (4)the prime contractor remains ultimately responsible for the contractor and subcontractor shall be liable to the United States(in payment of predetermined minimum wages,the submission of the case of work done under contract for the District of Columbia or payrolls,statements of compliance and all other Federal a territory,to such District or to such territory),for liquidated regulatory requirements. damages.Such liquidated damages shall be computed with respect to each individual laborer or mechanic,including watchmen and b."Specialty Items"shall be construed to be limited to work that guards,employed in violation of the clause set forth in paragraph requires highly specialized knowledge,abilities,or equipment not ordinarily available in the type of contracting organizations qualified and expected to bid or propose on the contract as a whole and in general are to be limited to minor components of the overall contract. Page 38 January 2019 Local Assistance Procedures Manual EXHIBIT B Exhibit 12-G Required Federal-Aid Contract Language FHWA-1273-- Revised May 1,2012 (1.)of this section,in the sum of$10 for each calendar day on which In order to assure high quality and durable construction in such individual was required or permitted to work in excess of the conformity with approved plans and specifications and a high standard workweek of forty hours without payment of the degree of reliability on statements and representations made by overtime wages required by the clause set forth in paragraph(1.) engineers,contractors,suppliers,and workers on Federal-aid of this section. highway projects,it is essential that all persons concerned with the project perform their functions as carefully,thoroughly,and honestly as possible. Willful falsification,distortion,or misrepresentation with 2.The contract amount upon which the requirements set forth in respect to any facts related to the project is a violation of Federal paragraph(1)of Section VI is computed includes the cost of law. To prevent any misunderstanding regarding the seriousness of material and manufactured products which are to be purchased these and similar acts,Form FHWA-1022 shall be posted on each or produced by the contractor under the contract provisions. Federal-aid highway project(23 CFR 635)in one or more places where it is readily available to all persons concerned with the 3.The contractor shall furnish(a)a competent superintendent or project: supervisor who is employed by the firm,has full authority to direct performance of the work in accordance with the contract requirements,and is in charge of all construction operations 18 U.S.C. 1020 reads as follows: (regardless of who performs the work)and(b)such other of its own organizational resources(supervision,management,and 'Whoever, being an officer,agent,or employee of the United engineering services)as the contracting officer determines is States,or of any State or Territory,or whoever,whether a person, necessary to assure the performance of the contract. association,firm,or corporation,knowingly makes any false statement,false representation,or false report as to the character, 4.No portion of the contract shall be sublet,assigned or otherwise quality,quantity,or cost of the material used or to be used,or the disposed of except with the written consent of the contracting quantity or quality of the work performed or to be performed,or the officer,or authorized representative,and such consent when cost thereof in connection with the submission of plans,maps, given shall not be construed to relieve the contractor of any specifications,contracts,or costs of construction on any highway or responsibility for the fulfillment of the contract. Written consent related project submitted for approval to the Secretary of will be given only after the contracting agency has assured that Transportation;or each subcontract is evidenced in writing and that it contains all pertinent provisions and requirements of the prime contract. Whoever knowingly makes any false statement,false representation,false report or false claim with respect to the 5.The 30%self-performance requirement of paragraph(1)is not character,quality,quantity,or cost of any work performed or to be applicable to design-build contracts;however,contracting performed,or materials furnished or to be furnished,in connection agencies may establish their own self-performance requirements with the construction of any highway or related project approved by the Secretary of Transportation;or Whoever knowingly makes any false statement or false VII.SAFETY:ACCIDENT PREVENTION representation as to material fact in any statement,certificate,or report submitted pursuant to provisions of the Federal-aid Roads This provision is applicable to all Federal-aid construction contracts Act approved July 1, 1916,(39 Stat.355),as amended and and to all related subcontracts. supplemented; 1. In the performance of this contract the contractor shall comply Shall be fined under this title or imprisoned not more than 5 years with all applicable Federal,State,and local laws governing or both." safety,health,and sanitation(23 CFR 635).The contractor shall provide all safeguards,safety devices and protective equipment IX.IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL and take any other needed actions as it determines,or as the WATER POLLUTION CONTROL ACT contracting officer may determine,to be reasonably necessary This provision is applicable to all Federal-aid construction contracts to protect the life and health of employees on the job and the and to all related subcontracts. safety of the public and to protect property in connection with the performance of the work covered by the contract. By submission of this bid/proposal or the execution of this contract, 2. It is a condition of this contract,and shall be made a condition of or subcontract,as appropriate,the bidder,proposer,Federal-aid each subcontract,which the contractor enters into pursuant to deevnt this contract,that the contractor and any subcontractor shall not deemed ned to have stipulatedapto as follows: or subcontractor,as appropriate,will be permit any employee,in performance of the contract,to work in 1.That any person who is or will be utilized in the performance of surroundings or under conditions which are unsanitary, this contract is not prohibited from receiving an award due to a hazardous or dangerous to his/her health or safety,as violation of Section 508 of the Clean Water Act or Section 306 of determined under construction safety and health standards(29 the Clean Air Act. CFR 1926)promulgated by the Secretary of Labor, in 2.That the contractor agrees to include or cause to be included the accordance with Section 107 of the Contract Work Hours and requirements of paragraph(1)of this Section X in every Safety Standards Act(40 U.S.C.3704). subcontract,and further agrees to take such action as the 3. Pursuant to 29 CFR 1926.3,it is a condition of this contract that contracting agency may direct as a means of enforcing such the Secretary of Labor or authorized representative thereof,shall requirements. have right of entry to any site of contract performance to inspect or investigate the matter of compliance with the construction safety and health standards and to carry out the duties of the Page 39 January 2019 Local Assistance Procedures Manual EXHIBIT B Exhibit 12-G Required Federal-Aid Contract Language FHWA-1273-- Revised May 1,2012 Secretary under Section 107 of the Contract Work Hours and X.CERTIFICATION REGARDING DEBARMENT,SUSPENSION, Safety Standards Act(40 U.S.C.3704). INELIGIBILITY AND VOLUNTARY EXCLUSION This provision is applicable to all Federal-aid construction contracts, VIII.FALSE STATEMENTS CONCERNING HIGHWAY design-build contracts,subcontracts,lower-tier subcontracts, PROJECTS purchase orders,lease agreements,consultant contracts or any other covered transaction requiring FHWA approval or that is This provision is applicable to all Federal-aid construction contracts estimated to cost$25,000 or more— as defined in 2 CFR Parts 180 and to all related subcontracts. and 1200. h.A participant in a covered transaction may rely upon a certification 1.Instructions for Certification—First Tier Participants: of a prospective participant in a lower tier covered transaction that is not debarred,suspended,ineligible,or voluntarily excluded from a.By signing and submitting this proposal,the prospective first tier the covered transaction,unless it knows that the certification is participant is providing the certification set out below. erroneous. A participant is responsible for ensuring that its principals are not suspended,debarred,or otherwise ineligible to b.The inability of a person to provide the certification set out below participate in covered transactions. To verify the eligibility of its will not necessarily result in denial of participation in this covered principals,as well as the eligibility of any lower tier prospective transaction.The prospective first tier participant shall submit an participants,each participant may,but is not required to,check the explanation of why it cannot provide the certification set out below. Excluded Parties List System website(https://www.epls gov/),which The certification or explanation will be considered in connection is compiled by the General Services Administration. with the department or agency's determination whether to enter into this transaction.However,failure of the prospective first tier i. Nothing contained in the foregoing shall be construed to require participant to furnish a certification or an explanation shall the establishment of a system of records in order to render in good disqualify such a person from participation in this transaction. faith the certification required by this clause.The knowledge and information of the prospective participant is not required to exceed c.The certification in this clause is a material representation of fact that which is normally possessed by a prudent person in the upon which reliance was placed when the contracting agency ordinary course of business dealings. determined to enter into this transaction.If it is later determined that the prospective participant knowingly rendered an erroneous j.Except for transactions authorized under paragraph(f)of these certification,in addition to other remedies available to the Federal instructions,if a participant in a covered transaction knowingly Government,the contracting agency may terminate this enters into a lower tier covered transaction with a person who is transaction for cause of default. suspended,debarred,ineligible,or voluntarily excluded from participation in this transaction,in addition to other remedies d.The prospective first tier participant shall provide immediate written available to the Federal Government,the department or agency notice to the contracting agency to whom this proposal is may terminate this transaction for cause or default. submitted if any time the prospective first tier participant learns that its certification was erroneous when submitted or has become ***** erroneous by reason of changed circumstances. 2. Certification Regarding Debarment,Suspension,Ineligibility e.The terms"covered transaction,""debarred,""suspended," and Voluntary Exclusion—First Tier Participants: "ineligible,""participant,""person," "principal,"and"voluntarily excluded,"as used in this clause,are defined in 2 CFR Parts 180 a.The prospective first tier participant certifies to the best of its and 1200. "First Tier Covered Transactions"refers to any covered knowledge and belief,that it and its principals: transaction between a grantee or subgrantee of Federal funds and a participant(such as the prime or general contract). "Lower Tier (1) Are not presently debarred,suspended,proposed for Covered Transactions"refers to any covered transaction under a debarment,declared ineligible,or voluntarily excluded from First Tier Covered Transaction(such as subcontracts). "First Tier participating in covered transactions by any Federal department Participant"refers to the participant who has entered into a or agency; covered transaction with a grantee or subgrantee of Federal funds (such as the prime or general contractor). "Lower Tier Participant" (2)Have not within a three-year period preceding this proposal refers any participant who has entered into a covered transaction been convicted of or had a civil judgment rendered against them with a First Tier Participant or other Lower Tier Participants(such for commission of fraud or a criminal offense in connection with as subcontractors and suppliers). obtaining,attempting to obtain,or performing a public(Federal, State or local)transaction or contract under a public transaction; f. The prospective first tier participant agrees by submitting this violation of Federal or State antitrust statutes or commission of proposal that,should the proposed covered transaction be entered embezzlement,theft,forgery,bribery,falsification or destruction into,it shall not knowingly enter into any lower tier covered of records,making false statements,or receiving stolen transaction with a person who is debarred,suspended,declared property; ineligible,or voluntarily excluded from participation in this covered transaction,unless authorized by the department or agency (3) Are not presently indicted for or otherwise criminally or civilly entering into this transaction. charged by a governmental entity(Federal,State or local)with commission of any of the offenses enumerated in paragraph g.The prospective first tier participant further agrees by submitting (a)(2)of this certification;and this proposal that it will include the clause titled"Certification Regarding Debarment,Suspension, Ineligibility and Voluntary (4) Have not within a three-year period preceding this Exclusion-Lower Tier Covered Transactions,"provided by the application/proposal had one or more public transactions department or contracting agency,entering into this covered (Federal,State or local)terminated for cause or default. Page 40 January 2019 Local Assistance Procedures Manual EXHIBIT B Exhibit 12-G Required Federal-Aid Contract Language FHWA-1273-- Revised May 1,2012 transaction,without modification,in all lower tier covered b.Where the prospective participant is unable to certify to any of transactions and in all solicitations for lower tier covered the statements in this certification,such prospective participant transactions exceeding the$25,000 threshold. shall attach an explanation to this proposal. 2.Instructions for Certification-Lower Tier Participants: i. Except for transactions authorized under paragraph e of these (Applicable to all subcontracts,purchase orders and other lower tier instructions,if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is transactions requiring prior FHWA approval or estimated to cost suspended,debarred,ineligible,or voluntarily excluded from $25,000 or more-2 CFR Parts 180 and 1200) participation in this transaction,in addition to other remedies available to the Federal Government,the department or agency a.By signing and submitting this proposal,the prospective lower tier with which this transaction originated may pursue available is providing the certification set out below. remedies,including suspension and/or debarment. b.The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was Certification Regarding Debarment,Suspension,Ineligibility entered into. If it is later determined that the prospective lower tier and Voluntary Exclusion--Lower Tier Participants: participant knowingly rendered an erroneous certification,in 1.The prospective lower tier participant certifies,by submission of addition to other remedies available to the Federal Government, this proposal,that neither it nor its principals is presently the department,or agency with which this transaction originated debarred,suspended,proposed for debarment,declared may pursue available remedies,including suspension and/or ineligible,or voluntarily excluded from participating in covered debarment. transactions by any Federal department or agency. c.The prospective lower tier participant shall provide immediate 2.Where the prospective lower tier participant is unable to certify to written notice to the person to which this proposal is submitted if any of the statements in this certification,such prospective at any time the prospective lower tier participant learns that its participant shall attach an explanation to this proposal. certification was erroneous by reason of changed circumstances. d.The terms"covered transaction,""debarred,""suspended," XI.CERTIFICATION REGARDING USE OF CONTRACT FUNDS "ineligible,""participant,""person,""principal,"and"voluntarily FOR LOBBYING excluded,"as used in this clause,are defined in 2 CFR Parts 180 This provision is applicable to all Federal-aid construction contracts and 1200. You may contact the person to which this proposal is and to all related subcontracts which exceed$100,000(49 CFR submitted for assistance in obtaining a copy of those regulations. 20). "First Tier Covered Transactions"refers to any covered transaction between a grantee or subgrantee of Federal funds 1.The prospective participant certifies,by signing and submitting and a participant(such as the prime or general contract). "Lower this bid or proposal,to the best of his or her knowledge and Tier Covered Transactions"refers to any covered transaction belief,that: under a First Tier Covered Transaction(such as subcontracts). a.No Federal appropriated funds have been paid or will be paid, "First Tier Participant"refers to the participant who has entered by or on behalf of the undersigned,to any person for influencing into a covered transaction with a grantee or subgrantee of or attempting to influence an officer or employee of any Federal Federal funds(such as the prime or general contractor). "Lower agency,a Member of Congress,an officer or employee of Tier Participant"refers any participant who has entered into a Congress,or an employee of a Member of Congress in covered transaction with a First Tier Participant or other Lower connection with the awarding of any Federal contract,the Tier Participants(such as subcontractors and suppliers). making of any Federal grant,the making of any Federal loan, the entering into of any cooperative agreement,and the e.The prospective lower tier participant agrees by submitting this extension,continuation,renewal,amendment,or modification of proposal that,should the proposed covered transaction be any Federal contract,grant,loan,or cooperative agreement. entered into,it shall not knowingly enter into any lower tier b.If any funds other than Federal appropriated funds have been covered transaction with a person who is debarred,suspended, paid or will be paid to any person for influencing or attempting to declared ineligible,or voluntarily excluded from participation in influence an officer or employee of any Federal agency,a this covered transaction,unless authorized by the department or Member of Congress,an officer or employee of Congress,or an agency with which this transaction originated. employee of a Member of Congress in connection with this Federal contract,grant,loan,or cooperative agreement,the f.The prospective lower tier participant further agrees by submitting undersigned shall complete and submit Standard Form-LLL, this proposal that it will include this clause titled"Certification "Disclosure Form to Report Lobbying,"in accordance with its Regarding Debarment,Suspension,Ineligibility and Voluntary instructions. Exclusion-Lower Tier Covered Transaction,"without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions exceeding the$25,000 threshold. 2.This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered g.A participant in a covered transaction may rely upon a into. Submission of this certification is a prerequisite for making certification of a prospective participant in a lower tier covered or entering into this transaction imposed by 31 U.S.C. 1352. transaction that is not debarred,suspended,ineligible,or Any person who fails to file the required certification shall be voluntarily excluded from the covered transaction,unless it knows subject to a civil penalty of not less than$10,000 and not more that the certification is erroneous.A participant is responsible for than$100,000 for each such failure. ensuring that its principals are not suspended,debarred,or otherwise ineligible to participate in covered transactions. To verify the eligibility of its principals,as well as the eligibility of any 3.The prospective participant also agrees by submitting its bid or lower tier prospective participants,each participant may,but is proposal that the participant shall require that the language of not required to,check the Excluded Parties List System website this certification be included in all lower tier subcontracts,which Page 41 January 2019 Local Assistance Procedures Manual EXHIBIT B Exhibit 12-G Required Federal-Aid Contract Language FHWA-1273-- Revised May 1,2012 (https.//www.epls.gov/),which is compiled by the General Services exceed information of participant is not required to exceed that Administration. which is$100,000 and that all such recipients shall certify and disclose accordingly. h.Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause.The knowledge and normally possessed by a prudent person in the ordinary course of business dealings. Page 42 January 2019 • CONTRACTOR'S SWORN STATEMENT AND WARRANTY • REGARDING CONTINUING INSURANCE OBLIGATIONS FROM: PTM General Engineering Services Inc. PROJECT: Project#CC-1499,Utica Avenue Bicycle Boulevard (contractor Name) from Main Street to Beach Boulevard in the City of Huntington Beach 5942 Acorn Street. (Street Address) Riverside,CA 92504 (City,State and zip) TO: CITY OF HUNTINGTON BEACH DECLARATION Attached hereto Is a true and correct copy of the current Certificate of Insurance and Additional Insured Endorsement CG 2010 1185, which Certificate complies with the insurance requirements of the Contract by and between the City of Huntington Beach("City")and the above-named Contractor("Contractor")for the above-described project("Project'. declare Linder penalty of perjury under the laws of the State of California that the above statement is true and correct signed on November 8 ,2022at erside,California (Date) (City,State) (Signs of Indivi Who Is Making Declaration) WARRANTY Contractor hereby warrants and agrees to maintain Products and Completed Operations Insurance in compliance with the Insurance requirements of the Contract for the Project Said insurance shall be maintained through and until the expiration of all Warranties provided by Contractor, Said insurance shall contain Additional Insured Endorsement CG 2010 1185,naming City as an additional insured. Contractor shall supply to City,on at least an annual basis,a Certificate of Insurance and the aforementioned Endorsement evidencing continued coverage which meets the Contract requirements. Signed on November 8 zo22 at Riverside,California (Date) (Ch'r Stoite) CONTRACTOR: Name; PT General Engineering Services Inc. By lizaT3 cRae Title; :7762F3 ISSUED IN TWO (2) ORIGINAL COUNTERPARTS BOND NUMBER 4532043 PAYMENT BOND (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS: WHEREAS, City of Huntington Beach(hereafter referred to as"City")has awarded to PTM GENERAL ENGINEERING SERVICES, INC. 5942 ACORN ST.RIVERSIDE,CA 92504 (name and address of Contractor) (hereinafter referred to as"Principal"),a contract("Contract")for the work described as follows: UTICA AVENUE BICYCLE BOULEVARD, PROJECT#CC-1499 (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 GREAT AMERICAN INSURANCE COMPANY 750 THE CITY DR.SOUTH#470,ORANGE,CA 92868 (name and address of Surety) as Surety,are held and firmly bound unto City in the penal sum of FOUR HUNDRED NINETY THREE THOUSAND FIVE HUNDRED EIGHTY NINE NO/100 dollars($ 493,589.00 ),this amount being not less than one hundred percent(100%)of the total price set forth in the Contract,in lawful money of the United States of America,for the payment of which sum,well and truly to be made,we bind ourselves,and each of our heirs, executors, administrators,successors,and assigns,jointly and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT,if the Principal, his,her,or its heirs,executors, administrators,successors or assigns,or subcontractors shall fail to pay any of the persons named in Section 3181 of the California Civil Code("Claimants")for all labor,materials or services used or reasonably required for use in performance of the work described in the Contract,or any amounts due under the Unemployment Insurance Code with respect to work or labor performed by any such Claimant, or prevailing wages due and penalties incurred pursuant to Sections 1774, 1775, 1813 or 1815 of the Labor Code, or any amounts required to be deducted,withheld and paid over to the Employment Development Department from the wages of employees of the Principal and Subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to the work or labor performed under the Contract, Surety will pay for the same, in an amount not exceeding the penal sum specified in this bond; otherwise,this obligation shall be null and void. This bond shall inure to the benefit of any of the persons named in Section 3181 of the California Civil Code so as to give a right of action to such persons or their assigns. In case any action is brought upon this bond, Surety further agrees to pay all court costs and a reasonable attorney's fee in an amount fixed by the court. PAYMENT BOND Page 1 of 2 15-45841117357 Surety stipulates and agrees,for value received,that no change,extension df 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: NOVEMBER 8TH,2022 ATTEST PTM GE RAL ENGINEERING SERVICES,INC. (Corporate Seal) Allazrincipal Name) :y Nam . - - . ngineering ervices, Inc. Title: abeth H.Mendoza de McRae President/CFO ATTEST GREAT AMERICAN INSURANCE COMPANY (Corporate Seal) S re ame), • By: CJ Name: K A (Signature of Attorney-in-Fact for Surety) (Attach Attorney-in-Fact Certificate) ( ) 714-740-3117 (Area Code&Telephone Number for Surety) APPROVED AS jfl/F(RM: BY: Whael E.Gates,'Gity 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 15-4584/117357 GREAT AMERICAN INSURANCE COMPANY® Administrative Office: 301 E 4TH STREET • CINCINNATI,OHIO 45202 • 513-369-5000 • FAX 513-723-2740 The number of persons authorized by this power of attorney is not more than FOUR No.0 20974 POWER OF ATTORNEY KNOW ALLMEN BY THESE PRESENTS: That the GREAT AMERICAN INSURANCE COMPANY,a corporation organized and existing under and by virtue of the laws of the State of Ohio,does hereby nominate,constitute and appoint the person or persons named below,each individually if more than one is named,its true and lawful attorney-in-fact,for it and in its name,place and stead to execute on behalf of the said Company,as surety,any and all bonds, undertakings and contracts of suretyship,or other written obligations in the nature thereof;provided that the liability of the said Company on any such bond, undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below. Name Address Limit of Power PHILIP E.VEGA ALL OF ALL KEVIN VEGA COViNA,CALIFORNIA $100,000,000 BRITTON CHRISTIANSEN MYRNA F.SMITH This Power of Attorney revokes all previous powers issued on behalf of the attomey(s)-in-fact named above. iN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 9TH day of FEBRUARY 2021 . Attest GREAT AMERICAN INSURANCE COMPANY • •-G e 3 Aft4Vide69- •........ Assistant Secretary Divisional Senior tree President STATE OF OHIO,COUNTY OF HAMILTON-ss: MARK VICARIO(877-377-2405) On this 9TH day of FEBRUARY , 2021 ,before me personally appeared MARK VICARIO,tome known, being duly sworn,deposes and says that he resides in Cincinnati,Ohio,that he is a Divisional Senior Vice President of the Bond Division of Great American Insurance Company,the Company described in and which executed the above instrument;that he knows the seal of the said Company;that the seal affixed to the said instrument is such corporate seal;that it was so affixed by authority of his office under the By-Laws of said Company,and that he signed his name thereto by like authority. SUSAN A KOHORST ' °: Notary Public Yo` F= State o.Ohio a / M Comy Comm.Expires G}ir4- May 18,2025 This Power ofAttomey is granted by authority of the following resolutions adopted by the Board of Directors of Great American Insurance Company by unanimous written consent dated June 9,2008. RESOLVED: That the Divisional President,the several Divisional Senior Vice Presidents,Divisional Vice Presidents and Divisonal Assistant Vice Presidents,or any one of them,be and hereby is authorized,from time to time,to appoint one or more Attorneys-in-Fact to execute on behalf of the Company, as surety,any and all bonds,undertakings and contracts ofsuretyship,or other written obligations in the nature thereof to prescribe their respective duties and the respective limits of their authority;and to revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the Company may be affixed by facsimile to any power of attorney or cert fcate of either given for the execution of any bond undertaking,contract of suretyship, or other written obligation in the nature thereof such signature and seal when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company,to be valid and binding upon the Company with the same force and effect as though manually affixed. CERTIFICATION i,STEPHEN C.BERAHA,Assistant Secretary of Great American Insurance Company,do hereby certify that the foregoing Power ofAttomey and the Resolutions of the Board of Directors of June 9,2008 have not been revoked and are now in full force and effect. Signed and sealed this 8th day of November , 2022 ocen'S, 3 t.vf, •.... _.... Assistant Secretary S1029AH(03/20) CLEARffi ,i CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE §1189 .iK`,t':(`rM,c"!•..er,c=fcY`.ffTffC's A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of Riverside On I I` " v before me, Yee Ping Leung, Notary Public Date Here Insert Name and Title of the Officer Personally appeared Elizabeth H. Mendoza de McRae Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the persons)whose nameNl is/are subscribed to the within instrument and acknowledged to me that f/she/th executed the same in h"s/her/Th.eirauthorized capacity(IL ),andthatbyhis/her/th ' signature( ,ontheinstrumenttheperson('s,),or the entity upon behalf of which the person(N,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. •......................... o.ry YEE PING LEUNG WITNESS my hand and official seal. ` .� COMM # 2416239 Z � RIVERSIDE County �� Signature gyp f TyLo � I; California Notary Publi ' ASP Comm Exp Sept. 1fi, 2026: Signature offvotaryPubliy/ CIF•"• ........ ....... ...... • 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)OtherThan 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 r�=r�r1,rrr..=rr4te ,errrc r.ety .car.erew,agrrrxo. rcrcrri,rrfrecrrr-t=n4=rfrr-nMr�^z��rMrrc rrrc cry ©2014 National NotaryAssociation • www.NationalNotary.org•1-800-US NOTARY(1-800-876-6827) Item#5907 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 - A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy, or validity of that document. State of California County of LOS ANGELES On 11/08/2022 before me, PHILIP VEGA, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared KEVIN VEGA,ATTORNEY-in-FACT Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person's,)whose named is/ate subscribed to the within instrument and acknowledged to me that he/slge/fife,' executed the same in his/her/thsir authorized capacity(tes) and that by his/h /heix signature($on the instrument the person()., 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. 15� � jhf. PHILIP VEGA WITNESS my hand and official seal. Notary Public.California = W Los Angeles County C-•Vq14p1 is Commission#2327592 Signature L,.o."' My Comm,Expires May 31,2024 r j'ignature of Notary Public `\ Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑Corporate Officer — Title(s): ❑Corporate Officer — Title(s): ❑ Partner — ❑Limited ❑ General 0 Partner — 0 Limited ❑General 0 Individual ❑Attorney in Fact 0 Individual ❑Attorney in Fact ❑Trustee 0 Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other: ❑ Other: Signer Is Representing: Signer Is Representing: ©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 ISSUED IN TWO (2) ORIGINAL COUNTERPARTS BOND NUMBER 4532043 PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS: WHEREAS,City of Huntington Beach(hereafter referred to as"City") has, by written agreement dated ,20 ,entered into a contract with PTM GENERAL ENGINEERING SERVICES,INC. 5942 ACORN ST.RIVERSIDE,CA 92504 (name and address of Contractor) • (hereinafter referred to as"Principal"),for performance of the work described as follows: UTICA AVENUE BICYCLE BOULEVARD,PROJECT#CC-1499 • (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 GREAT AMERICAN INSURANCE COMPANY 750 THE CITY DR.SOUTH#470,ORANGE,CA 92868 (name and address of Surety) as Surety,are held and firmly bound unto City in the penal sum of FOUR HUNDRED NINETY THREE THOUSAND FIVE HUNDRED EIGHTY NINE NO/100 Dollars($ 493,589.00 ),this amount being not less than one hundred percent of the price set forth in the Contract,in lawful money of the United States,for the payment of which sum,well and truly to be made, we bind ourselves,our heirs,executors, administrators and successors,jointly and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT if the Principal shall promptly,fully and faithfully perform each and all of the covenants,obligations and things to be done and performed by the Principal in strict accordance with the terms of the Contract as said contract may be altered,amended or modified from time to time;and if the Principal shall indemnify and save harmless City and all of City's officers,agents and employees(hereinafter collectively referred to as"Obligees")fromany and all losses, liability and damages, claims,judgments,stop notices,fees and costs of every description,whether imposed by law or in equity, which may be incurred by the Obligees by reason of the failure or default on the part of the Principal in the performance of any or all of the terms or the obligations of the Contract,including all alterations,amendments and modifications thereto, and any warranties or guarantees required thereunder,then this obligation shall be void;otherwise, it shall be and shall remain in full force and effect. Surety stipulates and agrees,for value received,that no adjustment of the time or price in the Contract or any alteration,change,deletion,addition or other modification to the Contract, or the work to be performed thereunder,shall in any way affect,limit, restrict,impair or release the obligations of the Surety under this Bond. Surety waives notice of any adjustment of contract or contract price,and any other alteration,change, deletion,addition or other modification to the Contract, or the work to be performed thereunder, and agrees 15-4584/117174 • Bond N0. 4532043 to automatically adjust the penal sum of this Bond to reflect such adjustments, alterations,changes, deletions,additions or other modifications. Surety agrees to provide written confirmation of such adjustments in the penal sum to City on not less than a quarterly basis. Surety also waives the provisions of Civil Code§§2845 and 2849. The obligations of this Bond shall survive the completion of the work described in the Contract as to all obligations and liabilities of the Principal which survive completion of the work. IN WITNESS WHEREOF,each party represents and warrants that this instrument has been duly executed by Principal and Surety,on the date set forth below,that the name of each corporate party being affixed hereto is such party's proper legal name and that the individuals signing this instrument have been duly authorized pursuant to the authority of its governing body. Surety, by execution of this bond,waives any defense which Surety has or may have by reason of any failure of the Principal to execute or properly execute this bond. Dated:NOVEMBER 8TH,2022 • ATTEST PTM GENERAL ENGINEERING SERVICES,INC. (Corporate Seal) A (Principal Name) N.me: e - .. 'ng Title: Services,Inc. Elizabeth H.Men•o�Z NY Rae ATTEST GREAT AMERICAN IN'��� ; �!- (Corporate Seal) . -Or By: A Name: KEVIN (Signature of Attorney-in-Fact for Surety) (Attach Attorney-in-Fact Certificate) (—) 714-740-3117 (Area Code&Telephone Number for Surety) • APPROVED AS TO FAA By: a- 'Michael 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. PERFORMANCE BOND Page 2 of 2 15-45 84/1 1 71 74 GREAT AMERICAN INSURANCE COMPANY® Administrative Office: 301 E 4TH STREET • CINCINNATI,OHIO 45202 • 513-369-5000 • FAX 513-723-2740 The number of persons authorized by this power of attorney is not more than FOUR No.0 20974 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That the GREATAMERICAN INSURANCE COMPANY,a corporation organized and existing under and by virtue of the laws of the State of Ohio,does hereby nominate,constitute and appoint the person or persons named below,each individually if more than one is named,its true and lawful attorney-in-fact,for it and in its name,place and stead to execute on behalf of the said Company,as surety,any and all bonds, undertakings and contracts of suretyship,or other written obligations in the nature thereof;provided that the liability of the said Company on any such bond, undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below. Name Address Limit of Power PHILIP E.VEGA ALL OF ALL KEVIN VEGA COVINA,CALIFORNIA $100,000,000 BRITTON CHRISTIANSEN MYRNA F.SMITH This Power of Attorney revokes all previous powers issued on behalf of the attomey(s)-in-fact named above. IN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 9TH day of FEBRUARY 2021 Attest GREAT AMERICAN INSURANCE COMPANY •......... god Assistant Secretary Divisional Senior Vice President STATE OF OHIO,COUNTY OF HAMILTON-ss: MARK VICARIO(877-377-2405) On this 9TH day of FEBRUARY , 2021 ,before me personally appeared MARK VICARiO,to me known, being duly sworn,deposes and says that he resides in Cincinnati,Ohio,that he is a Divisional Senior Vice President of the Bond Division of Great American insurance Company,the Company described in and which executed the above instrument;that he knows the seal of the said Company;that the seal affixed to the said instrument is such corporate seal;that it was so affixed by authority of his office under the By-Laws of said Company,and that he signed his name thereto by like authority. SUSAN A KOHORST ` = Notary Public State Com Gyi� o.Ohio a � My Comm.Expires ,2 -- May 18,2025 This Power of Attorney is granted by authority of the following resolutions adopted by the Board of Directors of Great American Insurance Company by unanimous written consent dated June 9,2008. RESOLVED: That the Divisional President,the several Divisional Senior Vice Presidents,Divisional ice Presidents and Divisonal Assistant Vice Presidents,or any one of them,be and hereby is authorized,from time to time,to appoint one or more Attorneys-in-Fact to execute on behalf of the Company, as surety,any and all bonds,undertakings and contracts ofsuretyship,or other written obligations in the nature thereof to prescribe their respective duties and the respective limits of their authority;and to revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the Company may be affixed by facsimile to any porter of attorney or certificate of either given for the execution of any bond undertaking,contract of suretyship, or other written obligation in the nature thereof such signature and seal when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company,to be valid and binding upon the Company with the same force and effect as though manually affixed. CERTIFICATION I,STEPHEN C.BERAHA,Assistant Secretary of Great American Insurance Company,do hereby certify that the foregoing Power of Attorney and the Resolutions of the Board of Directors of June 9,2008 have not been revoked and are now in full force and effect. Signed and sealed this 8th day of November , 2022 if TVA msu 4i-- c 3 • Assistant Secretary S1029AH(03/20) CLEAR CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE §1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of Riverside On /I, �� , )t7 Y'-- before me, Yee Ping Leung, Notary Public Date Here Insert Name and Title of the Officer Personally appeared Elizabeth H. Mendoza de McRae Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the persons)whose namets)is/Ste subscribed to the within instrument and acknowledged to me that h'1she/they executed the same in his/her/their authorized capacity(F ),andthatbyhNis/her/tersignature( on the instrumentthe person(s,),or the entity upon behalf of which the person('s)acted,executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. • WITNESS my hand and official seal. c'''lb YEE PING LEUNG .• COMM # 2416239 z Z! %z, RIVERSIDE County j� Signature 7), • 1; California Notary Publid� Signature of Nptary Public ,.Witt;Comm Exp Sept. 16, 2026: �I 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)OtherThan Named Above Capacity(ies) Claimed by Signer(s) Signer's Name Signer's Name ❑Corporate Officer—Title(s) El 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 5cr-.rrr,,(7;Ktrrrrrrr4r..R( .rrrer."rc,csrscrtrrrcrrrrrrtrnrrx-.r1^srce•r.F".e4 r.Fr.Frc,rsr.IWY:rrrr+s, V..c^e crr.4,C ,�r.4 ©2014 National NotaryAssociation • www.NationalNotary.org•1-800-US NOTARY(1-800-876-6827) Item#5907 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of LOS ANGELES On 11/08/2022 before me, PHILIP VEGA, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared KEVIN VEGA, ATTORNEY-in-FACT Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the persons whose namets) is/arm subscribed to the within instrument and acknowledged to me that he/sloe/fire y executed the same in his/her/their authorized capacity(tes) and that by his/hew/Thei4 signatureN.on 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. PHILIP VEGA Notary Public-California Los Angeles County Signature Commission#2327592 Signat!` .f Notary Public WO. My Comm.Expires May 31,2024 4\ 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 — 0 Limited ❑General 0 Partner — 0 Limited 0 General ❑Individual 0 Attorney in Fact ❑ Individual ❑Attorney in Fact ❑Trustee ❑Guardian or Conservator ❑Trustee 0 Guardian or Conservator ❑Other: 0 Other: Signer Is Representing: Signer Is Representing: ©2014 National Notary Association• www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 CITY OF HUNTINGTON BEACH *[1/1] :j BUSINESS LICENSE ( P.O.Box 190 Huntington Beach,CA 92648-2702 (714)536-5267 Dahle Bulosan Chief Financial Officer HNY0919A 628 1 MB 0.515 7000000634 00.0002.0153 628/1 MEMM11111 ���1��1�111�111�1�1�11�11��111�11��111iI��I�Il�lll�ll�lllllluill P T M GENERAL ENGINEERING SERVICES INC 5942 ACORN STREET '":".pe RIVERSIDE CA 92504-1057 Dear Business Owner: Thank you for your payment. Attached is your City of Huntington Beach Business License certificate. Please note that approximately one month prior to the license expiration date,you will be mailed a renewal notice for the upcoming year. If for any reason your renewal notice does not arrive,you are still responsible for renewing and paying your business license prior to the expiration date. Penalties will be incurred if the payment is not received by the expiration date. Please post the business license in public view. If you do not transact business from a fixed location within the City,you must carry this license with you at all times. If a vehicle license plate number is displayed on the Business License certificate below,you must carry a copy of the certificate in that vehicle. Please contact the Business License office if there are any changes to:ownership, address,business name, business vehicle,or type of business conducted.Additionally, please notify our office if you discontinue your business. The Gender Tax Repeal Act of 1995(Act)prohibits a business from discriminating based on a person's gender for prices of similar or like-kind goods and services. However,the Act does not prohibit price differences based on the amount of time,difficulty,or cost of providing the services.In addition to prohibiting discrimination based on a person's gender,the Act requires certain businesses to clearly and conspicuously disclose to customers in writing the pricing for each standard service provided.The posting requirement applies to barbers and hair salons,tailors or businesses providing aftermarket clothing alterations,dry cleaners,and laundries providing services to individuals.To access the Department of Consumer Affairs publication, please use the following webpage: https://www.barbercosmo.ca.gov/consumers/gender_policy.pdf. To access the publication in Korean,Spanish,Vietnamese, Traditional Chinese,Simplified Chinese,or Tagalog,please use the following webpage: https://www.dca.ca.gov/publications/index.shtml There are many resources available to our business owners. Listed below are a few that might be of interest and assistance to you. Office of Business Development -(714)536-5582 Service Corps of Retired Executives-(714)550-7369 Huntington Beach Chamber of Commerce-(714)536-8888 Fictitious Business Name Information-(714)834-2889 CA Department of Tax and Fee Administration-(949)440-3473 Community Development-(714)536-5271 If you have any questions, please call a Business License representative at(714) 536-5267. City of Huntington Beach Business License License Number Business Name/Service Address POST IN PUBLIC VIEW A271213 P T M GENERAL ENGINEERING SERVIC fib Effective Date ". O*ZL 09/01/2022 Owner/Corporation fl o f z�, P T M GENERAL ENGINEERING 11"t/ :�� Expiration Date SERVICES INC k� � F 08/31/2023 v 'fll� 9 ' 1 License Type N Xr. ? t.11,-r\cq 1 Amount Paid CONTRACTOR � $106.56 THIS LICENSE IS ONLY FOR THE BUSINESS AND TYPE SHOWN. IT IS FOR THE PERSON TO WHOM ISSUED AND IS NON-TRANSFERABLE. RENEWAL IS DUE ON OR BEFORE THE EXPIRATION DATE. N 0) N 44 r Lf1 N II 10 01 01 01 70 Q '-i .-i .-I a) >' 0! LO Lfl Lfl --- N 0 Z > O O .-i - � � a o a d o o _ c > 0 N W J al a co U W �I Q .0 o E w W N Z .6 U U a U I- 0 vCi rn gIn M10 Z ip u Z IX G inI-- >- cc • O VD o ° _Q U. F- O• o Z U co Z OUWg CO a .1 D a L-L Z Q. L O Z w O L-L O Z 1 in U z c III a H U U Z E W (n Z II CC O H Q a) t7 v Z a L.0 _ > .Z-' 2 0 O 01 C c C J OU LT_Ce O C o O 1a- Li.' W O O a Toa 'a+ ) Z E U in i+ U C ILI E E Z °�' < O c U E CD c co a) a O w Z Z ce = V �' O a N ii v `-' v) o . c >• O z I)) w .;j II U° `Q m 1- E 0. wa) C U 1D of Z o �, ao z C fl. Z U > ` J '- Ua Cr)00 c OO a Z co LL F U. U - o C E ¢ 0 o c _' O. 0 w Z W C Q p c y % ac) E �C U E -) a) C W. Q :i id U O y, V - U U a W 01 Q u) m 0) Z U O J U cn Lo Q 8 cc p < z V) Q u) vZ oC .0 Z o ='_S co i C to u : ° o ° L co c C Vf c F F a .., o Q 4., f0 > i4 N ¢ Its o (n (n C@ C a o (0 t_ a o '_' ��, E u c c ^ ° a ra 47, c ` m ` a > 0 a ,_ o ° o m co c o a . >• C U > rca .° > v p r34 E v al ai c C C —� a E C no Vi (1) C7 o a� a s c uo ro U y°�, a) c a E a a a s c < aj a U n 0 O L U c L U Ul Y O O 4-, ' 7 L N Q ° O 1- L. ?� V - in < a4 a o o Ln Eo - E a) ,U o o E E CTi� c u, c La a C O C C E 0 - a ° v L'�. Ln 01,: O O a) O C f0 01 a) 4- Q C ° o o a) u o t0 - C O a.. Q O a) O O C O o - _ a1 p N N o U Ua 8c Oz Q Z J UUccaU C Q Q cr ) Q UaU U W UU -0 LE > o y cs U LL a U Q N V N a. L Lo CV CO §C CN CO = LW 2 § / _ 0 / CO r E / \ \ / k o \ o0 co / � C cf z C 2a a 0 2 { k / § < < o E z o \ k \ ± @ j § } k } / i § La 7 t $- ) z \ z ° ca z » ( 5 § = .co Li) ‹ ƒ D \ f L - § ) j - } z L ® u e % \ \ \ \ j j 0 Ill 0 co k \ k § j \ \ / \ / ) { O. / { ( ■ 7 c E Q 0 { § } j \ ( \ 4. 3 \ c \ . Y a c / / co 0 3 k 0 t / \ S ± / ca 0 / } a. 0 > § \ _ ©C•J \ \ f 11/14/22,2:54 PM Great American Insurance Company I Reports I Moody's j) Searci Great American Insurance Company CONTACT ANALYST MICHAEL DION,CFA SUMMARY 0 Reports RATINGS VIEW ALL REPORTS ---- - LONG TERM RATING FILTER BY Rating Action,Announcement+3 0 1 Region I Series SYNOPSIS RATINGS& Al ASSESSMENTS Topics/Credit Foundations .. Date Range Insurance Financial Strength METHODOLOGIES 28 APR 2022 FRAMEWORKS Not on Watch DATE TYPE TITLE 143 DOCUMENTS .«m -Tw. :.««..r.. ,.T'TITT..:, ..«*=wN.,a., .,:.**' *»rv«.» M hhhhhhh..HIT.�..I...T.., OUTLOOK TOOLS. > 14 Jul 2022 Announcement of Periodic Review Moody's announces completion Stable of a periodic review for a group PEER o of Property and Casualty Insurer 28 APR 2022 COMPARISON issuers MOODY'S INVESTORS SERVICE OTHER DEBTS ON WATCH? No > 13 May 2022 Credit Opinion American Financial Group,Inc.: REFERENCE: Update following ratings Source:Moody's Investors Service SECTOR. . affirmation;outlookstable o MOODY'S INVESTORS SERVICE - — -- RATINGS DEFINITIONS A Ticker > 28 Apr 2022 Rating Action Moody's affirms American Q FG TEAR SHEET p Financial Group's ratings(Baal LEI senior debt);outlook 12YG7O7A7ZDZ7FPT1E08 stable MOODY'S INVESTORS SERVICE Moody's Org Id 600015996 > 04 Nov 2021 Issuer Profile American Financial Group,Inc.: Segment Market Key Facts and Statistics-FYE Mar MarketInsuran e 2020 N MOODY'S INVESTORS SERVICE Industry INSURANCE:PROPERTY& > 16 Aug 2021 Announcement of Periodic Review Moody's announces completion Q CASUALTY of a periodic review of ratings of American Financial Group, Domicile Inc. MOODY'S INVESTORS SERVICE UNITED STATES > 22 Jul 2021 Credit Opinion American Financial Group,Inc.: Diversified commercial lines insurer generates consistent profitability;significant proceeds from GALIC sale Ii MOODY'S INVESTORS SERVICE > 28 Jan 2021 Rating Action Moody's affirms AFG's ratings (Baal senior)upon announced sale of GALIC;outlook stable MOODY'S INVESTORS SERVICE > 18 Sep 2020 Announcement of Periodic Review Moody's announces completion of a periodic review of ratings of American Financial Group, Inc. MOODY'S INVESTORS SERVICE > 24 Apr 2020 Credit Opinion American Financial Group,Inc.: Diversified commercial lines and fixed annuity insurer produces good results o MOODY'S INVESTORS SERVICE > 11 Oct 2019 Announcement of Periodic Review Moody's announces completion Q of a periodic review of ratings of American Financial Group, Inc. MOODY'S INVESTORS SERVICE Privacy-Terms https://www.moodys.com/credit-ratings/Great-American-Insurance-Company-credit-rating-600015996/reports?category=Ratings_and_Assessments_R... 1/3 11/14/22,2:18 PM https://ratings.ambest.com/CompanyProfile.aspx?ambnum=2213&URatingld=3064292&b1=0&AltSrc=9&PPP=&AltNum= AM Best Rating Services Great American Insurance Company AMB#: 002213 NAIC#: 16691 FEIN#: 310501234 Domiciliary Address Assigns 301 E. Fourth Street have, in Cincinnati, Ohio 45202 meet the United States Web: www.greatamericaninsurancegroup.com Phone: 513-369-5000 Fax: 513-369-5830 View AM Best Rating Unit: AMB #: 005990 - Great American Insurance Companies produ, Based on AM Best's analysis, 058317 - American Financial Group, Inc. is the AMB Ultimate Parent ar the corporate structure. View a list of operating insurance entities in this structure. Best's Credit Ratings Financial Strength View Definition Best's Credit Rating Analy: Rating (Rating Category): A+ (Superior) Rating Office:A.M. Best Rating Si Outlook(or Implication): Stable Associate Director: Raymond Thi Action: Affirmed Director: Erik Miller Effective Date: December 03, 2021 Note: See the Disclosure informatioi Initial Rating Date: September 30, 1908 the office and analyst at the time of Long-Term Issuer Credit View Definition Disclosure Information Disclosure Information For Rating(Rating Category): aa-(Superior) View AM Best's Rating Discli Outlook(or Implication): Stable Action: Affirmed Press Release no n V,4 ARA Dc.of Affirm (`rtm lif I . +ir 11/14/22,2:18 PM https://ratings.ambest.com/CompanyProfile.aspx?ambnum=2213&URatingld=3064292&b1=0&AltSrc=9&PPP=&AltNum= October 28, 2020 A+ October 28, 2020 September 11, 2019 A+ September 11, 2019 August 17, 2018 A+ August 17, 2018 August 11, 2017 A+ August 11, 2017 Related Financial and Analytical Data The following links provide access to related data records that AM Best utilizes to provide financial a consolidated or branch basis. AMB# Company Name Company Description 005990 Great American Insurance Companies(SG) Represents the AM Best Consolidated financials for the Property/C Rating Unit 087045 Great American Insurance Company CAB Represents the Property/Casualty financials for the Canada Branch 094364 Great American Insurance Company(SGB) Represents the Property/Casualty financials for the Singapore Bran Best's Credit & Financial Reports Best's Credit Report- financial data included in Best's Credit Report reflects t the current credit rating(s) for AM Best Rating Unit: AMB #: 005990 - Great A Ohl Companies. Best's Credit Report -Archive - reports which were released prior to the curre ti h Best's Financial Report - financial data included in Best's Financial Report re' available to AM Best, including updated financial exhibits and additional comb ""no available to subscribers of Best's Insurance Reports. View additional news, reports and products for this company. Press Releases 11/14/22,2:18 PM https://ratings.ambest.com/CompanyProfile.aspx?ambnum=2213&URatingld=3064292&b1=0&AltSrc=9&PPP=&AltNum= European Union Disclosures A.M. Best(EU) Rating Services B.V. (AMB-EU), a subsidiary of A.M. Best Rating Services, Inc., is an External Credit Assessmen credit ratings issued and endorsed by AMB-EU may be used for regulatory purposes in the EU as per Directive 2013/36/EU. United Kingdom Disclosures A.M. Best—Europe Rating Services Limited (AMBERS), a subsidiary of A.M. Best Rating Services, Inc., is an External Credit As Kingdom(UK).Therefore, Credit Ratings issued and endorsed by AMBERS may be used for regulatory purposes in the United K Agencies(Amendment, etc.) (EU Exit) Regulations 2019. Australian Disclosures A.M. Best Asia-Pacific Limited (AMBAP),Australian Registered Body Number(ARBN No.150375287), is a limited liability compa Kong.AMBAP is a wholesale Australian Financial Services(AFS) Licence holder(AFS No.411055) under the Corporations Act AMBAP are not intended for and must not be distributed to any person in Australia other than a wholesale client as defined in Ch does not authorize its Credit Ratings to be disseminated by a third-party in a manner that could reasonably be regarded as being making a decision in relation to a particular product or class of financial product.AMBAP Credit Ratings are intended for wholes Credit Ratings determined and disseminated by AMBAP are the opinion of AMBAP only and not any specific credit analyst.AMB opinion and not statements of fact.They are not recommendations to buy, hold or sell any securities or any other form of financie and are not a recommendation to be used to make investment/purchasing decisions. A.M. Best Asia-Pacific(Singapore) Pte. Ltd. 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Important Notice:AM Best's Credit Ratings are independent and objective opinions, not statements of fact.AM Best is not an li investment advice of any kind, nor does the company or its Ratings Analysts offer any form of structuring or financial advice. AM recommendations to buy, sell or hold securities, or to make any other investment decisions. For additional information regarding opinions, as well as the rating process, information requirements and other rating related terms and definitions, please view Guic About Us I Careers I Contact I Events I Media Relations I Offices I Press Releases I Sod, Cookie Notice I Legal &Licensing I Privacy Notice I Regulatory Information I Site Map I Teri Copyright©2022 A.M. Best Company, Inc. and/or its affiliates ALL RIGHTS RESERVE PCL XL error Subsystem: GE_VECTOR Error: GEEmptyClipPath Warning: IllegalMediaSize 11/14/22,2:24 PM Rating details of Great American Insurance Co..I S&P Global Ratings Great American Insurance Co. Issuer Credit Rating LAST REVIEW E RATING TYPE RATING RATING DATE A+ Local Currency LT Regulatory. 05-Oct-2010 17-Feb-2022 Disclosures Financial Strength Rating LAST REVIEW E RATING TYPE RATING RATING DATE A+ Local Currency LT Regulatory. 05-Oct-2010 17-Feb-2022 Disclosures VIEW RATINGS DEFINITIONS TIMEZONE: EDT https://disclosure.spglobal.com/ratings/en/regulatory/org-details/sectorCode/INS/entityld/110679 1/6 11/14/22,2:07 PM Surety Bonds-List of Certified Companies BUSINESS ADDRESS: P.O. Box 6202, Metairie, LA 70009 - 6202. PHONE: (504) 888-7790. UNDERWRITING LIMITATION b/: $11,077,000. SURETY LICENSES c,f/: AL, AZ, AR, CA, DE, DC, GA, IL, KY, LA, MD, MS, MO, MT, NV, NH, NM, NY, NC, OK, PA, RI, SC, TN, TX, UT, VT, WV, WI, WY. INCORPORATED IN: Louisiana. GRAY INSURANCE COMPANY (THE) (NAIC#36307) BUSINESS ADDRESS: P.O. BOX 6202, METAIRIE, LA 70009 - 6202. PHONE: (504) 888-7790. UNDERWRITING LIMITATION b/: $20,072,000. 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, WV, WI, WY. INCORPORATED IN: Louisiana. Great American Alliance Insurance Company (NAIC #26832) BUSINESS ADDRESS: 301 E Fourth Street, Cincinnati, OH 45202. PHONE: (513) 369-5000. UNDERWRITING LIMITATION b/: $3,025,000. SURETY LICENSES c,f/: AL, AK, AS, 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, WV, WI, WY. INCORPORATED IN: Ohio. Great American Insurance Company (NAIC #16691) BUSINESS ADDRESS: 301 E Fourth Street, Cincinnati, OH 45202. Translate https://www.fiscal.treasury.gov/surety-bonds/list-certified-companies.html#g 36/92 11/14/22,2:07 PM Surety Bonds-List of Certified Companies PHONE: (513) 369-5000. UNDERWRITING LIMITATION b/: $305,096,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, GU, 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: Ohio. GREAT AMERICAN INSURANCE COMPANY OF NEW YORK (NAIC #22136) BUSINESS ADDRESS: 301 E Fourth Street, Cincinnati, OH 45202. PHONE: (513) 369-5000. UNDERWRITING LIMITATION b/: $24,568,000. 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, WV, WI, WY. INCORPORATED IN: New York. Great American Security Insurance Company (NAIC #31135) BUSINESS ADDRESS: 301 E Fourth Street, Cincinnati, OH 45202. PHONE: (513) 369-5000. UNDERWRITING LIMITATION b/: $1,649,000. 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, WV, WI, WY. INCORPORATED IN: Ohio. Great Midwest Insurance Company (NAIC #18694) BUSINESS ADDRESS: 800 Gessner, Suite 600, Houston, TX 77024. PHONE: (713) 935-0226. Translate I IMIrICD\A/DITIM l I I1AITATIr1Al ki. ct7/l DDC nnn https://www.fiscal.treasury.gov/surety-bonds/list-certified-companies.html#g 37/92 i t. AC R'D® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 11/08/2022 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 poiicy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LICENSE NO.0637431 CONTANAME: PATRICK MCRAE PATRICK MCRAE INSURANCE SERVICES (PHO A//CNo,Eat): (714)779-6999 FAX Not;(714)779-6903 1265 N. MANASSERO SUITE 303 a lESS: maricela@mcraeinsurance.insure ANAHEIM HILLS,CA 92807 INSURE R(S)AFFORDING COVERAGE NAlC1! INSURER A:ADMIRAL INSURANCE COMPANY 24856 INSURED INSURER B:EVEREST NATIONAL INSURANCE COMPANY 10120 INSURER C:ADMIRAL INSURANCE COMPANY 24856 PTM GENERAL ENGINEERING SERVICES INC, INsuRERD:GREAT AMERICAN INSURANCE CO. 16691 5942 ACORN STREET INSURER E;WESTCHESTER SURPLUS LINES INSURANC 10172 RIVERSIDE CA 92504 INSURERF; ATLANTIC SPECIALTY INSURANCE COMPAF"27154 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFP POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER IMM/PD/YYYY) (MMIDDNYYY) A X COMMERCIAL GENERAL UABIUTY CA 00003333504 01/29/202201/29/2023 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR Y Y DEDUCTIBLE:$5,000/ DPREMGE TO RENTED ISES SES(Ea occurrence) $ 300,000 OCCURRENCE MED EXP(Any one person) $ 5,000 AP9R VED AS O FOR'4 X EBL:$1,000,000 PERSONAL 8,ADV INJURY $ 1,000,000 GEN LAGGREGATE LIMIT APPLIES PER: _II -- GENERAL AGGREGATE $ 2,000,000 PRO- 5iV .�_ £t.6ATf:SPOLICY X JECT LOG Mt PRODUCTS-COMPlOPAGG $ 21000,000 OTHER: t TiYAfTENYBEACH $ B AUTOMOBiLELIABILITY CF1CA00225 2111IY()t 1111NO2l202202/0912023 (Ea accident) COMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO Y Y COMP DED.$1,000 BODILY INJURY(Par person) $ OWNED ONLY X SCHEDULED LOLL DED.$1,000AUTOS BODILY INJURY(Per accident) $ X AUHIREDTOS ONLY X NON-OOWNED SONLY PROPERTY DAMAGE (Per accident) $ _ AUT . X HIRED PHY. _ $ C UMBRELLA LIAR X OCCUR Y Y GX000005151-01 01/29/202201/29/2023 EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE Terms are in excess of AGGREGATE $ 5,000,000 X DED RETENTION$ NIL underlying GL and AL PROD>COMP/OPS $ 5,000,000 WORKERS COMPENSATION AND EMPLOYERS'LIABILITY OTH- STATUTE ER ANYPROPRIETORJPARTNER/EXECUTNE Y/N N!A EL.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED7 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ [(RAWribe under ION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ F PROPERTY&INLAND MARINE 710-03-95-03-0001 07/10/2022 07/10/2023 $1,100,000elxtdrI55836,65000Mants7260,000 Burnam income 05/23/2022 05/23/2023 $1,390.214Schedu'ed Equipment $300 000 Leased end Rented Equipment 0 BUILDERS RISK IMP25710850200 08/24/2022 08/24/2023 $500,000 LIMIT E POLLUTION LIABII ITY G71651593003 $1,000000 EACH INCIDENT/$2,000,OC$POLICY AGO. DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached II more space Is required) CITY OF HUNTINGTON BEACH,ITS OFFICERS,ELECTED OR APPOINTED OFFICIALS,EMPLOYEES,AGENTS,AND VOLUNTEERS ARE INCLUDED AS ADDITIONAL INSUREDS AS RESPECTS GENERAL LIABILITY PER ATTACHED ENDORSEMENT. THIS INSURANCE SHALL APPLY AS PRIMARY AND NON-CONTRIBUTORY PER ATTACHED ENDORSEMENT. WAIVER OF SUBROGATION FOR WORKERS COMPESATION:SEE ATTACHED ENDORSEMENT RE:PROJECT#CC-1499,UTICA AVENUE BICYCLE BOULEVARD FROM MAIN STREET TO BEACH BOULEVARD IN THE CITY OF HUNTINGTON BEACH(PTM JOB P22-31) CERTIFICATE HOLDER CANCELLATION CITY OF HUNTINGTON BEACH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2000 MAIN STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O BOX 190 ACCORDANCE WITH THE POLICY PROVISIONS. HUNTINGTON BEACH, CA 92648 AUTHORIZED REPRESENTATIVE ,F /. ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD / / / _MO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDUJYYYY) !� 11/08l2022 • PHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pollcy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Maricela Aguirre PATRICK MCRAE INSURANCE SERVICES (PHONE 1265 N.MANASSERO SUITE 303 (EE/uc•No.Exq; (714)779-6999 I FAX No); (714)779-6903 ADDRESS: certrequest@mcraeinsurance,insure ANAHEIM HILLS INSURER(S)AFFORDING COVERAGE NAIL# CA 92807 INSURER A: BURLINGTON INSURANCE COMPANY 23620 INSURED INSURER B: PTM GENERAL ENGINEERING SERVICES,INC. INSURER C; — PO BOX 7745 INSURER D: INSURER S: RIVERSIDE CA 92503 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADOL SUBR LTR TYPE OF INSURANCE INSD WVg POLICY NUMBER POLICYEPP POLICY EXP COMMERCIAL GENERAL LIABILITY POLICY (I11YlDDMYY) LIMITS EACH OCCURRENCE $ CLAIMS-MADE Li OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ • GEN'L AGGREGATE LIMIT APPLIES PER: POLICY IJEC I I LOC GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG $ OTHER: AUTOMOBILE LIABILITY $ COMBINED SINGLE LIMIT ANY AUTO (Eaaccident) $ OWNED SCHEDULED BODILY INJURY(Per person) $ AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE $ (Per accident) A UMBRELLAUAB X $ OCCUR Y Y 6448E00880-01 01/29/2022 01/29/2023 X EXCESS LAB 2ND TIER-GOING OVER EACH OCCURRENCE $ 5,000,000 CLAIMS•MAOE PRIMARY EXCESS AGGREGATE $ 5,000,000 DED I I RETENTION WORKERS COMPENSATION PER $ AND EMPLOYERS'LIABILITY I STATUTE I I£RH- ANYPROPRIETORlPARTNERlEXECUTIVE Y IN OFFICEWMEMBER EXCLUDED? I I N/A EL EACH ACCIDENT $ (Mandatory In NH) II yes,describe under E.L.DISEASE-EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLE'S-(ACORD 101,Additional Remarks Schedule,may 6e attached If more space Is required) CITY OF HUNTINGTON BEACH,ITS OFFICERS,ELECTED OR APPOINTED OFFICIALS,EMPLOYEES,AGENTS,AND VOLUNTEERS ARE INCLUDED AS ADDITIONAL INSUREDS AS RESPECTS GENERAL LIABILITY PER ATTACHED ENDORSEMENT. THIS INSURANCE SHALL APPLY AS PRIMARY AND NON CONTRIBUTORY PER ATTACHED ENDORSEMENT. WAIVER OF SUBROGATION FOR WORKERS COMPESATION:SEE ATTACHED ENDORSEMEN RE:PROJECT#CC-1499,UTICA AVENUE BICYCLE BOULEVARD FROM MAIN STREET TO BEACH BOULEVARD IN THE CITY OF HUNTINGTON BEACH(PTM JOB P22-31) CERTIFICATE HOLDER CANCELLATION ANY oFCITY OF HUNTINGTON BEACH THE SHOULD EXPIRATIIONH DATEE ABOVE VTHEREOF, NOTICE POLICIES WILLL BE E CANCELLED DELIVERED BEFORE IN 2000 MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS. P.O BOX 190 HUNTINGTON BEACH,CA 92648 AUTHORIZED REPRESENTATIVE 1 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD ® DATE(MMlDDNYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE ifisr-----' Atoll: 2525798 11/08/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder Is an ADDITIONAL INSURED,the policy(Ies)must have ADDITIONAL INSURED provisions or be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Locklon Companies PHONE FAX 444 W 47th Street,Suite 900 -(Ara.No.Ext): 844-290-4908 (AIC.No): E1VIKansas City,MO 64112-1906 ADDRESS: BBSlcerts@locktonafl)nity.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Ace American Insurance Co. 22687 INSURED INSURER B: Barrett Business Services,Inc. . L/C!F P.T.M.GENERAL ENGINEERING SERVICES,INC. INSURER C: 5942 ACORN STREET INSURER D. RIVERSIDE,CA 92604 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. INTRR TYPE OF INSURANCE INS°SUER POLICY NUMBER (MMIDDIYYYY) IMMIDDIYY YXP YY} LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $DAMAGE TO _J CLAIMS-MADE OCCUR PREM IS EaENTED ocFWrencel $ MED EXP(Any one person) $ PERSONAL&ADV INJURY_ $ _ GEM AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO ri JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON•OWNEO PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) S III UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ - DEO RETENTIONS $ WORKERS COMPENSATION X SATUTE OTH- ER AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Yf N E.L EACH ACCIDENT $ 2,000,000 A OFFICERIIdEMBER EXCLUDED? N/A X C51252950 8/112022 8/1/2023 2,000,000 (Mandatory In NH) EL,DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Policy State m CA Waiver of Subrogation In favor of certificate holder when required by written contract Longshore end Harbor Workers'Compensation Act Coverage Endorsement(USL&H) 30-Day Notice of Cancellation RE:RE:PROJECTS CC-1409,UTICA AVENUE BICYCLE BOULEVARD FROM MAIN STREET TO BEACH BOULEVARD IN THE CITY OF HUNTINGTON BEACH(PTM JOB P22-31) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF HUNTINGTON BEACH THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 2000 MAIN STREET IN ACCORDANCE WITH THE POLICY PROVISIONS. P.O BOX 190 HUNTINGTON BEACH,CA 92848 AUTHORIZED REPRESENTATIVE - ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Workers'Compensation and Employers'Liability Policy Named Insured Endorsement Number Barrett Business Services,Inc. L/C/F P.T.M.GENERAL ENGINEERING SERVICES,INC. Policy Number 5942 ACORN STREET Symbol: Number:C51252950 RIVERSIDE,CA 92504 Policy Period Effective Date of Endorsement 8/1/2022 TO 8/1/2023 8/1/2022 Issued By(Name of the insurance Company) Ace American Insurance Co. Insert the policy number.The remainder of the information is to be completed only when this endorsement Is issued subsequent to the preparation of the policy. CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the Information Page. We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Schedule 1. ( ) Specific Waiver Name of person or organization: (X) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: 3. Premium: The premium charge for this endorsement shall be INCLUDED percent of the California premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Minimum Premium: INCLUDED Authorized Agent WC 99 03 22 Policy Number:CA000033335-04 CG 20 10 04 13 Effective Date:01/29/2022 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) Location(s)Of Covered Operations Or Organization(s) City of Huntington Beach,Its Officers,Elected Or All locations at which the Named Insured is performing Appointed Officials,Employees,Agents,And Volunteers ongoing operations. Information required to complete this Schedule,if not shown above,will be shown in the Declarations. A. Section II—Who Is An Insured is amended to include as an additional insured the person(s)or organization(s)shown in the Schedule,but only with respect to liability for"bodily injury","property damage"or"personal and advertising injury"caused,in whole or in part,by: 1. Your acts or omissions;or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s)at the location(s)designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law;and 2. If coverage provided to the additional insured is required by a contract or agreement,the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds,the following additional exclusions apply: This insurance does not apply to"bodily injury"or"property damage"occurring after: 1. All work,including materials,parts or equipment furnished in connection with such work,on the project(other than service,maintenance or repairs)to be performed by or on behalf of the additional insured(s)at the location of the covered operations has been completed;or CG 20 10 04 13 ©Insurance Services Office,Inc.,2012 Page 1 of 2 ❑ • 2. That portion of"your work"out of which the injury or damage arises has been put to its intended use by any person • or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds,the following is added to Section III—Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement,the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement;or 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 10 04 13 ©Insurance Services Office,Inc.,2012 Page 2 of 2 C] Policy Number:CA000033335-04 CG 20 37 04 13 Effective Date:01/29/2022 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) Location And Description Of Or Organization(s) Completed Operations City of Huntington Beach,Its Officers,Elected Or All locations except locations where"your work"is or was Appointed Officials,Employees,Agents,And Volunteers related to a job or project involving single-family dwellings, multi-family dwellings(other than rental apartments in an apartment building:(a)originally constructed and at all times used for such purpose,or(b)converted from a commercial building),condominiums,townhomes,townhouses,time- share units,fractional-ownership units,cooperatives and/or any other structure or space used or intended to be used as a residence. • Information required to complete this Schedule,if not shown above,will be shown in the Declarations. A. Section II—Who Is An Insured is amended to include as an additional insured the person(s)or organization(s)shown in the Schedule,but only with respect to liability for"bodily injury"or"property damage"caused,in whole or in part,by "your work"at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the"products-completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law;and 2. If coverage provided to the additional insured is required by a contract or agreement,the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds,the following is added to Section III—Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement,the most we will pay on behalf of the additional insured is the amount of insurance: I. 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 04 13 0 Insurance Services Office,Inc.,2011 Page 1 of 1 ❑ 3. Limits of Insurance a. The amount we will pay for damages is limited as described below with respect to damages covered under this en- dorsement: (1) The Aggregate Limit shown in the Schedule is the most we will pay for the sum of all damages because of "property damage"; (2) The Each Occurrence Limit shown above is the most we will pay for the sum of all damages because of"prop- erty damage"arising out of any one"occurrence"; (3) Supplementary Payments will reduce the Each Occurrence and Aggregate Limits of Insurance shown in the Schedule; and (4) All sums we pay for damages or Supplementary Payments under this endorsement will reduce the Each Occur- rence Limit and the General Aggregate Limit shown in the Declarations. 4. Other Insurance This insurance is excess over any other valid and collectible Property or Inland Marine insurance available to you,either as a Named Insured or an Additional Insured,whether primary,excess,contingent or any other basis. PRIMARY AND NONCONTRIBUTORY OTHER INSURANCE CONDITION (Insurance Services Office Endorsement CG 20 01 04 13) The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to au additional insured under your policy provided that: (I) The additional insured is a Named Insured under such other insurance;and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek con- tribution from any other insurance available to the additional insured. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (Insurance Services Office Endorsement CG 24 04 05 09). SCHEDULE Name Of Person Or Organization: Any person or organization,bat only if the following conditions are met: (1) You have expressly agreed to the waiver in a written contract;and (2) The'injury or damage first occurs subsequent to the execution of the written contract.` Information required to complete this Schedule,if not shown above,will be shown in the Declarations. The following is added to Paragraph 8.Transfer Of Rights Of Recovery Against Others To Us of Section IV—Condi- tions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or"your work"done under a contract with that person or organization and included in the"products-completed operations hazard". This waiver applies only to the per- son or organization shown in the Schedule above. AD 68 93 01 17 Includes copyrighted material of Insurance Services Office,Inc., Page 3 of 8 0 with its permission,2009,2012&2013. POLICY NO.: CFICA00225-211 COMMERCIAL AUTO ECA 04 521 04 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART SCHEDULE Name Of Additional Insured Organization City of Huntington Beach, Its Officers, Elected Or Appointed Officials, Employees,Agents,And Volunteers Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The following is added to the Who Is An Insured B. Is executed after the date of"loss". paragraph under Section II—Liability Coverage: This paragraph does not apply if: The organization shown in the Schedule with respect 1. The terms and conditions of the written to the operation, maintenance, or use of a covered "insured contract" had been agreed upon prior "auto" if you are required to add such organization to to the"accident"or"loss"; and this policy as an additional insured in order to comply with the terms of a written"insured contract"or written 2. You can definitively establish that the terms agreement. This does not apply when such contract and conditions of the written "insured contract" or agreement: ultimately executed are the same as those which had been agreed upon prior to the A. Involves the owner or anyone else from whom you "accident"or"loss". hire or borrow a covered "auto" unless it is a "trailer"connected to a covered"auto"you own; or ECA 04 521 04 14 Copyright, Everest Reinsurance Company, 2014 Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., used with its permission POLICY NO.: CFICA00225-211 COMMERCIAL AUTO ECA 24 503 02 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM SCHEDULE Name of Person or Organization: City of Huntington Beach, Its Officers, Elected Or Appointed Officials, Employees,Agents, And Volunteers (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement,) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for an "accident" or"loss", provided that you are required under a written agree- ment to waive your rights of recovery. The written agreement must be made prior to the date of the "accident" or "loss".This waiver applies only to the person or organization shown in the Schedule above. ECA 24 503 02 14 Copyright, Everest Reinsurance Company, 2014 Page 1 of 1 D Includes copyrighted material of Insurance Services Office, Inc., used with its permission. POLICY NO.: CF1CA00225-211 COMMERCIAL AUTO ECA 24 509 04 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION - BLANKET This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART Paragraph c. of the Other Insurance General Condition is replaced by the following: c. Regardless of the provisions of Paragraph a. above, this Coverage Form's Liability Coverage is primary and we will not seek contribution from any other insurance for any liability assumed under an "insured contract" that requires liability to be assumed on a primary noncontributory basis. Additionally, only the coverage and limit of insurance requirements of the "insured contract" shall apply, and in no event shall those requirements exceed the coverage and limits of insurance provided under this policy. ECA 24 509 04 14 Copyright, Everest Reinsurance Company,2014 Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., used with its permission / Y:' : : City of Huntington Beach f 9'\ 2000 Main Street ♦ Huntington Beach, CA 92648 ". (714) 536-5227 • www.huntingtonbeachca.gov VS7� . o� Office of the CityClerk C0 yf �P��l Robin Estanislau, City Clerk December 8, 2022 PTM General Engineering Services, Inc. Attn: Elizabeth H. Mendoza de Mcrae 5942 Acorn Street Riverside, CA 92504 Re: Utica Avenue Bicycle Boulevard —CC No. 1499 The City Council awarded the bid to your company for the above referenced project. Enclosed is a copy of the executed contract with the City of Huntington Beach. A Certification of Compliance with Title VII of the Civil Rights Act, Certification of Compliance with Prevailing Wage Laws and Contractor's Certificate form must be returned to this office after the proiect is completed but prior to the release of retention funds. In addition, the following item must also be on file, with this office before the City can release any retention funds: A warranty bond guaranteeing the final amount of work and materials for one year. If your performance bond does not include specific wording for a one-year warranty, then a rider or separate bond must be submitted. Should you have any questions or concerns regarding the enclosures or items that must be on file in this office prior to release of retention funds, please call the Public Works Department at 536-5517. Sincer , 0401/ Robin Estanislau, CMC City Clerk RE:ds Enclosures: Copy of Contract including Proposal Copies of insurance/bonds Bid Bond (original) Sister City: Anjo, Japan RECEIVED BY: CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office (Name) after signing/dating (Date) Q CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION Ai 0 TO: City Treasurer FROM: City Clerk DATE: /Q1D,2/2D2 a SUBJECT: Bond Acceptance I have received the bonds for 1 4-prh J '�/ /' l�l'!/I?-1-d) i?/i. (Con" Name) CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. 4/5320L13 Payment Bond (Labor and Materials) Bond No. 1-153 QO i-/3 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 /0/4 z- 262 a (Council Approval Date) CC No. ' " / / No. a02- EV 0 MSC No. City Clerk Vault No. (od U. SO Other No. SIRE System ID No. 60 ea-y 71Z) g:/forms/bond transmittal to treasurer C _i q-cri Bin mew) IN C 0 rZrz--CT- P n.o `r- St 1ZE . Cc2 .'f-Lrt.D e 1 /P B D",-0 P,9-rr A-u L.,,31 1 2.au . BID BOND oa f--._ DS 9}1,42 BOND Na BBSu KNOW ALL MEN BY THESE PRESENTS, That we, PTM GENERAL ENGINEERING SERVICES, INC. as Principal,and GREAT AMERICAN INSURANCE COMPANY a corporation authorized to transact a general surety business in the State of CALIFORNIA as Surety, are held and firmly bound unto CITY OF HUNTINGTON BEACH (hereinafter called the Obligee) in the full and just sum of TEN PERCENT OF AMOUNT BID Dollars, ($ 10% )for the payment whereof in lawful money of the United States,we bind ourselves, our heirs, administrators, executors, successors and assigns,jointly and severally,firmly by these presents. WHEREAS, the said PRINCIPAL has submitted the accompanying bid for STREET LIGHTING MODIFICATIONS ON PALM AVE. FROM SEVENTEENTH ST.TO MAIN ST. NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid,or in the event of the failure of the Principal to enter such Contract, If the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid,then this obligation shall be null and void,otherwise to remain in full force and effect. Signed and Sealed this 19TH day of AUGUST , 2022 . YEAR PT., • ERAL ENGINEERING SERVICES, INC. GREAT AMERICAN INSURANCE COMPANY // Surely Brian Mend By: VICE PRESIDENT/SECRETARY Principal BRITTON CHRISTIANSEN Attorney-in-Fact GREAT AMERICAN INSURANCE COMPANY® Administrative Office: 301 E 4TH STREET • CINCINNATI,OHIO 45202 • 513-369-5000 • FAX 513-723-2740 The number of persons authorized by this power of attorney is not more than FOUR No.0 20974 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That the GREATAMERICAN INSURANCE COMPANY,a corporation organized and existing under and by virtue of the laws of the State of Ohio,does hereby nominate,constitute and appoint the person or persons named below,each individually if more than one is named,its true and lawful attorney-in-fact,for it and in its name,place and stead to execute on behalf of the said Company,as surety,any and all bonds, undertakings and contracts of suretyship,or other written obligations in the nature thereof;provided that the liability of the said Company on any such bond, undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below. Name Address Limit of Power PHILIP E.VEGA ALL OF ALL KEVIN VEGA COVINA,CALIFORNIA $100,000,000 BRITTON CHRISTIANSEN MYRNA F.SMITH This Power of Attorney revokes all previous powers issued on behalf of the attomey(s)-in-fact named above. IN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 7TH day of FEBRUARY 2020 . Attest GREATAMERICAN iNSU NCE COMPANY .111 �,ixswt + ♦Jfff f(Vtlet Assistant Secretary Divisional Senior Vice President STATE OF OHiO,COUNTY OF HAMILTON-ss: MARK VICARIO(877-377-2405) On this 7TH day of FEBRUARY , 2020 ,before me personally appeared MARK VICARIO,tome known, being duly sworn,deposes and says that he resides in Cincinnati,Ohio,that he is a Divisional Senior Vice President of the Bond Division of Great American insurance Company,the Company described in and which executed the above instrument;that he knows the seal of the said Company;that the seal affixed to the said instrument is such corporate seal;that it was so affixed by authority of his office under the By-Laws of said Company,and that he signed his name thereto by like authority. 45 . Put c,KOIIOiSt 1 -• Notary ,PIIbMc,Mete of Olio GL n % CQ 9� . � My commission Expires 08.182020 This Power ofAttomey is granted by authority of the following resolutions adopted by the Board of Directors of Great American Insurance Company by unanimous written consent dated June 9,2008. RESOLVED: That the Divisional President, the several Divisional Senior Vice Presidents,Divisional Vice Presidents and Divisonal Assistant Vice Presidents,or any one of them, be and hereby is authorized,from time to!line,to appoint one or more Attorneys-in-Fact to execute on behalf of the Company, as surety,any and all bonds,undertakings and contracts of suretyship,or other written obligations in the nature thereof to prescribe their respective duties and the respective limits of their authority;and to revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the Company may be affixed by facsimile to any power of attorney or certificate of either given for the execution of any bond,undertaking,contract of suretyship, or other written obligation in the nature!hereof such signature and seal when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company,to be valid and binding upon the Company with the same force and effect as though manually affixed. CERTIFICATION I,STEPHEN C.BERAHA,Assistant Secretary of Great American Insurance Company,do hereby certify that the foregoing Power of Attorney and the Resolutions of the Board of Directors of June 9,2008 have not been revoked and are now in full force and effect. Signed and sealed this 19TH day of AUGUST , 2022 4. e/f :4 ' Assistant Secretary S1029AG(07/18) 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 6 " e2 3 • '94? before me, PHILIP VEGA, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared BRIAN MENDOZA Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same In his/her/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. °C ra PHILIP VEGA ..Td Notary Public•California WITNESS my hand d official seal. 41.1. ' Los Angeles County r1-,Z144 ° Commission#2327592 '<• °" My Comm.Expires May 31,2024 Signature Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) • Signer's Name: Signer's Name: ❑Corporate Officer —Title(s): 0 Corporate Officer — Title(s): ❑Partner — ❑ Limited ❑General 0 Partner — ❑Limited 0 General ❑Individual ❑Attorney in Fact ❑Individual 0 Attorney in Fact ❑Trustee 0 Guardian or Conservator ❑Trustee El Guardian or Conservator ❑Other: El Other: Signer Is Representing: Signer Is Representing: ©2014 National Notary Association•www.NationalNotary.org •1-800-US NOTARY(1-800-876-6827) Item#5907 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of LOS ANGELES On AUG 19 2022 before me, PHILIP VEGA, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared BRITTON CHRISTIANSEN 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. r,., PHILIP VEGA WITNESS hand and official seal. • Notary Public•California <,m Los Angeles County zi�ti. o m # 2792 u�o Comm Expiresmission May23 315,2024 Signature 1� , Signature of Notary Public%`t 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 — 0 Limited 0 General 0 Partner — 0 Limited 0 General 0 Individual 0 Attorney in Fact 0 Individual 0 Attorney In Fact ❑Trustee 0 Guardian or Conservator 0 Trustee 0 Guardian or Conservator ❑Other: 0 Other: Signer Is Representing: Signer Is Representing: ©2014 National Notary Association• www.NationalNotary.org•1-800-US NOTARY(1-800-876-6827) Item#5907 G REATAMER/cAN. INSURANCE GROUP August 31st, 2022 City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 Project: UTICA AVENUE BIYCLE BOULEVARD FROM MAIN STREET TO BEACH BOULEVARD - The bid bond that was issued for PTM General Engineering Services, Inc. for the UTICA AVENUE BIYCLE BOULEVARD FROM MAIN STREET TO BEACH BOULEVARD bid on August 30th, 2022 was issued with a typo on the project description. That bond should have read the above project title. Great American Insurance Company has approved the above titled bid for PTM General Engineering Services, Inc. ,-// Sincerely / •• ',/ ;— Britton Christiansen, Attorney-in-Fact GREAT AMERICAN INSURANCE COMPANY® Administrative Office: 301 E 4TH STREET • CINCINNATI,OHIO 45202 • 513-369-5000 • FAX 513-723-2740 The number of persons authorized by this power of attorney is not more than FOUR No.0 20974 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the GREAT AMERICAN INSURANCE COMPANY,a corporation organized and existing under and by virtue of the laws of the State of Ohio,does hereby nominate,constitute and appoint the person or persons named below,each individually if more than one is named,its true and lawful attorney-in-fact,for it and in its name,place and stead to execute on behalf of the said Company,as surety,any and all bonds, undertakings and contracts of suretyship,or other written obligations in the nature thereof;provided that the liability of the said Company on any such bond, undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below. Name Address Limit of Power PHILIP E.VEGA ALL OF ALL KEVIN VEGA COVINA,CALIFORNIA $100,000,000 BRITTON CHRISTIANSEN MYRNA F.SMITH This Power of Attorney revokes all previous powers issued on behalf of the attorney(s)-in-fact named above. IN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 7TH day of FEBRUARY 2020 . Attest GREAT AMERICAN INS NCE COMPANY se9 C. 3 VUe69' Assistant Secretary Divisional Senior Vice President STATE OF OHIO,COUNTY OF HAMILTON-ss: MARK VICARIO(877-377-2405) On this 7TH day of FEBRUARY , 2020 ,before me personally appeared MARK VICARIO,tome known, being duly sworn,deposes and says that he resides in Cincinnati,Ohio,that he is a Divisional Senior Vice President of the Bond Division of Great American Insurance Company,the Company described in and which executed the above instrument;that he knows the seal of the said Company;that the seal affixed to the said instrument is such corporate seal;that it was so affixed by authority of his office under the By-Laws of said Company,and that he signed his name thereto by like authority. Susan A!collars( ci alloNotary PubiStillledOhb c ctir�- t`4 My Coerrrrktion Expires 06-18.2020 This Power of Attorney is granted by authority of the following resolutions adopted by the Board of Directors of Great American Insurance Company by unanimous written consent dated June 9,2008. RESOLVED: That the Divisional President,the several Divisional Senior Vice Presidents,Divisional Vice Presidents and Divisonal Assistant Vice Presidents,or any one of them, be and hereby is authorized,from time to time,to appoint one or more Attorneys-in-Fact to execute on behalf of the Company, as surety,any and all bonds,undertakings and contracts of suretyship,or other written obligations in the nature thereof to prescribe their respective duties and the respective limits of their authority;and to revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the Company may be affixed by facsimile to any power of attorney or certificate of either given for the execution of any bond,undertaking,contract of suretyship, or other written obligation in the nature thereof such signature and seal when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company,to be valid and binding upon the Company with the saute force and effect as though manually affixed CERTIFICATION I,STEPHEN C.BERAHA,Assistant Secretary of Great American Insurance Company,do hereby certify that the foregoing Power of Attorney and the Resolutions of the Board of Directors of June 9,2008 have not been revoked and are now in full force and effect. Signed and sealed this 31st day of AUGUST , 2022 . .s e 3 . .........• Assistant Secretary S1029AG(07/18) 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 AUG 3 1 2022 PHILIP VEGA, NOTARY PUBLIC On before me, Date Here Insert Name and Title of the Officer personally appeared BRITTON CHRISTIANSEN 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. r .l.i416d‘*1"16 -1.: PHILIP VEGA t Notary Public-California WITNESS m hand a.. official seal. ; Los Angeles County f f. Commission#2327592 My Comm.Expires May 31,2024 Signature Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Corporate Officer — Title(s): ❑Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑General ❑ Partner — ❑Limited 0 General 0 Individual ❑Attorney in Fact ❑ Individual ❑Attorney in Fact ❑Trustee 0 Guardian or Conservator ❑Trustee 0 Guardian or Conservator ❑Other: D Other: Signer Is Representing: Signer Is Representing: rSc'G w2=w" "*.�, a,gf4w i rSCzf t v�o: .,"wZ Cww.�(St CSE ©2014 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 BID BOND BOND NO. BBSU KNOW ALL MEN BY THESE PRESENTS, That we, PTM GENERAL ENGINEERING SERVICES, INC. as Principal,and GREAT AMERICAN INSURANCE COMPANY a corporation authorized to transact a general surety business in the State of CALIFORNIA as Surety, are held and firmly bound unto CITY OF HUNTINGTON BEACH (hereinafter called the Obligee) in the full and just sum of TEN PERCENT OF AMOUNT BID Dollars, ($ 10% )for the payment whereof in lawful money of the United States,we bind ourselves,our heirs, administrators, executors, successors and assigns,jointly and severally,firmly by these presents. WHEREAS, the said PRINCIPAL has submitted the accompanying bid for UTICA AVENUE BICYCLE BOULEVARD FROM MAIN STREET TO BEACH BOULEVARD NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid,or in the event of the failure of the Principal to enter such Contract, If the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid,then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and Sealed this 19th day of AUGUST , 2022 YEAR PTM G NE L ENGINEERING SERVICES, INC. GREAT AMERIC�,� INSURANCE COMPANY Surety -ifirr By: Principal B-ITTON C -ISTIANSEN Attorney-in-Fact PTM General Engineering Services, Inc. :Ilzabeth H.Mendoza de McRae President/CFO GREAT AMERICAN INSURANCE COMPANY® Administrative Office: 301 E 4TH STREET • CINCINNATI,OHIO 45202 • 513-369-5000 • FAX 513-723-2740 The number of persons authorized by this power of attorney is not more than FOUR No.0 20974 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the GREAT AMERICAN INSURANCE COMPANY,a corporation organized and existing under and by virtue of the laws of the State of Ohio,does hereby nominate,constitute and appoint the person or persons named below,each individually if more than one is named,its true and lawful attorney-in-fact,for it and in its name,place and stead to execute on behalf of the said Company,as surety,any and all bonds, undertakings and contracts of suretyship,or other written obligations in the nature thereof;provided that the liability of the said Company on any such bond, undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below. Name Address Limit of Power PHILIP E.VEGA ALL OF ALL KEVIN VEGA COVINA,CALIFORNIA $100,000,000 BRITTON CHRISTIANSEN MYRNA F.SMITH This Power ofAttomey revokes all previous powers issued on behalf of the attomey(s)-in-fact named above. IN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 7TH day of FEBRUARY 2020 . Attest GREAT AMERICAN INSU NCE COMPANY ��insur Tr.krit e. Vceiet.9- •.........• Assistant Secretary Divisional Senior Vice President STATE OF OHIO,COUNTY OF HAMILTON-ss: MARK VICARIO(877-377-2405) On this 7TH day of FEBRUARY , 2020 ,before me personally appeared MARK VICARIO,tome known, being duly sworn,deposes and says that he resides in Cincinnati,Ohio,that he is a Divisional Senior Vice President of the Bond Division of Great American Insurance Company,the Company described in and which executed the above instrument;that he knows the seal of the said Company;that the seal affixed to the said instrument is such corporate seal;that it was so affixed by authority of his office under the By-Laws of said Company,and that he signed his name thereto by like authority. Susan k Kohorst Notary Pubic,Ws of of o aci„,/,,44.„, My Con rrrbslon Bolles 06464020 This Power of Attorney is granted by authority of the following resolutions adopted by the Board of Directors of Great American Insurance Company by unanimous written consent dated June 9,2008. RESOLVED: That the Divisional President,the several Divisional Senior Vice Presidents,Divisional Vice Presidents and Divisonal Assistant Vice Presidents,or any one of them, be and hereby is authorized,from time to time, to appoint one or more Attorneys-in-Fact to execute on behalf of the Company, as surety,any and all bonds,undertakings and contracts of suretyship,or other written obligations in the nature thereof to prescribe their respective duties and the respective limits of their authority;and to revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the Company may be affixed by facsimile to any power of attorney or certfficate of either given for the execution of any bond,undertaking,contract of suretyship, or other written obligation in the nature thereof such signature and seal when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company,to be valid and binding upon the Company with the same force and effect as though manually affixed. CERTIFICATION I,STEPHEN C.BERAHA,Assistant Secretary of Great American Insurance Company,do hereby certify that the foregoing Power of Attorney and the Resolutions of the Board of Directors of June 9,2008 have not been revoked and are now in full force and effect. Signed and sealed this 19th day of AUGUST , 2022 4(._ e ■ Assistant Secretary S1029AG(07/18) 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 0 .? 3 • 702/7--- before me, PHILIP VEGA, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared ELIZABETH H. MENDOZA de McRAE 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 ,Al°`'r PHILIP VEGA is true and correct. t' ; Notary Public-California Los Angeles County E WITNESS my hand and official seal. 1 '` -,, �+° Commission#2327592 — °""� My Comm.Expires May 31,2024 f \ Signature Signat\V+`f Notary Public `� A Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑Corporate Officer — Title(s): 0 Corporate Officer — Title(s): ❑ Partner — 0 Limited ❑General 0 Partner — 0 Limited 0 General ❑Individual 0 Attorney in Fact 0 Individual 0 Attorney in Fact ❑Trustee 0 Guardian or Conservator 0 Trustee 0 Guardian or Conservator ❑Other: 0 Other: Signer Is Representing: Signer Is Representing: mgcl ,^�"- '�4w. ,..w,_-: 'w-mv^ o��v^* �`10 r4^Tr�,Kavma4 — — ©2014 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of LOS ANGELES On AUG 19 2022 before me, PHILIP VEGA, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared BRITTON CHRISTIANSEN 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 TN PHILIP VEGA is true and correct. a ; Notary Public•California WITNESS m and a.. official seal. 4 _•i Los Angeles County Commission#2327592 . i My Comm.Expires May 31,2024 — — — l Signature ids__ 41', Signature of Notary Public V Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) - Signer's Name: Signer's Name: ❑Corporate Officer — Title(s): ❑Corporate Officer — Title(s): ❑ Partner — 0 Limited 0 General 0 Partner — ❑ Limited 0 General ❑ Individual ❑Attorney in Fact 0 Individual ❑Attorney in Fact ❑Trustee 0 Guardian or Conservator ❑Trustee 0 Guardian or Conservator ❑Other: 0 Other: Signer Is Representing: Signer Is Representing: Lc r csc�su`c�c e �'kS 3 t'�!C ���G sv"�G CsT�'rcrer�C ck �C�wwo mwm.'? 3� ©2014 National Notary Association •www.NationalNotary.org •1-800-US NOTARY(1-800-876-6827) Item#5907 i.a.�. ,�...�.... .. � : t" v .{{ T. ; 4, eA1 'Yt 0 Af y $, y $r4 '£A at a".i. 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M 4 9a X ,94 ;.r. - Zr Wife{'}ro' w.,• R CEIVED BY' CITY CLERK RECEIPT COPY Return DUPLICATE to ��� City Clerk's Office (Na ) after signing/dating (Date) CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION ittr, TO: City Treasurer FROM: City Clerk DATE: 12/0.2/,202 2. SUBJECT: Bond Acceptance I have received the bonds for r T 1 / t ten.. (,2f1//f1' G� 1 r�Y�( l�l .Zf ex_}. (Company Name) c%J CAPITAL PROJECTS (Includes CC's and MSC's) J Performance Bond No. 4/5320113 Payment Bond (Labor and Materials) Bond No. L/53 aQ 11,E 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 /0//14ll,2!!2 Z. (Council Approval Date) CC No. PY /Q 1 Agenda Item No. " ?Do MSC No. City Clerk Vault No. Other No. SIRE System ID No. 1,1D crn2 1/ f O g:/forms/bond transmittal to treasurer 2000 Main Street, Huntington Beach,CA =4_ 648 City of Huntington Beach �t�n 6V87) 4- 1 DEZQ-0 ZE/[82W) File #: 22-800 MEETING DATE: 10/4/2022 REQUEST FOR CITY COUNCIL ACTION SUBMITTED TO: Honorable Mayor and City Council Members SUBMITTED BY: Al Zelinka, City Manager VIA: Sean Crumby, Director of Public Works PREPARED BY: Darren Sam, Senior Traffic Engineer Subiect: Accept bid and authorize execution of a construction contract with PTM General Engineering Services Inc., in the amount of$493,589 for the construction of the Utica Avenue Bicycle Boulevard Project (CC-1499) and authorize change orders not to exceed 15 percent and the use of project funding in the amount of $84,438 from the Citywide Mobility and Corridor Improvements Project Statement of Issue: The Utica Avenue Bicycle Boulevard Project was advertised and six (6) bids were received and opened on August 30, 2022. City Council action to award the project to the lowest responsive and responsible bidder is requested to move the project forward for construction. Financial Impact: The cost estimate for the project construction is $893,668. Funds in the amount of $809,230 are available both in the Fiscal Year 2021/22 Capital Improvement Program (CIP) carry forward in Proposition 42 business unit 21990010 ($124,970) and OCTA Grant business unit 87390019 ($684,260). Staff is requesting that City Council authorize funding the remaining project amount of $84,438 from the Citywide Mobility and Corridor Improvements Project in Infrastructure Fund business unit 31440005. Recommended Action: A) Accept the lowest responsive and responsible bid submitted by PTM General Engineering Services Inc., in the amount of$493,589; and, B) Authorize the Mayor and City Clerk to execute a construction contract in a form approved by the City Attorney; and, C) Authorize the Director of Public Works to execute change orders not to exceed a total of 15 % of the contract construction costs, or $74,038; and, City of Huntington Beach Page 1 of 3 Printed on 9/28/2022 powereIOA,LegistarTM File #: 22-800 MEETING DATE: 10/4/2022 D) Authorize the use of City Mobility and Corridor Improvements Project funding in the amount of $84,438 towards this project. Alternative Action(s): Reject all bids and provide staff with alternate direction. Analysis: City staff submitted a grant application for the Utica Avenue Bicycle Boulevard Project under the Bicycle Corridor Improvement Program (BCIP) Call for Projects administered by the Orange County Transportation Authority (OCTA). The grant application was approved and subsequently construction funds were allocated to the project. The BCIP is a federal Congestion Mitigation and Air Quality (CMAQ) funded program authorized under Moving Ahead for Progress in the 21st Century, the federal surface transportation program. The CMAQ program provides funding through annual appropriations to Orange County to be used for transportation-related projects that reduce congestion and improve air quality. The OCTA is responsible for selecting and collaborating with the California Department of Transportation in administering the selected projects. The City's Utica Avenue Bicycle Boulevard Project was an identified project eligible to receive grant funding for bicycle boulevard improvements under the BCIP. The Utica Avenue Bicycle Boulevard Project is located on Utica Avenue between Beach Boulevard and Main Street (Attachment 1). The project is identified in the City Bicycle Master Plan as a recommended bicycle boulevard facility. The project improvements incorporate street features to achieve these following goals: 1. Reduce motor vehicle traffic speeds more consistent with sharing the roadway with bicyclists, 2. Create an environment where motorists more readily recognize bicycle users and accept them as roadway users, and 3. Better accommodate pedestrians. The project improvements consist of installation of bicycle boulevard signing and markings, construction of a bicycle-only-through passageway between adjoining cul-de-sacs on Utica Avenue between Lake Street and Alabama Street, and installation of a new traffic signal at the intersection of Lake Street and Utica Avenue. A complete set of plans and specifications are available for review at the Public Works counter during normal business hours. Bids for the project were opened on August 30, 2022 and are listed in ascending order.. No. Bidder Submitted Bid 1 PTM General Engineering Services Inc. $493,589.00 2 Elecnor Belco Electric Inc. $550,579.00 3 California Professional Engineering Inc. $563,136.75 Select Electric Inc. $569,850.00 5 DBX Inc. $575,033.00 City of Huntington Beach Page 2 of 3 Printed on 9/28/2022 poweretMj Legistar- File #: 22-800 MEETING DATE: 10/4/2022 6 113eador Construction Company Inc. $657,700.00 None of the submitted bids required corrections. City staff recommends awarding a contract to PTM General Engineering Services, Inc., the lowest responsive and responsible bidder. The estimated project cost is $893,668 and is summarized below: Contractor's Bid $493,589 15% Construction Contingency $74,038 City Furnished Equipment $248,500 Contract Administration $77,541 Total $893,668 Additionally, staff is requesting that the Director of Public Works be given authorization to approve change orders on this project up to 15 percent of the construction bid rather than the standard 10 percent. The request is approximately equivalent to the standard 10 percent contingency based on the total of the construction contract amount plus City purchased materials. This authorization will provide the added flexibility needed to complete a typical construction project and be consistent with the 10 percent contingency limit intent. The total project cost will be primarily covered by existing appropriations including OCTA grant. However, staff is requesting that City Council authorize funding the remaining project amount of $84,438 from the Citywide Mobility and Corridor Improvements Project in Infrastructure Fund business unit 31440005 towards this project to move forward with construction. Citizen's Infrastructure Advisory Board/Public Works Commission Action: The Public Works Commission recommended the Utica Avenue Bicycle Boulevard Project at the June 16, 2021 public meeting of the Commission by a vote of 5-0-2 (Ferlita, Nguyen absent). Environmental Status: The project is categorically exempt pursuant to the California Environmental Quality Act, Section 15301 (c). Strategic Plan Goal: Infrastructure & Parks Attachment(s): 1. Vicinity Map City of Huntington Beach Page 3 of 3 Printed on 9/28/2022 poweretV LegistarT11 moo. s P� //n PROJECT cn BOLSA AVE. 0 LOCATION U Mc FADDEN AVE. U Lfi� V EDINGER Z Of c~n N AVE. � Z Y Q C� n N J p OHEIL Q �'' AVE. m m p N J V) Z W cn Q m WARNER o o AVE. Q SLATER o AVE. w 405 m ,0 TALBERT AVE. PACIFIC �� ELLIS AVE. GARFIELD —' AVE. 0 A U) c~n c~n c~n Q YORKTOWN AVE. ADAMS AVE. cn 0� q� m INDIANAPOLIS AVE. Y OCEAN Z J ATLANTA Q zo = AVE. m U w � m w Z HAMILTON AVE. m yGjir BANNING A VE. CITY OF HUNTINGTON BEACH PROJECT LOCATION MAP ATTACHMENT Iola UTICA AVENUE BICYCLE BOULEVARD Moore, Tania From: Steven C Shepherd Architect <steve@shepherdarchitects.com> Sent: Wednesday, October 5, 2022 1:27 PM To: supplementalcomm@surfcity-hb.org; CITY COUNCIL Subject: YES ON AGENDA ITEM #16 Hello Mayor and Councilmembers, My name is Steve Shepherd, and I am contacting you today to voice my support for Agenda Item #16 as it will further a project that prioritizes improvements to pedestrian and bicycle infrastructure in our community. Inadequate pedestrian and bicycle infrastructure presents a very real public safety and accessibility issues for residents and non-residents alike. Many of Huntington Beach's existing streets and roadways are ill-suited and virtually inaccessible for pedestrians and cyclists. Simply put,this is an unsustainable state of affairs. While this project will not solve all our community's public right-of-way issues, it is a step in the right direction and should be seen as representing a bare minimum of what must be done going forward. As a reminder,this project is primarily being funded through OCTA. City funds are only being authorized to cover potential change orders not to exceed 15%of the contract construction costs. I urge our entire local government, elected officials and staff alike,to join me in making the improvement of our public rights-of-way a city-wide priority. I view the approval of Agenda Item#16 as just a very small step toward this goal. Thank you, Steve Shepherd Huntington Beach,CA 92646 1 NOTICE INVITING SEALED BIDS for the construction of Utica Avenue Bicycle Boulevard Project on Utica Avenue between Beach Boulevard and Main Street CC No. 1499 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 August 30, 2022. 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 $20.00 nonrefundable fee if picked up, or payment of a$35.00 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.gov/2ovemment/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 the bid opening. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. All extension of unit prices will be subject to verification by the AGENCY. In case of a variation between the unit price and the extension, the unit price will govern. Project Description: The project consists of installation of bicycle boulevard signage and roadway markings, constructing a bicycle and pedestrian only passage through an area of two non-connecting street segments separate by a block wall, and installation of a traffic signal at the intersection of Lake Street & Utica Avenue including construction of ADA compliant curb ramps. The contract shall allow the Contractor 50 working days to complete the contract. The Project Disadvantage Business Enterprises (DBE) goal is 6.00% 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 7th day of June 2022, by Resolution No. 2022-28. Attest: /s/Robin Estanislau CITY CLERK OF THE CITY OF HUNTINGTON BEACH Switzer, Donna From: Christine Gonzalez <cgonzales@scng.com> Sent: Thursday,July 21, 2022 2:02 PM To: Switzer, Donna Subject: Re: Request for Publication - NISB CC-1499 - Group account# 5190751 Attachments: 11549986R.pdf Got it. OC Register Legal Advertising Sales Coordinator Chrissy Gonzalez 1771 S. Lewis St. Anaheim, CA 92805 714-796-6736 M-F 8:00 a.m. - 4:30 p.m. Lunch 12 Noon to 1:00 p.m. Closed Sat. and Sun. On Thu, Jul 21, 2022 at 1:59 PM Switzer, Donna<Donna.Switzerksurki . -hb.org>wrote: Hi Chrissy, Thank you for bringing my mistake to my attention! Please publish the Notice on 8/4,8/11 and 8/18. Thank you! T)0VVA' WSWxbe'r, CMC Senior Deputy City Clerk-City of Huntington Beach 1 2000 Main Street-Huntington Beach,CA 92648 (714)374-1649 From: Christine Gonzalez<cgonzales@scng.com> Sent:Thursday,July 21, 2022 1:18 PM To: Switzer, Donna <Donna.Switzer@surfcity-hb.org> Subject: Re: Request for Publication - NISB CC-1499 -Group account#5190751 HI Donna, There is not a publication date for 8/30 HB Wave. Cost $1,726.40, pub 8/4, 8/11, 8/25 Hb Wave OC Register Legal Advertising Sales Coordinator Chrissy Gonzalez 1771 S. Lewis St. Anaheim, CA 92805 714-796-6736 M-F 8:00 a.m. - 4:30 p.m. Lunch 12 Noon to 1 :00 p.m. 2 Closed Sat. and Sun. On Thu, Jul 21, 2022 at 10:47 AM Switzer, Donna<Donna.Switzergsurfcity-hb.org>wrote: Good morning, Chrissy: Please publish the attached NISB for CC-1499, in The Wave, on August 4t", 1 lt" and 301", 2022. Thank you. Sincerely, D0nna,'Swft3Z4-, CMC Senior Deputy City Clerk-City of Huntington Beach 2000 Main Street-Huntington Beach,CA 92648 (714)374-1649 3 NOTICE INVITING SEALED BIDS for the construction of Utica Avenue Bicycle Boulevard Protect on Utica Avenue between Beach Boulevard and Main Street CC No. 1499 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 proiects 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 August 30, 2022. 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$20.00 nonrefundable fee if picked up,or payment of a$35.00 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: htta://www.huntingtonbeachca.goy/government/departments/public works/Bids/ Open website,then click on"Current Advertised Proiects"tab. This is a Davis-Bacon proiect 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 Contractors License Class A at the time of the bid opening. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. All extension of unit prices will be subiect to verification by the AGENCY. In case of a variation between the unit price and the extension,the unit price will govern. Proiect Description: The proiect consists of installation of bicycle boulevard signage and roadway markings,constructing a bicycle and pedestrian only passage through an area of two non-connecting street segments separate by a block wall,and installation of a traffic signal at the intersection of Lake Street & Utica Avenue including construction of ADA compliant curb ramps. The contract shall allow the Contractor 50 working days to complete the contract. The Proiect Disadvantage Business Enterprises(DBE)goal is 6.00% 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 COUNCI L of the CITY OF HUNTINGTON BEACH,CALI FORN IA, the 7%day of June 2022.by Resolution No.2022-n. Attest: /s/Robin Estanislau CITY CLERK OF THE CITY OF HUNT INGTON BEACH Published Huntington Beach WaveAug.4,11,18,2022 11549986 Nuntington Beach Wave 1771 S. Lewis Street Anaheim,CA 92805 714-796-2209 5190751 HUNTINGTON BEACH, CITY OF PROOF OF PUBLICATION CITY CLERK DEPARTMENT 2000 MAIN ST Legal No. 0011549986 HUNTINGTON BEACH, CA 92648-2763 FILE NO. NISB CC-1499 AFFIDAVIT OF PUBLICATION STATE OF CALIFORNIA, SS. County of Orange I am a citizen of the United States and a resident of the County aforesaid; I am over the age of eighteen years,and not a party to or interested in the above entitled matter. I am the principal clerk of the Huntington Beach Wave, a newspaper that has been adjudged to be a newspaper of general circulation by the Superior Court of the County of Orange, State of California, on July 1, 1998, Case No. A-185906 in and for the City of Huntington Beach, County of Orange, State of California;that the notice, of which the annexed is a true printed copy, has been published in each regular and entire issue of said newspaper and not in any supplement thereof on the following dates,to wit: 08104/2022,08/11/2022,08/18/2022 1 certify(or declare) under the penalty of perjury under the laws of the State of California that the foregoing is true and correct: Executed at Anaheim, Orange County, California, on Date: August 18, 2022. Ch, Signature r.LP1-12/15/16 1 NOTICE INVITING SEALED BIDS for the construction of Utica Avenue Bicycle Boulevard Proiect on Utica Avenue between Beach Boulevard and Main Street CC No.1499 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 proiects 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 August 30, 2022. 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$20.00 nonrefundable fee if picked up, or payment of a$35.00 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.huntingtQnbeachca.gov/government/departments/pubiis works/Bids/ Open website,then click on"Current Advertised Projects"tab. This is a Davis-Bacon Proiect 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 the bid opening. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. All extension of unit prices will be subiect to verification by the AGENCY. In case of a variation between the unit price and the extension,the unit price will govern. Proiect Description: The proiect consists of installation of bicycle boulevard signage and roadway markings, constructing a bicycle and pedestrian only passage through an area of two non-connecting street segments separate by a block wall, and installation of a traffic signal at the intersection of Lake Street & Utica Avenue including construction of ADA compliant curb ramps. The contract shall allow the Contractor 50 working days to complete the contract. The Proiect Disadvantage Business Enterprises(DBE)goal is 6.00% The AGENCY reserves the right to reiect 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 7t_h_day of June 2022_,by Resolution No. 2022-28 Attest: /s✓Robin Estanislau -- CITY CLERK OF THE CITY OF HUNTINGTON BEACH Published Huntington Beach WaveAug.4,11,18,2022 11549986 i.LP1-12J15/16 2 RECEIVED iTON EIVED RECEIV a:oo PM 20 AUG 30 PM�-W 0 PM 30 PM 3: 00 CITY CLERK RK CITY' CLERK CITY OF TY OF HUNTMOTON 9EAC"` PEA TtNGTON BE��C" C 1�n. l L. °tol LAJ _>. 0- B6 Ri.d C.0 ~ -4 C o.<n o ti"ri o �1��• ¢ �IO�i n S� :"' i�73�I N019N11N�11ti J0 A 113 WM310 A113 os :i Nd of 3nu ila C13AI3338 CC� 1 4 M BID DATE: ,L ,�,� � TIW PrAl/ Engineer's Estimate: $ BID LIST BIDDER'S NAME -RANK. TOTAL BID"OUNT 4. no $ (� 5. ` $ �eiya) 6. 7. $ ' 8. $ 9. $ 10. $ ll. $ 12. $ 13. $ 14. $ I UNSUCCESSFUL BIDS CC No. 1499 Utica Avenue Bicycle Boulevard 0��NTIN6TO. City of Huntington Beach CFPO(„r• e4, ,•.9\� 2000 Main Street ♦ Huntington Beach, CA 92648 - _ (714) 536-5227 • www.huntingtonbeachca.gov V' .• Office of the City Clerk _FCoUNT`?•�jj/�� Robin Estanislau, City Clerk January 10, 2023 Beador Construction, Inc. 26320 Lester Circle Corona, CA 92883 RE: Utica Avenue Bicycle Boulevard —CC No. 1499 Enclosed please find your original bid bond for CC No. 1499 Sincerely, 6/1411, 9,6Sein Robin Estanislau, CMC City Clerk RE:ds Enclosure Sister City: Anjo, Japan CONTRACT DOCUMENTS SPECIFICATIONS AND STANDARD DRAWINGS for the construction of UTICA AVENUE BICYCLE BOULEVARD from Main Street to Beach Boulevard CC NO. 1499 FEDERAL AID PROJECT CML-5181(191) in the CITY OF HUNTINGTON BEACH • ►0► le 2000 MAIN STREET HUNTINGTON BEACH,CALIFORNIA 92648 (714)536-5431 BIDS DUE: August 30,.2022 2:00 PM,2nd FLOOR City Clerk's Office SEAN CRUMBY,P.E. DIRECTOR DEPARTMENT OF PUBLIC WORKS CITY OF HUNTINGTON BEACH PLANS { SPECIFICATIONS AND CONTRACT DOCUMENTS for the construction of UTICA AVENUE BICYCLE BOULEVARD from Main Street to Beach Boulevard CC NO. 1499 FEDERAL AID PROJECT CML-5181(191) Prepared Under the Supervision of: Q�t�FES ;4(\ ruCt NO. 44002 4412 William F.Janusz,R.G .No. 4400 . ` Date Approved by: C44) 6,//7/02 Thomas Herbel, City Engineer,R.C.E.No. 53300 Date ll SECTION C PROPOSAL for the construction of UTICA AVENUE BICYCLE BOULEVARD from Main Street to Beach Boulevard CC NO. 1499 FEDERAL AID PROJECT CML-5181(191) in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids,the undersigned hereby proposes and agrees to perform all the work therein described,and to furnish all labor,material, equipment and incident insurance necessary therefor,in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 50 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site,plans,specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work,that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses,taxes,royalties,fees,etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts,and words shall govern over figures. C-1 If awarded the Contract,the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option,be considered null and void. Accompanying this proposal of bid,find Bidder's Bond in the amount of 10%of bi which said amount is not less than 10%of the aggregate of the total bid price,as required by the Notice Inviting Sealed Bids,payable to the AGENCY. (Please insert the words"Cash","Certified Check",or"Bidder's Bond for_% ", as the case may be) Any standard Surety Bid Bond form is acceptable. Bidder shall signify receipt of all Addenda here,if any: Addenda No:. `Date Received +.< ?Bidder's Signature 1 08/23/2022 C-2 Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Item Estimated Item Unit Price Extended No. Quantity Amount 1 1 L.S. Mobilization. $ 66, 000 $ ( 5Doo Per L.S. _ 2 1 L.S. Furnish Project Traffic Control. $ I2?, o45 $ (27,04 5 Per L.S. 3 1 L.S. Preparation of project Specific Storm Water Pollution Prevention Plan (SWPPP). $ 3 o o o $ 3, 000 Per L.S. 4 1 EA. Installation and maintenance of BMP's per the approved SWPPP. $ IS,Doo $ IS,Ooo Per L.S. 5 21 LF Remove existing block wall and footing $ 400 $ 8,4 oo 6 1 EA Construct concrete island $ �{, UO o $ q, 0 00 7 40 LF Construct 8"median curb $ 2 -o $ S, Soo 8 1,500 SF Remove and dispose existing A.C. and base material $ ID $ 15 Do 0 9 130 LF Remove and dispose of existing curb and gutter $ 6,0 $ 7, 2.00 10 76 LF Construct 6"curb and gutter $ IZo $ qIts) 11 33 LF Construct 6" curb $ 200 $ , 600 C-2.l Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Item Estimated Item Unit Price Extended No. Quantity Amount 12 1 LS Reconstruct existing improvements $ I0/ $Oo $ 100 Soo 13 1 EA Adjust manhole to grade $ 5, Soo $ 5 oc. 14 2 EA Finish raw edge of wall with matching existing material and color $ q, 00o $ $, 00 0 15 113 SF Remove and dispose existing sidewalk $ y5 $ 5oa5 16 70 TONS Construct new 2" type III-C3-PG 64-10 (1/2") surface course over 4"class B- $ 235 $ Ilo, `fS c, PG 70-10 (3/4") base course over 1.0' C.M.B. 17 100 TONS Construct 1' crushed miscellaneous $ I orj $ I0/ $coo base 18 3 EA Construct Curb Access Ramp on northwest, northeast and southeast corners at Lake Street/Utica Ave per $ 27 r✓' oo $ $2, 5 o o Caltrans Standard Plan No. RSP A88A, Case A and Details on Sheets 3 and 4. (Item includes all appurtenances, curb and gutter, depressed curb, sidewalk, domes, retaining curb, slot pave, etc.) Per EA. C-2.2 Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Item Estimated Item Unit Price Extended No. Quantity Amount 19 1 EA Construct Curb Access Ramp on southwest corner Lake St/Utica Ave per Caltrans Standard Plan No. RSP A88A and Detail on Sheet 4 (Item includes all $ 27 5 O c $ 27, 50 appurtenances, curb and gutter, depressed curb, sidewalk, domes, retaining curb, slot pave, etc.) Per EA. 20 1 L.S. Install traffic signal at the intersection of Lake Street and Utica Avenue (excludes curb ramps and city furnished equipment) $ Z) , q 0 6 $ 21 I� I o 0 Per L.S. 21 1 L.S. Furnish and install signing and striping. $ 5,500 $ 5 50 C-2.3 Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Total Amount Bid Total Amount Bid in Figures: $_ (s57, 7on Total Amount Bid in Words: $ Six kindred fif+y- seveh +hods .e ci seven hundred Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (also includes anchor bolts) to the contractor. The contractor is to pick up the materials, with its own labor, at the City Yard, 17371 Gothard Street. Contact traffic signal maintenance two working days in advance for pick up at(714) 536-5530. 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 r 'JName and Address of F +State Class ti161144T %of �. �Item(s) rt ii Subcontractor, 5 Licenset wr n Registrat,on# i Amount Contract;. �� �.� 4i . ti , �i,, 0 !,f7.?; r F 5; �t,i m'• 1Vumber=: f. -.. Dg ElecrrIG Zo Eas-.vale, CA 10104'N C-Io I0000ybg72 vet%530 30.2-V/o Superior Paven,en+ 2% MarKin95 77(e'JO(o C-3Z IDo0o01476 $52,0oo 7.' CyprrsS,CA C-3 I By submission of this proposal,the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on08/25i2022,at Corona , CA Date City State David A.Beador , being first duly sworn, deposes and says that he or she is President of Beador Construction Company,Inc the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company,association,organization,or corporation;that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded,conspired, connived,or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not,directly or indirectly,submitted his or her bid price or any breakdown thereof,or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Beador Construction Company,Inc. N•, - • 1 idder Sign 41A e of Bidder 26320 Lester Circle,Corona CA 92883 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 UTICA AVENUE BICYCLE BOULEVARD,(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. Beador Construction Company,Inc. Contra r • (David A. Beador) By President Title Date:08/27/2022 C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder,any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes a 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. Beador C struction Company,Inc. Contr.- o (David A. Beador) By President Title Date: 08/27/2022 C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Beador Construction Company,Inc. Bidder Name 26320 Lester Circle Business Address Corona CA 92883 City, State Zip ( 951 ) 674-7352 dabeador@beador.com Telephone Number Email Address 720483-Class A State Contractor's License No. and Class 03/24/96 Original Date Issued 07/31/24 Expiration Date The work site was inspected by David A. Beador of our office on Aug 92 , 20222 The following are persons, firms, and corporations having a principal interest in this proposal: David A. Beador 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. Bead, Co • ruction Company,Inc. Compa \I Signature of Bidder David A. Beador Printed or Typed Signature C-8 NOTARY CERTIFICATE Subscribed and sworn to before me this 2 day of JI} , 2022, A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document, to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California ) County of Riverside ) On 0.14- 2et2JZZ before me, wc.) IN ?J';L Month,Day, and Year Insert Name and Title of Notary personally appeared 1aec, Se- 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. R.QUEZADA WITNESS my hand and official seal. Notary Public California lllll Riverside County Commission#2278239 My Comm.Expires Mar 19,2023 Signature 1r Signature of Nota 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 traffic signals,curb&gutter and sidewalk. 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. Route 101 and Camarillo Name and Address of Public Agency Name and Telephone No. of Project Manager: David Beador 951-674-7495 $1,155,300.00 Replacing Structural Concrete and place concrete harrier Feb 2021 Contract Amount Type of Work. Date Completed Provide additional project description to show similar work: 2. Temple Hills Drive in Laguna Beach Name and Address of Public Agency Name and Telephone No. of Project Manager:- David Beador 951-674-7495 Pedestrian Improvements August 2020 $1,050,700.00 P g Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 3. Temescal Canyon Widening Projects Name and Address of Public Agency Name and Telephone No.of Project Manager: David Beador 951-674-7495 $1,581,730.00 Widening,Slurry,&Drainage Improvements November 2020 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: G10 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 David Beador Name of proposed Project Manager Telephone No. of proposed Project Manager: 951-674-7302 See Job List Project Name&Contract Amount Type of Work Date Completed 951-674-7302 Project Name&Contract Amount Type of Work Date Completed Project Name&Contract Amount Type of Work Date Completed 2. Adam Prieto Name of proposed Superintendent Telephone No. of proposed Superintendent: 951 674 7302 See ,�bt 4- 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-ti Beador Construction Company.Inc. Attachment"A" MAJOR CONSTRUCTION PROJECTS/COMPLETED&In Progress PHONE NUMBER Email PROJECTMGR PROJECTSUPT CONTRACT DATE PROJECT NAME OWNER CONTACT PERSON PHONE NUMBER PHONE NUMBER AMOUNT COMPLETION San Juan Capistrano CalTrans Majid Javahemeshan David Beador Ramiro Acevedo $8,404,700.00 Start June 2011 Rte 5-Widen Roadway and Bridges 12-0E5704 949-289-3551 951-674-7352 949-279-0057 Complete June 2013 Irvine City of Irvine Steve Sherwood David Beador Larry Coleman 8248,567.00 Start Nov 2010 314120 Macarthur Median Drainage Imprvmnts 1 Civic Center Plaza,Irvine 92623 949-724-6000 951-674-7352 949-279-0386 Complete Sept 2011 Irwindale-Bridge Canty of Los Angeles Salman Khan David Beador Bob Ortega $1.929786.00 Start May 2011 RDC0011613 Foothill Blvd over San Gabriel 900 S.Fremont Ave,Alhambra 91803- River 1331 626-458-4956 951-674-7352 949-678-2041 Complete April 2012 Long Beach-Road Improvements Port of Long Beach PK Wang David Beador Bob Ortega 5428,822.00 Start Oct 2010 925 Harbor Plaza,Long Beach 90802 PO HD-S2339 710-Ninth and Shoemaker Bridge Box 570 Long Mach 90801 562-901-1759 951-674-7352 949-678-2041 Complete 2012 Long Beach-Bridge Girder Repair Port of Long Beach PK Wang David Beador Bob Ortega $439,371.00 Start Oct 2010 333 West Ocean Blvd 11th Floor,Long Beach 90802-4664 PO Box 570 Long HD-S2320A SR 710-Anaheim Street Bridge Beach 90801 562-901-1759 951-674-7352 949-678-2041 Complete 2012 Newport Beach Seismic Retrofit City of Newport Beach Thomas Sandefur David Beador Ramiro Acevedo $780,759.00 Start Dec 2010 3300 Newport Blvd,PO Box 1768, #3531 Bridge Seismic Retrofit Newport Beach 92658-8915 949-644-3312 951-674-7352 949-279-0057 Complete Aug 2011 1.10 WB Lane addition SANBAG Ken Loncharich David Beador Ramiro Acevedo $16,083,300.00 Start Feb 2011 C10190 STPLN 6053(088)Rte 10 in Redlands&1170 W.3rd Street 2nd Floor,San Yucaipa Bernardino 92410-1715 949-283-0854 951-674-7352 949-279-0057 Complete 2013 City of Newport Beach City of Newport Beach AB Fakhouri David Beador Ramiro Acevedo $3,522,723.00 Start May 2011 3300 Newport Blvd,PO Box 1768, #3724 Jamboree Road over SR-73 Newport Beach 92658-8915 949-644-3312 951-674-7352 949-279-0057 Complete 2012 City of Moreno Valley City of Moreno Valley Vireo Shah David Beador Bob Ortega $229,000.00 Start April 2011 2011 Citywide Bridge Maintenance Program 11-22679828 951-314-2288 951-674-7352 949-678-2041 Complete June 2011 County of Riverside Canty of Riverside Vu Thanh Nguyen David Beador Bob Ortega $11,870.00 Start July 2011 Blythe Emergency Repair 08-007004 909-825-2753 951-674-7352 949-678-2041 Completed July 2011 County of Orange County of Orange Mo Raista David Beador Ramiro Acevedo $235,551.00 Start Sept 2011 91 Freeway Emergency 12-0M1904 949-279-8803 951-674-7352 949-279-0057 Completed Oct 2011 County of Los Angeles County of Los Angeles Hassan Fayad David Beador Bob Ortega $1,169,693.00 Start May 2011 PCH Bridge Emergency Job 07-3X4604 562-860-3085 x-107 951-674-7352 949-678-2041 Completed Jan 2012 County of San Bernardino Canty of San Bernardino Ken Tran David Beador Bob Ortega $360,422.00 Start May 2012 Hwy 330 08-0J8004 951-674-7352 949-678-2041 Complete Aug 2012 County of Riverside City of Corona/Murieta David Beador Bob Ortega $726,521.00 15/215/91 08-002104 951-674-7352 949-678-2041 Completed Nov 2012 County of Orange County of Orange Hiram Downard David Beador Ramiro Acevedo $20,053,300.00 Start June 2011 #ER08990 Antonio Parkway 1152 E.Fruit St,Santa Ana 92701 714-567-7838 951-674-7352 949-279-0057 Complete 2013 County of LA Caltrans Juan C.Arias David Beador Bob Ortega $769,700.00 Start July 2012 Route 105,West of Facade Ave 07-4S8404 951-674-7352 949-678-2041 Completed JUIy 2013 57 FWY CalTrans Adrian Wu David Beador Jeff B&Bob Ortega $28,581,800.00 Start Feb 2011 Re 57 in Placentia&Fullerton 12-0F0314 949-279-8488 951-674-7352 951-674-7352 Complete Dec 2013 City of Carlsbad City of Carlsbad Casey Arndt David Beador Ramiro Acevedo $660,000.00 Start Jan.2015 6016/3557 Carlsbad Blvd.OH Railing Improvements 1635 Faraday Ave,Carlsbad 92008-7314 (760)602-2780 x7320 951-674-7352 714-393-9855 Complete August 2015 City of Tustin City of Tustin Jon Draugelis David Beador Ramiro Acevedo $1,560,000.00 Start August 2015 CIP 50041 Install Biofiltration Urals 300 Centennial Way,Tustin 92780 714-573-3164 951-674-7352 714-393-9855 Complete April 2016 County of Riverside Canty of Riverside Trai Nguyen David Beador Larry Coleman $960,000.00 Start June 2016 4080 Lemon Street,8th Floor,PO Box Project No.C6-0081 Exchange Club Park 1090.Riverside 92501 951-961-5363 951-674-7352 760-908-5129 Completed Oct 2016 City of Diamond Bar City of Diamond Bar John Beshay David Beador Larry Coleman $465,502.00 Start Sept 2016 Project No.26315 Diamond Bar Blvd/Brea Canyon Rd Enhancement 21810 Copley Dr,Diamond Bar 91765 909-839-7043 951-674-7352 760-908-5129 Completed Jan 2017 City of Torrance City of Torrance Elizabeth Overstreet David Beador Larry Coleman $786,400.00 Start Sept 2016 Project No.B-2016-19 PCH from Calle Mayor to Janet Lane Safety Enhancement Project,1-133 3031 Torrance Blvd,Torrance 90503 310-618-3074 951-674-7352 760-908-5129 Completed Jan 2017 Park West Rescom,Inc. Forester Toscana Development David Beador Ramiro Acevedo $329,950.00 Start Jan 2017 4590 MacArthru Blvd Suite 600,Newport Temescal Canyon Road Beach 92660 951-674-7352 714-393-9855 Completed Mar 2017 County of LA/City of Porter Ranch CalTrans Ali Mohsenzadeh David Beador Ramiro Acevedo $1,367,300.00 Start Oct 2016 Tampa Ave Off Ramp on Route 118 07-2849U4 818-364-2760 x-233 951674-7352 714-393-9855 Completed June 2017 City of Torrance City of Torrance Angel Lotus alotuslftorrarceca.0ov David Beador Ramiro Acevedo $80,300.00 Start Apr 2017 Bluff Drive Stonn Drain 3031 Torrance Blvd,Torrance 90503 310-618-3079 951-674-7352 714-393-9855 Completed May 2017 Forestar Chatsworth,LLC Forester Chatsworth,LLC Brian Woods David Beador Ramiro Acevedo $3,676,700.00 Start Oct 2016 4590 MacArthru Blvd Suite 600,Newport Canoga Avenue Bridge Beach 92660 949.748-6714 x-204 951-674-7352 714-393-9855 After CO's-$3,873.610.50 Completed Forester Chatsworth,LLC Forester Chatsworth,LLC Brian Woods David Beador Ramiro Acevedo $7,550,300.00 Start Sept 2016 4590 MacArthru Blvd Suite 600,Newport Poema Bridge Beach 92660 949-748-6714 x-204 951-674-7352 714-393-9855 Completed Apr 2019 City of Costa Mesa City of Costa Mesa Ballazar Mejia laltazar.meiia®costamesaca.0o David Beador Bodean Matteson $1,682,300.00 Started 10/9/17 Project No.16-04-Placentia Ave Median Improvements 77 Fair Drive,Costa Mesa,92628 714-754-5291 951-674-7352 619-889-0515 $1,700,259 00 Completed 07/14/18 City of Stanton City of Stanton Guillermo Perez David Beador Larry Coleman $517,700.00 Start 8/16/17 Thunderbird Lane Sewer&Street Improvements 7800 Kahane Ave,Stanton 90680 714-890-4204 951674-7352 760-908-5129 Completed 12/8/17 City of Laguna Beach City of Laguna Beach Louis Kneip David Beador Ramiro Acevedo $1,824,816 00 Start 9/19/17 CIP 436-Agate and Thalia Street Beach stair replacement 505 Forest Ave,Laguna Beach 92651 949464-6688 951-674-7352 714-393-9855 Completed 09/11/18 East Orange County Water District East Orange County Water District Lisa ONund David Beador Larry Coleman $393,000.00 Start 12/12/17 Open Trench Sewer Line Replacement 185 N.McPherson Rd,Orange 92689 714-538-5815 951-674-7352 760-908-5129 Completed 219/18 Jurupa Valley Care Clinic Pacific Construction Group Share Dixon David Beadle Adam Prieto $350,000.00 Start 01/15/18 Jurupa Valley 17895 Sky Park Circle Unit K,Irvine 92614 714-460-3573 951-674-7352 714-552-5818 Complete 2/15/18 Brookhurst Ave Bridge City of Huntington Beach John Griffin David Beador Adam Prieto $866,300.00 Start 2/21/18 2000 Main Street,PO Box 190,Huntington CC-1449-Bridge Preventive Maintenance Beach 92648 714-375-5011 951-674-7352 714-552-5818 Completed 9/6/18 Magnolia Ave Bridge City of Huntington Beach John Griffin David Beador Adam Prieto $833,700.00 Start 2/26/18 2000 Main Street,PO Box 190.Huntington CC-1448 Bridge Preventive Maintenance Beach 92648 714-375-5011 951674-7352 714-552-5818 Completed 7/7/18 City of Norco City of Norco Chad Blois David Beador Jose Lopez Lemus $372,300.00 Start 9/18/18 Norco MDP Line Bluf Street Storm Drain 2870 Clark Ave,Norco 92860 951-270-5678 Oplaisfdci.rorco.ca.ug 951-674-7352 949-445-9299 Completed 11/21/18 Dorn Court Storm Drain Improvements City of Laguna Beach Tri Nguyen David Beador Jose Lopez Lemus $262,700.00 Start 9/10/18 CIP 509 Storm Drain Improvements on Dom Court 505 Forest Ave,Lague Beach 92651 949-497-0741 In agyerh lagunnabeachcitv.nel 951674-7352 949-445-9299 Completed 11/13/18 07-1XG904-Emergency Caltrans Caltrans-Emergency job Kris Venkataraman David Beador Bodeen Matheson $345,000.00 Start 10/19/18 07-1XG904-damaged concrete barrier& Rte N5/W118 connector sign structure 714-376-2022 951-674-7352 619-889-0515 Completed 11/29/20 07-1XJ504-Emergency Caltrans Caltrans-Emergency job Pravin Patel David Beador Bodean Matheson $420,000.00 Start 11/01/18 Route EB 606 Peck Rd,South El Monte 07-1XJ504-damaged bridge 213-798-6053 951-674-7352 619-889-0515 Completed 08/23/19 07-1XL604-Emergency Caltrans Caltrans-Emergency job Thong David Beador Larry Coleman $386,279.20 Start 4/19/19 W.190th Street&223rd Street&110 07-1XL604 951-674-7352 760-908-5129 Completed 01/8/20 12-052404-91 WB At La Palma Caltrans-Emergency job KBah David Beador Omar Lara $267,915.42 Start 10/24/19 PHONE NUMBER Email PROJECT MGR PROJECT SUPT CONTRACT DATE PROJECT NAME OWNER CONTACT PERSON PHONE NUMBER PHONE NUMBER AMOUNT COMPLETION Emergency Bridge girder repair 12-0S2404 951-674-7352 Completed 12/21/19 Pearl Street-Emergency Job City of Laguna Beach Matthew Oxford modordelaounabeachcity net David Beador Larry Coleman $137,000.00 Start 2/26/20 Pearl Street 8 PCH 949-613-4045 951-674-7352 Completed 3/5/20 • PHONE NUMBER Email PROJECT MGR PROJECT SUPT CONTRACT DATE PROJECT NAME OWNER CONTACT PERSON PHONE NUMBER PHONE NUMBER AMOUNT COMPLETION Temescal Wash/Elm Street County of Riverside Hector Davila hedaviladrivco.orq David Beador Adam Prieto Start 11/25/19 DO-0025 2950 Washington St.,Riverside 92504 951-955-6885 951-674-7352 714-552-5818 Completed 04/27/20 07-326104-Soldier Pile Wall Caltrans Fuad Aziz fuad.azizl8dot.ca aov David Beador Adam Prieto $1,395,300.00 Start 08/02/18 Construct soldier pile wall at bottom of slope 07-326104 310-403-9747 951-674-7352 714-552-5818 Completed 02/13/20 Construction on Hwy 605 @ Live Oak City of Irwindale-250W0's A.B.Fakhotzi ab.fakholzirdacaconsitants.com David Beador Bodean Matheson $1,869,300.00 Start 01/7/19 P-974,interchange improvmenls 5050 N.Irwindale Ave,Irwindale 91706 714-225-3007 951-674-7352 619-889-0515 250 WD's 12-0N3004-ramp realignment,paving,striping Caltrans Nabil Ruda nabil nda(3/dol.ca.aov David Beador Larry Coleman $937,300.00 Start 05/08/19 Route 241,Rancho Santa Margarita 12-0N3004 949-279-8491 951-674-7352 Completed 10/23/19 Oliver Street Bridge DR Horton-2280 Wardlow Circle,Coron Keith Alex David Beador Omar Lara $485,000.00 Start 9/3/2019 Oliver Street/JFK,Moreno Valley Oliver Street 951-972-9000 951-674-7352 Completed Jan 2020 07-313804-Install RCP&Corrugated metal ri Caltrans Edgar Hernandez edaar.herrerardot.ca.aov David Beador Adam Prieto $1,078,700.00 Start 12/5/19 Route 110 near Redondo Beach Blvd 07-313804 310-609-0364 951-674-7352 714-552-5818 Complete 01/16/20 07-299104-Replace roadside sign& pavement marking,construct catch basin Caltrans Fuad Aziz fuad.azizthhdot.ca.aov David Beador Ramiro $459,300.00 Start 2/17/20 Route 1,Long Beach at Los Alamitos Traffic Circle 07-299104 310-403-9746 951-674-7352 Complete 04/08/20 07-1XH504-Emergency Caltrans Caltrans-Emergency job Kalyanakrisfnan Venkataraman oakrishnan Venkataramandclol.l David Beador Bodean Matheson $75,000.00 Start 6/29 Route 5/118 07-1XH504 818-262-8853 951-674-7352 619-889-0515 Complete 7/10/20 Temescal Canyon Widening Projects County of Riverside Hector Davila hedavila6rivco.ong David Beador Adam Prieto $13,581,730.00 Start 12/10/18 Project No.C5-0072,C6-0066&B9-0988 Widening,Slurry&Drainage improvements 2950 Washington St.,Riverside 92504 951-955-6885 951-674-7352 714-552-5818 Completed 11/02/20 07-313604-Remove&Replace RCP Caltrans Ridwan Salman ridwan.salmav(ddot.ca.aov David Beador Larry Coleman $1,174,700.00 Start 06/01/20 Route 5 and Angeles National Forest 07-313604-30W D's 661-257-0273 951-674-7352 760-908-5129 Completed 9/2/20 University Drive Widening Improvements City of Irvine Alex Salazar asalazar(ilcilvofirvine.orq David Beador Ramiro Acevedo $11,472,300.00 Start 03/21/18 CIP 311306-University Drive Widening 1 Civic Center Plaza,PO Box 19575 Irvine Improvements 92623-9575 949-724-7408 951-674-7352 714-393-9855 Est Completion April2019 Culver I University Intersection City of Irvine Alex Salazar asalazar(bcitvofirvina.org David Beador Ramiro Acevedo $3,549,300.00 Start 12/12/18 1 Civic Center Plaza,PO Box 19575,Irvine CIP 318030-Bid No.18-1336 92623-9575 949-724-7408 951-674-7352 714-393-9855 Est Completion April 2019 08-0H4704-Widen bridge for std shoulders Caltrans John Santos jolm.sanlos4ldoLca,aov David Beador Ron Hernandez $2,740,300.00 Start 04/30/19 Route 2,San Bernardino County,in W rightwood at Sheep Creek Bridge 08-0H4704-267 WD's 951-538-5315 951-674-7352 267W D's 08.1J3904 Widen off ramp with HMA Caltrans Vu Thanh vu t hanh.nauvenattdot.ca.aov David Beador Larry Coleman $731,700.00 Start 01/22/20 Route 210 in San Bernardino at Del Rosa AveEB Ramp exit 08-1J3904-65WD's 951-232-3784 951-674-7352 760-908-5129 Completed 06/11/20 Temple Hills Drive Pedestrian Improvements City of Laguna Beach Natalie Chan nchan2Dlaaunabeachcilv.ne( David Beador BoDean Matheson $1.050.700.00 Start 01/03/20 Temple Hills Drive from Thalia Street to Alta 505 Forest Ave,Laguna Beach,CA 92651 CIP Laguna Blvd 241-60W D's 949-497-0741 951-674-7352 619-889-0515 Completed 8/29/20 08-106804-Sediment Control and stabilization measures Caltrans David Benson david.benson8dot.ca.aov David Beador Jason Beesmer $1443,70000 tM working day 08/1420 Route 15 in Murrieta/Mentee off Scott Road OC 08-1 C6604-70 WD's 951-232-6478 951-674-7352 Start 09/04/20 complete 01/05/i 07-4W8204-Replace structural concrete bridge and place concrete barrier Caltrans Saeid Shaken saeid.shake8i0140Lca.aov David Beador Ramiro Acevedo $1,155,300.00 I Approved 06/22/20 Route 101 in Camarillo at Central Ave OC 07-4W 8204-180 WD's 213-808-7976 951-674-7352 Start 09/28/20 completed 02/15/ 07-1XN004-Emergency Caltrans Caltrans-Emergency job Ramon Robillos ramon.robillosi5doLca.aov David Beador Larry $370,000,00 Completed Jan 2021 Route 105 at Long Beach Blvd 07-1XN004 805-431-4352 951-674-7352 12-006604-RR structural concrete roadway, approach slabs&sign structures Caltrans Dal Pham datoham0doLca aov David Beador Ramiro/Larry $2,260,300.00 Start Approx 8/6/2020 Route 55/405 separation in Costa Mesa/Santa Ana 12-006604-190 WD's 949-279-8586 951-674-7352 Completed 02/06/21 Laguna Canyon Channel City of Laguna Beach Matthew Oxford moxfordrlaaunabeachcitv.nel David Beador Adam Prieto $1,230,300.00 Start 05/04/20 From transition structure at Beach St to Main 505 Forest Avenue I Laguna Beach,CA 926s,CIP 1st portion completed Beach 209 949-613-4045 951-674-7352 714-552-5818 07/03/20 08-1 M0104-replace signs Caltrans-Emergency job Vu Nguyen vu,thanh.rwuven(ddot.ca.aov David Beador Bodean Matheson $29,316.88 Start 10/4/21 Route 215 at Beech Avenue,Fontana 08-1M0104 951-674-7352 Completed 10/6/21 Santa Margarita Parkway Hinge Bridge City of Rancho Santa Margarita Ti!Nguyen Inauvenecitvofrsm.orq David Beador Adam Prieto/Ron $2,536,700.00 Start 07/07/20 180 WD's 22112 El Paseo,Rancho Santa Margarita,CA From San Sebastian to SR-241 92688 949-635-1813 951-674-7352 Completed amen -1st warkktg 07-309304-Reinforce Concrete Bridge Caltrans Michael Chou micheahchoula/dotca.aov David Beador Ron/LarrylBoDean $5,812.300.00 day01/04/21 Route 210/405/605 07-309304-200 WD's 626-339-1601 a-104 951-674-7352 Start 01/07/21-Completed Approved 06/1820-ratan 12-0P5204-Replace concrete barrier&sign start wAn 190 days-approu panel&modify lighting system Caltrans Elie Najm elie.naim(/dot.ca.aov David Beador Ramiro Acevedo $1,674.300.00 start09/1420 Rte 22,57-in Orange on Rte 22 from Lewis St OC to City Drive UC and Rte 57 from Chapman Ave UC to Orangewood Ave UC 12-0P5204-110 WD's 951-674-7352 Start 01/14/21-Completed 08-1 H7704-Install sign structure,HMA, Approved 06/30/20-mid modify ramp metering&retaining wall Caltrans Nick Mineo nicholas.mine0l5ldotca.aov David Beador Jason Beesmer $5,559,700.00 start wAn 55 days- Route 215 at Orange Show Rd in San Bernardino 08-1 H7704-180 WD's 951-232-8549 951-674-7352 Start 10/12/20-Completed 18117C/820763-2018 Thomas Fire Debris Flow Repairs&Culver#305 Replacement/ County of Santa Barbara Brooktree Road 60WD's Diana Estorga Destoraecosbow.net David Beador Ramiro Acevedo S723,30000 On Brooktree Road and Mountain Drive,Santa 123 East Anapamu Street Barbara,CA Santa Barbara,CA 93101 805-803-8763 951-674-7352 Start 08/21/21-Completed 1-ernald Point Lane Bridge Replacement County of Santa Barbara 9862330 230WD's Steven Manuel ynanuel0cosbcw.nel David Beador Ramiro Acevedo $2.406,700.00 Start 06/19/21 Fernald Point Lane near Romero Creek,Santa 123 East Anapamu Street Barbara,CA Santa Barbara,CA 93101 805-803-8762 951-674-7352 Completed 06/27/22 06-1 A0404-Repair bridge bent caps Caltrans Javier Huerta javier.huerta(a/dotca.aov David Beador Adam Prieto $405,700 00 Start 11/1521 Route 99/137 Separation in Tulare 06-1 A0404-55 WD's (559)651-8319 951674-7352 Completed 12-060404-Traffic Safety Devices Caltrans Nabil Ruda David Beador Adam Prieto $1,064,700.00 Start 12/3/21 Route 55 @ various locations in Orange& Anaheim near Katella and Lincoln 12-0SO404-70W D's 949-279-8491 nabil.r da@dol.ca.aov 951-674-7352 Completed 4/15/22 12-0T8404-Emergency Job Caltrans Jay Joubeen jay.joubeen@dotca.gov David Beador Adam Prieto $464,000.00 $440,732.00 Route 405 at MacArthur 12-0T8404 949-279-8638 951-674-7352 Completed 7/1/22 189th Street Pedestrian Bridge City of Carson Ken Young k,vounaCdcarsonca.aov David Beador Adrian Prieto $506,700.00 Start 5/4/22 189th Street near Main St,Carson,CA 189th Street-6OW D's 951-674-7352 Completed 7/1/22 12-066604-replace concrete panels Caltrans Adrian Wu adnan.wurrdoLca,a0y David Beador Adam Prieto $1,587,300.00 Start 4/29/22 Route 91/241 Connector near Gypsum Canyon 12-0S6604-40WD's 949279.8488 951-674-7352 Completed 07/01/22 12-0N8604-Replace Structural bridge&kW, Approved 0723120-must place HMA Caltrans Jay Jorbeen jay.joubeen@dut.ca.gov David Beador Adam Prieto $6,700,40000 Mart wAn 55 days- Route 73 in Newport Beach from Bison Ave to University Drive 12-0N8604-515 WD's 949-279-8638 951-674-7352 Start 10/28/20-in PE 12-0N9204-upgrade drainage system Caltrans Dat Pham dat.Dham8/dot.ca.aov David Beador $919,700.00 In Progress Route 22 at Plaster Street in Garden Grove 12-0N9204-90W D's 949-279-8586 951-674-7352 04-4J0304-Install Steel piles,density soil, construct approach slabs and RSP Caltrans Thanh Phug David Beador Victor Olguin $2,112,300.00 Start 05/02/2022 Route 101 near Gilroy al Sargen Bridge OH 04-4J0304-70 WD's,250 PE days 408-569-0404 yrgph.d.ohlma/dot ca aov 951-674-7352 05-1F8104-Install sheet pile wall and RSP Caltrans Shoukie Alawar David Beador $516,700.00 Route 1 in Santa Barbar County near Lompoc at San Antonio Creek Bridge 05-1 F8104-60W D's 530-356-7296 shosdoe.alawar(g19otca.aov 951-674-7352 PHONE NUMBER Email PROJECT MGR PROJECT SUPT CONTRACT DATE PROJECT NAME OWNER CONTACT PERSON PHONE NUMBER PHONE NUMBER AMOUNT COMPLETION 08-1 K5104-Culvert contact grouting,concrete invert paving&misc iron&Steel Caltrans Mike Bergevin David Beador Jose Pilar $699,700.00 Start 05/09/2022 on Route 15 near Horsethief Canyon in Corona and Route 215 near Murnela Hot Springs Rd in Munieta 08-1K5104-100W D's 951-232-3739 fnike.11waevin@dol.ca.aov 951-674-7352 12-0P7004-Replace Concrete Channel lining Caftans Arezo Ghiam aottiam@fountainheadcom.cotri David Beador Adam Prieto $4,769,300.00 Start 1/11/21 Route 5 at Avenida Pico,San Clemente 12-0P7004-400 wd's 949-278-4124 951-674-7352 12-003204-Concrete Barrier Caltrans Arezo Ghiam Agliam@fountainheadcom.corg David Beador Adam Prieto $4,769,300.00 Route 22 in Orange and Santa Ana 12-003204-200WD's 949-278-4124 951-674-7352 12-0S9004-Clean and inspect culvert,invert pay Caltrans Kfah Ramadan kfah.ramadanadotca.00v David Beador Ramiro Acevedo $550,300.00 Start 06/24/22 Route 241 at Hicks Haul Rd,Irvine 12-0S9004-60 WD's 949-279-8625 951-674-7352 Mesmer Low Flow Diversion City of Culver City Sean Singletary 56ansinolelarv@culvercilv,orq David Beador Adam Prieto $1,259,700 00 Mesmer Avenue and Jefferson Blvd,Culver City Mesmer Low Flow-90W D's 213-925-6589 951-674-7352 D-178 Tustin St,Katella Ave,La Veta City of Orange Salvador Martinez SfQl+kv@citvoforarlce.oq David Beador $753,300.00 Tustin St,Kalella Ave,La Veta,Orange,CA D-178 Tustin St/Katella Ave-45 CD's 714-744-5547951 951-674-7352 864050 Modoc Rd Multiuse County of Santa Barbara Philip Gaston paaston@countvofsb.orq David Beador Jesus Duran $2,397,300.00 Start 07/18/22 Modoc Road/Via Sedona 864050-Modoc-60 WD's 805-803-8776 951-674-7352 Coneio Canyons Bridge at HCTP City of Thousand Oaks Saeed ofaghan 8zofaohari@toaks.orq David Beador $2,155,300.00 CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854(citing Labor Code Section 1771.1(a)),passed by the California State Senate on June 20, 2014, established a new public works Contractor Registration Program, which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July 1 through June 30 state fiscal year) with the California Department of Industrial Relations (DIR). Currently the annual non-refundable registration fee for Contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 http://www.dir.ca.gov/DLSE/PublicWorks/SB854FactSheet 6.30.14.pdf DIR's Contractor Registration Link—Call(844)522-6734 https://efiling.dir.ca.gov/PWCR/ActionServlet?action=displayP WCRegistrationForm DIR's Contractor Registration searchable database: https://efiling.dir.ca.gov/PWCR/Search.action I am aware and will comply with the provisions of Labor Code Section 1771.1(a)which states: "A contractor or subcontractor shall not be qualified to bid on,be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725.5.It is not a violation of this section for an unregistered contractor to submit a bid that is authorized by Section 7029.1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract Code,provided the contractor is registered to perform public work pursuant to Section 1725.5 at the time the contract is awarded." I furthermore will comply by providing proof of registration with DIR as the primary contractor, as well as for ALL subcontractors at the time of submitting the bid. Beador Construction Company,Inc. Co ac r David A. Bearinr By dabeador@beador.com Email President Title Date: 08/27/22 PWC Registration#: 1000009909 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 f 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: Beador Construction Company,Inc. Contact Person: David Beador Contact Phone: 95, : --•;52 Signed: Date: 08/27/2022 *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 EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION Ns\let,on 9eaaoY co„s The bidder ,proposed subcontractor ,hereby certifies that he has X , has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. C-14 PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder, has been x has not been convicted within the preceding three years of any offenses referred to in that section,including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon,award of, or performance of,any public works contract,as defined in Public Contract Code Section 1101,with any public entity,as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term"bidder"is understood to include any partner,member,officer,director,responsible managing officer,or responsible managing employee thereof,as referred to in Section 10285.1. Note: The bidder must place a checkmark after "has" or"has not" in one of the blank spaces provided. The above Statement is part of th• Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this ` to i t.Bidders are cautioned that making a false certification may subject the certifier to criminal prosecut.• David A. Beador 08/27/22 Sign. e Print Name Date PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury,the following questionnaire: Has the bidder, any officer of the bidder,or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal,state, or local government project because of a violation of law or a safety regulation? 11 Yes X No If the answer is yes,explain the circumstances in the following space. C-1 s PUBLIC CONTRACT CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232,the Contractor,hereby states under penalty of perjury,that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note:The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. (\4 \ David A. Beador 08/27/22 Signature Print Name Date C-16 Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY of Huntington Beach DEPARTMENT OF PUBLIC WORKS. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person,partnership, company,association,organization, or corporation;that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired,connived,or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder,or to fix any overhead,profit, or cost element of the bid price,or of that of any other bidder,or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true; and,further,that the bidder has not,directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto,or paid,and will not pay, any fee to any corporation, partnership,company association,organization,bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Non-collusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Non-collusion Affidavit. Bidders a - au, i ned that making a false certification may subject the certifier to criminal prosecutio `i David A. Beador 08/27/22 Signa - Print Name Date C-17 DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS,PART 29 The bidder,under penalty of perjury, certifies that,except as noted below,he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: • is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any Federal agency; • has not been suspended,debarred,voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted,convicted,or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification,insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above,indicate below to whom it applies,initiating agency,and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitut sign e of this Certification. David A. Beador 08/27/22 Signature Print Name Date C-18 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. David A. Beador 08/27/22 Stature Print Name Date C-19 Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract . — a. bid/offer/application E a. initial b. grant b. initial award ❑ b. material change c. cooperative agreement _ c. post-award d. loan For Material Change Only: e. loan guarantee year quarter f. loan insurance • date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No.4 is Subawardee, Enter Name and Address of Prime: —1 Prime n Subawardee Tier ,if known Congressional District,if known Congressional District,if known 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number,if applicable 8. Federal Action Number,if known: 9. Award Amount,if known: 10. Name and Address of Lobby Entity 1. Individuals Performing Services (If individual,last name,first name,MI) (including address if different from No. 10) (last name,first name,MI) (attach Continu tion Sheet(s)if necessary) 12. Amount of Payment(check all that apply) 14. Type of Payment(check all that apply) $ ❑ actual ❑planned a. retainer b. one-time fee 13. Form of Payment(check all that apply): c. commission Ha. cash d. contingent fee b. in-kind;specify:nature e deferred Value f. other,specify 15. 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 12: (attach Continuation Sheet(s)if necessary) 16. Continuation Sheet(s)attached: Yes No n 17.Information requested through this form is authorized by Title 31 U.S.C.Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. Print Name: 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject Title: to a civil penalty of not less than$10,000 and not more than $100,000 for each such failure. Telephone No.: Date: __ Authorized for Local Reproduction Federal Use Only: Standard Form-LLL Standard Form LLL Rev.04-28-06 Distribution: Orig-Local Agency Project Files C-20 Page 1 LPP 13-01 May 8,2013 Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities INSTRUCTIONS FOR COMPLETING EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime federal recipient at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is 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. Enter the full name,address,city,state,and zip code of the lobbying entity engaged by the reporting entity identified in Item 4 to influence the covered federal action. 11. Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last Name, First Name and Middle Initial(Ml). 12. 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. 13. Check all boxes that apply. If payment is made through an in-kind contribution,specify the nature and value of the in-kind payment. 14. Check all boxes that apply. If other,specify nature. 15. 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. 16. Check whether or not a continuation sheet(s)is attached. 17. The certifying official shall sign and date the form,and print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30-minutes per response,including time for reviewing instruction,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project(0348-0046),Washington,D.C.20503.SF- LLL-Instructions Rev.06-04 C-21 Page 2 LPP 13-01 May 8,2013 Local Assistance Procedures Manual Exhibit 12-B Bidders List of Subcontractors(DBE and Non-DBE) Exhibit 12-B: Bidder's List of Subcontractor (DBE and Non-DBE) - Part 1 As of March 1, 2015 Contractors (and sub-contractors)wishing to bid on public works contracts must be registered with the State Division of Industrial Relations and certified to bid on Public Works contracts. Please register at https://www.dir.ca.gov/Public-Works/Contractor- Registratio n.html.The local agency will verify registration of all contractors and subcontractors on public works projects at bid and thereafter annually to assure that yearly registration is maintained throughout the life of the project. In accordance with Title 49,Section 26.11 of the Code of Federal Regulations,and Section 4104 of the Public Contract Code of the State of California, as amended,the following information is required for each sub-contractor who will perform work amounting to more than one half of one percent(0.5%) of the Total Base Bid or$10,000(whichever is greater). FEDERAL PROJECT NUMBER: Photocopy this form for additional firms. Subcontractor Name&Location Line Item E.Description Subcontract Percentage of Contractor License Number DBE DBE Cert Number Annual Gross Receipts Amount Bid Item (Y/N) c Subcontracted DR Reg Number NAME 1 ns.l-4I I 1-rA.(ti"1L< <$1 million (,I 14 electric Si al ti°�9� 530 ob./0 <$5 million Ibl��l? Y y36y� X `$10million City,State <$15 million �asttla1e� CA 1000041.17Z. Age of Firm in lei years NAME ZI Ffryti$N cola <$1million 77(.�v/ x <$5million Suptrior ?account Mft S InStwil StynS re, ODv I b(1% _ 1� <$la million City,State / <$15 million eon( strlipin . 10000o11476 Age of Firm in 10 CyereSS/ CA years NAMEI <$1 million <$5million <$10 million City,State `- - <$15million Age of Firm in years NAME <$1 million <$5 million <$10 million City,State <$15 million Age of Firm in years NAME <$1 million <$5million <$10 million City,State <$15 million Age of Firm in years NAME • <$1million <$5 million <$10million City,State <$15 million Age of Firm in years NAME <$1 million <$5 million <$10 million City,State <$15 million Age of Firm in years NAME - <$1 million <$5 million <$10million Z ify,State <$15 million Age of Firm in years NAME <$1 million <$5 million <$10 million City,State <$15 million Age of Firm in years Distribution—Original:Local Agency File;Copy:DLAE w/Award Package C-26 Page 1 of 2 September 2021 • Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors(DBE and Non-DBE) Exhibit 12-B: Bidder's List of Subcontractor (DBE and Non-DBE) - Part 2 In accordance with Title 49,Section 26 of the Code of Federal Regulations,the Bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. FEDERAL PROJECT NUMBER: Photocopy this form for additional firms. Subcontractor Name&Location Line Item&Description Subcontract Percentage of Contractor License Number DBE DBE Celt Number Annual Gross Receipts Amount Bid Item (Y/N) Subcontracted DIR Reg Number NAME 21 FvrniSh an <$1 million C r p OWtkel n ll S� n5 Q 3'jy X <$5million IS C y 1 St* ,9 Q,p d�5 6bo ,I <$10million City,Staid _ ee And [ , /� v l�J <$15million 00 h G^ J P t Ip00000St , Aged Firm in �O Min years NAME <$1million <$5 million <$10 million city,Slate <$15 million Age of Firm in years NAME _ <$1 million <$5 million <$10 million City,State <$15 million Aged Firm in years NAME <$1 million <$5 million <$10 million City,State <$15 million Age of Firm in years NAME <$1 million <$5million <$10 million City,State <$15 million Age dFirm in years NAME <$1 million <$5 million <$10 million City,State <$15 million Age dFirm in years NAME <$1 million <$5 million <$10 million City,State <$15 million Age of Firm in years NAME <$1 million <$5 million <$10 million City,State <$15 million Age of Firm in years NAME <$1 million <$5 million <$10 million City,State <$15 million Age of Firm in years Distribution—Original:Local Agency File;Copy:DLAE w/Award Package C-27 Page 2 of 2 September 2021 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For the UTICA AVENUE BICYCLE BOULEVARD PROJECT from Main Street to Beach Boulevard CC NO. 1499 in the CITY OF HUNTINGTON BEACH August 23, 2022 Notice To All Bidders: Please note the following clarification to the Project Specifications and Contract Documents: 1) Page viii,APPENDIX I, PART 1 and PART 2 is replaced with the following: PART 1 —FEDERAL&STATE REQUIREMENTS FOR FEDERAL-AID CONSTRUCTION PART 2—FEDERAL LABOR RATES PART 3—STATE LABOR RATES 2) FEDERAL LABOR RATES The Federal Labor Rates contained in Appendix I, Part 2 of the specifications for the: Utica Avenue Bicycle Boulevard Project, CC-1499 shall be replaced with the following attached documents: The Federal Labor Rates dated August 23, 2022. These rates shall be the labor rates in effect for the subject project. 3) STATE LABOR RATES The State Labor Rates contained in Appendix I, Part 3 of the specifications shall be replaced with the following attached document: State Labor Rates dated August 23, 2022 The State Labor Rates Dated August 23, 2022 shall be the labor r s in effect for the subject project. This is to acknowledge receipt and review of Addendum Numb , ated above. Beador Construction Company, Inc. - David Beador Company Name B 08/29/2022 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. For Addendum questions, please call Darren Sam at(714) 374-1619 within 3 days of posting. ✓- A Document A310TM - 2010 Bid Bond CONTRACTOR: SURETY: (Name, legal status and address) (Nance, legal status and principal place Beador Construction,Inc. of business) 26320 Lester Circle Great Midwest Insurance Company This document has important legal Corona,CA 92883 800 Gessner Rd Ste 600,Houston TX 77024 consequences.Consultation with OWNER: an attorney is encouraged with (Name, legal status and address) respect to its completion or City of Huntington Beach modification. 2000 Main Street.Huntington Beach,CA 92648 Any singular reference to Contractor,Surety,Owner or BOND AMOUNT: 0 TEN PERCENT(10%)of the Total Amount Bid other party shall be considered plural where applicable. PROJECT: Utica Avenue Bicycle Boulevard from Main Street to Beach Boulevard-CC No.1499 (lame, location or address, and Project number, if ant) Project Number,if any: Federal Aid Proect CML-5181(191) The Contractor and Surety are bound to the Owner in the amount set forth above,for the payment of which the Contractor and Surety bind themselves,their heirs,executors.administrators,successors and assigns,jointly and severally,as provided herein.The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents,or within such time period as may be agreed to by the Owner and Contractor,and the Contractor either(1)enters into a contract with the Owner in accordance with the terms of such bid,and gives such bond or bonds as may be specified in the bidding or Contract Documents,with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Owner,for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof:or(2)pays to the Owner the difference,not to exceed the amount of this Bond,between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid,then this obligation shall be null and void.otherwise to remain in full force and effect.The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid.Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60)days in the aggregate beyond the time for acceptance of bids specified in the bid documents,and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty(60)days. If this Bond is issued in connection with a subcontractor's bid to a Contractor,the tern 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 herefroin and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so fitnushed_the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. Signed and sealed this 19th day of August,2022 Be..a S •truction,Inc. By: (p (Seal) \ 1 (Witness) , `J��A� ! 'e2 (Tit'. ? lade Great Midwest Insurance Company t��y By: � • .� (Su AUG 19 202E (Seal) (ffQess) Christine Maestas,Witness (Title) Edward N.Hackett,Attorney in Fact AIA Document A310"—2010.Copyright 0 1963,1970 and 2010 by The American Institute of Architects.All rights reserved. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT llilll1..1lil.1lA.11 AAAA111.11ii1i11111111111111iAi11111< State of California County of Riverside ss. On August 29, 2022 before me, R. Quezada, Notary Public Date Name and Title of Officer Personally appeared David A. Beador 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 R QUEZADA signature(s)on the instrument the person(s) R. or,the entity upon behalf of which the person(s) Notary Public•California Riverside County acted,executed the instrument. ;; Commission#2278239 My Comm.Expires Mar 19,2023 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, 7- Signature of Nota ublic Place Notary Seal Above OPTIONAL Though the information below is not required by law,it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Signer's Name: Signer's Name: _Individual _Individual _Corporate Officer Title(s): _Corporate Officer Title(s) _Partner- Limited_General _Partner-_Limited_General _Attorney-in-Fact _Attorney-in-Fact _Trustee Top of thumb _Trustee Top of thumb _Guardian or Conservator here _Guardian or Conservator here Other: Other: Signer is Representing: Signer is Representing: TiiTiziiiTTi iiWWWWWiWWWWWWwiiiiTitzriiiiTiTTiTiiiiTi-w 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 AUG 1 9 2a77 before me, C. Maestas , Notary Public, Date Insert Name of Notary exactly as it appears on the official seal personally appeared Edward N. Hackett 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. C.MAESTAS I certify under PENALTY OF PERJURY under the laws of • ` r g, ' 1 COMM.#2295096 the State of California that the foregoing paragraph is true ; I, , r .,1 NOTARY FUBLIC-CALIFORNIA f� and correct. ORANGE COUNTY %+' MY CORM.EXP.JULY 24,2023 Witness my ha and official seal. Signature Place Notary Seal Above Si ry Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of the form to another document. Description of Attached Document Title or Type of Document: Beador Construction Bid Bond AUG 1 9 '-'c../, Document Date: , Number of Pages: Signer(s) Other Than Named Above: None Capacity(ies)Claimed by Signer(s) Signer's Name: Edward N. Hackett Signer's Name: None ❑ Individual ❑ Individual ❑ Corporate Officer—Title(s): ❑ Corporate Officer —Title(s): ❑ Partner ❑Limited ❑General ❑ Partner ❑Limited❑General g Attorney in Fact RIGHT THUMBPRINT ❑ Attorney in Fact RIGHT THUMBPRINT ❑ Trustee OF SIGNER ❑ Trustee OF SIGNER ❑ Guardian or Conservator Top of thumb here ❑ Guardian or Conservator Top of thumb here ❑ Other: ❑ Other: Signer is Representing: Signer is Representing: POWER OF ATTORNEY Great Midwest Insurance Company KNOW ALL MEN BY THESE PRESENTS,that GREAT MIDWEST INSURANCE COMPANY, a Texas Corporation,with its principal office in Houston, TX, does hereby constitute and appoint: Edward N. Hackett, Christine Maestas its true and lawful Attorney(s)-In-Fact to make, execute, seal and deliver for, and on its behalf as surety, any and all bonds, undertakings or other writings obligatory in nature of a bond. This authority is made under and by the authority of a resolution which was passed by the Board of Directors of GREAT MIDWEST INSURANCE COMPANY, on the 1st day of October,2018 as follows: Resolved, that the President, or any officer, be and hereby is, authorized to appoint and empower any representative of the Company or other person or persons as Attorney-In-Fact to execute on behalf of the Company any bonds, undertakings,policies,contracts of indemnity or other writings obligatory in nature of a bond not to exceed Ten Million dollars($10,000,000.00),which the Company might execute through its duly elected officers, and affix the seal of the Company thereto. Any said execution of such documents by an Attorney-In-Fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company.Any Attorney-In-Fact,so appointed, may be removed in the Company's sole discretion and the authority so granted may be revoked as specified in the Power of Attorney. Resolved, that the signature of the President and the seal of the Company may be affixed by facsimile on any power of attorney granted, and the signature of the Secretary, and the seal of the Company may be affixed by facsimile to any certificate of any such power and any such power or certificate bearing such facsimile signature and seal shall be valid and binding on the Company.Any such power so executed and sealed and certificate so executed and sealed shall,with respect to any bond of undertaking to which it is attached, continue to be valid and binding on the Company. IN WITNESS THEREOF, GREAT MIDWEST INSURANCE COMPANY, has caused this instrument to be signed by its President, and its Corporate Seal to be affixed this 11th day of February, 2021. tNSUgghcF GREAT MIDWEST INSURANCE COMPANY 0 CORPORATE SEAL BY Mark W. Haushill " ` a4 President qS CORPOO ACKNOWLEDGEMENT On this 11th day of February, 2021, before me, personally came Mark W. Haushill to me known, who being duly sworn, did depose and say that he is the President of GREAT MIDWEST INSURANCE COMPANY,the corporation described in and which executed the above instrument; that he executed said instrument on behalf of the corporation by authority of his office under the By-laws of said corporation. ++"�rP�'�+,, CHRISTINA BISHOP %kik! iNotary Public,State of Texas BY Comm.Expires 04.14-2026 Christina Bishop itiNti Notary ID 131090488 Notary Public CERTIFICATE I,the undersigned, Secretary of GREAT MIDWEST INSURANCE COMPANY,A Texas Insurance Company, DO HEREBY CERTIFY that the original Power of Attorney of which the foregoing is a true and correct copy,is in full force and effect and has not been revoked and the resolutions as set forth are now in force. Signed and Sealed at Houston,TX this 19th Day of August 20 22 g CORPORATE SEAL I BY �� III Leslie K. Shaunty Secretary "WARNING: Any person who knowingly and with intent to defraud any insurance company or other person,files and application for insurance of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act,which is a crime and subjects such person to criminal and civil penalties. No. 5780-2 STATE OF CALIFORNIA DEPARTMENT OF INSURANCE SAN FRANCISCO Amended Certificate of Authority THIS IS TO CERTIFY,That,pursuant to the Insurance Code of the State of California, Great Midwest Insurance Company of Texas, organized under the laws of Texas, 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 following classes of insurance: Fire,Marine,Surety,Disability,Plate Glass,Liability, Workers'Compensation,Common Carrier Liability,Boiler and Machinery, Burglary,Credit,Sprinkler,Team and Vehicle,Automobile,and Aircraft as such classes are now or may hereafter be defined in the Insurance Laws of the State of California. THIS CERTIFICATE is expressly conditioned upon the holder hereof now and hereafter being in full compliance with all,and not in violation of any, of the applicable laws and lawful requirements made under authority of the laws of the State of California as long as such laws or requirements are in effect and applicable, and as such laws and requirements now are, or may hereafter be changed or amended. IN WITNESS WHEREOF,effective as ofthe 4th day ofAugust,2015, I have hereunto set my hand and caused my official seal to be affixed this 4`i'day of August, 2015. Dave Jones Insurance Commissioner kP41---4Zt By Valerie Sarfaty for Nettie Hoge Chief Deputy 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 to do so will be a violation of Insurance Code section 701 and will be Bounds for revoking this Certificate of Authority pursuant to the covenants made in the application therefor and the conditions contained herein. J 'T--- S S..- Qd . .___ Llt.) ,.. - „....) __) <.) .5,.... 8 s- cr, . ._ .L_c T s O y o U o Q 1 Lai = aim y_ a- �oz O ld..W O c �/-- u u �734 z . ----. irF 61 Ni_-_ 6.(:) , o 6 s 2 , � c- o U o v y -- - y 1rT — SS S IS r•1 )c �-aim � O U N Ln .0 _ cQ � � in u c-^ v E . . ,.,, „7,(NI 2 Ln ca. c_D — , \_ ,,c, c,_, CO v 1 ,' �N , City of Huntington Beach .... ' c PD6q�•.• ;''•�9 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov \�o'ck Office of the City Clerk CpUNT\?•�P �/� Robin Estanislau, City Clerk January 10, 2023 Elecnor Belco Electric, Inc. 14320 Albers Way Chino, CA 91710 RE: Utica Avenue Bicycle Boulevard —CC No. 1499 Enclosed please find your original bid bond for CC No. 1499, Sincerely, 440L, 9AM/Zilatti.d Robin Estanislau, CMC City Clerk RE:ds Enclosure Sister City: Anjo, Japan SECTION C PROPOSAL for the construction of UTICA AVENUE BICYCLE BOULEVARD from Main Street to Beach Boulevard CC NO.1499 FEDERAL AID PROJECT CML-5181(191) in the • CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids,the undersigned hereby proposes and agrees to perform all the work therein described,and to furnish all labor,material,equipment and incident insurance necessary therefor,in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 50 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site,plans,specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work,that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses,taxes,royalties,fees,etc.,and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded,the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts,and words shall govern over figures. c-1 If awarded the Contract,the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may,at the AGENCY'S option,be considered null and void. 10%of bid amount Accompanying this proposal of bid,find Bidder's Bond in the amount of which said amount is not less than 10%of the aggregate of the total bid price,as required by the Notice Invitin Sealed Bids,payable to the AGENCY. (Please insert the words"Cash","Certified Check",o idder's Bond for i 0% ",as the case may be) Any standard Surety Bid Bond form is acceptable. Bidder shall signify receipt of all Addenda here,if any: Ac7dendallo ceided- 1 "r'. .• .. Bidder'sSi, nature 1 8/23/2022 ,John Wong Vice President C-2 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For the UTICA AVENUE BICYCLE BOULEVARD PROJECT from Main Street to Beach Boulevard CC NO. 1499 in the CITY OF HUNTINGTON BEACH August 23, 2022 Notice To All Bidders: Please note the following clarification to the Project Specifications and Contract Documents: 1) Page viii, APPENDIX I, PART 1 and PART 2 is replaced with the following: PART 1 —FEDERAL & STATE REQUIREMENTS FOR FEDERAL-AID CONSTRUCTION PART 2—FEDERAL LABOR RATES PART 3—STATE LABOR RATES 2) FEDERAL LABOR RATES The Federal Labor Rates contained in Appendix I, Part 2 of the specifications for the: Utica Avenue Bicycle Boulevard Project, CC-1499 shall be replaced with the following attached documents: The Federal Labor Rates dated August 23, 2022. These rates shall be the labor rates in effect for the subject project. 3) STATE LABOR RATES The State Labor Rates contained in Appendix I, Part 3 of the specifications shall be replaced with the following attached document: State Labor Rates dated August 23, 2022 The State Labor Rates Dated August 23, 2022 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Nu •-r One, dated above. Elecnor Belco Electric,Inc. A John Won• Vice President Company Nameflar R 23,2022 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. For Addendum questions, please call Darren Sam at(714)374-1619 within 3 days of posting. Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Item Estimated Item Unit Price Extended No. Quantity Amount 1 1 L.S. Mobilization. $i6,cO0 $ Ie,Ooc Per L.S. _ 2 1 L.S. Furnish Project Traffic Control. $ 5000 $ Oa' Per L.S. 3 1 L.S. Preparation of project Specific Storm Water Pollution Prevention Plan (SWPPP). $2 000 $ `2, a Per L.S. 4 1 EA. Installation and maintenance of BMP's per the approved SWPPP. $2 000 $ )j aao Per L.S. 5 21 LF Remove existing block wall and footing $ 1-05. 6 1 EA Construct concrete island $ IS,q,31 $ 1513/ 7 40 LF Construct 8"median curb $ 7L( $ 206e, 8 1,500 SF Remove and dispose existing A.C. and base material $25. 10 $37/0 Sv 9 130 LF Remove and dispose of existing curb and gutter $3 5 $ `1) 55o o 10 76 LF Construct 6"curb and gutter q 11 33 LF Construct 6" curb $ 103 $3/'541 `( C-2.1 Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Item Estimated Item Unit Price Extended No. Quantity Amount 12 1 LS Reconstruct existing improvements $(!13 o $ (( 3g' 13 1 EA Adjust manhole to grade $ 5,700 $ 5 'zoo 14 2 EA Finish raw edge of wall with matching existing material and color $3, 1 cb3 $7j U6 L 15 113 SF Remove and dispose existing sidewalk $ I $a,vy 16 70 TONS Construct new 2"type III-C3-PG 64-10 (1/2") surface course over 4" class B- $ $to 3(t 0 PG 70-10 (3/4")base course over 1.0' C.M.B. 17 100 TONS Construct 1' crushed miscellaneous $ l0 3 $ ((s 300 base 18 3 EA Construct Curb Access Ramp on northwest,northeast and southeast corners at Lake Street/Utica Ave per $15/1 ( $ 4 7l )13 Caltrans Standard Plan No. RSP A88A, Case A and Details on Sheets 3 and 4. (Item includes all appurtenances,curb and gutter, depressed curb, sidewalk, domes,retaining curb, slot pave, etc.) Per EA. lucf , 5► 3 C-2.2 Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Item Estimated Item Unit Price Extended No. Quantity Amount 19 1 EA Construct Curb Access Ramp on southwest corner Lake St/Utica Ave per Caltrans Standard Plan No. RSP A88A and Detail on Sheet 4 (Item includes all $ 15/61 31 $ !5/ q 3 appurtenances,curb and gutter, depressed curb, sidewalk, domes, retaining curb,slot pave, etc.) Per EA. 20 1 L.S. Install traffic signal at the intersection of Lake Street and Utica Avenue (excludes curb ramps and city furnished equipment) $2( 773 oo $ 3 3 00 Per L.S. 21 1 L.S. Furnish and install signing and striping. $3q 177- $sli lea I C-2.3 Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Total Amount Bid Total Amount Bid in Figures: $ 5dj 57C1 .00 Total Amount Bid in Words: $ ' NC, --rkekt5k,vci, pi.06 I4° r 4 cet• -y Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (also includes anchor bolts) to the contractor. The contractor is to pick up the materials, with its own labor, at the City Yard, 17371 Gothard Street. Contact traffic signal maintenance two working days in advance for pick up at(714) 536-5530. 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. 1 .rt�ii'E,• .('�.: .W :s4;f .a5,,:%t+ 'a'Sate+, iC[asSs,;:ri r:DIR: �. ��'Dbj1ar'.. %o. '''- N and 4,41:0s..o EWcx. ..,o: ,�:-,Bid��SM., �'�. }::-�l�a , ��.,,�..�±;,����;° t�� :.,t, �,�• ,-�;p,�• I :y-,. +�a k��3� h gip. ''•�rac •.;''iC �•{ c ns 'J ,I,.Re. .•tration 7�,: Amount ?CP71t1"IYCt'•: !late (s) r €. Subcbntrdcta , i, Licens �'' 6. fy F..sl ,, , ,' pm d [ r: "i R d� i4�5,- y , ..�.- ys,.4 ',kit 441 � �. i, 1,Pi- T.1 4 Pkw. l 3 ,h4,1:1�7 .,-`�jL k,�;y.'. . d.j.t. 1...:No i�i il,;.i }S' Numbey It p i. h,.11:l t56,,,i,v;:vi'ii"iji ,,,,._`�" 1, :.,. A.hi..,..;. ;li i �:.. ".4. t 4.. j..'L��, i{� 'l!i.- :�4:.�.�R i.h:-.f5.1 /:+ T � .1�' !d z) roly e ,f del / 2� o� OP ....-) 41', 11-7 -2-fic,7 5-I 1 AI at-lei-aq/ 1A11 /11 Z 70'73 Pr, 100 e s1 sit 1911 sYs 1. 7a<t, (0,04 ?2Vel,Cara".1,Cj c-!a , 1)-0 W—2211 `I ii , GAT Tmait,'nj',tva c 't' /121. Pi ei 10=11I75o $'S1 1 o 41. Y°°' -DI- N 14'K I p,'`/ to/uz 47, C ,'6/r5�C C59 � �5l /L � !�A•-�12so7 _ 'ii`Lo 5 +14' r6v) 616. '1.iG/jhC, bltitlyd (-la 0;0000lt O 1b/€170 1, 3of, c t - h7 1 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 on8/22/2022,at Chino , CA Date City State John Wong , being first duly sworn, deposes and says that he or she is Vice President of Elecnor Belco Electric,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. John Wong Name of Bidder Si tore f Bi er 14320 Albers Way,Chino,CA 91710 Address of Bidder C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH,CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the UTICA AVENUE BICYCLE BOULEVARD,(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. Elecnor Belco Electric,Inc. Contractor • 4 ,John Won_ By . ill Vice Presi. Title Date: 8/22/2022 C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162,the Bidder shall complete,under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder,any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑Yes ®No If the answer is yes,explain the circumstances in the space provided. N/A Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 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. • Elecnor Belco Electric,Inc. • Contractor • r l ' At, 111 1111. • B Vice ' -side Title Date: 8/22/2022 • • C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Elecnor Belco Electric,Inc. Bidder Name 14320 Albers Way Business Address Chino CA 91710 City, State Zip ( 909 )993-5470 jwong@elecnor.com Telephone Number Email Address 738518 A,B,C-10 State Contractor's License No. and Class 7/28/1997 Original Date Issued 7/31/2023 Expiration Date The work site was inspected by Ralph Antuna of our office on August 15 ,202 2. The following are persons, firms, and corporations having a principal interest in this proposal: Alberto Garcia De Los Angeles-President John Wong-Vice President Jeroni Gervilla-Treasurer Pedro Enrile-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. Elecnor Belco Electric,Inc. Company Name S na r Bidder John g Vi President Printed or Typed Signature C-8 UNANIMOUS WRITTEN CONSENT IN LIEU OF 2021 ANNUAL MEETING OF THE BOARD OF DIRECTORS OF ELECNOR BELCO ELECTRIC,INC. January 1,2021 The undersigned, being all of the members of the Board of Directors (the "Board") of Elecnor Belco Electric, Inc.,a California corporation(the"Company"), in lieu of holding a meeting of the Board,hereby take the following actions and adopt the following resolutions by unanimous written consent: WHEREAS,the Board has determined that it is in the Company's best interests to appoint a revised slate of Officers of the Company. NOW,THEREFORE,BE IT RESOLVED,that the following persons be,and hereby are,elected to the offices set forth opposite their respective names,to hold such offices until their respective successors are elected and qualified at or before the next annual meeting of the Board,or until their earlier respective deaths, resignations or removals: NAMES OFFICE Alberto Garcia De Los Angeles President and Chief Executive Officer Jeroni Gervilla Chief Financial Officer Roger DeVito Senior Vice President, General Counsel and Assistant Secretary Pedro Enrile Secretary Leonardo Sancho Frances Vice President John Wong Vice President for Construction FURTHER RESOLVED, that Alberto Garcia De Los Angeles, Jeroni Gervilla, Alberto Garcia and Roger DeVito in their respective capacities (listed above) subject to such supervisory powers of the Board of Directors,hereby are authorized and directed to perform all the duties commonly incident to that office; shall have authority to execute in the name of the Company contracts, leases and other written instruments to be executed by the Company;and,shall perform such other duties as the Board of Directors may from time to time determine. FURTHER RESOLVED,that the President and Chief Executive Officer may delegate authority to any Chief Financial Officer or Chief Operating Officer or Senior Vice President or Vice President as and within their authority levels as set forth in the Company's Bylaws,as the same may be amended from time to time; FURTHER RESOLVED, that Roger DeVito, in his capacity of Senior Vice President, or Leonardo Sancho Frances in his capacity of Vice President are hereby authorized and directed to: 1. Negotiate,sign,amend and terminate agreements in connection with the purpose of the Company,for all contracts up to $250,000.00, and acting jointly with Alberto Garcia De Los Angeles or Jeroni Gervilla for all contracts in amounts greater than$250,000.00. 1 2. Execute, amend and finalize bid proposals in connection with the purpose of the Company, for all proposals up to $1,000,000.00, and acting jointly with Alberto Garcia De Los Angeles or Jeroni Gervilla for all proposals in amounts greater than$1,000,000.00. 3. Acting jointly with Alberto Garcia De Los Angeles or Jeroni Gervilla, execute,amend and finalize purchase orders for materials and equipment in connection with the purpose of the Company. 4. Acting jointly with Alberto Garcia De Los Angeles or Jeroni Gervilla,execute,amend and terminate agreements for the lease of real estate to be used as offices or job related temporary yards. 5. Acting jointly with Alberto Garcia De Los Angeles or Jeroni Gervilla,execute,amend and terminate insurance and/or bid bonds arrangements in connection with the purpose of the Company. 6. Acting jointly with Alberto Garcia De Los Angeles or Jeroni Gervilla, hire, suspend, impose sanctions and dismiss the administrative personnel of the Company,setting forth their employment terms and conditions, obligations and remuneration. 7. Acting jointly with Alberto Garcia De Los Angeles or Jeroni Gervilla,settle and claims on behalf of the Company. AND IT IS FURTHER RESOLVED, that all actions heretofore taken by the officers of the Company on behalf of and in the name of the Company, relating to the conduct of the business of the Company, the expenditure of money, the making of contracts and all other acts taken or omitted in the performance of their duties to the Company be,and the same hereby are, in all respects,approved,ratified and affirmed,as of the date taken,done or omitted,respectively. The actions taken by the Board Consent shall have the same force and effect as if taken by the undersigned at a meeting of the Board of Directors,duly called and constituted pursuant to the Bylaws of the Company and the laws of the State of California. This Board Consent may be executed in counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same document. IN WITNESS WHEREOF, the undersigned, being all of the members of the Board of Directors of Elecnor Belco Electric, Inc., have executed these actions by written consent as of the date first written above. Ar im. o Ramon,Director Luis Alcibar, Director Alexander Arrola, Director 2 NOTARY CERTIFICATE Subscribed and sworn to before me this22nd day of August , 202 2 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 August 22,2022 before me, 9\12, 2-FC CA v V l' 1 N 44tirly P.41O I /l t. Month,Day, and Year Insert Name and Title of Notary personally appeared John Wong Vice President 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. ..o., REBECCA WILKS ■ a ll WITNESS my hand and official seal. Notary?_bis California'� Sao Be' a°cino County ;Ar„,rea! Commission s 2300424 My Coy--.Expi•es A,.g 5,2023 i _ 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 I ; referencing the construction of traffic signals,curb&gutter and sidewalk. 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 Glendale/633 East Broadway,Glendale Name and Address of Public Agency Name and Telephone No.of Project Manager: Sarkis Oganesyan (818)548-3945 $2,844,613.00 Traffic Signal Improvements&Fiber Work February 2021 Contract Amount Type of Work. Date Completed Provide additional project description to show similar work: I�t 2. City of Plam Springs/62000 East Tahquitz Canyon Way,Palm Springs,CA 92262 • Name and Address of Public Agency • Name and Telephone No.of Project Manager:- Kevin Higgins(909)890-9693 • $2,847,759.00 Traffic Signal and ADA Improvements December 2021 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 3 City of Diamond Bar/21810 Copley Drive,Diamond Bar,CA 91765 Name and Address of Public Agency i Name and Telephone No.of Project Manager: Christian Mal pica (909)839-7042 $418,975.00 Traffic Signal and Fiber Work September 2018 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. T.B.D. Name of proposed Project Manager • i Telephone No. of proposed Project Manager: (909)993-5470 City of Palm Desert $2,847,613.00 Traffic Signal and ADA Improvements December 2021 Project Name&Contract Amount Type of Work Date Completed• • Traffic Signal and Fiber Work February 2021 City of Glendale $2,844,613.00 g Project Name&Contract Amount Type of Work Date Completed City of Rancho Mirage $2,864,345.00 Traffic Signal Interconnect&Fiber Work June 2020 Project Name&Contract Amount Type of Work Date Completed • 2. Ralph Antuna • Name of proposed Superintendent • • j Telephone No.of proposed Superintendent: (909)993-5470 City of Palm Desert $602,259.00 Traffic Signal Modifications&Fiber Optic Work August 2020 Project Name&Contract Amount Type of Work Date Completed City of Huntington Park $1,013,928.00 Signal Synchronization April 2020 Project Name&Contract Amount Type of Work Date Completed • City of Glendale $2,844,613.00 Traffic Signal Modifications&Fiber Optic Work February 2021 • Project Name&Contract Amount Type of Work Date Completed • • • C-11 • A A A A A A A 0 0 0 0 OA .A A A A A A A A A t 4- ? A A A A ? ? ? ? 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[ § ° - CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854(citing Labor Code Section 1771.1(a)),passed by the California State Senate on June 20, 2014, established a new public works Contractor Registration Program, which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July 1 through June 30 state fiscal year) with the California Department of Industrial Relations (DIR). Currently the annual non-refundable registration fee for Contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 http://www.dir.ca.gov/DLSE/PublicWorks/SB854FactSheet_6.30.14.pdf DIR's Contractor Registration Link—Call(844)522-6734 https://efiling.dir.ca.gov/PWCR/ActionServlet?action=displayPWCRegistrationFonn 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. Elecnor Belco Electric,Inc. Contractor John Wong iwong'Yele •.r.com Email Vice President Title Date: 8/22/2022 PWC Registration#: 1000004804 C-12 Contractor Information Registration History Effective Date Expiration Date Legal Entity Name ELECNOR BELCO ELECTRIC,INC. 06/13/18 06/30/19 Legal Entity Type Corporation 05/24/17 06/30/18 Status Active 06/01/16 06/30/17 Registration Number 1000004804 06/04/15 06/30/16 Registration effective date 07/01/22 01/06/15 06/30/15 Registration expiration date 06/30/25 07/01/19 06/30/22 Mailing Address 07/01/22 06/30/25 14320 ALBERS WAY CHINO 91710 CA United States... Physical Address 14320 ALBERS WAY CHINO 91710 CA United States... Email Address rwilks@elecnor.com Trade Name/DBA License Number(s) CSLB:738518 Legal Entity Information Corporation Entity Number: C1982436 330768970 President Name: Alberto Garcia Agency for Service: Agent of Service Name: Roger DeVito 14320 Albers Way Chino 91710 CA United States of America Worker's Compensation Do you lease employees through Professional Employer Organization(PEO)?: No Insured by Carrier Policy Holder Name: ELECNOR BELCO ELECTRIC,INC. HARTFORD FIRE INSURANCE COMPANY 10 WEA AA6VQ6 11/01/21 11/01/22 Contractor Information Registration History Effective Date Expiration Date Legal Entity Name CAT TRACKING INC 06/15/18 06/30/19 Legal Entity Type Corporation 06/07/17 06/30/18 Status Active 06/16/16 06/30/17 Registration Number 1000011750 07/16/15 06/30/16 Registration effective date 07/01/22 02/24/15 06/30/15 Registration expiration date 06/30/24 07/01/19 06/30/20 Mailing Address 07/01/20 06/30/22 17 Commercial Avenue RIVERSIDE 92507 CA United... Physical Address 07/01/22 06/30/24 17 Commercial Avenue RIVERSIDE 92507 CA United... Email Address accounting@cattrackinginc.com Trade Name/DBA CAT TRACKING INC License Number Is) CSLB:991122 CSLB:991122 Legal Entity Information Corporation Entity Number: C3592541 463407155 President Name: Pam Follmer Pam Follmer Pam Follmer Pam Follmer Pam Follmer Agency for Service: Agent of Service Name: Pam Follmer Cat Tracking,17 Commercial Ave Riverside 92507 CA United States of America Worker's Compensation Do you lease employees through Professional Employer Organization(PEO)?: No Insured by Carrier Policy Holder Name: CAT TRACKING INC NATIONAL LIABILITY&FIRE USO1BH221725604C11 01/16/22 01/16/23 Contractor Information Registration History Effective Date Expiration Date Legal Entity Name SMITHSON ELECTRIC,INC 05/24/18 06/30/19 Legal Entity Type Corporation 05/23/17 06/30/18 Status Active 06/20/16 06/30/17 Registration Number 1000001610 06/11/15 06/30/16 Registration effective date 07/01/22 10/01/14 06/30/15 Registration expiration date 06/30/25 07/01/19 06/30/22 Mailing Address 07/01/22 06/30/25 1938 E KATELLA AVE ORANGE 92867 CA United Sta... Physical Address 1938 E KATELLA AVE ORANGE 92867 CA United Sta... Email Address laurie@smithsonelectric.com Trade Name/DBA License Number(s) CSLB:614518 Legal Entity Information Corporation Entity Number: C1672574 330447874 President Name: Patrick T.Smithson Christopher L.Zell Agency for Service: Agent of Service Name: Patrick T.Smithson 1938 E Katella Avenue Orange 92867 CA United States of America Worker's Compensation Do you lease employees through Professional Employer Organization(PEO)?: No Insured by Carrier Policy Holder Name: SMITHSON ELECTRIC,INC STATE COMPENSATION INSURANCE FUND 6601063 01/01/22 01/01/23 Contractor Information Registration History Effective Date Expiration Date Legal Entity Name ALL AMERICAN ASPHALT 05/11/18 06/30/19 Legal Entity Type Corporation 05/08/17 06/30/18 Status Active 05/02/16 06/30/17 Registration Number 1000001051 06/09/15 06/30/16 Registration effective date 07/01/20 08/25/14 06/30/15 Registration expiration date 06/30/23 07/01/19 06/30/20 Mailing Address PO BOX 2229 CORONA 92878 CA United States of... 07/01/20 06/30/23 Physical Address 400 E SIXTH ST CORONA 92879 CA United States o... Email Address publicworks@allamericanasphalt.com Trade Name/DBA License Number(s) CSLB:267073 CSLB:267073 Legal Entity Information Corporation Entity Number: C0570879 952595043 President Name: MARK LUER EDWARD J CARLSON MICHAEL FARKAS MICHAEL FARKAS Agency for Service: Agent of Service Name: MICHAEL FARKAS 400 E SIXTH ST CORONA 92879 CA United States of America Worker's Compensation Do you lease employees through Professional Employer Organization(PEO)?: No Insured by Carrier Policy Holder Name: ALL AMERICAN ASPHALT ZURICH AMERICAN INSURANCE COMPANY WC593205701 08/01/19 08/31/20 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 HUE)Act of 1968;or 75 `A 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: Elecnor Belco Electric,Inc. Contact Person: John Wong Contact Phone: (9"")993-5470 Signed: Date: 8I �' �- *Note: The above certific. 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 EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION Elecnor Belco Electric,Inc. The bidder,proposed subcontractor ,hereby certifies that he has X , has not ,participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. C-14 EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION Elecnor Belco Electric,Inc. The bidder__,proposed subcontractor Cat Tracking ,hereby certifies that he has X , has not ,participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency, or the former Presidents Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. C-14 EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION Elecnor Belco Electric,Inc. The bidder ,proposed subcontractor Smithson Electric,Inc. ,hereby certifies that he has x , has not ,participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. C-14 EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION Elecnor Belco Electric,Inc. • The bidder,proposed subcontractor All American Asphalt ,hereby certifies that he has X has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency, or the former Presidents Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. C-14 PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder, has been X has not been convicted within the preceding three years of any offenses referred to in that section,including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon,award of, or performance of,any public works contract,as defined in Public Contract Code Section 1101,with any public entity,as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term"bidder"is understood to include any partner,member,officer,director,responsible managing officer,or responsible managing employee thereof,as referred to in Section 10285.1. Note: The bidder must place a checkmark after"has" or"has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement.Bidders are cautioned that making a false certification may subject the certifier to criminalp • ecution. John Wong 8/22/2022 _na . Print Name Date PUBLIC CONTRACT.,K!d DES ' ION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury,the following questionnaire: Has the bidder,any officer of the bidder,or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified,removed, or otherwise prevented from bidding on, or completing a federal,state,or local government project because of a violation of law or a safety regulation? Yes X No If the answer is yes,explain the circumstances in the following space. C-15 PUBLIC CONTRACT CODE 10232 STATEMENT j • In conformance with Public Contract Code Section 10232,the Contractor,hereby states under penalty of perjury,that no more than one final unappealable fording of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note:The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. 4i John Wone 8/22/2022 Print Name Date C-16 Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) ton Beach of Huntington To the CITY g DEPARTMENT OF PUBLIC WORKS. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of,any undisclosed person,partnership, company,association,organization,or corporation;that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly { induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded,conspired,connived,or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner,directly or indirectly,sought by agreement,communication, or conference with anyone to fix the bid price of the bidder or any other bidder,or to fix any overhead,profit, or cost element of the bid price,or of that of any other bidder,or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true; and,further,that the bidder has • not,directly or indirectly,submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto,or paid,and will not pay, any fee to any corporation, partnership,company association,organization,bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Non-collusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Non-collusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. John Wong 8/22/2022 S tab Print Name Date C-17 DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS,PART 29 The bidder,under penalty of perjury, certifies that,except as noted below,he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: • is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any Federal agency; • has not been suspended,debarred,voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending;and • has not been indicted,convicted,or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification,insert the exceptions in the following space. N/A Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above,indicate below to whom it applies,initiating agency,and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. John Wong 8/22/2022 Print Name Date • C-18 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. John Wong 8/22/2022 S : - Print Name Date C-19 Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activitie EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C.1352 1. T-le of Federal Action: 2. Status of Federal Action: 3. Report Type: a. co act a. bid/offer/application a. initial b. gran b. initial award ❑ b. material ch:':e _ c. coope . 've agreement c. post-award _ d. loan For Materia hange Only: e. loan guaran-e year quarter f. loan insuranc= date.f last report 4. Name and Ad I ss of Reporting Entity 5. If Reporting Entity in N 4 is Subawardee, Enter Name and Addr ss of Prime: nPrime Subawardee Tier ,if known Congressional District,i . own Congression: 1 istrict,if known 6. Federal Department/Agenc • 7. Federal P.s gram Name/Description: CFD umber,if applicable 8. Federal Action Number,if known: 9. A and Amount,if known: 10. Name and Address of Lobby Entity 1 .Individuals Performing Services (If individual,last name,first name,MI) (including address if different from No. 10) (last name,first name,MI) (attach Continuat'.n Sheet(s)if necessary) 12. Amount of Payment(check all that apply) 14. Type of Payment(check all that apply) $ n actual ❑p1... ed = a. retainer b. one-time fee 13. Form of Payment(check all that ap y): c. commission a. cash d. contingent fee b. in-kind;specify:natur- e deferred alue other,specify 1111. 15. Brief Description of Serv' es Performed or to be performed and Da (s)of Service,including officer(s),employee(s), .r member(s)contacted,for Payment Indicate in Item 12: (attach Continuation Sheet(s)if necessary 16. Continuation S. et(s)attached: Yes n No MI 17.Information reque .d through this form is authorized by Title ' 31 U.S.C.Secti. 1352. This disclosure of lobbying reliance Signature: was placed by e tier above when his transaction was made or entered into This disclosure is required pursuant to 31 U.S.C. Print Name: A on 1352. T information will be reported to Congress semian, ally and will be available for public inspection. Any V ice Preside`i pers. who fails to file the required disclosure shall be subject Title: to:civil penalty of not less than$10,000 and not more than . 00,000 for each such failure. Telephone No.: (909)993-5470 Date: 8/22/2022 Authorized for Local Reproduction / Federal Use Only: Standard Form-LLL Standard Form LLL Rev.04-28-06 Distribution: Orig-Local Agency Project Files C-20 Page 1 LPP 13-01 May 8,2013 Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities INSTRUCTIONS FOR COMPLETING EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime federal recipient at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C.Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is 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. Enter the full name,address,city,state,and zip code of the lobbying entity engaged by the reporting entity identified in Item 4 to influence the covered federal action. 11. 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). 12. 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. 13. Check all boxes that apply. If payment is made through an in-kind contribution,specify the nature and value of the in-kind payment. 14. Check all boxes that apply. If other,specify nature. 15. 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. 16. Check whether or not a continuation sheet(s)is attached. 17. The certifying official shall sign and date the form,and print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30-minutes per response,including time for reviewing instruction,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project(0348-0046),Washington,D.C,20503.SF- LLL-Instructions Rev.06-04 C-21 Page 2 LPP 13-01 May 8,2013 • Local Assistance Procedures Manual Exhibit 15-G Construction Contract DBE Commitment • EXHIBIT 15-G CONSTRUCTION CONTRACT DBE COMMITMENT • • ' 1.Local Agency: The City of Huntington Beach 2.Contract DBE Goal: 6% 3.Project Description: Utica Avenue Bicycle Boulevard ' 4.Project Location: Utica Avenue(Main Street—Beach Blvd) G 5.Bidders Name: Elecnor Belco Electric,Inc. *s 6.Prime Certified DBE: ❑ 7.Bid Amount: 55d,.5 7q• -0 8.Total Dollar Amount for ALl.Subcontractors: 0`l,3 //'if& =11C 9.Total Number of ALL Subcontractors: 3 10.Bid 12.DBE14.DBE Item 11.Description of Work,Service,or Materials Certification 13.DBE Contact information Dollar Number Supplied Number (Must be certified on the date bids are opened) m Aount ..4/6,11,_ T . . '�"_` { ti% / `7 J 1.i _ • rrvit OIry4t€ fAf�11111.IlfG o / , rG�//ntSn •° 012-5a7 • Local.oency to wimp late this Section upon Exeoution of Award rj' 4 5d=C+� 2,i, oval¢gency Contract Number, h A+n =I«1.5.4'3..kc` ,,,/,;F;i u i,.','. Yi .a ¢� , 43i{,• g .i.;}.,t ; r F 15,TOTALCLAIMEDDBEPARTICIPATION 22 Federal Aid Project Number'{•*p,f•Ipw,L.c;� i M1 r. $tiYSit F ,i r 1,; ` "� , M,.i t..4:.f 4�d., : , �g: o:, h „;- t?}+,y '`j*ja'I41 SY:'.:1 23 Bid Opening Date k , t i(e� r-w G�$I a, .I Y q $yi •,F, I r i Ii rac A c�,d:G ,, ,,v :i',3 ..,i e...1.1 .{ riwiP :a' 13SIM„ .r• . 24"Confrad'Rwa Date 25, Award Amount: paw IMPORTANT: Identify all DOE firms being claimed for credit, i K regardless of tier.Names of the First Tler DBE Subcontractors and w F;Y ti.` c.. 5 4 7�,v,;t..,,14, �, ,k.�,,. _, I 1 h*., t;.`(..,yl if'• their respective item(s)of work listed above must be cons[stent,where ;r a i'.�41,,. v < i,,41: ',#ti�,�+k�--1j;�. -'.�,,°r iu C7 o. ,1 applicable 1.:1• �,"- 4y 1r)1':.�1,:fi lit M1,4,ga�il..9 iii*.t .a_a +;.':isf,i,;;;.{., r4`_At= a licable with the names and items of the work in the"Subcontractor I •Lopal Agency.cerrtifies t at all DBE rtifications are acid and,kfgrmatibn on List'submitted w)th your bid.Written confirmation of each listed DBE ,thrs,[orrn is complete an.accurate," q• 't!+,� ",�;ti'Fr)y Ak '`,.i i c;;I t"hE is it [ , ' 4 +.. .. ,L�s ,Np't-u 1. .;.'�hixf E"±'' s- iT.15 r 9fr,13 I A 8/22/2022 26:•LocalA a Re resentative'sSi nat{rre, s'r27s'Date': 4, TM)+' 16 _es gnature 17,Date g ncy P 9 4 :xr'{,Ahk ir II. ?� r 'rr. ry: .4I tr, ,q.,,,1'i�� i} 44.= � . , r I..4 f I '* �; on. (909)993 5470 IIf4 •li t 1, { ,_�j1#kO MCW'4'4h i yy,, 4.1,144ik'e I {{ i.t _ —__ • _, i + .-', T. t•. ' c isa , as t; F. J� 28 Local Ager)cy Representatil(e i•IJame 1. dL29 Pon@ IfFa a st,i, r"j t 18.P • ame 19,Phone I 12 1rc's , hI,,it j� t-•tti,,,#�� j a;r61'J+!,r� tit d aye T : . i I/M;tip•?*:W'r9k + Fi '1'ss, a ; �a,A.,,et t1+:,1Oty_ ` vk - . s i c r X v l.4 ,.--fT 1• '' 20.Preparers Title • ivi.30 Lobel Agency Repress to e 8111 , �i'}rt .p E•: y-41 1 , , DISTRIBUTION: 1.Original—Local Agency 2.Copy—Caltrans District Local Assistance Engineer(DLAE).Failure to submit to DLAE within 30 days of contract execution may result In de-obligation of federal funds on contract. • 3.Include additional copy with award package. ADA Notice: For Individuals with sensory disabilities,this document Is available In alternate formats. For Information cell(816)651-6410 orTDD(916)654-3880 or write Records and Forms Management,1120 N Street,MS-89,Sacramento,CA 95814. i Page 1 of 3 • C-22 January 2019 Local Assistance Procedures Manual Exhibit 15-H Proposer/Contractor Good Faith Effort EXHIBIT 15-H: PROPOSER/CONTRACTOR GOOD FAITH EFFORTS Cost Proposal Due Date PE/CE Federal-aid Project No(s). CML-5181(191) Bid Opening Date 8/30/2022 CON The City of Huntington Beach established a Disadvantaged Business Enterprise(DBE)goal of 6.00%for this contract.The information provided herein shows the required good faith efforts to meet or exceed the DBE contract goal. Proposers or bidders submit the following information to document their good faith efforts within five(5)calendar days from cost proposal due date or bid opening. Proposers and bidders are recommended to submit the following information even if the Exhibit 10-01: Consultant Proposal DBE Commitments or Exhibit 15-G: Construction Contract DBE Commitment indicate that the proposer or bidder has met the DBE goal.This form protects the proposer's or 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. The following items are listed in the Section entitled"Submission of DBE Commitment"of the Special Provisions, please attach additional sheets as needed: 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): Publicationsbl Dates of Advertisement Pa1i / - 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 Solic' Date of Initial Solicitation Follow Up Methods and Dates C T '/°1t'4ii/yrt C. Ala/Z Z cj/7-7-/22-i 0/2-3 / D-- kle , t�h-►ill C-23 Page 1 of 3 May 2020 Local Assistance Procedures Manual Exhibit 15-H Proposer/Contractor Good Faith Effort C. The items of work made available to DBE firms including those unbundled contract work items into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation in order to meet or exceed the DBE contract goal. Items of Proposer or Bidder Breakdown of Amount Percentage Work Normally Performs Item Items ($) Of (Y/N) Contract 0.00% Sib/ h 'SI l��r�9 EPick1 Z I ti 5 etc-0,vc a 0.0o% q, `/°/a Pick 0.00% 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 pop.,DBEs: pop., 60,1I n1e4- Names, addresses and phone numbers of firms selected for the work above: i Alt Sent _5, 1-1-c c�+ ��, 3:T r o,t,ri / G -'[24°7 ; E. Efforts(e.g. in advertisements and solicitations)made to assist interested DBEs in obtaining information related to the plans, specifications and requirements for the work which was provided to DBEs: ME CI obiI me�' C-24 Page 2 of 3 May 2020 Local Assistance Procedures Manual Exhibit 15-H Proposer/Contractor Good Faith Effort F. Efforts(e.g. in advertisements and solicitations) made to assist interested DBEs in obtaining bonding, lines of credit or insurance, 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: /1-1 e4- 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 PM?. 114741I ri,,t H. Any additional data to support a demonstration of good faith efforts: per (-iv‘/ l /1/10-- C-25 Page 3 of 3 May 2020 Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors(DBE and Non-DBE) Exhibit 12-B: Bidder's List of Subcontractor (DBE and Non-DBE) - Part 1 As of March 1, 2015 Contractors(and sub-contractors)wishing to bid on public works contracts must be registered with the State Division of Industrial Relations and certified to bid on Public Works contracts. Please register at https://www.dir.ca.gov/Public-Works/Contractor- Reg istration.html.The local agency will verify registration of all contractors and subcontractors on public works projects at bid and thereafter annually to assure that yearly registration is maintained throughout the life of the project. In accordance with Title 49,Section 26.11 of the Code of Federal Regulations,and Section 4104 of the Public Contract Code of the State of California, as amended,the following information is required for each sub-contractor who will perform work amounting to more than one half of one percent(0.5%) of the Total Base Bid or$10,000(whichever is greater). FEDERAL PROJECT NUMBER: Photocopy this form for additional fines. CML-5181(191) Subcontractor Name&Location Line item&Description Subcontract Percentage of Contractor License Number DBE DBE Cent Number Annual Gross Receipts Amount Bid Item (Y/N) t�1 t/C C Subcontracted DIR Reg rNumber NAME�j •1ME✓!awl C 1 G1 1 l/ (�V45 -5'r 7 d/a 1,6x 1 3 ` ) <$ million /y5. (h r�,,((�� 4't J' ik /O // <$5$10 million ilon City,State ac� "yVi l 1 N\<S15mdlian t '( cte • 1�� ©�' !'Ag,Aged Firm in years v7 NAME <$1 million rOtvpc ✓ DD ` 4505-0 C,Y°l° git 1 2-- r t "g2 $S Stomllicnn <S15million City,Stale,,.... �q _ �Iv'�--J�lk . r� � �V �����C� A9syof earsFirm in NAMEr'n �// // 4 ry-r( <$1 million 5/'4 r1M El l° 6/0"0 I 3`�la v ' l"` i,4 <$5mMir' nLi � Iv <L l / p� Slo r millian City,State .4l/P5 0� f'` J S15millian OfrA 9 ldod oast o Aged yoursmin ZZ NAME <$1 million <$5 m Glen <S10 million City,State — <S15million Aged Firm in years NAME <St million <$5 million <$10 million City,State <$15 million Aged Firm in years NAME • <$1million <$5 million <$10 million City,State <$15 million Age d Firm in years NAME <$1 million <umillion <$10 million City,State <$15 million Aged Firm In years NAME <$1 million <$5 m illion <S10million tlity,State <$15million Aged Firm in years NAME <$1 million <SSmillion <$10 million City,State <$15 million Age ofFirm in years Distribution—Original:Local Agency File;Copy:DLAE w/Award Package C-26 Page 1 of September 2021 Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors(DBE and Non-DBE) Exhibit 12-B: Bidder's List of Subcontractor (DBE and Non-DBE) -Part 2 In accordance with Title 49,Section 26 of the Code of Federal Reg ulatio n s,the Bidder sh all list all subcontractors who provided a quote o r bid but were not selected to participate as a subcontractoron this project. FEDERAL PROJECT NUMBER Photocopy this form for additional firms. CML-5181(191) Subcontractor Name&Location Line Item 6Description Subcontract Percentage of Contractor License Number DBE DBE Cert Number Annual Gross Receipts Amount Bid Item (YIN) Subcontracted DIR Reg Number NAME <$1 million <$5 million <$10 million City,State <$15 million Aged Firm in years NAME <$1 million <$5 million <$10 million Lily,State <$15 million Aged Firm in years NAME <$1 million <$5 minim <$10 million City,State <$15 million Aged Firm in years NAME <S1 million <$5 million <510 million City,State <$15 million Aged Firm in years NAME <$1 million <55 million <$10million City,State <$15 million Aged Firm in years NAME <$1 million <$5 million <$10 million City,Slate <515million Aged Firm in years NAME <$1 million <$5 million <$10 million City,State <$15 m Mien Aged Firm In years NAME <$1 million <55million <510miillon City,State <$15 million Aged Firm In years NAME <$1 million <$5 million <$10 million bey,State <$15 million Aged Firm in years Distribution—Original:Local Agency File;Copy:DLAEw/Award Package C-27 Page2of2 September 2021 N V) i L OH O r O y v- O N .r ++ y@y. ❑ N O E o N ❑ O ❑LL @ '� p Qt . k o O �, a a. r u_ - W 0 U E a /� 0 v 0 m V 2 8 F! `�" 3 o n CO CL O C o to ❑ ❑ o h U 0 E ui, a c N N r i Pa < U W ,7 v t 3 to CA CO `o w a o '' U N d I c m y A ii: ❑ wTo at :4 n• d m 4 a. q ` W °° 0)€ r 00) �3 L. Z o CO O N« C E CS 0 d U ❑W o ) .0 z .0 c � W -sZ 6° a w a °I? of yN 2a M as 8 1 _ E V _ 03 c U � WN � W Ca) Co ` - L W a W a 'fl con CO m D mm n yD R c �c E O u V ea F D o c W J �y z O 0 �mZ mca LL `��' el PA a o w ° la 0 m N Z � g ia z a 3 52 W a) • dx o @0 g a A Q4 3 V E d w m q c@iY °g z w K e O O.� Q 3 O • W 0 C c P > APa O c a8 1 mm 0 0 c - E �+ A 'I' y C c c � U m a O N Z y 'u E , C EI o .az o o` U - @ Q - o 0 . Z Eg W ZA O. m a c 1.8u Q N3 (0 m (0 €( C o T cl) � _i aa`) E C Nw - O a - 00W Cn yQo co < U O o c' E A = oc o z LisZ 2 fr., ? M y A U Q CE 0^ omO a m 5 F - Z O O' m .c. a re O F " v • Qo U pJ N m . ¢ '. .-) voE-( Q v - co U • m Q wV I a I-W N Ca i g JJ EU a O N F. )i 0 o a+ �' 0.2 o L m N 8 W m C F m 6 co N �i Zco CG c .- We..)U v 0> v J Ua Id R 0.1 0 m mm as yw 0) o o2 u� R .2. C O 'O F+ "-M ¢ E� C C fp u p�p 14 U ) z y 0 G) N C C Cl) m .t 0 0 N u.1 C j Z L F-i� . O d 0 0. a w N "0 �l 7 .�"'-� 2 I- of m 0' C N d Z U U cG S` V, C C N J w C 0 r _ N W 2 O O Y `) I N t m cW 0 OU 5 m 's E 0. F c el' Oi W Cm c ( •m ca as w F 0 „ c) m 8 E o T •c c V oa) ❑ 0o 0 c O u°-s y coL>4 C U Q `m v 0 rn Z 'a," rn L. 0 z Q {�- U d W Q R '•' E 6 2 c t� CO O 0 oW o a,�E O . ° C a o -1 J U 0 Z m N Cl a Local Assistance Procedures Manual Exhibit 17-F Final Report-Utilization of Disadvantaged Business Enterprises(DBE) and First-Tier Subcontractors INSTRUCTIONS—FINAL REPORT-UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES (DBE)AND FIRST-TIER SUBCONTRACTORS 1.Local Agency Contract Number-Enter the Local Agency contract number or identifier. 2. Federal-Aid Project Number-Enter the Federal-Aid Project Number. 3.Local Agency-Enter the name of the local or regional agency that is funding the contract. 4. Contract Completion Date-Enter the date the contract was completed. 5. Contractor/Consultant-Enter the contractor/consultant's firm name. 6. Business Address-Enter the contractor/consultant's business address. 7.Final Contract Amount-Enter the total final amount for the contract. 8. Contract Item Number-Enter contract item for work, services, or materials supplied provided.Not applicable for consultant contracts. 9.Description of Work,Services,or Materials Supplied -Enter description of work, services, or materials provided. Indicate all work to be performed by DBEs including work performed by the prime contractor/consultant's own forces, if the prime is a DBE. If 100%of the item is not to be performed or furnished by the DBE,describe the exact portion to be performed or furnished by the DBE. See LAPM Chapter 9 to determine how to count the participation of DBE firms. 10. Company Name and Business Address-Enter the name, address, and phone number of all subcontracted contractors/consultants.Also, enter the prime contractor/consultant's name and phone number, if the prime is a DBE. 11.DBE Certification Number-Enter the DBE's Certification Identification Number. Leave blank if subcontractor is not a DBE. 12. Contract Payments-Enter the subcontracted dollar amount of the work performed or service provided. Include the prime contractor/consultant if the prime is a DBE.The Non-DBE column is used to enter the dollar value of work performed by firms that are not certified DBE or for work after a DBE becomes decertified. 13.Date Work Completed-Enter the date the subcontractor/subconsultant's item work was completed. 14.Date of Final Payment-Enter the date when the prime contractor/consultant made the final payment to the subcontractor/subconsultant for the portion of work listed as being completed. 15.Original DBE Commitment Amount-Enter the"Total Claimed DBE Participation Dollars"from Exhibits 15-G or 10-02 for the contract. 16.Total-Enter the sum of the"Contract Payments"Non-DBE and DBE columns. 17. Contractor/Consultant Representative's Signature-The person completing the form on behalf of the contractor/consultant's firm must sign their name. 18. Contractor/Consultant Representative's Name-Enter the name of the person preparing and signing the form. 19.Phone-Enter the area code and telephone number of the person signing the form. 20.Date-Enter the date the form is signed by the contractor's preparer. 21.Local Agency Representative's Signature-A Local Agency Representative must sign their name to certify that the contracting records and on-site performance of the DBE(s)has been monitored. 22.Local Agency Representative's Name-Enter the name of the Local Agency Representative signing the form. 23.Phone-Enter the area code and telephone number of the person signing the form. 24.Date-Enter the date the form is signed by the Local Agency Representative. C-29 Page 2 of 2 July 23,2015 Query Criteria Certification Types: DBE DBA Name:cat hacking inc Firm ID 43242 DBA Name CAT TRACKING INC. Firm Name Address Lind 17 COMMERCIAL AVENUE Address Line2 City RIVERSIDE State CA Zip Cocle1 92057 Zip Code2 Mailing Address Line.] Mailing Address Line2 Mailing City Mailing State Mailing Zip Code1 Mailing Zip Code2 Certification Typo DBE EMail Contact Name Area Code 951 Phone Number 682-1494 Extension Alt Area Code Alt Phone Number Extension Fax Area Code Fax Phone Number Agency Name DEPARTMENT OF TRANSPORTATION Counties 13;30;33;36;37; Districts 08; 11; 12; DBE NAICS 237310;238990;488490;561990; ACDBE NAICS Work Codes C1200 CONSTRUCTION AREA SIGNS; C1201 TRAFFIC CONTROL SYSTEM; C1211 TRAFFIC FLAGGERS; C8405 THERMOPLASTIC TRAFFIC STRIPING&MARKING; C8406 PAINTED TRAFFIC STRIPING&MARKIN\ A General Engineering Contractor; B General Building Contractor; C08 Concrete Contractor; C12 Earthwork and Licenses Paving Contractor;C31 Construction Zone Traffic Control Contractor;C32 Parking and Highway Improvement Contractor; Trucks Gender Ethnicity Firm Type DBE t-i g . w a m: QW,,r;! a skit t.), i V & b m mI 3, MEW 11 y= p ,4 _:yw u u . y C, (J ! i--r V .I 0 e w CD W v, w O , t n j� MO I N l - q�q-d 7 tll illl i.� U O oaf � � 1 Q 1-1 Q OQ :11:1311/1 Lll CD 1 Z t-- n-ii c0 o -0 v0 r` � <n �-y v z•'�, o S CO tc: 8 ',:' --0 I W ? z a wu a �o � W w�u � c MINIM a H II-1 ct p §,_ i_J o vN M. • N N N N. g N Cn m e in 1 -+ 0.!H T' )0 N � �i' € NM o ��, 2v o .O u v� ,-I X, 0a� Q Q N ,,S� s G 8 z o r �/� v, "d 4-4 cad N ! •7, t 311 O� 0--11 O U {�rn 3 0^, at Qr G.1 O� :.:�f.l worm cl U . 0 s. N O O C0. i�'7 U Q741 (/ -i Z `nU 8 V cz S Zo �0 1-1 Gq o. ea.)VIII Cfl, r Ji a 1 Printed on:4/18/2022 12:02:33 PM To verify most current certification status go to:https://www.caleprocure.ca.gov DES r Al Ir 00,11A OC PAH r 11r., Or GENERAL SERVICES Office of Small Business & DVBE Services Certification ID:2000409 Email Address: Legal Business Name: PAM@CATTRACKINGINC.COM CAT TRACKING INC Business Web Page: Doing Business As(DBA)Name 1: • WWW.CATTRACKINGINC.COM Business Phone Number: Doing Business As(DBA)Name 2: 951/682-1494 Business Fax Number: Address: 17 COMMERCIAL AVE Business Types: RIVERSIDE Construction,Service CA 92507 Certification Type Status From To SB(Micro) Approved 04/13/2022 04/30/2024 Stay informed!KEEP YOUR CERTIFICATION PROFILE UPDATED! -LOG IN at CaleProcure.CA.GOV Questions? Email:OSDSHELP@DGS.CA.GOV Call OSDS Main Number:916-375-4940 707 3rd Street,1-400,West Sacramento,CA 95605 THE AMERICAN INSTITUTE OF ARCHITECTS MA Document A310 Bid Bond KNOW ALL MEN BY THESE PRESENTS, that we Elecnor Belco Electric, Inc. 14320 Albers Way,Chino,CA 91710 as Principal, hereinafter called the Principal, and Fidelity and Deposit Company of Maryland 1299 Zurich Way,5th Floor, Schaumburg, IL 60196-1056 a corporation duly organized under the laws of the State of IL as Surety, hereinafter called the Surety,are held and firmly bound unto City of Huntington Beach 2000 Main Street, Huntington Beach, CA 92648 as Obligee, hereinafter called the Obligee, in the sum of Ten Percent of Amount Bid Dollars ($ 10% ), 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 Utica Avenue Bicycle Boulevard from Main Street to Beach Boulevard CC NO.1499; Federal Aid Project: CML-5181(191) 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 26th day of August 2022 Elecnor Belco Electric, Inc. (Principal) (Seal) I(Witness) By: JL�1vl t9�/J� C ff"tci levl (Title) Fidelity a Depos Company of Maryland (�„ rery) ?(Seal) Nicholas Milli\jiAlc4iv.,_ ( By: (Witness) (Title) Aman . D'Angelo,Attorney-In-Fact CONFORMS WITH AIA DOCUMENT A310•BID BOND•AIA••FEBRUARY 1970 ES-.fHE AMERICAN INSTITUTE OF ARCHITECTS,1735 N.Y.AVE.,N.W.,WASHINGTON,D.0 20006 1 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 San Bernardino } On 8/30/22 before me, Rebecca Wilks, Notary Public , (Here insert name and title of the officer) personally appeared John Wong , who proved to me on the basis of satisfactory evidence to be the persons-) whose name(-s) Is re subscribed to the within instrument and acknowledged to me that 0-he/they executed the same in4r er/their authorized capacity(ics), and that by Qp er/their signatures) on the instrument the person(s-), 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. WIT ESS myhand and official seal. REBECCAwIIKS _ ,- _ Notary Public-California AAC,f_.4.4A------ 11jelded>2 1 �.•S = San Bernardino County > = Commission r 2300424 My Comm.Expires A..g 5,2023 i Notary Public Signature (Notary Public Seal) ♦ • ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM This f our complies with current California.statutes regarding notary r+ordmg and, DESCRIPTION OF THE ATTACHED DOCUMENT if needed,should be completed and attached to the docuent.Acknowledgments from other states may be completed_for documents being.sent to that s state so long as the wording does not require the California notaty to violate California notaty bid bond law. (Title or description of attached document) • State and County information must he the State and County where the document signer(s)personally appeared before the notary public for acknowledgment. • l.)ate of notarization must he 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) 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. he/she/they, is! )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 he 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. • Signature of the notary public must match the signature on file with the office of ❑ Partner(s) the county clerk. Cl Attorney-in-Fact Additional information is not required but could help to ensure this ❑ Trustee(s) aclatowledgmtent is not misused or attached to a different document. OtherIndicate 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). Not r ar Cly ,e. c tt r.00 r. Nifjr;r • Securely attach this document to the signed document with a staple. 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. Connecticut State of 13atifoaxi'i x County of Hartford On August 26,2022 before me, Stephanie Harvey,Notary Public (insert name and title of the officer) personally appeared Amanda P.D'Angelo 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. STEPHANIE HARVEY 62 NOTARY c commission Expires Mar. i,2027 Signature '4.2 (Seal) Stcph me Harvey Notary Public ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That the ZURICH AMERICAN INSURANCE COMPANY,a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of 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 Jacqueline R.SUSCO,Kathryn PRYOR,Nicholas TURECAMO,Gentry STEWART,Amanda P. D ANGELO,Donna M. PLANETA, Bethany STEVENSON, Joshua SANFORD, Aimee R. PERONDINE, Jennifer G. GODERE, Alexis R. APOSTOLIDIS,Michelle Anne MCMAHON,Rebecca M.JOSEPHSON,Brendan W.FLETCHER,Cassandra BAEZ, of Hartford, Connecticut, EACH,its true and lawful agent and Attorney-in-Fact,to make,execute,seal and deliver,for,and on its behalf as surety,and as its act and deed: any and all bonds and undertakings,and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies,as fully and amply,to all intents and purposes,as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York,New York.,the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills,Maryland.,and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland.,in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V,Section 8,of the By-Laws of said Companies,and is now in force. IN WITNESS WHEREOF,the said Vice-President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND,this 26th day of August,A.D.2021. 0 0[IOJi� ��l 2..di . 41d ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND By: Robert D.Murray Vice President 4 By: Dawn E.Brown Secretary State of Maryland County of Baltimore On this 26th day of August, A.D.2021, before the subscriber,a Notary Public of the State of Maryland,duly commissioned and qualified,Robert D. Murray,Vice President and Dawn E.Brown,Secretary of the Companies,to me personally known to be the individuals and officers described in and who executed the preceding instrument,and acknowledged the execution of same,and being by me duly sworn,deposeth and saith,that he/she is the said officer of the Company aforesaid,and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies,and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF,1 have hereunto set my hand and affixed my Official Seal the day and year first above written. Cerv'evtoel‘e.-e_ t) 4.\,�.. / �tr ` :my*,;..: Constance A.Dunn,Notary Public •:,rt?�ai,iia$.`� My Commission Expires:July 9,2023 r'"lnlnip%s. Authenticity of this bond can be confirmea at oonavalidator.zurichna.com or 410-559-8790 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V,Section 8,Attorneys-in-Fact. The Chief Executive Officer,the President,or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys-in-fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney-in-fact to affix the corporate seal thereto;and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate;and I do further certify that Article V,Section 8,of the By-Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney...Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice-President,Secretary,or Assistant Secretary of the Company,whether made heretofore or hereafter,wherever appearing upon a certified copy of any power of attorney issued by the Company,shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF,I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this 26th day of August ,2022 SZAL E,.,.� t. By: Brian M.Hodges Vice President TO REPORT A CLAIM WITH REGARD TO A SURETY BOND,PLEASE SUBMIT A COMPLETE DESCRIPTION OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BOND,THE BOND NUMBER,AND YOUR CONTACT INFORMATION TO: Zurich Surety Claims 1299 Zurich Way Schaumburg,IL 60196-1056 www.reportsfclaims@zurichna.com 800-626-4577 Authenticity of this bond can be confirmed at bondvalidator.zurichna.com or 410-559-8790 CO 12 s[„pr a r- >' -4- = C`cs 4 tt : ca 0 -" , m O * +r co J i. a aim nCC +.? c. 00 v00 CO ( 0Lu u j N E J cc O1 el co C o I CO c� •R Q L V H cLu 7 O s a OA of 0 U CO '0 Z C Y 0 CU . d c � Nm 3 °' 0 V O O m '8 ~ `F'• +�' LL i0 Z O = C N u m ,� o 0J = 0J . N N O m > ri I— C W CO O D d Q k v Z V o LLI N O 0 Q N t v m rn rn al i 2 O ` ' O m o rn V � 3 ~ \ Q V n O ^_' N � � Z W a ~ ~ W N ° ° W Q m o O al c p u rn Q re 0. m m I e��NTINGTOA= City of Huntington Beach ss`• > �•; ‘\ 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 • www.huntingtonbeachca.gov `14:C'•.*•• ......09,*°• Office of the City Clerk CGUNTY Robin Estanislau, City Clerk January 10, 2023 California Professional Engineering, Inc. 19062 San Jose Avenue La Puente, CA 91748 RE: Utica Avenue Bicycle Boulevard — CC No. 1499 Enclosed please find your original bid bond for CC-1499. Sincerely, e6'klilieLLIAd Robin Estanislau, CMC City Clerk RE:ds Enclosure Sister City: Anjo, Japan SECTION C PROPOSAL for the construction of UTICA AVENUE BICYCLE BOULEVARD from Main Street to Beach Boulevard CC NO. 1499 FEDERAL AID PROJECT CML-5181(191) in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids,the undersigned hereby proposes and agrees to perform all the work therein described,and to furnish all labor,material, equipment and incident insurance necessary therefor,in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 50 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site,plans,specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work,that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses,taxes,royalties,fees,etc.,and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded,the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts,and words shall govern over figures. c-1 If awarded the Contract,the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security • accompanying'this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option,be considered null and void. Accompanying this proposal of bid,find WitI in the amount of Ib' 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 Noy TDate; ;op; Sigitatu`re;'fx",{ `.. : • • 1 08/23/2022 1 • V • • • • • • ' I it f C-2 1 Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Item Estimated Item Unit Price Extended No. Quantity Amount 1 1 L.S. Mobilization. $ 3OO $ �tYQO Per L.S. 2 1 L.S. Furnish Project Traffic Control. $ 27000 $ goo° Per L.S. 3 1 L.S. Preparation of project Specific Storm Water Pollution Prevention Plan (SWPPP). $ g 00 $ 500 Per L.S. 4 1 EA. Installation and maintenance of BMP's per the approved SWPPP. �� $ I, 000 $ i3O Per L.S. 5 21 LF Remove existing block wall and footing $ 0-01 $ gf34'7 6 1 EA Construct concrete island $ Its, (0 ° $ I (p,IOO 7 40 LF Construct 8"median curb $ H $ 2- 61 O 8 1,500 SF Remove and dispose existing A.C. and 30 base material $ ,� $ 31, ° 9 130 LF Remove and dispose of existing curb and gutter $ 3 4 $q,1/8 10 76 LF Construct 6" curb and gutter 1� $ 113 $ I0/612- 11 33 LF Construct 6" curb $ I b $39 1 C-2.1 Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Item Estimated Item Unit Price Extended No. . Quantity Amount 12 1 LS Reconstruct existing improvements $ WO) $ IC v 13 1 EA Adjust manhole to grade $ $ 0;1513 14 2 EA Finish raw edge of wall with matching existing material and color $ b/�'/ $ 15 113 SF Remove and dispose existing sidewalk $ $ ( qy�l 16 70 TONS Construct new 2"type III-C3-PG 64-10 may° (1/2") surface course over 4"class B- $ Z1PLI $_I 51‘ PG 70-10 (3/4")base course over 1.0' C.M.B. 17 100 TONS Construct 1' crushed miscellaneous $ $ E0,360 base 03 18 3 EA Construct Curb Access Ramp on northwest,northeast and southeast corners at Lake Street/Utica Ave per $ I(L 100 $ 11$ 300 Caltrans Standard Plan No. RSP A88A, Case A and Details on Sheets 3 and 4. (Item includes all appurtenances,curb and gutter, depressed curb, sidewalk, domes,retaining curb, slot pave, etc.) Per EA. C-2.2 Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Item Estimated Item Unit Price Extended No. Quantity Amount 19 1 EA Construct Curb Access Ramp on southwest corner Lake St/Utica Ave per Caltrans Standard Plan No. RSP A88A DO and Detail on Sheet 4 (Item includes all $ 1� 0� $ (ID I W appurtenances, curb and gutter, depressed curb, sidewalk, domes, retaining curb, slot pave, etc.) Per EA. 20 1 L.S. Install traffic signal at the intersection of Lake Street and Utica Avenue (excludes curb ramps and city furnished � � $ equipment) $ $ 7 Per L.S. 21 1 L.S. Furnish and install signing and striping. $012 O (( $ 01201 C-2.3 Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Total Amount Bid Total Amount Bid nin Figures: $ S0( ) I ✓"' •16 Total Amount Bid in Words: $T I 044 q)(1'y-1✓0e -1"1oUsano( Dh.e i}unitrMG 1'W r'y-5i ,( do gars 11414 ve Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (also includes anchor bolts) to the contractor. The contractor is to pick up the materials, with its own labor, at the City Yard, 17371 Gothard Street. Contact traffic signal maintenance two working days in advance for pick up at (714) 536-5530. 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. ,,Btd 4 f 'Name andAddress`ofi� State. ; Gass: DIR PWC Dollar %ofs i �Iteart(s)i�' }; i� Subcontractor a` , Licensea. ; 3 � ` Registrataoni# LAmount Contracli 51 � , .. i st�r i 5: 1 pia ,, 17 �.�,s l�"'Y E n t r,�ti i p. i. i,y I C�,: , ii 5� 4.., r r � 1 }�;,,. ' 1Vumber•.�, 1,+.,,. :� yrL�j !���� �,#1J o�. 4 i .0 1,14! p 4I1 /tfr i(gn �V r 11 ?O Bo( 29-9g, Coon 6� Al'1t�3 A 1,ocwoo1v51 ►-7u,51/5- 1.1111 /. cflk" r Dc. Dri e-• gg5-DL/q 7 't O000/029-qc >l1D a W ,��/ • p I e01 a\ OVIV 5? (01-Q61‘1 ;14(obd e i3 (o000o0N9 50,01r9 - . 1 1 • 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 on08130/2022 at La Puente , Ca, Date City State Van Nguyen , being first duly sworn, deposes and says that he or she is President of California Professional Engineering,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. Van Nguyen, resident Name of B'd er . r Signature of Bidder 19062 San Jose Ave, La Puente, CA 91748 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 UTICA AVENUE BICYCLE BOULEVARD, (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. California Professional Engineering, Inc. Contractor • Van Nguyen By President • Title • Date: 08/30/2022 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? Cl Yes El No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code,each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. California Professi nal Engineering, I c. Contractor • Van Nguyen By President Title • Date: 08/30/2022 • C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: California Professional Engineering, Inc. Bidder Name 19062 San Jose Ave Business Address La Puente CA 91748 City, State Zip ( 626 ) 810-1338 van@cpengineeringinc.com; estimating@cpengineeringinc.com Telephone Number Email Address 793907; A, C-10 State Contractor's License No. and Class 04/16/2001 Original Date Issued 04/30/2023 Expiration Date The work site was inspected by Van Nguyen of our office on 08/30 , 2022. ,The following are persons, firms, and corporations having a principal interest in this proposal: V OtVk N9vtyerli CeS;Q.eh- 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. Califo is ofessional ngineering, Inc. Comp y am Signatur of Bidder Van Nguyen, President Printed or Typed Signature C-8 NOTARY CERTIFICATE Subscribed and sworn to before me this 14 day of P , 2022. 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 10- 4 ` ) County of VS'' , . ) On �b al before me, PAA(A 'VM Mo th,Da , and Year Insert Name and Title of Notary personally appeared Vci NMVP 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 myhand and • ial seal. ��': '�f ALICIA NGIrYEV `,M_" r Notary Public California z € W. Los Angeles County ` Commission;2375906 'i: ••' My Comm,Expires Sep 23,2025 Signatu Signatu - 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 traffic signals,curb&gutter and sidewalk. 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. Please see 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: 2. Name and Address of Public Agency Name and Telephone No.of Project Manager:- Contract Amount Type of Work Date Completed • Provide additional project description to show similar work: • 3. Name and Address of Public Agency i Name and Telephone No.of Project Manager: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: c-10 California Professional Engineering, Inc. COMPLETED PRIME Projects startinr with most recent) document last modified 02.17.2022//dc Total Contract Amount+Extra grief Scope of Work Approx, Approx. Owner/Contact/Info Project Name&No. Approximate,4 WorkICCO's Commencement Completion Completed by CPE original contract final contract City of Westlake Village Mike Bustos Pedestrian Safety Lighting&Beacons Dec 2021 Jan 2022 31200 Oak Crest Drive Triunfo Canyon Rd-Saddle 95% $ 151,488.00 $ 136,332.20 Westlake Village,CA 91361 Mountain Dr (805)653-6597 mbustos@willdan.com original contract final contract Catrans District 12 Gagandeep Sidhu Replace CMS(changeable message sign) Jun 2021 Oct 2021 1727 30th Street Replace Panel on CMS37 100% $ 118,898.00 $ 127,071.92 on freeway. Sacramento,CA 95816 #12A1791 949-279-8466 gagandeep.sidhu@dot.ca.gov original contract final contract City of Whittier Raul Fiore Traffic Signal Construction, Dec 2020 Jul 2021 13230 Penn Street Greenleaf Ave/Putnam Ave TS 95% $ 343,760.00 $ 340,252.00 Conduit,Pull Boxes,Wiring Whither,CA 90602 #STPL-5111 562-567-9525 rflore@cityofwhittier.org original contract final contract City of Lancaster Marc Alius Traffic Signal Construction: May 2021 Sept 2021 44933 North Fern Avenue City of Lancaster-Avenue I/60th 90% $ 173,654.00 $ 176,503.35 Conduit,Pull Boxes,Wiring Lancaster,CA 93534 Street West#17-0123 661-945-6879 malius@cityoflancasterca.org original contract final contract City of Lancaster Marc Alius Traffic Signal Construction, Nov 2020 Feb 2021 44933 North Fern Avenue 2017 Traffic Signal Upgrades#16- 85% $ 524,628.00 $ 535,123.83 Conduit,Pull Boxes,Wiring Lancaster,CA 93534 007;#STPL-5419(054) 661-945-6879 malius@cityoflancasterca.org original contract final contract City of Colton Traffic signal construction at Three Marty Ragels Locffians,Concrete&Sidewalk 160 South 10th Street Three Traffic Signal Intersections In"iovemeMs.S•Ignmg 8 Striping.SCE Nov 2019 Aug 2020 80% $ 678,065.00 $ 678,065.00 undegauMsabsaucWes.se tie Colton,CA 92324 #3186-4 Pe°`sta`"` 909-370-5065 mragels@coltonca.gov original contract final contract City of Fountain Valley Traffic Signal Constructbn.Concrete& John Nguyen Sidewalk Improvements.Signing 8 10200 Slater Ave Ship$ 626,339.40 $ 580,294.66 Swam Pedestal.Underground n Nov 2019 Jul 2020 Fountain Valley,CA 92708 Talbert/Mt Washington TS#TI233 80% Conduit&Communication systems.CCTV 714-593-4443 john.nguyen@fountainvalley.org original contract final contract City of Ontario Traffic Signal,Battery Back Mauricio Diaz Up Systems,Video Detection 303 E"B"St Vineyard&Sixth;Grove&Francis ° $ 140,568.00 $ 141,327.00 Systems,Controller Cabinet, Jul2020 Jul2020 Ontario,CA #TR180111802 90% CCTV,Wiring,Pull Boxes, etc. 909-395-2000 mdiaz@ontarioca.gov original contract final contract City of Oxnard Traffic signal Construction,Concrete& Debbie O'Leary Sidewalk Improvements,Signing& Striping,SCE pmmu 'a ona" M Aug 2019 Feb 2020 305 W 3rd Street Rose Ave/Gary Dr TS#A-8128 70% $ 678,072.40 $ 720,691.43 senconaud&Cenicsyao7sn,rbe, Oxnard,CA 93030 no. 805-200-5283 debbie.oleary@oxnard.org original contract final contract City of Redlands Kyle Wagner Limelight In-Pavement LED Crosswalk 35 Cajon Street HSIPL Cycle 7 Uncontrolled ° Lgnhng.spninglSmpirq,Fkaning Jul2020 Jul2020 95/0 $ 324,743.00 $ 348,661.05 &aconpoio PUrnoonstuboms Redlands,CA 92373 Crosswalk#HSIPL-5083(019) 909-798-7584 kwagner@cityofredlands.org original contract final contract City of Arcadia Kevin Merrill Traffic Signal construction upgrades at Mar 2020 Oct 2020 240 West Huntington Drive Santa Anita Corridor#41852417 85%� $ 713,791.00 $ 775,716.75 ousintem°`a°ne Arcadia,CA 91066 626-574-5481 kmerrill@ArcadiaCA.gov original contract final contract City of Santa Ana Michael Ortiz Security Lighting for PE Bike Trail& Park&Security Lghting.Conduit Pull 20 Civic Center Plaza Boxes,Lighting Foundations.service Mar 2020 Jan 2021 Saddleback View Park#18-7254; 95% $ 421,043.00 $ 410,127.79 Pedestals,Ant-Grafitti Santa Ana,CA #18-7533 714-647-5624 MOrtiz@santa-ana.org original contract final contract Traffic Signal Synchronization atVenous City of Burbank Imeraec°ona,Condor Pull Boxes,Loop Detector Vikki Davtian F;,o,onset 275 E Olive Ave Traffic Responsive Signal System ° $ 954,429.66 $ 1,043,603.19 Apr 2020 Dec 2020 Burbank,CA Project#1461 90/o 818-238-3965 VDavfian@burbankca.gov original contract final contract CA DOT Roy Tomello Replacement of Traffic Signal Oct 2018 Jun 2020 790 Via Lata,#100 On Call Loop Detectors#08A2921 100% $ 387,550.00 $ 94,050.00 Loop Detectors Colton,CA 92324 909-915-9717 roy.tomello@dot.ca.gov original contract final contract City of Menifee TrafficsgnelCosmctmnatT� Carlos Geronimo Intersections,Concrete&Sideeslk 29844 Haun Road Two Traffic Signal Intersections Improvements,Stomp&Striping.SCE Sept 2019 May 2020 75% $ 814,935.00 $ 867,901.78 Underground Substructures,Same Menifee,CA 92586 #19-04/05 Pedestal,etc. 951-723-3722 cgeronimo@cityofmenifee.us original contract final contract City of San Bernardino Ryan Castillo SCE Substructures,Power 300 North"D"Street $ 95,420.00 $ 89,021.53 Feed Conduit,Caltrans ROW Mar 2020 May 2020 San Bernardino,CA 92418 Hospitality/Waterman#13330 100% Coordination,etc. 909-384-5535 castillo_ry@sbcity.org original contract final contract City of Pasadena Sarah Tawadrous Removal&Replacement of 100 N Garfield Ave Fair Oaks/Mountain;Green/Arroyo ° $ 188,870.00 $ 179,237.40 Traffic Signal and Street Apr 2020 May 2020 100% Lighting Poles. Pasadena,CA Pole Replacement#31383 626-744-4304 stawadrous@cityofpasadena.net original contract final contract City of Pasadena RRFB,FLIR Tthennal Elvin Jiang Cameras at Various May 2019 Apr 2020 100 North Garfield Avenue,N306 Pedestrian Crossing Improvements 100% $ 185,110.00 $ 199,478.04 Locations,Integration Pasadena,CA #31299 626-744-7311 ejiang@cityofpasadena.net original contract final contract City of Downey Ed Norris Traffic Signal&Flashing Apr 2020 Apr 2020 11111 Brookshire Avenue Brookshire Ave&Everest St#20- 100% $ 53,445.00 $ 60,207.66 Beacons Downey,CA 90241 29 562-904-7110 enorris@downeyca.gov original contract final contract City of Buena Park Ken Kim Banner Pole&Arm Feb 2020 Apr 2020 6550 Beach Blvd Banner Poles on Orangethorpe& 100% $ 20,300.00 $ 21,945.14 Installations Buena Park,CA 90620 Indiana#618 714-562-3688 kkim@buenapark.com original contract final contract City of Huntington Beach Traffic Signal Construction, Joe Fuentes Conduit,Pull Boxes,Wiring, 2000 Main Street Concrete&Sidewalk Sept 2019 Apr 2020 Main St&17th St#CC-1488 75% $ 643,490.20 $ 676,697.47 Improvements,Handicap Huntington Beach,CA 92648 Ramps,etc. 714-394-5676 jfuentes@surfcity-hb.org original contract final contract City of Oceanside Jeff Freetly Replacement of Traffic Signal Feb 2020 Feb 2020 4927 Oceanside Boulevard On Call Loop Detectors 100% $ 45,000.00 $ 40,338.00 Loop Detectors Oceanside,CA 92056 760-435-5323 JFreetly@oceansideca.org original contract final contract City of Pasadena Traffic Signal,Battery Back Arnold Dichosa Up Systems,Video Detection Metro Goldline At-Grade Crossing 100 North Garfield Avenue,N306 Systems,Controller Cabinet, Apr 2019 Jul 2019 Mobility Enhancements#31131 1 100% $ 858,785.50 $ 916,950.71 CCTV,Wiring,Pull Boxes, Pasadena,CA FedAid#CML-5064(083) etc. 626-744-7402 adichosa@cityofpasadena.net original contract final contract Traffic Signal,Curb Ramps, CA DOT Signing&Striping,SCE Manuel Ruiz Underground Subsructures, 790 Via Lata,#100 $ 2,587,172.50 $ 2,587,172.50 Concrete/Asphalt Aug 2017 May 2019 Colton,CA 92324 Route 10,210#08-0E5514 90% Improvements,Fiber Optic, Networking,Microwave 951-965-6327 Systems manuetruiz@dot.ca.gov original contract final contract City of Fontana Flashing Beacon,Curb Jazmine Pena Ramps,Signing&Striping, Apr 2019 Apr 2019 16489 Orange Wy PE Trail at Maple Ave#CC-91-DE- 80% $ 108,786.00 $ 108,786.00 Concrete/Asphalt Fontana,CA 18 Improvements 949-644-3336 jpena@fontana.org original contract final contract City of Corona Traffic Signal,Curb Ramps, Dennis Rails Signing&Striping,SCE 400 S Vicentia Ave,#210 Traffic Signal at Green River and 80% $ 314,729.92 $ 314,729.92 Underground Subsructures, Oct 2018 Mar 2019 Corona,CA Montana Ranch#2016-03 Concrete/Asphalt Improvements 951-736-2266 dennis.ralls@coronaca.gov original contract final contract City of Newport Beach Traffic Signal Modifications, Eric Loke Curb Ramps, Jul 2018 Mar 2019 100 Civic Center Dr TS Rehabilitation FY2017-2018 80% $ 354,777.54 $ 354,777.54 Concrete/Asphalt Newport Beach,CA #7314-1 Improvements 949-644-3311 eloke@newportbeachca.gov original contract final contract City of Rancho Cucamonga Natalie Avila Traffic Signal Video Detection May 2018 Feb 2019 10500 Civic Center Dr Traffic Signal Video Detection at 15 100% $ 203,650.88 $ 203,650.88 Rancho Cucamonga,CA Locations#800-2018-01 909-774-4076 natalie.avila@cityofrc.us original contract final contract City of Orange Left Turn Phase Signal Modification Traffic Signal,Curb Ramps, Medel Llanes Signing&Striping,SCE I Chapman Ave&Cannon St Underground Subsructures, Apr 2018 Oct 2018 300 E Chapman Ave #HSIPL-5073(079)SP-3868; 80% $ 608,424.00 $ 608,424.00 Concrete/Asphalt Orange,CA Batavia St&Collins Ave#HSIPL- Improvements,CCTV 714-744-5535 5073(081)SP3870 mllanes@cityoforange.org original contract final contract LACDPW Traffic Signal,Curb Ramps, Joel Zaragoza Signing&Striping,SCE Colima Rd I Camino Del Sur to East Underground Subsructures, Jan 2017 Oct 2018 900 S Fremont Ave (Pedestrian of Tierra Luna 85% $ 1,816,477.16 $ 1,816,477.16 Concrete/Asphalt Alhambra,CA 91803 Crossing) 10196 Improvements 626-458-4973 JZARA@dpw.lacounty.gov original contract final contract LACDPW Traffic Signal,Curb Ramps, Anoush Hovsepians Florence Ave/Mills Ave Orr and Signing&Striping,SCE 900 S Fremont Ave Underground Subsructures, Aug 2017 Sept 2018 Day Rd to Whittier Blvd 85% $ 1,039,990.01 $ 1,039,990.01 Concrete/Asphalt Alhambra,CA 91803 #TSM0010312 Improvements 626-458-3139 ahovsepians@dpw.lacounty.gov original contract final contract City of Torrance Jess Caballero Video Detection 20500 Madrona Ave Traffic Signal Left Turn Phasing ° $ 132,351.83 $ 132,351.83 Improvements,Flashing May 2018 Sept 2018 Torrance,CA Ph.2B#T-128 95/0 Beacons,TS Modifications 909-350-6648 jcaballero@torranceca.gov original contract final contract City of South El Monte Traffic Signal,Curb Ramps, Okan Demirci Signing&Striping,SCE 1415 Santa Anita Ave Tyler and Thienes Traffic Signal ° $ 324,296.33 $ 324,296.33 UndergroundCon Subsructures,halt Jun 2018 Sept 2018 South El Monte,CA #67-900-9020-291 80% Concrete/Asphalt Improvements 626-579-6540 okan.demirci@transtech.org original contract final contract LACDPW Traffic Signal,Curb Ramps, Fred Kherdavar Signing&Striping,SCE Aviation Blvd 1118th SUNorthrup Underground Subsiuctures, Sept 2016 Apr 2018 900 S Fremont Ave Grumman Ave to Ocean Dr 85% $ 1,415,076.67 $ 1,415,076.67 Concrete/Asphalt Alhambra,CA 91803 #TSM0010190 Improvements 626-458-3199 FKHERADV@dpw.lacounty.gov original contract final contract LACDPW Traffic Signal,Curb Ramps, Robert Eisenhamer Signing&Striping,SCE Florence-Firestone Community Underground Subsnictures, Oct 2017 Mar 2018 900 S Fremont Ave Safe Routes to School 65% $ 733,074.89 $ 733,074.89 Concrete/Asphalt Alhambra,CA 91803 #RDC0016046utes Improvements 626-458-3155 REISENHA@dpw.lacounty.gov original contract final contract RCTLMA Pourroy Rd Traffic Signal&Safety Traffic Signal,Curb Ramps, Ivan Mendoza Lighting Project I French Valley Signing&Striping,SCE 4080 Lemon St Area#C8-0067;Weirick Rd Underground Subsructures, Aug 2018 Oct 2018 85% $ 458,048.00 $ 458,048.00 Concrete/Asphalt Riverside,CA 92502 Restriping&Signal Modification Improvements 562-254-9351 Project I Temescal Valley Area#C8- ivanmmendoza@aol.com 0076 original contract final contract City of Santa Ana Michael Ortiz Park Lighting Sept 2018 Oct 2018 20 Civic Center Plaza Sandpointe Paseo Security Lighting 100% $ 176,425.00 $ 203,691.00 Santa Ana,CA #16-2648 714-647-5624 • MOrtiz@Santa-ana.org original contract final contract City of Pasadena Sarah Tawadrous Street Lighting Mar 2018 Sept 2018 100 N Garfield Ave Street Lighting Phase II#31097 100% $ 251,199.00 $ 251,199.00 Pasadena,CA 626-744-4304 stawadrous@cityofpasadena.net original contract final contract City of Santa Ana Michael Ortiz Park Lighting Mar 2018 Mar 2018 20 Civic Center Plaza Thorton Park Security Lighting#16- 100% $ 96,330.00 $ 96,330.00 Santa Ana,CA 2655 714-647-5624 MOrtiz@Santa-ana.org original contract final contract City of Downey Calvin Catig Park Lighting Oct 2017 Jan 2018 11111 Brookshire Blvd Furman-Apollo Park Lighting#15- 100% $ 168,157.00 $ 168,157.00 Downey,CA 02B/15-003C 562-622-5898 ccatig@downeyca.org original contract final contract Great Los Angeles Zoo Association Dawn Peterson Street Lighting Sept 2016 Jun 2018 5333 Zoo Drive LA Zoo Street Lighting Phase II 100% $ 689,000.00 $ 689,000.00 Los Angeles,CA 323-644-4222 dpetersenamend@lazoo.org original contract final contract City of Rolling Hills Estates Greg Grammer RRFB&IRWL Aug 2017 Jan 2018 4045 Palos Verdes Dr North RRFB&IRWL at Rolling Hills Rd 100% $ 148,362.00 $ 148,362.00 Installation Rolling Hills Estates #17-04 310-377-1577 gregg@rollinghillsestatesca.gov original contract final contract City of Santa Ana Traffic Signal,Curb Ramps, Michael Ortiz TS Modifications on:17th St at Signing&Striping,SCE English;MacArthur Blvd at Plaza Underground Subsructures, Jan 2017 Dec 2017 20 Civic Center Plaza Dr;Edinger Ave at Sullivan St; 80% $ 872,755.00 $ 872,755.00 Concrete/Asphalt Santa Ana,CA Westminster Ave at Clinton St#15- Improvements,CCTV714-647-5624 3864 MOrtiz@santa-ana.org original contract final contract City of Santa Ana Traffic Signal,Curb Ramps, Michael Ortiz Signing&Striping,SCE Safe Routes to School 20 Civic Center Plaza $ 429,508.89 $ 429,508.89 Underground Subsructures, Jan 2017 Dec 2017 Santa Ana,CA Enhancements of Heninger 80% Co ncrete/Asphalt menu It Elementary#16-6870 Improvements 714-647-5624 MOrtiz@santa-ana.org original contract final contract City of Westminster Traffic Signal,Curb Ramps, Bill Pham Signing&Striping,SCE 8200 Westminster Blvd Traffic Signal Modifications Various ° $ 543,508.69 $ 543,508.69 Underground Subsructures, May 2017 Nov 2017 Concrete/AsphalttelAsphalt Westminster,CA Locations(4 Intersections)#2373 80/° Concrete/Asphalt Improvements 714-548-3457 hpham@westminster-ca.gov original contract final contract City of Ceres Vehicular Traffic&Controller Samir Royal Cabinet Modificafions, July 2017 October 2017 2220 Hackett Rd Traffic Signal Synchronization 100% $ 339,226.87 $ 339,226.87 Battery Backup System Ceres,CA #CML-5241(055) Upgrades 209-538-5617 samir.royal@ci.ceres.ca.us Bidder's Critical Staff j . 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. Pleased see attached. Name of proposed Project Manager Telephone No, of proposed Project Manager: ( 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. Vim NcItAftin Name of proposed Superintendent V NI Telephone No. of proposed Superintendent: \V 1 1' (Q9.A -411v- 1395' .0,)20tSt See 0144C6A 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-it California Professional Engineering, Inc. 9stes ltv /V • — ATTENTION: City of Huntington Beach REFERENCE: Intended Key Personnel 1OO 41t Education I Studied Science of Industrial Engineering, BS. Knowledge of Auto CAD and Elemental Standard Time(EST). Vocation training in Fiber Optic Theory, Cable Construction, OSP Cable Breakout, Installation, Connectorization, Fusion/Mechanical Splicing, OTDR/Power Meter/Fault Locator Testing System Design. Experience 121 Years within Construction Industry. Ensure project is carried out smoothly and effectively,utilizing maximum production and minimum time. Senior Estimator. Er/ �� v,.. ... .... ,p„, E ,.�. . „i'„ fi u fw f � � �� � hY'4 „ ,.f t t Education I Studied Spanish and Biological Sciences.Studying extended Construction Management including Accounting,CPM, Estimating, Legalities, Labor and Employment and Managing Employee Relations. Experience 18 Years within Construction Industry. Supervised multiple County/City/Caltrans jobs successfully from project procurement through construction stages until completion/close out.Addressed any discrepancies from Site to Plan. Senior Project Manager. Education I Studied Business and Accounting, BS. Experience 112 Years within Construction Industry. Supervised multiple County/City/Caltrans jobs successfully from project procurement through construction stages until completion/close out.Addressed any discrepancies from Site to Plan. A171, . ,'"10(0)Ctitt**0.0,04040iii041114 Education I Studied Nursing and Accounting. Studying extended Construction Management including Accounting, CPM, Estimating, Legalities, Labor and Employment and Managing Employee Relations. Experience 17 Years within Construction Industry. Administered Bids. Executed Payroll and Labor Compliance Documents. Project coordination and procurement. For additional information,please do not hesitate to contact our office at the numbers listed below. California Professional Engineering,Inc. 19062 San Jose Avenue, La Puente,CA 91748 I Ph:(626)810-1338 Fax:(626)810-1322(Email:estimating@cpengineeringinc.com California Professional Engineering, Inc. COMPLETED PRIME Projects(starting with most recent) document last modified 02.1 7.2022//do Total Contract Amount+Extra CPE Project Manager, Approx, Approx. Approximate Worn CC0's Brief Scope of Work Superintendent Commencement Completion Owner,Contactilnfo Project Name&No. Completed by CPE original contract final contract City of Westlake Village Tracy SoocNan Nguyen Mike Bustos Pe.�esG,an saraty snh,,, tkaxs Dec 2021 Jan 2022 31200 Oak Crest Drive Triunfo Canyon Rd-Saddle 95,/0 $ 151,488.00 $ 136,332.20 • Westlake Village,CA 91361 Mountain Dr (626)810-1338 (805)653-6597 mbustos@willdan.com original contract final contract Catrans District 12 Tracy SoocNan Nguyen Gagandeep Sidhu Rtnia,x CMS(chm,goabte passage,,,go) Jun 2021 Oct 2021 1727 30th Street Replace Panel on CMS37 100% $ 118,898.00 $ 127,071.92 «'freeway Sacramento,CA 95816 #12A1791 (626)810-1338 949-279-8466 gagandeep.sidhu@dot.ca.gov original contract final contract City of Whittier Diem ChuNan Nguyen Raul Flore Traffic Signal Construction, Dec 2020 Jul 2021 13230 Penn Street Greenleaf Ave/Putnam Ave TS 95,/0 $ 343,760.00 $ 340,252.00 Conduit,Pull Boxes,Wiring Whittier,CA 90602 #STPL-5111 (626)810-1338 562-567-9525 rflore@cityofwhittier.org original contract final contract City of Lancaster Tracy SoocNan Nguyen Marc Alius Traffic Signal Construction, May 2021 Sept 2021 44933 North Fern Avenue City of Lancaster-Avenue I/60th 90% $ 173,654.00 $ 176,503.35 Conduit,Pull Boxes,Wiring Lancaster,CA 93534 Street West#17-0123 (626)810-1338 661-945-6879 mal ius@cityoflancaste rca.org original contract final contract City of Lancaster Tracy SoocNan Nguyen Marc Alius Traffic Signal Construction, Nov 2020 Feb 2021 44933 North Fern Avenue 2017 Traffic Signal Upgrades#16- $ 524,628.00 $ 535,123.83 Conduit,Pull Boxes,Wiring Lancaster,CA 93534 007;#STPL-5419(054) 85% (626)810-1338 661-945-6879 malius@cityoflancasterca.org original contract final contract City of Colton Trafic&gnat C«n°ucP«,at`hree Diem ChuNan Nguyen Marty Ragels Look.Concrete&S,dewaik 160 South 10th Street Three Traffic Signal Intersections ° $ 678,065.00 $ 678,065.00 a xyta�ms„ ,atskP�!gNsw Nov 2019 Aug 2020 80% Colton,CA 92324 #3186-4 Pedestal,el` (626)810-1338 909-370-5065 mragels@coltonca.gov original contract final contract City of Fountain Valley Traffic SignalCccsma Concrete& Diem ChuNan Nguyen John Nguyen S'aewalk improvements,Signing a Strp g,SCE Underground 10200 Slater Ave $ 626,339.40 $ 580.294.66 &trice,''"'"Peiw,lel s5na' Nov 2019 Jul 2020 Fountain Valley,CA 92708 Talbert/Mt Washington TS#TI233 80% ir:te,or-.oecl Conch,a comnnkel:cn y Syate,-a,CCTV (626)810-1338 714-593-4443 john.nguyen@fountainvalley.org original contract final contract City of Ontario Traffic Signal,Battery Back Tracy SoocNan Nguyen Mauricio Diaz Up Systems,Video Detection 303 E*8"St Vineyard&Sixth;Grove&Francis o $ 140,568.00 $ 141,327.00 Systems,Controller Cabinet, Jul 2020 Jul 2020 Ontario,CA #TR1801/1802 90% CCTV,wring,Pull Boxes, etc. (626)810-1338 909-395-2000 mdiaz@ontarioca.gov original contract final contract City of Oxnard Tmtr,sigralCor.atriir,Cc,,FeteO Diem ChuNan Nguyen Debbie O'Leary SnewaIk mp,oveme',s,Signing a S,rncv.SCE u,aergrourd Aug019 Feb 2020 305 W 3rd Street Rose Ave/GaryDr TS#A-6128 70% $ 678,072.40 $ 720,691.43 Sc..-idwes,Secr,eP....LSgna, g Oxnard,CA 93030 ;nlemonnert Conduit&Ccm,numcat:on Systems,rne,cpaK (626)810-1338 805-200-5283 debbie.oleary@oxnard.org original contract final contract City of Redlands Tracy SoocNan Nguyen Kyle Wagner Lanngm In-Pavement LED Crosswak 35 Cajon Street HSIPL Cycle 7 Uncontrolled $ 324,743.00 $ 348,661.05 u.oo,;:in1LP2'n1= Jul 2020 Jul 2020 Redlands,CA 92373 Crosswalk#HSIPL-5083(019) 95% (626)810-1338 909-798-7584 kwagner@cityofredlands.org original contract final contract City of Arcadia Diem ChuNan Nguyen Kevin Merrill 'traffic Sx,el Ccreirm,oc°Fades a' Mar 2020 Oct 2020 240 West Huntington Drive Santa Anita Corridor#41852417 85% $ 713,791.00 $ 775,716.75 °n 'n'am°`°^= Arcadia,CA 91066 (626)810-1338 626-574-5481 kmerrill@ArcadiaCA.gov original contract final contract City of Santa Ana Diem ChuNan Nguyen Michael Ortiz Security Lighting for PE Bike Trail Par,a Sr,,onty LCPi,g,c«to:a Poll 20 Civic Center Plaza K,;;,,g F«;nd,,,m,samKn Mar 2020 Jan 2021 8 Saddleback View Park#18- 95% $ 421,043.00 $ 410,127.79 Pedeatax.nr.l,oaii. Santa Ana,CA 7254;#18-7533 (626)810-1338 714-647-5624 MOrtiz@santa-ana.org original contract final contract City of Burbank Tracy SoocNan Nguyen Vikki Davtian T,atrt Signal sy,,oh,oni°,t°n at Vmtous 275 E Olive Ave Traffic Responsive Signal System Intersect,.Conduit we Boxes,Loopp Apr 2020 Dec 2020 p g90% $ 954,429.66 $ 1,043,603.19 Cx+cro''n°'alian"-rMaCenay Burbank,CA Project#1461 Street I'p,ovements Floe,Oats (626)810.1338 818-238-3965 VDavtian@burbankca.gov original contract final contract CA DOT Diem ChuNan Nguyen Roy Tomello Replacement of Traffic Signal Oct 2018 Jun 2020 790 Via Lata,#100 On Call Loop Detectors#08A2921 100% $ 387,550.00 $ 94,050.00 Loop Detectors Colton,CA 92324 (626)810-1338 909-915-9717 roy.tomello@dot.ca.gov original contract final contract City of Menifee TrafficSgnalca,yi,,w,10„a,Two Diem ChuNan Nguyen CarlosGeronimo '"'tl9& ,0IX11B1a ft Jid""'a'" 29844 Haun Road Two Traffic Signal Intersections $ 814,935.00 $ 867,901.78 uemgr saci a ,roses, ' Sept 2019 May 2020 Menifee,CA 92586 #19-04/05 75% F 4 'al'e'` (626)810-1338 951-723-3722 cgeronimo@cityofmenifee.us original contract final contract City of San Bernardino Diem ChuNan Nguyen Ryan Castillo SCE Substructures,Power 300 North"D"Street $ 95,420.00 $ 89,021.53 Feed Conduit,Caltrans ROW Mar 2020 May 2020 San Bernardino,CA 92418 Hospitality/Waterman#13330 100% Coordination,etc. (626)810-1338 909-384-5535 castillo Jy@sbcity.org original contract final contract City of Pasadena Diem ChuNan Nguyen Sarah Tawadrous Removal&Replacement of 100 N Garfield Ave Fair Oaks/Mountain;Green/Arroyo $ 188,870.00 $ 179,237.40 TrafficLightin Signgal Pdes.and Street Apr 2020 May 2020 Pasadena,CA Pole Replacement#31383 100% (626)810-1338 626-744-4304 stawadrous@cityotpasadena.net original contract final contract City of Pasadena Diem ChuNan Nguyen Elvin Jiang RRFB,FLIR Tthermal 100 North Garfield Avenue,N306 Pedestrian Crossing Improvements $ 185,110.00 $ 199,478.04 Cameras at Various May 2019 Apr 2020 Pasadena,CA #31299 100% Locations,Integration (626)810-1338 626-744-7311 ejiang@cityofpasadena.net original contract final contract City of Downey Van Nguyen Ed Norris Traffic Signal&Flashing Apr 2020 Apr 2020 11111 Brookshire Avenue Brookshire Ave&Everest St#20- 100% $ 53,445.00 $ 60,207.66 Beacons Downey,CA 90241 29 (626)810-1338 562-904-7110 enorris@downeyca.gov original contract final contract City of Buena Park Diem ChuNan Nguyen Ken Kim Banner Pole&Arm Feb 2020 Apr 2020 6550 Beach Blvd Banner Poles on Orangethorpe& 100% $ 20,300.00 $ 21,945.14 Installations Buena Park,CA 90620 Indiana#618 (626)810-1338 714-562-3688 kkim@buenapark.com original contract final contract City of Huntington Beach Traffic Signal Construction, Tracy SoocNan Nguyen Joe Fuentes Conduit,Pull Boxes,Wiring, 2000 Main Street $ 643,490.20 $ 676,697.47 Concrete&Sidewalk Sept 2019 Apr 2020 Huntington Beach,CA 92648 Main St&17th St#CC-1488 75% n Improvements,Handicap 9 Ramps.etc. (626)810-1338 714-394-5676 jfuentes@surfcity-hb.org original contract final contract City of Oceanside Diem ChuNan Nguyen Jeff Freetly Replacement of Traffic Signal 4927 Oceanside Boulevard $ 45,000.00 $ 40,338.00 Loop Detectors Feb 2020 Feb 2020 On Call Loop Detectors 100/° Oceanside,CA 92056 (626)810-1338 760-435-5323 JFreetly@oceansideca.org original contract final contract City of Pasadena Traffic Signal,Battery Back Diem ChuNan Nguyen Arnold Dichosa Up Systems,Video Detection Metro Goldline At-Grade Crossing 100 North Garfield Avenue,N306 Systems,Controller Cabinet, Apr 2019 Jul 2019 Mobility Enhancements#31131/ 100% $ 858,785.50 $ 916,950.71 CCTV,Wiring,Pull Boxes, Pasadena,CA FedAid#CML-5064(083) etc. (626)810-1338 626-744-7402 adichosa@cityofpasadena.net original contract final contract Traffic Signal,Curb Ramps, CA DOT Signing&Striping,SCE Diem ChuNan Nguyen Manuel Ruiz Underground Subsructures, 790 Via Lata,#100 Concrete/Asphalt Aug 2017 May 2019 Route 10,210#08-0E5514 90% $ 2,587,172.50 $ 2,587,172.50 Improvements,Fiber Optic, Colton,CA 92324 Networking,Microwave (626)810-1338 951-965-6327 Systems manuel.ruiz@dot.ca.gov original contract final contract City of Fontana Flashing Beacon,Curb Tracy SoocNan Nguyen Jazmine Pena Ramps,Signing&Striping, Apr 2019 Apr 2019 16489 Orange Wy PE Trail at Maple Ave#CC-91-DE- BO% $ 108,786.00 $ 108,786.00 Concrete/Asphalt Fontana,CA 18 Improvements (626)810-1338 949-644-3336 jpena@fontana.org original contract final contract City of Corona Traffic Signal,Curb Ramps, Diem ChuNan Nguyen Dennis Rails Signing&Striping,SCE 400 S Vicentia Ave,#210 Traffic Signal at Green River and $ 314,729.92 $ 314,729.92 Underground Subsructures, Oct 2018 Mar 2019 Concrete/Asphalt Corona,CA Montana Ranch#2016-03 80/a Improvements (626)810-1338 951-736-2266 dennis.ralls@coronaca.gov original contract final contract City of Newport Beach Traffic Signal Modifications, Tracy SoocNan Nguyen Eric Loke Curb Ramps, Jul 2018 Mar 2019 100 Civic Center Dr TS Rehabilitation FY2017-2018 80% $ 354,777.54 $ 354,777.54 Concrete/Asphalt Newport Beach,CA #7314-1 Improvements (626)810-1338 949-644-3311 eloke@newportbeachca.gov _original contract final contract City of Rancho Cucamonga Diem ChuNan Nguyen Natalie Avila Traffic Signal Video Detection May 2018 Feb 2019 10500 Civic Center Dr Traffic Signal Video Detection at 15 100% $ 203,650.88 $ 203,650.88 Rancho Cucamonga,CA Locations#800-2018-01 (626)810-1338 909-774-4076 netalie.avila@cityoim.us original contract final contract City of Orange Traffic Signal,Curb Ramps, Nguyen Left Turn Phase Signal 9 p Diem ChuNan N u en Medal Lianas Signing&Striping,SCE Modification I Chapman Ave& 300E Chapman Ave $ 608,424.00 $ 608,424.00 Underground Subsructures. Apr 2018 Oct 2018 Oran e,CA Cannon St#HSIPL-5073(079)SP- 80% Concrete/Asphalt 3868;Batavia St&Collins Ave Improvements,CCTV (626)810-1338 714-744-5535 mllanes@cityoforange.org #HSIPL-5073(081)SP3870 original contract final contract LACDPW Traffic Signal,Curb Ramps, Tracy SoocNan Nguyen Joel Zaragoza Signing&Striping,SCE Colima Rd I Camino Del Sur to 900 S Fremont Ave Underground Subsructures, Jan 2017 Oct 2018 East of Tierra Luna(Pedestrian 85% $ 1,816,477.16 $ 1,816,477.16 Concrete/Asphalt Alhambra,CA 91803 Crossing)#TSM0010196 Improvements (626)810-1338 626-458-4973 JZARA@dpw.lacounty.gov original contract final contract LACDPW Traffic Signal,Curb Ramps, Diem ChuNan Nguyen Anoush ianS Florence Ave/Mills Ave Signing&Striping,SCE 900 S Fremontremont Ave Orr and $ 1,039,990.01 $ 1,039,990.01 Underground Subsructures, Aug 2017 Sept 2018 Alhambra,CA 91803 Day Rd to Whittier Blvd 85% Concrete/Asphalt #TSM0010312 Improvements (626)810-1338 626-458-3139 ahovsepians@dpw.lacounty.gov original contract final contract I City of Torrance Tracy SoocNan Nguyen Jess Caballero Video Detection 20500 Madrona Ave Traffic Signal Left Turn Phasing $ 132,351.83 $ 132,351.83 Improvements,Flashing May 2018 Sept 2018 Torrance,CA Ph.2B#T-128 95% Beacons.TS Modifications (626)810-1338 909-350-6648 jcaballero@torranceca.gov original contract final contract City of South El Monte Traffic Signal,Curb Ramps, Diem ChuNan Nguyen Okan Demirci Signing&striping:SCE 1415 Santa Anita Ave Tyler and Thienes Traffic Signal ° $ 324,296.33 $ 324,296.33 Underground Subsructures, Jun 2018 Sept 2018 South El Monte,CA #67-900-9020-291 80% Concrete/Asphalt Improvements (626)810-1338 626-579-6540 okan.demimi@transtech.org original contract final contract LACDPW Traffic Signal,Curb Ramps, Diem ChuNan Nguyen Fred Kherdavar Signing&Striping,SCE Aviation Blvd 1118th St/Northrup 900 S Fremont Ave Underground Subsructures. Sept 2016 Apr 2018 Grumman Ave to Ocean Dr 85% $ 1,415,076.67 $ 1,415,076.67 Concrete/Asphalt Alhambra,CA 91803 #TSM0010190 Improvements (626)810-1338 626-458-3199 FKHERADV@dpw.lacounty.gov original contract final contract LACDPW Traffic Signal,Curb Ramps, Tracy SoocNan Nguyen Robert Eisenhamer Florence-Firestone Community Signing&Striping,SCE 900 S Fremont Ave Underground Subsructures, Oct 2017 Mar 2018 Safe Routes to School 65% $ 733,074.89 $ 733,074.89 Concrote/Asphalt Alhambra,CA 91803 #RDC0016046 Improvements (626)810-1338 626-458-3155 REISENHA@dpw.lacounty.gov original contract final contract RCTLMA Pourroy Rd Traffic Signal&Safety Traffic Signal,Curb Ramps, Tracy SoocNan Nguyen Ivan Mendoza Lighting Project French Valley Signing&Striping,SCE 4080 Lemon St Area#C8-0067;Weirick Rd $ 458,048.00 $ 458,048.00 Underground Subsructures, Aug 2018 Oct 2018 Riverside,CA 92502 Restriping&Signal Modification 85%Concrete/Asphalt P 9 Improvements (626)810-1338 562-254-9351 Project I Temescal Valley Area ivanmmendoza@aol.com #C8-0076 original contract final contract City of Santa Ana Tracy SoocNan Nguyen Michael Ortiz Park Lighting Sept 2018 Oct 2018 20 Civic Center Plaza Sandpointe Paseo Security 100% $ 176,425.00 $ 203,691.00 Santa Ana,CA Lighting#16-2648 (626)810-1338 714-647-5624 MOrtiz@santa-ana.org original contract final contract City of Pasadena Tracy SoocNan Nguyen Sarah Tawadrous Street Lighting Mar 2018 Sept 2018 100 N Garfield Ave Street Lighting Phase II#31097 100% $ 251,199.00 $ 251,199.00 Pasadena,CA (626)810-1338 626-744-4304 stawadrous@cityofpasadena.net original contract final contract City of Santa Ana Tracy SoocNan Nguyen Michael Ortiz Park Lighting Mar 2018 Mar 2018 20 Civic Center Plaza Thorton Park Security Lighting#16- 100% $ 96,330.00 $ 96,330.00 Santa Ana,CA 2655 (626)810-1338 714-647-5624 MOrtiz@santa-ana.org original contract final contract City of Downey Van Nguyen Calvin Catig Park Lighting Oct 2017 Jan 2018 11111 Brookshire Blvd Furman-Apollo Park Lighting#15- 100% $ 168,157.00 $ 168,157.00 Downey,CA 028/15 003C (626)810-1338 562-622-5898 ccatig@downeyca.org original contract final contract Great Los Angeles Zoo Association Diem ChuNan Nguyen Dawn Peterson Street Lighting Sept 2016 Jun 2018 5333 Zoo Drive LA Zoo Street Lighting Phase II 100% $ 689,000.00 $ 689,000.00 Los Angeles,CA (626)810-1338 323-644-4222 dpetersenamend@lazoo.org original contract final contract City of Rolling Hills Estates Diem ChuNan Nguyen Greg Grammer 4045 Palos Verdes Dr North RRFB&IRWL at Rolling Hills Rd 100% RRFB&IRWL Aug 2017 Jan 2018 $ 148,362.00 $ 148,362.00 Installation Rolling Hills Estates #17-04 (626)810-1338 310-377-1577 gregg@rollinghillsestatesca.gov original contract final contract City of Santa Ana TS Modifications on:17th St at Traffic Signal,Curb Ramps, Diem ChuNan Nguyen Michael Ortiz Signing&Striping,SCE English;MacArthur Blvd at Plaza Underground Subsructures, Jan 2017 Dec 2017 20 Civic Center Plaza Dr;Edinger Ave at Sullivan St 80% $ 872,755.00 $ 872,755.00 Concrete/Asphalt Santa Ana,CA Improvements,CCTV (626)810-1338 714-647-5624 Westminster Ave at Clinton St#15- MOrtiz@santa-ana.org 3864 original contract final contract City of Santa Ana Traffic Signal,Curb Ramps, Tracy SoocNan Nguyen Michael Ortiz Signing&Striping,SCE Safe Routes to School 20 Civic Center Plaza $ 429,508.89 $ 429,508.89 Underground Subsructures, Jan 2017 Dec 2017 Santa Ana,CA Enhancements of Heninger 80% Concrete/Asphalt Elementary#16-6870 Improvements (626)810-1338 714-647-5624 MOrtiz@santa-ana.org original contract final contract City of Westminster Traffic Signal,Curb Ramps, Tracy SoocNan Nguyen Bill Pham Signing&Striping,SCE 8200 Westminster Blvd Traffic Signal Modifications Various $ 543,508.69 $ 543,508.69 Underground Subsructures. May 2017 Nov 2017 Westminster,CA Locations Intersections)#2373 80% Concrete/Asphalt (4 Improvements (626)810-1338 714-548-3457 hpham@westminster-ca.gov original contract final contract City of Ceres Vehicular Traffic&Controller! Diem ChuNan Nguyen Samir Royal Cabinet Modifications, July 2017 October 2017 2220 Hackett Rd Traffic Signal Synchronization 100% $ 339,226.87 $ 339,226.87 Battery Backup System Ceres,CA #CML-5241(055) Upgrades I (626)810-1338 209-538-5617 samir.royal@ci.ceres.ca.us • CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854(citing Labor Code Section 1771.1(a)),passed by the California State Senate on June 20, 2014, established a new public works Contractor Registration Program, which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July 1 through June 30 state fiscal year) with the California Department of Industrial Relations (DIR). Currently the annual non-refundable registration fee for Contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 http://www.dir.ca.gov/DLSE/PublicWorks/SB854FactSheet 6.30.14.pdf DIR's Contractor Registration Link—Call (844) 522-6734 https://efiling.dir.ca.gov/PWCR/ActionServlet?action=displayP 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 1771.1(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. California Professional Engineering, Inc. Contractor Van Nguyen By van@cpengineeringinc.com; estimating@cpengineeringinc.com Email President Title Date: 08/30/2022 PWC Registration#: 1000377609 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): Y� Will ensure that 10%of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968;or • Will hire no new employees in conjunction with this project. Will award 10%of its sub-contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub-contracts related to this project. Contractor: California Professional Engineering, Inc. Contact Person: Van Nguyen Contact Phone: 626-810-1 Signed: Date: 08/30/20 *Note: The above certification is requir 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 EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION C'oitl f r proficion4e 69 ►h erir3/Tkc The bidder ✓ ,proposed subcontractor ,hereby certifies that he has V , has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency, or the former Presidents Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. C-14 EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION D C . Dr; ((it'll, '') C - The/bidder V ,proposed subcontractor i V ,hereby certifies that he has V , has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. 31 � {J1 i • C-14 1 EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION ill Ar►n.(2 ri ca n ?tat I-I- Th1e bider V ,proposed subcontractor V ,hereby certifies that he has V , has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114,or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. C-14 EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION Ckvi sp Company The bidder V ,proposed subcontractor ,hereby certifies that he has V , has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. • C-14 PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT ii In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder, has been has not been convicted within the preceding three years of any offenses referred to in that section,including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon,award of, or performance of,any public works contract,as defined in Public Contract Code Section 1101,with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term"bidder"is understood to include any partner,member,officer,director,responsible managing officer,or responsible managing employee thereof,as referred to in Section 10285.1. Note: The bidder must place a checkmark after "has" or"has not" in one of the blank spaces provided. The above Statement is part of e Proposa Signing this Proposal on the signature portion thereof shall also constitute signature of thi St ement.Bid are cautioned that making a false certification may subject the certifier to criminal prosec do . Van Nguyen 08/30/2022 Signature Print Name Date PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury,the following questionnaire: Has the bidder,any officer of the bidder,or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal,state, or local government project because of a violation of law or a safety regulation? DYes V No If the answer is yes,explain the circumstances in the following space. C-IS PUBLIC CONTRACT CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232,the Contractor,hereby states under penalty of perjury,that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note:The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Van Nguyen 08/30/2022 Signature Print Name Date C-16 Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY of Huntington Beach DEPARTMENT OF PUBLIC WORKS. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person,partnership, company,association,organization, or corporation;that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired,connived,or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement,communication, or conference with anyone to fix the bid price of the bidder or any other bidder,or to fix any overhead,profit, or cost element of the bid price,or of that of any other bidder,or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true; and, further, that the bidder has not,directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto,or paid,and will not pay, any fee to any corporation, partnership,company association,organization,bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Non-collusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Non-collusion Affidavit. Bidde s ar cautioned that making a false certification may subject the certifier to criminal prose do . Van Nguyen 08/30/2022 Signature Print Name Date C-17 DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS,PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: • is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any Federal agency; • has not been suspended,debarred,voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending;and • has not been indicted,convicted,or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification,insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above,indicate below to whom it applies, initiating agency,and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certifi ation is part of the Proposal. Signing this Proposal on the signature portion thereof shall also consti to signature- is Certification. Van Nguyen 08/30/2022 igzr Print Name Date C-18 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. Van Nguyen 08/30/2022 i e Print Name Date C-19 Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities • EXHIBIT 10-Q 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: 7 a. contract `I a. bid/offer/application El a. initial ® b, grant b. initial award El 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: El Prime n Subawardee IPC Tier ,if known Congressional District,if known Congressional District,if known 6. Federal Depart ent/Agency: 7. Federal Program Name/Description: N �Pt CFDA Number,if applicable 8. Federal Action Number,if known: 9. Award Amou t,if known: N I I.) N 10. Name and Address of Lobby Entity 11.Individuals Performing Services (If individual,last name,first name,MI) (including address if different from No.10) I (last name,first name,MI) 1(1 (attach Continuation Sheet(s)if necessary) 12. Amount of Payment(check all that apply) 14. Type of Payment(check all that apply) 0 ipr $ N 1 fr 0 actual 0 planned a. retainer b. one-time fee 13. Form of Payment(check all that apply): J - c. commission Ha. cash / d. contingent fee b. in-kind;specify:nature e deferred Value f. other,specify 15. Brief Description of Services Performed or to be performed and Date(s)of Service,incl ding officer(s),employee(s),or member(s)contacted,for Payment Indicated in Item 12: N �A (attach Continuation Sheet(s)if necessary) 16. Continuation Sheet(s)attached: Yes 0 No 50 17.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:Van N U en 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject Title: President to a civil penalty of not less than$10,000 and not more than 626-810-1338 $100,000 for each such failure. Telephone No.: Date:08/30/2022 Authorized for Local Reproduction Federal Use Only: Standard Form-LLL Standard Form LLL Rev.04-28-06 • Distribution: Orig-Local Agency Project Files C-20 Page 1 LPP 13-01 May 8,2013 Local Assistance Procedures Manual EXNBIT 10-Q Disclosure of Lobbying Activities INSTRUCTIONS FOR COMPLETING EXHIBIT 10-Q 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 3l U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is or has been secured to influence,the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which the change occurred. Enter the date of the last,previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name,address,city,state,and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to he a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to: subcontracts,subgrants,and contract awards under grants. 5. If the organization filing the report in Item 4 checks"Subawardee"then enter the full name,address,city,state,and zip code of the prime federal recipient. Include Congressional District,if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name,if known. For example,Department of Transportation,United States Coast Guard. 7. Enter the federal program name or description for the covered federal action(item 1). If known,enter the full Catalog of Federal Domestic Assistance(CFDA)number for grants,cooperative agreements,loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 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. Enter the full name,address,city,state,and zip code of the lobbying entity engaged by the reporting entity identified in Item 4 to influence the covered federal action. 11. 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). 12. 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. 13. Check all boxes that apply. If payment is made through an in-kind contribution,specify the nature and value of the in-kind payment. 14. Check all boxes that apply. If other,specify nature. 15. 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. 16. Check whether or not a continuation sheet(s)is attached. 17. The certifying official shall sign and date the form,and print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30-minutes per response,including time for reviewing instruction,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project(0348-0046),Washington,D.C.20503.SF- LLL-Instructions Rev.06-04 C-21 Page 2 LPP 13-01 May 8,2013 • Local Assistance Procedures Manual Exhibit 15-G Construction Contract DBE Commitment EXHIBIT 15-G CONSTRUCTION CONTRACT DBE COMMITMENT 1.Local Agency: The City of Huntington Beach 2,Contract DBE Goal: 6% • 3.Project Description: Utica Avenue Bicycle Boulevard 'I 1 � 4.Project Location: Utica Avenue(Main Street—Beach Blvd) I,,y in 5.Bidders Name: California Professional Engineering,Inc. 6.Prime Certified DBE: 0 7.Bid Amount: �1f/J/ 13ty•15- : B.Total Dollar Amount for ALL Subcontractors: ' (O 114(..9U 9.Total Number of ALL Subcontractors: ' 10.Bid 12.DBE 14.DBE Item • 11.Description of Work,Service,or Materials Certification 13.DBE Contact Information Dollar Number Supplied Number (Must be certified on the date bids are opened) Amount VP' ufS73����►ac� /,qc.� i QC) '41 �On �i '"his'— '77��f �10,N� • • i • - • Local Agency to co►npiete this Section upon Execution of Award 21 Local Ag enc Contract Number- "1 , + q k I 1 ) y h ` 1; i , 1 , 310,gV' i g,,'. ,. -• = i '1 15.TOTAL CLAIMED DBE PARTICIPATION i I.-':•, e,gran ')-, I:f,'i l,,'.371,g .gyp. ,y ':y:.;,.TAII- 1: ' . I: 22 Federal Afd FroJect fJumber � „� � � ,,: r 4� ,4 f 1 1 r., „ , , /� o w, t/J L /1 r .• `� • {i tA,•,•l-tit p , Y + ,: vl • a , ! 23BidOpeningyDate#1 )aet5.{ ,li t_gtio5ri)' 41.Y, ti,!;J:':.Oo-tcnh�',.,-. i ill, ., 1 I,h , ,..r l� I �, . art t. �.� Yi r i :24:.ConiractAw,,.,,,ei': i`t'.x. I+��� ;.:53. �bisA;P i ,(..i^r..l ..aii#.t! 25. Award Amount: pr IMPORTANT: Identify all DBE firms being claimed for credit, :,: qv; regardless of tier.Names of the First Tier DBE Subcontractors and • •.•,,••i 7r�rr::.5a,:-a:;,r-=„s;t'4;1k'»;;,,'i 41 y;,!?;;,...s`1'ic,,i4�;'°itr"^i;;?:i g.;,;i;"'a1, •4 ?, their re pective item(s)', work listed above must be consistent,where �iilk G t'!;;� yY i of i,�. t.'y°r *i1{-*�ti-x, �4y1 j4""a,;).t%r=.i y�.rw ,"r� •epic : •with the na, s and items of the work in the"Subcontractor • [opal Agency cer fifes that:all DBEs?rtiflcations are yfalid and,lnformationrgn Lis s,bm .• ith'A bid,Written confirmation of each listed DBE this form)iscomplete endlaccur�ate,]ta j*' iiii.i+)trl tl ti'.t f6'; ;JjSr�4il. is r q ired. ,i1,}%, f,,,�„t.6 `5.,,,•l!f,.Y., t`r .�� h''� .. i-. 3.rh,`�I t'_i, .1:.IIi1 _1t1,.', AO 08/30/2022 �.26 Local{agency Representative s Signature 5'27 Date j,' ".r, 16.Pre lrr's Signa 17.Date • d.,q d. 't., ,y iti fr k . 1> r i .x y iLt }. i a l 1�t ,Y.: ._' ;.ai °r':E.1., ';4 .''t' ,; }��; , j5;1 ':r ;;: 4 ` Et f�t-0 Van N.0 en ` 626-810-1338 1p,:28.Locaj Agency rRepresentadve's Name 1,` ;!+ '29.1 P.hone44+.`<F,k1,lt;,t: �;; 18,Preparer's Nam;' 19.Phone z ,Il1�k k' t.- i t Y �Y N `7 n Yz4 t i<i 1 s h' ki. L+. ' ,,..,:,_..30.y t-4,! lt,ti !ktP1i+•�It l �,it� s+�,;.i rh1l s �, I•f'hi� .x rptir. eti,' 20. rep Presidents Title i !r. -,o c Re rese9tati e;S:Thiel ,,,r,t. :.1.' ,.y s . :r1...,.i. ...n ... r ....,... .�. i.:t�'"_?.t>b'v.pi.,,,..:i',•F1 .'1 � � k 4f'U'11,j+'Y • DISTRIBUTION: 1.Original—Local Agency 2,Copy—Caltrans District Local Assistance Engineer(DLAE).Failure to submit to DLAE within 30 days of contract execution may result In de-obligation of federal funds on contract. • 3.Include additional copy with award package. ` ADA Notice: For Individuals with sensory disabilities,this document is available In alternate formals. For Information call(916)654-6410 or TDD(916)654.3880 or write Records and Forms Management,1120 N Street,MS-89,Sacramento,CA 95814. Page 1 of 3 • C-22 January 2019 Local Assistance Procedures Manual Exhibit 15-H Proposer/Contractor Good Faith Effort EXHIBIT 15-H: PROPOSER/CONTRACTOR GOOD FAITH EFFORTS Cost Proposal Due Date 08/30/2022 PE/CE Federal-aid Project No(s). CML-5181(191) Bid Opening Date 08/30/2022 CON The City of Huntington Beach established a Disadvantaged Business Enterprise(DBE) goal of 6.00% for this contract.The information provided herein shows the required good faith efforts to meet or exceed the DBE contract goal. Proposers or bidders submit the following information to document their good faith efforts within five(5)calendar days from cost proposal due date or bid opening. Proposers and bidders are recommended to submit the following information even if the Exhibit 10-01: Consultant Proposal DBE Commitments or Exhibit 15-G: Construction Contract DBE Commitment indicate that the proposer or bidder has met the DBE goal.This form protects the proposer's or 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. The following items are listed in the Section entitled"Submission of DBE Commitment"of the Special Provisions, please attach additional sheets as needed: 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 N/A N/A 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 Solicitation Follow Up Methods and Dates Cat Tracking, Inc. 08/29/2022 email; 08/30/2022 D.C. Drilling 08/29/2022 email; 08/30/2022 C-23 Page 1 of 3 May 2020 <4) Reply all " ® Delete 0 Report ••• RFQ I Huntington Beach 0 You forwarded this message on Tue 8/30/2022 10:36 AM CE CPE Estimating �E` To: CPE Estimating Mon 8/29/2022 4:11 PM Bcc: Duarte, Shellie <SDuarte@mccain- inc.com>; dan@ddltraffic.com; jr@ddltraffic.com; Gary Rivers <grivers@calstripe.com>; Cat Tracking Inc. <estimating@cattrackinginc.com>; PCI <egurney@lineuppci.com>; dcdirectional@gmail.com; Maurice Ramirez <Mramirez@allamericanasphalt.com>; Bids(EBS, Inc.) <bids@ebsgeneral.com>; Vivian Tran <vivian@paverehabco.com>; Andrea Heermance(aheermance@crosstowndata.com) ATTN: ESTIMATING DEPT. California Professional Engineering, Inc. would like to invite you to bid on the project referenced below as a subcontractor, vendor, or supplier. Please see the invitation below for more information. Please respond to this fax/email indicating whether or not you will be bidding. Also, please send your quote at least one day before the bid due date. INVITATION TO BID CALIFORNIA PROFESSIONAL ENGINEERING, INC. 19062 San Jose Ave, La Puente, CA 91748 PHONE (626) 810-1338 FAX (626) 810-1322 ESTIMATING@CPENGINEERINGINC.COM AGENCY: City of Huntington Beach PROJECT NAME: Utica Avenue Bicycle Boulevard PROJECT#: CC-1499 BID DATE/TIME: 08/30/2022 at 2:00 PM ENGINEER ESTIMATE: $526,000.00 LIQUIDATED DAMAGES: $500.00 CONTRACT DURATION: 50 Working Days GOALS: 6%- DBE ADDENDUM: 1 -as of 8/29/22 PLEASE REPLY TO THIS INVITATION BIDDING? : YES NO DBE? : YES NO I DVBE? : YES NO MBE? : YES NO I WBE? : YES NO SBE? : YES NO Plans and Specifications can be obtained via our dropbox link below: https://www.dropbox.com/sh/ntcafnf2kd541w3/AAAYIr3p7ckDsjyK7N6mU5fba?d1=0 Local Assistance Procedures Manual Exhibit 15-H Proposer/Contractor Good Faith Effort C. The items of work made available to DBE firms including those unbundled contract work items into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation in order to meet or exceed the DBE contract goal. Items of Proposer or Bidder Breakdown of Amount Percentage Work Normally Performs Item Items ($) Of (Y/N) Contract 9-0_ pa r f; al Pick — —� W)V I eY0v 140° 0.00% (0. 1401, :Pick 0.00% Pick 0.00% 'Pick _— --- 0.00% 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: N/A Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: N/A Names, addresses and phone numbers of firms selected for the work above: E. Efforts (e.g. in advertisements and solicitations) made to assist interested DBEs in obtaining information related to the plans, specifications and requirements for the work which was provided to DBEs: Email solicitation via DropBox link. • C-24 Page 2 of 3 May 2020 Local Assistance Procedures Manual Exhibit 15-H Proposer/Contractor Good Faith Effort F. Efforts (e.g. in advertisements and solicitations)made to assist interested DBEs in obtaining bonding, lines of credit or insurance, 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: None 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: N/A C-25 Page 3 of 3 May 2020 Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors(DBE and Non-DBE) Exhibit 12-B: Bidder's List of Subcontractor (DBE and Non-DBE) - Part 1 As of March 1, 2015 Contractors (and sub-contractors) wishing to bid on public works contracts must be registered with the State Division of Industrial Relations and certified to bid on Public Works contracts. Please register at https://www.dir.ca.gov/Public-Works/Contractor- Reg istratio n.html.The local agency will verify registration of all contractors and subcontractors on public works projects at bid and thereafter annually to assure that yearly registration is maintained throughout the life of the project. In accordance with Title 49,Section 26.11 of the Code of Federal Regulations,and Section 4104 of the Public Contract Code of the State of California, as amended,the following information is required for each sub-contractor who will perform work amounting to more than one half of one percent(0.5%) of the Total Base Bid or$10,000(whichever is greater). FEDERAL PROJECT NUMBER: Photocopy this form for additional firms. CML-5181(191) Subcontractor Name&Location Line Item&Description Subcontract Percentage of Contractor License Number DBE DBE Cert Number Annual Gross Receipts Amount Bid Item (YIN) Subcontracted DIR Reg Number NAME41i CAA G /1 <$1 million �.J ✓� 7 Z� VA,// G <$515millio n '` /7 +t . .. / ,�Q7 / city,StaterAj Ail t F 00K0'/0 Age Firm in S( NAME I` Gt��y [� years ,r• bn11r�' `//�-k9 A 1 /G t / 0 / 1/ - `�]// ����� <$5million J (/ 1 .V• I � •'] 1 f• / $i5 million Kitty,State' i y� 2 1 �',rrl V 9 <$15 million � aNli/ 411sr �� Y)/19 /000('l r va' Age of Firm in J years �U NAM Lopkf4ny �� < 1 million Vl�/ T r VI/ 'n Lo �' I// ��./,�,y��p��h `✓ /-�// ' ;Ilion City,State orris n 30,0( % �" ' 1 �t <$15million rn' JI' l� / 1� 24-(• l°°° 0030( Age of Firm in • years NAME - <$1 million <$5million <$10 million City,State <$15 million Age of Firm in years NAME <$1 million <$5 million <$10 million City,Stale <$15 million Age of Firm in years NAME <$1 million <$5 million <$10 million City,State <$15 million Age cf Firm in years NAME <$1 million <$5 million <$10 million City,State <$15 million Ageof Firm in years NAME <$1 million <$5 million <$10 million City,State <$15 million Age of Firm in years NAME <$1 million <$5 million <$10 million City,Slate <$15 million Age of Firm in years Distribution—Original:Local Agency File;Copy:DLAE w/Award Package C-26 Page 1 of September 2021 Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors(DBE and Non-DBE) Exhibit 12-B: Bidder's List of Subcontractor (DBE and Non-DBE) - Part 2 In accordance with Title 49,Section 26 of the Code of Federal Regulations,the Bidder shall list all subcontractors who provided a quote or bid but were notselected to participate as a subcontractor on this project. FEDERAL PROJECT NUMBER: Photocopy this form for additional firms. CML-5181(191) Subcontractor Name&Location Line Item&Description Subcontract Percentage of Contractor License Number DBE DBE Cart Number Annual Gross Receipts Amount Bid Item (YIN) Subcontracted DIR Reg Number NAME <$1 million <$5 million <$10million City,Slate <$15 million Age of Firm in years NAME <$1 million <$5 million <$10 million City,State <$15mdlion Aged Firm in years NAME <$1 million a$5million <$10 million City,Stale <$15 million. Age of Firm in years NAME <$1 million <$5 million <$10 million City,State <$15 million Aged Firm in years NAME c$1 million <$5 million <$10 m illion City,State <$15 million Age of Firm in years NAME <$1 million <$5 million <$10 million City,State <$15 million Aged Firm in years NAME <$1 million <$5 million <$10 million City,State <$15 million Age ofFirm in years NAME <$1 million <$5 million <$10 million City,State <$15 million Age of Firm in years NAME <$1 million <$5 million a$10 million City,State <S15 million Aged Firm In years Distribution—Original:Local Agency File;Copy:DLAE w/Award Package C-27 Page 2 of 2 September 2021 Local Assistance Procedures Manual Exhibit 17-F Final Report-Utilization of Disadvantaged Business Enterprises(DBE)and First-Tier Subcontractors EXHIBIT 17-F FINAL REPORT-UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES(DBE)AND FIRST-TIER SUBCONTRACTORS 1.Local Agency Contract Number 2.Federal-Aid Project Number 3.Local Agency 4.Contract Completion Date CC-No. 1499 CML-5181(191) City of Huntington Beach 08/30/2022 • 5.Contractor/Consultant 6.Business Address 7.Final Cnntract Amount California Professional Engineering, Inc. 19062 San Jose Ave, La Puente, CA 91748 '1-. . 8.Contract 9.Description of Work,Service.or 10.Company Name and 11.DBE 12.Contract Payments 13.Date 14.Date of Item Materials Supplied Business Address Certification Work Final Number pp Number Non-DBE DBE Completed Payment g4ipt�''� AC Pei llru 'Ltic' PI/ 15.ORIGINAL DBE COMMITMENT AMOtUNT S V,WOO 16.TOTAL Ust all first-tier subcontractora/subconsuhants nd DBEs regardless of tier whether or not the firms were originally listed for goal credit.If actual DBE utilization(or Itme of work)was different than that approved at the time of award,provide comments on an tonal pa e.Ust actual amount paid to each entity,If no subconlractorslsubconsutianls were used on the contract,Indicate on the form. t CERTIFY THAT THE ABOVE INFORMATION IS COMPLETE AND CORRECT 17.Co racto p entative's Signature 18.Contractor/Consultant Representative's Name 19.Phone 20.Date Van Nguyen (626)810-1338 08/30/2022 I CERTIFY THAT THE CONTRACTING RECORDS AND ON-SITE PERFORMANCE OF THE DBE(S)HAS BEEN MONITORED 21.Local cy epresentative i ature 22.Local Agency Representative's Name 23.Phone 24.Date DISTRIBUTIO :Original-Local Agency, opy-Caltrans District Local Assistance Engineer.Include with Final Report of Expenditures ADA NOTICE For individuals with sensory disabilities.Ode document Is available in alternate formats.For Information,call(916)445-1233,Local Assistance Procedures Manual TTY 711,or write to Records and Forms Management,1120 N Street,MS-89,Sacramento,CA 95814. C-28 Page 1 of 2 July 23,2015 =4A.1 Document A3IOTM — 2010 . ... . . . . . . . • Bid Bond No:N/A Bid Bond CONTRACTOR: SURETY: (Name. legal status and address) (Name, legal status and principal place California Professional Engineering, Inc. gfhusiness)United States Fire Insurance Company 19062 San Jose Avenue 305 Madison Avenue La Puente, CA 91748 Morristown, NJ 07962 This document has important legal consequences.Consultation with OWNER an attorney is encouraged with (Name,• legal status and address) respect to its completion or • modification. 1.1 City of Huntington Beach 2000 Main Street Any singular reference to Huntington Beach, CA 92648 Contractor,Surety,Owner or BOND AMOUNT::Ten Percent of the Total Amount Bid(10%of Bid Amount) other party shall be considered plural where applicable. PROJECT: ('Name,location or address, and Project number, if any) • Utica Avenue Bicycle Boulevard Project on Utica Avenue between Beach Project Number,if any: Boulevard and Main Street; CC-1499 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 hid 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(I)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.tle jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the prompt paylnent of labor,and material furnished in the prosecution thereof;or(2)pays to the Owner the difterence,.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 hid,then this obligation shall he 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 hid.Waiver of notice by the Surety shall not apply to any extension exceeding sixty(60)days in the aggregate beyond the time for acceptance of bids specified in the bid documents,and the Owner and Contractor shall obtain.the Surety's consent for an extension:beyond.sixty(60)days: If this Bond is issued in connection with a subcontractor's bid to a Contractor,the term Contractor in this Bond shall he deemed to he •Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project, any provision in.this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein.When so furnished;the intent is that this Bond shall he construed as a statutory bond and not as a common law bond. Signed and sealed this 29th day of August 2022 California Profes io a ngin (Principal) (Seal) (Witness) _ • (Tirlej iIAY) N bi , pre . United States Insurance Comp (Surety) (Seal) (Witness) (Tide) Chri tin Ho g,Attorney-in-Fact ALA Document A3107m—2010,Copyright©1963,1970 and 2010 by The American Institute of Architects.All rights reserved.WARNING:This Al AA Init. Document is protected by U.S:Copyright Lew and international Treaties.Unauthorised reproduction or distribution of this Aid°Document,or any portion of it.may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible condor the tsar,This document was created on 01/27/2012 07.23:12 under the terms of A{A Documents-on-Demand'*'order no. 2008397483,and is not for resale.This document is licensed by The American Institute of Architects for one-time use only,and may not be reproduced odor to its completion.re,,,o CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 rc- 4-W-5(c-rrNC`,c,ex-fx-rc-C c-ecr,-".cx",ri -x^,c, c Cx-rc-X,M,,<- 4-<`,-,M,Mcf,:rc^,rrs rrecr.rr.-C,, •CA-c l c s.4- ,c ,c•v"i A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California ) County o 1 Los Angeles ) On DI aI f'0`=2-- before me, Alicia Nguyen Date ��n �\'��/Hnere Insert Name and Title of the Officer personally appeared `''l 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 haj . . official seal. 0.r ALICIA NGUYEN Commission#2375906` Notary Public.California i s; _ Los Angeles County Signature 1,__ � ,�,�� Signature`f Notary Public -..e'- My Comm.Expires Sep 23,2025 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: ,c. ,- ) . : e.�<.x=<:;<-..z:,,cx-A--uc-w ��< ucu� ^c>ce-u:x, .. uwx c.;<=,<r;<:r%e� -<x--xuecru.xux-cx=xc,x=Ax,c: :,:x. ,cx. 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 AUG 2 9 21192 before me, Irene Luong , Notary Public, Date Insert Name of Notary exactly as it appears on the official seal personally appeared Christine Hoang 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) >ti IRENE LUONG acted, executed the instrument. ww Notary Public-California ` = Orange County 4 I certifyunder PENALTY OF PERJURY under the laws of Commission 9 2384919 •'��- My Comm.Expires Nov 30,2025 the State of California e fore.•ing paragraph ': true and correct. Witness my hand a f• al ._�' Signature �v�/' IIII Place Notary Seal Above Signature Notary Pub • Luong OPTIONAL Though the information below is not required by law it may prove valua•le 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 —Title(s): ❑ Partner ❑Limited ❑General ❑ Partner ❑Limited❑General ❑ Attorney in Fact RIGHT THUMBPRINT ❑ Attorney in Fact RIGHT THUMBPRINT ❑ Trustee OF SIGNER ❑ Trustee OF SIGNER ❑ Guardian or Conservator Top of thumb here ❑ Guardian or Conservator Top of thumb here ❑ Other: ❑ Other: Signer is Representing: Signer is Representing: POWER OF ATTORNEY UNITED STATES FIRE INSURANCE COMPANY PRINCIPAL OFFICE-MORRISTOWN,NEW JERSEY 07626 KNOW ALL MEN BY THESE PRESENTS:That United States Fire Insurance Company,a corporation duly organized and existing under the laws of the state of Delaware,has made,constituted and appointed,and does hereby make,constitute and appoint: Yung T.Mullick,James W.Moilanen,Irene Luong,P.Austin Neff,Emilie George,Christine Hoang,Danielle Hanson each,its true and lawful Attorney(s)-In-Fact,with full power and authority hereby conferred in its name,place and stead,to execute,acknowledge and deliver:Any and all bonds and undertakings of surety and other documents that the ordinary course of surety business may require,and to bind United States Fire Insurance Company thereby as fully and to the same extent as if such bonds or undertakings had been duly executed and acknowledged by the regularly elected officers of United States Fire Insurance Company at its principal office,in amounts or penalties: Fifty Million Dollars($50,000,000). This Power of Attorney limits the act of those named therein to the bonds and undertakings specifically named therein,and they have no authority to bind United States Fire Insurance Company except in the manner and to the extent therein stated. This Power of Attorney is granted pursuant to Article IV of the By-Laws of United States Fire Insurance Company as now in full force and effect, and consistent with Article III thereof,which Articles provide,in pertinent part: Article IV,Execution of Instruments-Except as the Board of Directors may authorize by resolution,the Chairman of the Board,President,any Vice-President,any Assistant Vice President,the Secretary,or any Assistant Secretary shall have power on behalf of the Corporation: (a) to execute,affix the corporate seal manually or by facsimile to,acknowledge,verify and deliver any contracts,obligations,instruments and documents whatsoever in connection with its business including, without limiting the foregoing, any bonds, guarantees, undertakings, recognizances, powers of attorney or revocations of any powers of attorney, stipulations, policies of insurance, deeds, leases, mortgages, releases,satisfactions and agency agreements; (b) to appoint,in writing,one or more persons for any or all of the purposes mentioned in the preceding paragraph(a),including affixing the seal of the Corporation. Article III, Officers, Section 3.11, Facsimile Signatures. The signature of any officer authorized by the Corporation to sign any bonds, guarantees, undertakings,recognizances, stipulations,powers of attorney or revocations of any powers of attorney and policies of insurance issued by the Corporation may be printed, facsimile, lithographed or otherwise produced. In addition, if and as authorized by the Board of Directors,dividend warrants or checks,or other numerous instruments similar to one another in form,may be signed by the facsimile signature or signatures,lithographed or otherwise produced,of such officer or officers of the Corporation as from time to time may be authorized to sign such instruments on behalf of the Corporation. The Corporation may continue to use for the purposes herein stated the facsimile signature of any person or persons who shall have been such officer or officers of the Corporation,notwithstanding the fact that he may have ceased to be such at the time when such instruments shall be issued. IN WITNESS WHEREOF,United States Fire Insurance Company has caused these presents to be signed and attested by its appropriate officer and its corporate seal hereunto affixed this 28th day of September,2021. UNITED STATES FIRE INSURANCE COMPANY j( Matthew E.Lubin, President State of New Jersey} County of Morris } On this 28th day of September,2021,before me,a Notary public of the State of New Jersey,came the above named officer of United States Fire Insurance Company,to me personally known to be the individual and officer described herein,and acknowledged that he executed the foregoing instrument and affixed the seal of United States Fire Insurance Company thereto by the authority of his office. E UB8AH.'MEMO Num PUBLIC OF tel JERSEY Rs Cambia EglissilT4031 . /4 4 "di. Melissa H.D'Alessio (Notary Public) I,the undersigned officer of United States Fire Insurance Company,a Delaware corporation,do hereby certify that the original Power of Attorney of which the foregoing is a full,true and correct copy is still in force and effect and has not been revoked. IN WITNESS WHEREOF,I have hereunto set my hand and affixed the corporate seal of United States Fire Insurance Company on the29th day of August 20 22 UNITED STATES FIRE INSURANCE COMPANY Py,,....44 4.tki V &..,......1„ Michael C.Fay,Senior Vice President STATE OF CALIFORNIA DEPARTMENT OF INSURANCE NQ 07812 SAN FRANCISCO Certificate of Authority THIS IS TO CERTIFY THAT,Pursuant to the Insurance Code of the State of California, United States Fire Insurance Company of Wilmington, Delaware , organized under the laws of Delaware ,subject to its Articles of Incorporation or other fundamental organizational documents,is hereby authorized to transact within the State,subject to all provisions of this Certificate, the following classes of insurance: Fire, Marine, r1 Surety, Disability, Plate Glass, Liability, Workers' Compensation, Common Carrier Liability, Boiler and Machinery, Burglary, Credit, Sprinkler, Team and Vehicle, Automobile, Aircraft, and Miscellaneous as such classes are now or may hereafter be defined in the Insurance Laws of the State of California. THIS CERTIFICATE is expressly conditioned upon the holder hereof now and hereafter being in full compliance with all,and not in violation of any,of the applicable laws and lawful requirements made under authority of the laws of the State of California as long as such laws or requirements are in effect and applicable,and as such laws and requirements now are,or may hereafter be changed or amended. IN WITNESS WHEREOF,effective as of the 31st day of December' 2003 ,I have hereunto set my hand and caused my official seal to be affixed this 31st day of December 2003 • go,. Gram di . • A toned ByWorl 1114r97) 1,40 Ida Zodro o V ty. NOTICE: Qualification with the Secretary of State must be accomplished as ragiii 1+ Corporations C promptly after issuance of this Certificate of Authority.Failure to do so will be a violation of Insurance Code Section 701 and will be grounds for revoking this Certificate of Authority pursuant to the convenants made in the application therefor and the conditions contained herein. 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'���a+,,.tar�sz_',��.. 1 T?i1,9 w n'''',. �. t.' h,� a �.' �-s ?ii'�. \ IINGT��_ City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 • www.huntingtonbeachca.gov \ : Q1 � • @,�� jgp9`*.:::.o�/i1 Office of the City Clerk FcoUNTV•CPS/l# Robin Estanislau, City Clerk January 10, 2023 DBX, Inc. 42024 Avendia Alvarado, Suite A. Temecula, CA 92590 RE: Utica Avenue Bicycle Boulevard —CC No. 1499 Enclosed please find your original bid bond for CC No. 1499 Sincerely, 9.471andalAd Robin Estanislau, CMC City Clerk RE:ds Enclosure Sister City: Anjo, Japan SECTION C PROPOSAL for the construction of UTICA AVENUE BICYCLE BOULEVARD from Main Street to Beach Boulevard CC NO. 1499 FEDERAL AID PROJECT CML-5181(191) in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids,the undersigned hereby proposes and agrees to perform all the work therein described,and to furnish all labor,material,equipment and incident insurance necessary therefor,in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 50 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site,plans,specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work,that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses,taxes,royalties,fees,etc.,and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 • If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates •within 10 working days after the •• • date of the AGENCY'S notice of award of'contract to the BIDDER, the proceeds of the security accompanying-this bid shall become the property of the AGENCY and this bid and the acceptance hereof may,at the AGENCY'S option,be considered null and void. i y Accompanying this proposal of bid,find Bidder's Bond in the amount of r 0%of bid total 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. (PIease 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:: ;ik ;.Date;Received: L'`` y; .:.,v ,,.� Bidder.•s Siiaturei t';, s. `: ° • 1 08/23/22 OLrw.o C.. • • • • • • • • I l • I ' C-2 • Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Item Estimated Item Unit Price Extended No. Quantity Amount 1 1 L.S. Mobilization. $2o,000. Oo $ 2.o,000.oo Per L.S. 2 1 L.S. Furnish Project Traffic Control. $ \2,MO.00 $ 12 k m Per L.S. 3 1 L.S. Preparation of project Specific Storm Water Pollution Prevention Plan (SWPPP). $ 2ic0o.0c $ 21spo.o0' Per L.S. 4 1 EA. Installation and maintenance of BMP's per the approved SWPPP. $ 215 lb.c - $ 215o0.Oo Per L.S. 5 21 LF Remove existing block wall and footing $ 280.0o $ S,g8O.oo 6 1 EA Construct concrete island $ 1500.op $ 14 t500.co 7 40 LF Construct 8"median curb $ bO .00 $ 21c-j co .00 8 1,500 SF Remove and dispose existing A.C. and base material $ '-0 .0t $ I5i000.00 9 130 LF Remove and dispose of existing curb and gutter $ 36.o0 $ 1I,Loso.oo 10 76 LF Construct 6" curb and gutter $ 62.00 $ �l,?12.co 11 33 LF Construct 6" curb $ (p5.00 $ 2,I I .0o C-2.1 Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Item Estimated Item Unit Price Extended No. Quantity Amount 12 1 LS Reconstruct existing improvements $ 15,a00.00 $ t5,0oo.co 13 1 EA Adjust manhole to grade $ 2,Soc••co $ 25oo.00 14 2 EA Finish raw edge of wall with matching existing material and color $ 3(000.06 $ V 1000•coo 15 113 SF Remove and dispose existing sidewalk $ ‘2..oo $ i'b5(0 •00 16 70 TONS Construct new 2"type III-C3-PG 64-10 (1/2") surface course over 4"class B- $ 810 .00 $ 5(, n co.o0 PG 70-10 (3/4") base course over 1.0' C.M.B. 17 100 TONS Construct 1' crushed miscellaneous $ 150 .00 $ IS loco.00 base 18 3 EA Construct Curb Access Ramp on northwest, northeast and southeast corners at Lake Street/Utica Ave per $ \,lo,Ooo.00 $ 4B4OW.Oo Caltrans Standard Plan No. RSP A88A, Case A and Details on Sheets 3 and 4. (Item includes all appurtenances, curb and gutter, depressed curb, sidewalk, domes, retaining curb, slot pave, etc.) Per EA. C-2.2 Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Item Estimated Item Unit Price Extended No. Quantity Amount 19 1 EA • Construct Curb Access Ramp on southwest corner Lake St/Utica Ave per Caltrans Standard Plan No. RSP A88A and Detail on Sheet 4 (Item includes all $ V71000.00 $ 11 tpo0 .00 appurtenances, curb and gutter, depressed curb, sidewalk, domes, retaining curb, slot pave, etc.) Per EA. 20 1 L.S. Install traffic signal at the intersection of Lake Street and Utica Avenue (excludes curb ramps and city furnished equipment) $ 2.11 lto p.00 $2:11 0 1L0.Oo Per L.S. 21 1 L.S. Furnish and install signing and striping. L5kotcoo. 00 $ 5b 0O0 .00 C-2.3 Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Total Amount Bid Total Amount Bid in Figures: $ S 15 %O33 ,00 Total Amount Bid in Words: -y, $ �VQ- A‘maiedl� �r, JtvkICIVLIVIDu ►v�TWA-V1 1An.L bol\c4 ' q...Ncl se,rt3 Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (also includes anchor bolts) to the contractor. The contractor is to pick up the materials, with its own labor, at the City Yard, 17371 Gothard Street. Contact traffic signal maintenance two working days in advance for pick up at (714) 536-5530. 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. t Sit tii - ,;u.� .rh. �,. ryt_ ;,� __,+r 1.C/aSS:'s:,tn. �� ;� ....,., ' 1Va e�and.Addres oftk v .State. a DIR PWC,t: ,.�Dollar , �::I•,yBld ���.-, ru2�4,y. � � ly>, l'� 4�a - ,.t. •. t 11 y h t { 7 I O1 3t ti i I i I "a5'llbCOtttYQCt01 c, I�jI c t LicenSea t't v ' I Registratron.# i Amou7tt Cp�ttraci IlC(}y'S 4 r • t• Id!' ?�tl ��115 !i i{ rP•1 �ytl_ k t I M t l �ih q -'?eSox ot5i3 - C-t\ohA\ 15151aq AG o ta0000,ity $,82aon 1.1 1 2-0 �k k O to9S1.Doroir vc $y Etardtan G!rovt, OR •12645 5-tt,t3— F1er_C.ov%Covvs xhtan5vvc. cjrJ1f A ‘0011012(0'Eq 91ee,1431.91. 2,2.�1 1411 2C47 442,q;.,oty\okvw G8 2.0 1-vvvkrtc, co \, lnL MC)M\ 001 `uooLitE. 4 fkI,000• 0,(0 Q b dox t‘2 V boa o,nco rto W °1►lb2 2\ Sui?erivr Qo►w F tNaetais 114306 C32. tonudo 1411v $52,Coa`v of.0 5312 C itrt%/ Sk. c'4% C.vArt,SS CA g0b30 cci 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 30th ,at August , 22 Date City State James C. Perry , being first duly sworn, deposes and says that he or she is President/Secretary/Treasurer of DBX, 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. DBX, Inc. Name of Bidder S' ature of Bidder 42024 Avenida Alvarado, Suite A., . Temecula, CA 92590 Address of Bidder C-4 CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of Riverside On 08/30/22 before me, Stephany Bravo,Notary Public Date Here Insert Name and Title of the Officer personally appeared James C. Perry Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/are 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 SEA >ti� P BRAVO paragraph is true and correct. �_� Notary Publicublic-California Z 4 ° - Riverside County .5' .f.$ Commission 2348074 WITNESS my hand and official seal. oa" My Comm.Expires Feb 19,2025 Signature � OtAltp Place Notary Seal and/or Stamp Above Signapuregf Nstory Public 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: James C. Perry Signer's Name: Corporate Officer — Title(s):President/Secretary/Treasurer 0 Corporate Officer— Title(s): o Partner— ❑ Limited 0 General 0 Partner— ❑ Limited ❑ General ❑ Individual 0 Attorney in Fact 0 Individual 0 Attorney in Fact ❑ Trustee 0 Guardian or Conservator ❑ Trustee ❑ Guardian or Conservator ❑ Other: ❑ Other: Signer is Representing: Signer is Representing: ©2019 National Notary Association 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 UTICA AVENUE BICYCLE BOULEVARD,(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. DBX, Inc. Contractor ."V7)0./WvLD e--••c:),./-k—^— President/Secretary/Treasurer Title Date: 08/30/22 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 No If the answer is yes, explain the circumstances in the space provided. N/A Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 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. DBX, Inc. Contractor 4).(1\ President/Secretary/Treasurer Title Date: 08/30/22 C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: DBX, Inc. Bidder Name 42024 Avenida Alvarado, Suite A., Business Address Temecula, CA 92590 City, State Zip ( 951 ) 296-9909 dbxinc@hotmail.com Telephone Number Email Address 240547, A & C-10 State Contractor's License No. and Class 01/20/1966 Original Date Issued 07/31/23 Expiration Date The work site was inspected by Tim Seaman of our office on August 24 , 2022 . The following are persons, firms, and corporations having a principal interest in this proposal: DBX,Inc.- James C. Perry-President James C. Perry-Secretary/Treasurer The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. DBX, Inc. Co ..any Name n p Signature of Bidder James C. Perry Printed or Typed Signature C-8 CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of Riverside J} On 08/30/22 before me, Stephany Bravo,Notary Public Date Here Insert Name and Title of the Officer personally appeared James C. Perry Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/are 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 4y{J 06_ryf STEPHANY BRAVO laws of the State of California that the foregoing NotaryPublic-California paragraph is true and correct. Riverside County Commission#2348074 WITNESS my hand and official seal. `ttro,k"'' My Comm.Expires Feb 19,2025 Signature .02e4.4.:Th Place Notary Seal and/or Stamp Above Signa re N ary Public 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: James C. Perry Signer's Name: ® Corporate Officer —Title(s):President/secretary/Treasurer❑ Corporate Officer— Title(s): ❑ Partner— 0 Limited 0 General 0 Partner— 0 Limited 0 General ❑ Individual 0 Attorney in Fact 0 Individual 0 Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Trustee 0 Guardian or Conservator O Other: 0 Other: Signer is Representing: Signer is Representing: ©2019 National Notary Association NOTARY CERTIFICATE Sub- ribed and sworn to before me this day of , 202_. A notary .ublic or other officer completing this certificate verifies only the identity of the individual ho signed the document, to which this certificate is attached, and not the truthfulness, a.curacy, 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 evi.-nce to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowled: d to me that he/she/they executed the same in his/her/their authorized capacity(ies),and that by his 'er/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws . the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature Signature of Notary Public (PLACE NOTAR EAL 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 traffic signals,curb&gutter and sidewalk. 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 Orange, 300 E. Chapman Ave, Orange, CA 92866 Name and Address of Public Agency Name and Telephone No. of Project Manager: Gabrielle Hayes, 714-744-1561 $344,941.90 Traffic Signal Installation 06/01/21 Contract Amount Type of Work. Date Completed Provide additional project description to show similar work: Installation of New Traffic Signal. 2, City of Menifee, 29844 Haun Rd, Menifee,CA 92586 Name and Address of Public Agency Name and Telephone No. of Project Manager:- Carlos Geronimo, 951-723-3722 $920,898.00 Install Traffic Signals 03/02/21 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: TRAFFIC SIGNALS AT MENIFEE RD ANT) HOT.T.AND RD MENIFEE RD AND CAMINO CRIST 3. City of Pasadena-100 N. Garfield Ave, Pasadena, Ca 91 101 Name and Address of Public Agency Name and Telephone No. of Project Manager: Elvin Jiang, 626-744-7103 $420,803.01 Installation of new traffic signals 08/01/22 Contract Amount Type of Work Date Completed p vide additional project description to show similar work: INSTALLATION OF NEW "TRAFFIC SIGNAL AT THE INTERSECTION OF FAIR OAKS AVE AND BELLEVUE DR c-io 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, James C. Perry Name of proposed Project Manager Telephone No, of proposed Project Manager: 951-296-9909 City of Pasadena, $420,803.01 Install Traffic Signals 08/01/22 Project Name&Contract Amount Type of Work Date Completed City of Menifee, $920,898.00 Install Traffic Signals 03/02/21 • Project Name&Contract Amount Type of Work Date Completed • City of Orange, $344,941.90 Traffic Signal Install 06/01/21 Project Name&Contract Amount Type of Work Date Completed 2. Tim Seaman Name of proposed Superintendent Telephone No. of proposed Superintendent: 909-721-4024 City of Pasadena, $420,803.01 Install Traffic Signals 08/01/77 Project Name&Contract Amount Type of Work Date Completed City of Menifee, $920,898.00 Install Traffic Signals 03/02/21 Project Name&Contract Amount Type of Work Date Completed City of Orange, $344,941.90 Traffic Signal Install n6/0l/21 Project Name&Contract Amount Type of Work Date Completed • c-11 • CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854(citing Labor Code Section 1771.1(a)),passed by the California State Senate on June 20, 2014, established a new public works Contractor Registration Program, which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July 1 through June 30 state fiscal year) with the California Department of Industrial Relations (DIR). Currently the annual non-refundable registration fee for Contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 http://www.dir.ca.gov/DLSE/PublicWorks/SB854FactSheet 6.30.14.pdf DIR's Contractor Registration Link—Call (844) 522-6734 https://efiling.dir.ca.gov/P WCR/ActionServlet?action=displayP WCRegistrationForm DIR's Contractor Registration searchable database: https://efiling.dir.ca.gov/PWCR/Search.action I am aware and will comply with the provisions of Labor Code Section 1771.1(a)which states: "A contractor or subcontractor shall not be qualified to bid on,be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725.5.It is not a violation of this section for an unregistered contractor to submit a bid that is authorized by Section 7029.1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract Code,provided the contractor is registered to perform public work pursuant to Section 1725.5 at the time the contract is awarded." I furthermore will comply by providing proof of registration with DIR as the primary contractor, as well as for ALL subcontractors at the time of submitting the bid. DBX, Inc. tractor dbxinc(a�hotmail.com Email President/Secretary/Treasurer Title Date: 08/30/22 PWC Registration#: 1000004242 C-12 Contractor Information Registration History Legal Entity Name Effective Date Expiration Date DBX,INC. Legal Entity Type 5/4/2018 6/30/2019 Corporation Status 5/1/2017 6/30/2018 Active Registration Number 5/2/2016 6/30/2017 1000004242 Registration effective date 6/5/2015 6/30/2016 7/1/2021 Registration expiration date 12/22/2014 6/30/2015 6/30/2023 Mailing Address 7/1/2019 6/30/2021 42024 AVENIDA ALVARADO,SUITE A TEMECULA 92590 CA United States of America Physical Address 7/1/2021 6/30/2023 42024 AVENIDA ALVARADO,SUITE A TEMECULA 92590 CA United States of America Email Address Trade Name/DBA DBX,INC. License Number(s) CSLB:240547 CSLB:240547 Legal Entity Information Corporation Number: C0424191 Federal Employment Identification Number: President Name: JAMES CHARLES PERRY Vice President Name: N/A Treasurer Name: JAMES CHARLES PERRY Secretary Name: JAMES CHARLES PERRY CEO Name: JAMES CHARLES PERRY Agent of Service Name: RUSSELL INGLEDEW Agent of Service Mailing Address: 7301 GIRARD AVENUE#303 LA JOLLA 92037 CA United States of America Workers Compensation Do you lease employees through Professional No 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: DBX,INC. Insurance Carrier: Travelers Property Casualty Co of America Policy Number: UB 9N101481 Inception date: 10/1/2020 Expiration Date: 10/1/2021 Contractor Information Registration History Legal Entity Name Effective Date Expiration Date CD TRENCHING LLC Legal Entity Type 7/19/2018 6/30/2019 LLC Status 9/7/2017 6/30/2018 Active Registration Number 3/5/2016 6/30/2016 1000035806 Registration effective date 7/9/2019 6/30/2020 7/1/2022 Registration expiration date 7/1/2020 6/30/2021 6/30/2023 Mailing Address 7/1/2021 6/30/2022 PO BOX 958 TEMECULA 92593 CA United States of America Physical Address 7/1/2022 6/30/2023 31939 AVENIDA ENRIQUE TEMECULA 92591 CA United States of America Email Address Trade Name/DBA License Number(s) CSLB:A-938605 Legal Entity Information Corporation Number: result[iCtr].License_RegistrationRoot.Registration Accounts__r[regAccts].Corp_or_LLC_ID_ c Federal Employment Identification Number: Member Name(s): Agent of Service Name: David Sherman Agent of Service Mailing Address: 31939 Avenida Enrique Temecula 92591 CA United States of America Workers Compensation Do you lease employees through Professional No Employer Organization(PEO)?: Please provide your current workers compensation insurance information below: PEO PEO PEO PEO InformationName Phone Email Contractor Information Registration History Legal Entity Name Effective Date Expiration Date GLOBAL ROAD SEALING,INC. Legal Entity Type 6/21/2018 6/30/2019 Corporation Status 6/23/2017 6/30/2018 Active Registration Number 6/14/2016 6/30/2017 1000007714 Registration effective date 7/6/2015 6/30/2016 7/1/2022 Registration expiration date 2/2/2015 6/30/2015 6/30/2025 Mailing Address 7/1/2019 6/30/2022 10832 DOROTHY AVE GARDEN GROVE 92843 CA United States of America Physical Address 7/1/2022 6/30/2025 10832 DOROTHY AVE GARDEN GROVE 92843 CA United States of America Email Address Trade Name/DBA GLOBAL ROAD SEALING,INC. GRSI License Number(s) CSLB:757584 Legal Entity Information Corporation Number: Federal Employment Identification Number: President Name: Tri La Vice President Name: Phong La Treasurer Name: Secretary Name: CEO Name: Agent of Service Name: Catherine Vu Agent of Service Mailing Address: 10832 Dorothy Avenue Garden Grove 92843 CA United States of America Workers Compensation Do you lease employees through Professional No 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: GLOBAL ROAD SEALING,INC. Insurance Carrier: INSURANCE COMPANY OF THE WEST Policy Number: WSD 5034236 05 Inception date: 7/8/2021 Expiration Date: 7/8/2022 Contractor Information Registration History Legal Entity Name Effective Date Expiration Date HER-CON CONSTRUCTION SERVICES,INC. Legal Entity Type 7/20/2018 6/30/2019 Corporation Status 6/26/2017 6/30/2018 Active Registration Number 7/6/2016 6/30/2017 1000012689 Registration effective date 7/8/2015 6/30/2016 7/29/2022 Registration expiration date 3/2/2015 6/30/2015 6/30/2023 Mailing Address 7/9/2019 6/30/2020 489 Fairlane Way COVINA 91723 CA United States of America Physical Address 7/9/2020 6/30/2022 489 Fairlane Way COVINA 91723 CA United States of America Email Address 7/29/2022 6/30/2023 Trade Name/DBA License Number(s) CSLB:945955 CSLB:945955 Legal Entity Information Corporation Number: Federal Employment Identification Number: President Name: Joseph Hernandez Vice President Name: Joseph Hernandez Treasurer Name: Joseph Hernandez Secretary Name: Joseph Hernandez CEO Name: Joseph Hernandez Agent of Service Name: Joseph Hernandez Agent of Service Mailing Address: 489 Fairlane Way Covina 91723 CA United States of America Workers Compensation Do you lease employees through Professional No 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: HER-CON CONSTRUCTION SERVICES,IN9079677-13C. Insurance Carrier: Insurance company of the west Policy Number: WSD503830402 Inception date: 11/22/2021 Expiration Date: 11/22/2022 Contractor Information Registration History Legal Entity Name Effective Date Expiration Date M.J.DIRECTIONAL,INC Legal Entity Type 7/1/2019 6/30/2020 Corporation Status 7/1/2020 6/30/2021 Active Registration Number 7/1/2021 6/30/2022 PW-LR-1000418354 Registration effective date 7/1/2022 6/30/2025 7/1/2022 Registration expiration date 6/30/2025 Mailing Address PO BOX 1126 ONTARIO 91762 CA United States of America Physical Address 3113 HALF CIRCLE RD NORCO 92860 CA United States of America Email Address Trade Name/DBA License Number(s) CSLB:790871 Legal Entity Information Corporation Number: Federal Employment Identification Number: President Name: MYLO JUNGERS Vice President Name: Treasurer Name: Secretary Name: CEO Name: Agent of Service Name: MYLO JUNGERS Agent of Service Mailing Address: 3113 HALF CIRCLE NORCO 92860 CA United States of America Workers Compensation Do you lease employees through Professional No 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: statefund Insurance Carrier: statefund Policy Number: 9228547-2019 Inception date: 3/25/2022 Expiration Date: 3/25/2023 Contractor Information Registration History Legal Entity Name Effective Date Expiration Date SUPERIOR PAVEMENT MARKINGS Legal Entity Type 6/18/2018 6/30/2019 Corporation Status 6/23/2017 6/30/2018 Active Registration Number 6/7/2016 6/30/2017 1000001476 Registration effective date 6/22/2015 6/30/2016 7/1/2022 Registration expiration date 9/24/2014 6/30/2015 6/30/2023 Mailing Address 7/1/2019 6/30/2022 5312 CYPRESS STREET CYPRESS 90630 CA United States of America Physical Address 7/1/2022 6/30/2023 5312 CYPRESS STREET CYPRESS 90630 CA United States of America Email Address Trade Name/DBA STREET STRIPING CONSTRUCTION ZONE TRAFFIC CONTROL PARKING&HIGHWAY IMPROVEMENT License Number(s) CSLB:776306 Legal Entity Information Corporation Number: Federal Employment Identification Number: President Name: John Lucas Vice President Name: Robert Garcia Treasurer Name: Darren Veltz Secretary Name: Darren Veltz CEO Name: Darren Veltz Agent of Service Name: Darren Veltz Agent of Service Mailing Address: 5312 Cypress St Cypress 90630 CA United States of America Workers Compensation Do you lease employees through Professional No 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: SUPERIOR PAVEMENT MARKINGS Insurance Carrier: Cypress Insurance Company Policy Number: SUWC352595 Inception date: 6/1/2022 Expiration Date: 6/1/2023 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: DBX, Inc. Contact Person: James C. Perry Contact Phone: -296-9909 Signed: (0 C Date: /30/22 *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 CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of Riverside J} On 08/30/22 before me, Stephany Bravo,Notary Public Date Here Insert Name and Title of the Officer personally appeared James C. Perry Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/are 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 'Sf'�L OO thF PHANY BRAVO laws of the State of California that the foregoing Notary Public.California Riverside County paragraph is true and correct. %, Commission#23 074 •°a"' My Comm.Expires Feb 19,2025 WITNESS my hand and official seal. Signature Place Notary Seal and/or Stamp Above Signa re o N tory Public 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: James C. Perry Signer's Name: ail Corporate Officer— Title(s):President/secretary/Treasurer❑ Corporate Officer— Title(s): ❑ Partner— ❑ Limited 0 General ❑ Partner— ❑ Limited ❑ General El Individual 0 Attorney in Fact 0 Individual 0 Attorney in Fact ❑ Trustee 0 Guardian or Conservator ❑ Trustee 0 Guardian or Conservator ❑ Other: 0 Other: Signer is Representing: Signer is Representing: ©2019 National Notary Association EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION DBX, Inc. The bidder A ,proposed subcontractor ,hereby certifies that he has X , has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. C-14 EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION DBX, Inc. The bidder A ,proposed subcontractor CilcAo0,\ R0c,0\ �WA.�� \v c ,hereby certifies that he has X has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. C-14 EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION DBX, Inc. The bidder A ,proposed subcontractor A¢X-C,or, CA)rAsh- a�,,� Suvic_e_S test. ,hereby certifies that he has X , has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. C-14 EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION DBX, Inc. The bidder A ,proposed subcontractor MS• ,hereby certifies that he has X , has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. • C-14 EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION DBX, Inc. The bidder A ,proposed subcontractor 5of. or Qa.v N1cir‘.4.4. �s ,hereby certifies that he has X , has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. C-14 PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder, has been X has not been convicted within the preceding three years of any offenses referred to in that section,including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon,award of, or performance of,any public works contract,as defined in Public Contract Code Section 1101,with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term"bidder"is understood to include any partner,member,officer,director,responsible managing officer,or responsible managing employee thereof,as referred to in Section 10285.1. Note: The bidder must place a checkmark after "has" or"has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement.Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. James C. Perry 08/30/22 Signature Print Name Date PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury,the following questionnaire: Has the bidder, any officer of the bidder,or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal,state, or local government project because of a violation of law or a safety regulation? LI Yes X No If the answer is yes,explain the circumstances in the following space. C-15 PUBLIC CONTRACT CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232,the Contractor,hereby states under penalty of perjury,that no more than one final unappealable fording of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note:The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Cd C �� James C. Perry 08/30/22 Signature Print Name Date C-16 Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY of Huntington Beach DEPARTMENT OF PUBLIC WORKS'. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person,partnership, company,association,organization, or corporation;that • the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived,or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder,or to fix any overhead,profit, or cost element of the bid price,or of that of any other bidder,or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto,or paid,and will not pay, any fee to any corporation, partnership,company association,organization,bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Non-collusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Non-collusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. aD C-1 James C. Perry 08/30/22 Signature ►/ Print Name Date C-17 CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California l County of Riverside )} On 08/30/22 before me, Stephany Bravo, Notary Public Date Here Insert Name and Title of the Officer personally appeared James C. Perry Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/are 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 ,,.,OlTh STEPHANY BRAVO paragraph is true and correct. s Notary Public-California `. '- z Riverside County WITNESS my hand and official seal. - %c Commission#2348074 My Comm.Expires Feb 19,2025 Signature ' Grt.( D Place Notary Seal and/or Stamp Above /�/Signa/re N ary Public 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: James C. Perry Signer's Name: ® Corporate Officer- Title(s):President/secretary/Treasurer 0 Corporate Officer- Title(s): O Partner- 0 Limited 0 General 0 Partner- ❑ Limited 0 General ❑ Individual 0 Attorney in Fact 0 Individual 0 Attorney in Fact ❑ Trustee 0 Guardian or Conservator ❑ Trustee 0 Guardian or Conservator o Other: 0 Other: Signer is Representing: Signer is Representing: ©2019 National Notary Association 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 is any other person associated therewith in the capacity of owner, partner, director, officer, manager: • is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any Federal agency; • has not been suspended,debarred,voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted,convicted,or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification,insert the exceptions in the following space. N/A Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency,and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. C James C. Perry 08/30/22 Signature Print Name Date C-18 NONLOBEYING 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$100,000 and that all such subrecipients shall certify and disclose accordingly. )(4.N11.5 C P James C. Perry 08/30/22 Signature Print Name Date C-19 Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities • EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. ontract a. bid/offer/application ❑ a. initial b. gr.st b. initial award b. material change c. coop- .tive agreement c. post-award d. loan For Material Chi ge Only: e. loan guaran<- year quarter f. loan insurance date of . t report 4. Name and Addre of Reporting Entity 5. If Reporting Entity in No. is Subawardee, Enter Name and Addr•: of Prime: nPrime ubawardee Tt. ,if known Congressional District,if known Congressi. al District,if known 6. Federal Department/Agency: 7. Feder. 'rogram Name/Description: DA Number,if applicable 8. Federal Action Number,if known: '. Award Amount,if known: 10. Name and Address of Lobby Entity Individuals Performing Services (If individual,last name,first name,MI) '$eluding address if different from No. 10) (las ame,first name,MI) (attac. ontinuation Sheet(s)if necess 12. Amount of Payment(check all at apply) 14. Type of Pay ent(check all that apply) $ actu. n planned a. retainer b. one-time fee 13. Form of Payment(c.•ck all that apply): c, commission a. cash d. contingent fee b. in- ' d;specify:nature e deferred Value f. other,specify 15. Brief:escription of Services Performed or to be performed and Date(s)of Service,including of er(s),employee(s),or member(s)contacted,for Payment Indicated in Item 12: (attach Continuation Sheet(s)if necessary) 6. Continuation Sheet(s)attached: Yes n No 17.Information requested through this form is authorized by Title /n��y,,,_. 31 U.S.C.Section 1352. This disclosure of lobbying reliance Signature: C ntb C.. 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: James C. Perry 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any Title: President/Secretary/Treasurer person who fails to file the required disclosure shall be subject to a civil penalty of not less than$10,000 and not more than $100,000 for each such failure. Telephone No.: 95 1-296-9909 Date: 08/30/2 2 Authorized for Local Reproduction Federal Use Only: Standard Form-LLL Standard Form LLL Rev,04-28-06 Distribution: Orig-Local Agency Project Files C-20 Page 1 LPP 13-01 May 8,2013 Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities INSTRUCTIONS FOR COMPLETING EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime federal recipient at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C.Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is 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. Enter the full name,address,city,state,and zip code of the lobbying entity engaged by the reporting entity identified in Item 4 to influence the covered federal action. 11. Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last Name, First Name and Middle Initial(Ml). 12. 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. 13. Check all boxes that apply. If payment is made through an in-kind contribution,specify the nature and value of the in-kind payment. 14. Check all boxes that apply. If other,specify nature. 15. 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. 16. Check whether or not a continuation sheet(s)is attached. 17. The certifying official shall sign and date the form,and print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30-minutes per response,including time for reviewing instruction,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project(0348-0046),Washington,D.C.20503.SF- LLL-Instructions Rev.06-04 C-21 Page 2 LPP 13-01 May 8,2013 • Local Assistance Procedures Manual Exhibit 15-G . Construction Contract DBE Commitment EXHIBIT 15-G CONSTRUCTION CONTRACT DBE COMMITMENT 1.Local Agency: The City of Huntington Beach 2.Contract DBE Goal: 600 . t 3.Project Description: Utica Avenue Bicycle Boulevard 4.Project Location: Utica Avenue(Main Street-Beach Blvd) 1 i 5.Bidder's Name: t K 1 1v,G• 6.Prime Certified DBE: ❑ 7.Bid Amount: 515,033•to I� y 8.Total Dollar Amount for ALL Subcontractors: Z.Sy 1251•�to 9,Total Number of ALL Subcontractors: r • 10.Bid 12.DBE 14.DBE Item • 11.Description of Work,Service,or Materials Certification 13.DBE Contact Information Dollar Number Supplied Number (Must be certified on the date bids are opened) Amount 20 \rSV\\ \00‘* 311-16 letoO` N00.c t:nc.k Seex 41 ia2O.o0 • 2PrS�11� Ov+r.TIC r0.ew•oVt 1mlo.t w t ►1MEroo#t�. N 14 se. CoCoe.- ekto"Sow:a,trkc• . 13-1R ` •.�k uaba��s� w� 6�sc tkee„ N 2 i y$o1 ta'tvlovwi.Wow•Co.Rno CA o102,s #1e6r43�.d. 6.434•CVOs r+.w.Q, 411e-SNR-1000 . . Ltoca(Agency tolCornpleie this Section upon E;ecutiori of Award' j . SA24,51.11, . , '11 {' rr * 11�11 t V $ E I 1 .11 L,a 21 t Local Agency Contract•Nuttmber i k+r k 4 1 4),, ' Si a", i `'i. 15,TOTAL CLAIMED DBE PARTICIPATION 11{:' S.� ',iiI'il 4 4IH tr J ' II Ip,i 4, • 22 ederal Afd Project u beni t ti' Ii141w , �' ,r `1l. , I ,1 F l it ry . i d - I "1 i N m x a. ti�4 r h 4v 4.. 3LJ I-1 I M 7 59[� at ,, ?' th.� filly•II Tl�S i I �,5 .�• y I 'y I cv �i-j,i' _I o 23 Bid Opening Date a M 4 t ti, I W,ul 1,a.'I I I'1. IO {o ] 1,1 r,' 'ti P c�t7 ., 41I 1`'I 1 „i . , .1 I , -' !k 9 I `�r 1•.. 24 CdntractAwa(dDate ,,: I.Y ,.!I, � '.0iiiiI,)jr 4,4. Flti I'41pi:.'i �i�li! i.J ti 25. Award Amount: 1"1 IMPORTANT: Identify at DBE firms being claimed for credit, r4 i:'I�',, regardless of tier.Names of the First Tier DBE Subcontractors and I. t „..,._,, i,,._, ,.,,s._,,,,....�,„ti :L..^, ,,....;y,_.a";,,,;.ii,.,,1;.4,..,,:o.i.i,;,l:y . li:• their respective item(s)of work listed above must be consistent,where 11,,,. ..ii;y4t,{� r,v;;,�, L'Iv,,,,n.,,'`a<�,.+ ,.I I y i,01.Es„? I �i.ILr `14t,i,�r4'tl f it i 1 F.)_l„la' applicable with the names and items of the work in the'Subcontractor L`opal Agenc .c'rtrfles t at al DBE c rtiflcatlons are Valid and information 4n List" bmitted with your bid.Written confirmation of each listed DBE this form Is`complete and accurate1'r �g 9 #'`r' u{i 441,1;,l �,'ll `iis'w;I}i!.itil req fired. it 4 1Pr11y f.4' ',f'1'4l,..;r,F,�.r t.'t1 �$ :•th:4 ' 1i.S ,.Z, LIJr1�'sti, II. .� � aid �, � ik1+ ?.,. 4I•,i7'1�F} i 5 Irr' I t .�•itr{,E,.I !� 1r.yI ?, i4 14 .. 08/30/22 h ;c 2Q Local Agency Representatives.Slgnature "k�'',1,27 Date t l t4 y i�j �'' 1 .Preparers Signature 17.Date .I 9II1 i,i 'ail. ;, Eve!I F,att ul;tl;5 h "1,,:1`.`'l'.R� ,,�r,�r ''j ik' James C. Perry 951-296-9909 :'i "i}'29,P on °',' "1`' 18,Preparers Name 19,Phone [+S'2.8i.Loca Ageric ,Re reseritative's,Name:j J h e.'r.°�;i;-1 �;ilf:�: P w 4'q.,;l., l -'01..,P;:' sni;: '..12.i,;`.41< r,M1- izt.I t 9 is :;d'i.i: �r.R', xii*4,5.,!{,fii,= Ix i t( 3 , II t I u ( r , ,' , r R�1ill lit '�I a- I:';i-.' �it�' ��"• ' �61,utp;: fit`• G7'µ,a�a•' I�+�s :..,. , 1+1„i'tj I',. 11 4 't, .'t.: President/Secretary/Treasurer q j p y r } 3t) I'ocal Agency Representactye s Tk,.4,lti E,,{, o--.i 1' 'rat ',,4:Iri I t 0t a* 20.Preparers Title '_?:�R;-,,,:.1-.r•.n N.-. ,.,;,.pr i._,:..- I_.!n?_v.i -_,�.*„5. .,. ,S,.I t,w.1.,,..7.�5.i k, ;L I1, 'Pi..:,.. ' DISTRIBUTION: 1.Original-Local Agency 2.Copy-Caltrans District Local Assistance Engineer(DLAE).Failure to submit to DLAE within 30 days of contract execution may result In de-obflgation of federal funds on contract. 3.Include additional copy with award package. ADA Notice: For Individuals with sensory disabilities,this document Is available In alternate formats. For Information call(916)854-6410 or TDD(916)654-3880 or write Records and Forms Management,1120 N Street,MS-89,Sacramento,CA 95814. Page 1 of 3 • C-22 January 2019 GLOBAL ROAD SEALING, INC. ii ��• dba G.R.S.I I Union Signatories I UDBE and MBE Certified CT#-031176 CA SBE#2001305 I CA License#757584 A,C-10,C-32 I DIR#1000007714 __ _ 10832 Dorothy Ave. I Garden Grove I CA 92843 '� P 714-893-0845 I F 714-893-0945 Estimator: Tri La tri@globalroadsealing.com Project: Utica Ave Bycycle Blvd Main St to Beach Blvd Contract: Location: City of Huntington Beach,Orange County Bid Date: 08-30-2022 @ 2PM Quote Date: SUBCONTRACT QUOTATION ITEM# DESCRIPTION QUANTITY UNIT PRICE TOTAL Traffic Loops Type E 14.00 EA 380.000 $ 5,320.00 2O Traffic Loop Type E Modified and D Loops 10.00 EA 450.000 $ 4,500.00 Prices are good for 45 days from the date of this proposal Total Bid $ 9,820.00 INCLUSIONS: Sawcut and install traffic loops per plan Splice loops to existing DLCs One mobilization. Additional move ins at$2,500 ea Traffic control for our scope of work DLCs must in be place at time of loop cutting or additional mobilization charge applied for Global to return to splice the loops EXCLUSIONS: Insurance premium in excess of$2M, bonding not available at this time Utility permits and fees,inspection fee Lane closure submittal Concrete and asphalt restoration Traffic Control Plan,CMS,Speed Radar,Prewarning sign,Attenuator Truck,Rumble Strip,Light Tower,posting of any kinds Contact:grs@globalroadsealing.com(document requests relating to bid) ***Four week notice required for scheduling ACCEPTED BY Date GRSI# cip to Main Content Back To Query Form(IicenseForm.htm) Search Returned 1 Records Tue Aug 30 09:07:40 PDT 2022 Query Criteria Certification Types:DBE Firm ID:031176 Firm ID 31176 DBA Name GLOBAL ROAD SEALING,INC Firm Name GLOBAL ROAD SEALING,INC Address Linel 10832 DOROTHY AVE Address Line2 City GARDEN GROVE State CA Zip Code1 92843 Zip Code2 Mailing Address LIne1 Mailing Address Line2 Mailing City Mailing State Mailing Zip Codel Mailing Zip Code2 Certification Type DBE EMail grs@globalroadsealing.com Contact Name TRI LA Area Code 714 Phone Number 893-0845 Extension Alt Area Code Alt Phone Number Extension Fax Area Code 714 Fax Phone Number 893-0945 Agency Name DEPARTMENT OF TRANSPORTATION Counties 01;02;03;05;07;09;10;13;14;15;16;17;19;20;21;22;24;26;27;28;30;33;34;35;36;37;38;39;40;41;42;43;44;48;49;50;51;54;55;56;57;58; Districts 01;03;04;05;06;07;08;09;10;11;12; DBE NAICS 238210;238910;561990; ACDBE NAICS C8601 MAINTENANCE EXISTING TRAFFIC MGMT SYSTEM ELEMENTS DURING CONSTRUCTION;C8611 RAMP METERING SYSTEM;C1901 ROADWAY EXCAVATION; C8605 MESSAGE SIGNS,LIGHTING&SIGN ILLUMINATION;C1940 DITCHES EXCAVATION;C1920 STRUCTURE EXCAVATION;C8608 DETECTOR;C1601 CLEARING& Work Codes GRUBBING;C8501 PAVEMENT MARKER;C1201 TRAFFIC CONTROL SYSTEM;C1930 STRUCTURE BACKFILL;C3701 SEAL COAT;C4040 CLEAN&SEAL PAVEMENT JOINTS-ROUT&SEAL CRACKS;C4101 PAVEMENT SUBSEALING&JACKING;C8602 SIGNAL&LIGHTING;C8609 TRAFFIC COUNT STATION;C9858 RESIDENTIAL ELECTRICAL; Licenses A General Engineering Contractor;C10 Electrical Contractor;C32 Parking and Highway Improvement Contractor; Trucks Gender M Ethnicity ASIAN PACIFIC Firm Type DBE t jE oft W_ `. .,4 0 4 & lc s ; CSL 945955 489 Fairiane Way, Covina, CA 91'723 'hone: (626)339-7000 Certified - DBE/MBE Contractor E-mail: hercon7774511@aol.com DIR# 1000012689 SCCA Member Date: 8/30/2022 ►TTN: Charles Perry TO: DBX, Inc. gi. Mill RE: Huntington Beach Utica Ave. PRICES INCLUDE ALL ITEMS AND QUANTITIES LISTED INCLUDING(EXCLUSION SHEET)ATTACHED. TEM DESCRIPTION QUANTITY UNIT UNIT$ COST 5 Remove existing block wall and footings 21 LF $ 253.14 $ 5,315.90 6 Construct concrete island 1 Each $ 10,570.30 $ 10,570.30 7 Construct median curb 40 LF $ 56.78 $ 2,271.20 8 Remove and dispose of existing AC and base material 1,500 SF $ 9.17 $ 13,755.00 9 Remove and disopose of existing curb and gutter 130 LF $ 34.41 $ 4,473.30 10 Construct 6"curb and gutter 76 LF $ 58.67 $ 4,458.92 11 Construct 6"curb 33 LF $ 57.04 $ 1,882.32 13 Adjust manhole to grade 1 Each $ 2,372.40 $ 2,372.40 14 Finish raw edge of wall with matching existing material and color 2 Each $ 2,354.50 $ 4,709.00 15 Remove and dispose of existing sidewalk 113 SF $ 11.01 $ 1,244.13 Construct new 2"type III C3-PG64-10 1/2"surface course over 4" 70 Tons 16 class B PG70-10 3/4"base course over 1.0"CMB $ 785.98 $ 55,018.60 17 Construct 1'crushed miscellaneous base 100 Tons $ 139.02 $ 13,902.00 Construct Curb Ramp on NW,NE and SE corners at Lake Street/Utica Ave per Caltrans Standard Plan No.RSP A88A,Case A (Item includes all appurtenances, 3 Each curb and gutter,depressed curb,sidewalk,domes,retaining curb,slot pave,etc.) 18 Per EA. $ 15,012.93 $ 45,038.79 Construct Curb Ramp on SW comer Lake St/Utica Ave per Caltrans Standard 1 Each Plan No.RSP A88A(Item includes all$appurtenances,curb and gutter, 19 depressed curb,sidewalk,domes,retaining curb,slot pave,etc.)Per EA $ 16,215.10 $ 16,215.10 $ - $ - Add TC for Hercon work only(excludes TC plans,Plates,all/any Temp AC, 1 I/S $ 7,211.00 $ 7,21 1.00 K-rail,Lighted baracades,Temp.Ped.Ramps,Message Boards. 1.,%kie Price is based on natural color concrete w/med.brm,fin.,and at work will be during regular iit'working hours 7 am to 3:30 pm,and based on 1-move for all work above. I Please Review Notes Below Vote: Price is based on 1-move see sheet 2 for add mob.Costs. We have excluded all BMP's,SWWP's,Footing Removals,All Overexcavating,Cut and Cap and Relocating of all Existing Utilities,Locating and Pot Holing for any and all Utilities, All Weekend and Night work,Fees,Permits,Licenses,All Survey and Staking.Shop Drwngs, Badging,All signage and striping,Traffic control plans,Engineering,Water source and permit, Message boards,sign postings,Light Source and Towers,Street sweeping,All Badging, ,Washouts,Dumpsters,Rubberized Asphalt,Handling all Hazardous materials,and temp ac excldg.All temp AC,Plates,K-railing,Temp AC ramps. Grand Total $ 188,437.96 Temp.Toilet to be provided by others Jote: Included with this proposal; please find attached sheet 2 of 2-Her-Con Construction Services, Inc. itandard Exclusions with all terms and conditions. If you have not received sheet 2 of 2 'lease contact our office prior of acceptance 626 339-7000 ,skip to Main Content Back To Query Form(JicenseForm.htm) Search Returned 1 Records Tue Aug 30 09:11:51 PDT 2022 Query Criteria Certification Types:DBE Firm ID:36281 Firm ID 36281 DBA Name HER-CON CONSTRUCTION SERVICES,INC. Firm Name HER-CON CONSTRUCTION SERVICES,INC. Address Linel 489 FAIRLANE WAY Address Line2 City COVINA State CA Zip Code1 91723 Zip Code2 Mailing Address Line1 Mailing Address Line2 Mailing City Mailing State Mailing Zip Code1 Mailing Zip Code2 Certification Type DBE EMail hercon7774511@aol.com Contact Name JOSEPH HERNANDEZ Area Code 626 Phone Number 339-7000 Extension Alt Area Code Alt Phone Number Extension Fax Area Code Fax Phone Number Agency Name DEPARTMENT OF TRANSPORTATION Counties 19;30;33;36; Districts 07;08;12; DBE NAICS 236220;237110;237120;237130;237990; ACDBE NAICS C7500 MISC IRON&STEEL FRAME,COVER&GRATE;C1901 ROADWAY EXCAVATION;C3901 ASPHALT CONCRETE;C6500 REINFORCED CONCRETE PIPE;C8851 Le Work Codes Compliance;C9810 SMALL STRUCTURES;C1601 CLEARING&GRUBBING;C0651 CONCRETE&CEMENT SUPPLIER;C9801 BUILDING CONSTRUCTION;C5100 CONCRETE STRUCTURE;C5105 MINOR CONCRETE STRUCTURE;C7301 CONCRETE CURB&SIDEWALK-MISC; Licenses A General Engineering Contractor;C08 Concrete Contractor; Trucks Gender M Ethnicity HISPANIC Firm Type DBE Local Assistance Procedures Manual Exhibit 15-H Proposer/Contractor Good Faith Effort EXHIBIT 15-H: PROPOSER/CONTRACTOR GOOD FAITH EFFORTS Cost Proposal Due Date PE/CE Federal-aid Project No(s). CML-5181(191) Bid Opening Date D*I 501 Z CON The City of Huntington Beach established a Disadvantaged Business Enterprise (DBE) goal of 6 00% for this contract.The information provided herein shows the required good faith efforts to meet or exceed the DBE contract goal. Proposers or bidders submit the following information to document their good faith efforts within five (5) calendar days from cost proposal due date or bid opening. Proposers and bidders are recommended to submit the following information even if the Exhibit 10-01: Consultant Proposal DBE Commitments or Exhibit 15-G: Construction Contract DBE Commitment indicate that the proposer or bidder has met the DBE goal.This form protects the proposer's or 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. The following items are listed in the Section entitled "Submission of DBE Commitment"of the Special Provisions, please attach additional sheets as needed: 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 Goal Achieved 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 Solicitation Follow Up Methods and Dates Goal Achieved C-23 Page 1 of 3 May 2020 Local Assistance Procedures Manual Exhibit 15-H Proposer/Contractor Good Faith Effort C. The items of work made available to DBE firms including those unbundled contract work items into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation in order to meet or exceed the DBE contract goal. Items of Proposer or Bidder Breakdown of Amount Percentage Work Normally Performs Item Items ($) Of (Y/N) Contract Goal Achieved ;Pick _ __i 0.00% _Pick ? 0.00% Pick j 0.00% _Pick 0.00% 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: Goal Achieved Names, addresses and phone numbers of firms selected for the work above: Goal Achieved E. Efforts(e.g. in advertisements and solicitations) made to assist interested DBEs in obtaining information related to the plans, specifications and requirements for the work which was provided to DBEs: Goal Achieved C-24 Page 2 of 3 May 2020 Local Assistance Procedures Manual Exhibit 15-H Proposer/Contractor Good Faith Effort F. Efforts (e.g. in advertisements and solicitations) made to assist interested DBEs in obtaining bonding, lines of credit or insurance, 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: Goal Achieved 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 Goal Achieved H. Any additional data to support a demonstration of good faith efforts: Goal Achieved C-25 Page 3 of 3 May 2020 Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors(DBE and Non-DBE) Exhibit 12-B: Bidder's List of Subcontractor (DBE and Non-DBE) - Part 1 As of March 1, 2015 Contractors (and sub-contractors) wishing to bid on public works contracts must be registered with the State Division of Industrial Relations and certified to bid on Public Works contracts. Please register at https://www.dir.ca.gov/Public-Works/Contractor- Reg istratio n.html.The local agency will verify registration of all contractors and subcontractors on public works projects at bid and thereafter annually to assure that yearly registration is maintained throughout the life of the project. In accordance with Title 49,Section 26.11 of the Code of Federal Regulations,and Section 4104 of the Public Contract Code of the State of California, as amended,the following information is required for each sub-contractor who will perform work amounting to more than one half of one percent(0.5%) of the Total Base Bid or$10,000(whichever is greater). FEDERAL PROJECT NUMBER: Photocopy this form for additional firms. CML-5151(191) Subcontractor Name&Location Line Item&Description Subcontract Percentage of Contractor License Number DBE DBE Cert Number Annual Gross Receipts Amount Bid Item (Y/N) Subcontracted DIR Reg Number NAME �_Tj__K _�E�� %•3rZ00.0 <$1 million f���' / <$5million —Ip1-. _____ <$10 million City,State // <$15 million �1 IM:\ Age of Firmin TberlIMICAllereasiligrodliir iS years NAME <$1 million WOktsaQmatStAl.t.1u.,. 2,0--rra C pp C <$5million gIyZQ,O() �j,(p ,�j15$� <$10million City,Stale L0OTS 1 �1� `" <$15 million 11Je32()prot\'1.y#441- Age of Firm in QLKCrit-Ot.126113 000001104 years NAME f:Qwr.iYlli4C*40.1 31.21\.00 (pQ <$1million kAgr.(,0v\Con9lwt)rtan 5-blotlswwt111 ' i' *VW"„ow 1O / <$5million cluryl_Lnf. b.Istoset $tor0.30 la CALI5C16 y �\OZb <$10million 1 City,State g81-^ `ry #\.,1'1'S�.Oo ,1 G7 <$15million RYA.A.N.4►J'«4 C r'. s%Wow $e.1.i3.3p 445 Age of Firm in CovVAACA1till) towrolt VAlear $444StA2. 144 100on1?WA years NAME %%Wrt0 4 1. 32 in <$1 million 13 two.ntiD1L $2S71.4o 14 ‘. \ / / <$5million \\ I / bM row&die wpm 4 4104.00 7$ �( <$10 million City,State t5 SiCWNA:taw. A 1.14't.1� 41 — j <$15million Ma 150,44 t sT.04540 447 \%, 1 1 11 b..yt t tlb°1102 pV IS Age of Firm in (Q Gorb $'MASSA" RI years NAME`\ I I \q Wrto t f A11o.2%T.to ,S <$1million \ %•-• 1 / <$5million <$10 m illion City,State <$15 million `� 1 / \. ` Age of Firm in years NAME • 2C). V`f 1 <$1 million TA 5QtYQ[.tylp inp(t.1G t1_1`,1 $�(lpoo,p) 1.4 gyp\()Z11 <$10million `t/rl I-l ` 1 d <$tOmillion City,State N 1.1�/� <$15 million PO;%O C \t 2ise ^r, Age of Firm in UA6..rio 'CA gl1t.l M 1W`J"11a5q years NAME 2\ -Si NCV b 4S '000•170 9Z <$1million su of Par t.N.ti/\1 ' k ti 'I 7 0C. <$5 millionM,NAA�ti1n\S i,•0�" -- N/A <$10 million City,State <$15million S311.G.1rrcSt'r Age of Firm in G1preas Gt1QV30 tt)Q ,14,(p years NAM <$1 million <$5 million <$10 million City,Slate <$15 million Age of Firm in years NAME <$1 million <$5 million <$10 million City,Slate <$15 million Age of Firm in years Distribution—Original:Local Agency File;Copy:DLAE w/Award Package C-26 Page 1 of 2 September 2021 Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors(DBE and Non-DBE) Exhibit 12-B: Bidder's List of Subcontractor (DBE and Non-DBE) - Part 2 In acco rd an ce with Title 49,Sectio n 26 of the Code of Federal Reg ulations,the Bidder sh all list all subco n tractors who p rovided a q uote or bid but were not selected to participate as a subco ntracto r on this project. FEDERAL PROJECT NUMBER: Photocopy this form for additional firms. Su ontractor Name&Location Line Item&Description Subcontract Percentage of Contractor License Number DBE DBE Cert Number Annual Gross Receipts Amount Bid Item (Y/N) Subcontracted DIR Reg Number NAME <$1 million <$5million <$10 million City,State <$15 million Age of Firm in years NAME <$1 million <$5 million <$10 million 'City,State — <$15 million Aged Firm in years NAME <$1 million <$5 million <$10 million City,State <$15 million Age dFirm in years NAME <$1 million <$5 million <$10million City,State <$15million Aged Firm in years NAME <$1 million <$5million <$10 m dbon City,State <$15million Age dFirm in years NAME <$1 million <$5 million <$10 million City,State <$15million Aged Firm in years NAME <$1 million <$5 million <$10 million City,State <$15 million Age of Firm in years NAME <$1 million <$5 million <$10million City,State <$15 million Ago of Firm in years NAME <$1 million < million <$1,4 illion City,State <$15m on Age dFirm in years Distribution—Original:LocalAgency File;Copy:DLAE w/Award Package C-27 Page 2 of September 2021 el V) vi W H w }+ O 0,h d ti el co N a, N0 o b O a to E ,.. CQ Pa k u n' h W 0 U E Tu C 0 v 0 i 0 o 2 o w a) a) R f-+ N C is d oo.. Q) a) 0 ..E.. o D o n N m 0 o U 0 E � E 'to 0 O CO U Q o o v w IO C% Ti 15 UT. ' N N E G a, c c ° 01 0 d W '"` 0 y lL is A c d co -0E H Lt. p a) G N W 0 d n a. Y C y W 3 E Or 2 C3.,a' oIL o p z o y Z m E o Qq o Oo ' t z C v W C go a w 0- v, W Z c°« of m ri d o y N § ya CI... - < •N• U = o M 41 C -J reN. 'n W W o ,_ H U.1 E rO m tk gj 0 z E U � s V W o W F d OW 3 al W U _ ° F o w N v w 3 R h W C d Z 'v o d A Cl) rn o o 0 Q x m o V1 < °° 3 V E w o W y C tA N 0 vis z w W 0 e pi y � F > ua�y! a' a °� N �.$ m F m € 00 '«� A to y C y o N Z y C "E N W E CO .g` Z d 0 .c c o a) r U t d m� �� w y Z '' § U 0. E"' T a a) > rx < C .° y A' Q 0 0 a . 8 < m o ai c E •o E y � v', w 5 O y d C d ai Q Um w o K x C E r� 1 E y o .g 5- a U O o g z g w 3 Q y m cd u F c ,Too m O 0-Z ITm � S o oill U Oz J a m‘70 ,"( 'O N v — co U N H m Q A 0) 50 - S -, acU a) C� yo I. � d a E- cu IL 0, 00 d F 0E o G v' VTo O } C m N 0 y o N It N -2 N 0 U w w C F V) E' .E� z o fc. v 0 v � Ta O N y _ o I a O 0, •o.Q a) O 0 a, j c o v ON t a o) U < � N W N 4w r3 C !A 6: o . y ° N - C C / �' N pr- C. Za) C 0) IA j rnH 4 E .o2 0 0. < tNa C o § no 44 c2 0 2 1 osc r C 8 — � in 28 o CC y - 4 E.O U a) O p 10 d I v N C a - y •Smp. -I ' 0 y E-, oa a; m C C f - c Cto VCOLW T O E 0 ° a) Z� 0 0 . a o z ^v VI X .0 vi 0 w W Q A g o a) � e a C c m O En - G o o z o Co C 0 0 �7 0 J 3 0 0 a 6 . 0o Z H ro N o a City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For the UTICA AVENUE BICYCLE BOULEVARD PROJECT from Main Street to Beach Boulevard CC NO. 1499 in the CITY OF HUNTINGTON BEACH August 23, 2022 Notice To All Bidders: Please note the following clarification to the Project Specifications and Contract Documents: 1) Page viii, APPENDIX I, PART 1 and PART 2 is replaced with the following: PART 1 —FEDERAL & STATE REQUIREMENTS FOR FEDERAL-AID CONSTRUCTION PART 2—FEDERAL LABOR RATES PART 3—STATE LABOR RATES 2) FEDERAL LABOR RATES The Federal Labor Rates contained in Appendix I, Part 2 of the specifications for the: Utica Avenue Bicycle Boulevard Project, CC-1499 shall be replaced with the following attached documents: The Federal Labor Rates dated August 23, 2022. These rates shall be the labor rates in effect for the subject project. 3) STATE LABOR RATES The State Labor Rates contained in Appendix I, Part 3 of the specifications shall be replaced with the following attached document: State Labor Rates dated August 23, 2022 The State Labor Rates Dated August 23, 2022 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number One, dated above. DBX, Inc. 0 Company Name ithwvzh James C. Perry-Pres dent/Secretary/Treasurer 08/30/22 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. For Addendum questions, please call Darren Sam at (714) 374-1619 within 3 days of posting. Liberty Mutual Surety ��,�" Liberty Mutual. 17771 Cowan,Suite 100•Irvine,California 92614•(949)263-3300 SURETY www.libertymutualsurety,com i'. BID BOND BOND NO. N/A Premium: Nil • KNOW ALL MEN BY THESE PRESENTS, That we DBX, Inc . as Principal,and The Ohio Casualty Insurance Company a corporation authorized to transact a genera!surety business in the State of California as Surety, are held and firmly bound unto City of Huntington Beach } (hereinafter called the Obligee) in the full and just sum of ten percent of amount bid Dollars, ($ 10% )for the payment whereof in lawful money of the United States, we bind ourselves,our heirs,administrators,executors,successors and assigns,jointly and severally,firmly by these presents. WHEREAS,the said PRINCIPAL has submitted the accompanying bid for Utica Avenue Bicycle Boulevard C.C. No. 1499 Federal Aid Project CML-5181 (191) is NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid,or in the event of the failure of the Principal to enter such Contract, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid,then this obligation shall be null and void,otherwise to remain in full force and ( effect. f _ Signed and Sealed this 15th day of August 2022 $ YEAR DBX, Inc. The Ohio Casualty. Insurance Company Surety By. Principal Spencer Flake, Attorney-in-Fact ID-1198(Bid Bond)(REV.5/19) CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of Riverside J} On 08/30/22 before me, Stephany Bravo,Notary Public Date Here Insert Name and Title of the Officer personally appeared James C. Perry Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/are 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 ,5 r40. STEPHANY BRAVO laws of the State of California that the foregoing � Notary Public-California paragraph is true and correct. Riverside County Commission#2348074 r WITNESS myhand and official seal. My Comm.Expires Feb 19,2025 Signature ` Place Notary Seal and/or Stamp Above Sign ure f 7i7.- 7 tary Public 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: James C. Perry Signer's Name: MI Corporate Officer —Title(s):President/secretary/Treasurer❑ Corporate Officer— Title(s): ❑ Partner— 0 Limited 0 General 0 Partner— 0 Limited 0 General ❑ Individual 0 Attorney in Fact 0 Individual ❑ Attorney in Fact ❑ Trustee 0 Guardian or Conservator 0 Trustee ❑ Guardian or Conservator ❑ Other: ❑ Other: Signer is Representing: Signer is Representing: ©2019 National Notary Association 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 8/15/22 before me, Lexie Sherwood , Notary Public, Date Insert Name of Notary exactly as it appears on the official seal personally appeared Spencer Flake Name(s)of Signer(s) 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), 010 LEXIE SHERWOOD I and that by his/her/their signature(s) on the instrument the ET_/i��� ��i - Lt COMM.#2363681 cn person(s), or the entity upon behalf of which the person(s) I s I NOTARY PUBLIC-CALIFORNIA acted, executed the instrument. :/� ORANGE COUNT — 'n I certify under PENALTY OF PERJURY under the laws of 1 �+.,��, MY COMM EXPIRES JULY 27,2025 the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal Signature Place Notary Seal Above Signatur of ry Public Lexie Sherwood OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of the form to another document. Description of Attached Document Title or Type of Document: Document Date: 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 —Title(s): ❑ Partner ❑Limited ❑General ❑ Partner ❑Limited❑General ❑ Attorney in Fact RIGHT THUMBPRINT ❑ Attorney in Fact RIGHT THUMBPRINT ❑ Trustee OF SIGNER ❑ Trustee OF SIGNER ❑ Guardian or Conservator Top of thumb here ❑ Guardian or Conservator Top of thumb here ❑ Other: ❑ Other: Signer is Representing: Signer is Representing: ow- This Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated. yI� i Liberty Liberty Mutual Insurance Company A ' Mutual. The Ohio Casualty Insurance Company Certificate No: 8205649-971919 West American Insurance Company SURETY POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS:That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies'),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Charles L. Flake,David L.Culbertson,Heather Willis,Lexie Sherwood,Spencer Flake all of the city of Anaheim state of CA each individually if there be more than one named,its true and lawful attorney-in-fact to make, execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act 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 their 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 25th day of May , 2021 . u Liberty Mutual Insurance Company v tNSUR 01 INSV tHSU,q The Ohio Casualty Insurance Company 4JP°oaPOf4rgfn 0, cp O-ray VPcoaPORa�y° West American Insurance Company • ? Fo cb ,1- Fo 3 Fo • 1912 ° ° 1919 „ L 1991 ° /� rn " �3 y z a` o Q o // vi CD rd"O9s'%1ctb �.aa ° HAMPS�,aD� �s tN°IANP da f ,� •N O C U m David M.Carey,Assistant Secretary Cr= c`o State of PENNSYLVANIA SS c' co County of MONTGOMERY 0 .— 4_ m On this 25th day of May , 2021 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance c1Oi o m Company,The 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 E—Q 2> therein contained by signing on behalf of the corporations by himself as a duly authorized officer. 0 -0a 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. O N m PAS yG�aoD7;t•E rF! Commonwealth of Pennsylvania-Notary Seal p t.. pct q<�, t' Teresa Pastella,Notary Public N'm � 't`• u 'r � Montgomery County /y�,-A��/� C O 0 OF My commission expires March 28,2025 By: ��2� / 0 0 C CO v Commission number 1126044 '.. �, yLJPa�`(j Member,Pennsylvania Association of Notaries eresa Pastella,Notary Public Q O to N ARY P� This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual 3 0o0 E•S Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: a a? CNI ARTICLE IV-OFFICERS:Section 126 2 .Power of Attorney. `o o Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the-0 23- ef President may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal,acknowledge and deliver as surety @ CO > C 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,shall 0 3 o 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 o a)Z o instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under the XI 2 provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. tL a ARTICLE XIII-Execution of Contracts:Section 5.Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president,and subject to such limitations as the chairman or the president may prescribe, shall 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,shall have full 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 attorneys-in- fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Authorization-By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or 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 bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I,Renee C.Llewellyn,the undersigned,Assistant Secretary,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 15th day of August , 2022 . v tt4Sbq �SY INsoq A tNSUq Jp'00Oft,47+ ,b p.f.0/ �q uP oaPORgfq'y • 1912 0 0 1919 11 1991 0 c141. 41*-.. By: d0 &Aclit15 da; y°�HA""PS aAu. ems, 14toi o- At, Renee C.Llewellyn,Assistant Secretary * ? •yl * 1.. M * 1, LMS-12873 LMIC OCIC WAIC Multi Co 02/21 1 co 2 v co Q rn w mw U ZU I OtL =U OwwCcnmIX D0co0 Q O Ov2 • >- moZ D 0a. N2 -3. /.„.. 1 w z oc m '.;;-_ C)>O! - • tl-J CJ - V ' >-f-t. FUZ � z.cC a.. a Q a o z > - o w -J N O oo 0 m U N) 0 1 c2 oQN Z _1�F- n a (B Q) V. N zwr�0 c 0 Q O O 0u_ 030ix sp. ›CO ' pp W U C. Z -0 Q 'Cr o n z p W di a¢ o a Wa a 0• > aZ cn a ixo U - 0 .0 N w 173 a z m DXN 1• N odN- (n i- � a ero/�\N INGT���/ `\ City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 x Ilk (714) 536-5227 ♦ www.huntingtonbeachca.gov %,` .F ;..-\�0 0 Office of the City Clerk �D�.NTY CPS o Robin Estanislau, City Clerk January 10, 2023 Select Electric, Inc. 2790 Business Park Drive Vista, CA 92081 RE: Utica Avenue Bicycle Boulevard —CC No. 1499 Enclosed please find your original bid bond for CC No. 1499. Sincerely, 6?ritfq, e4i-a414)44J Robin Estanislau, CMC City Clerk RE:ds Enclosure Sister City: Anjo, Japan SECTION C PROPOSAL for the construction of UTICA AVENUE BICYCLE BOULEVARD from Main Street to Beach Boulevard CC NO. 1499 FEDERAL AID PROJECT CML-5181(191) in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids,the undersigned hereby proposes and agrees to perform all the work therein described,and to furnish all labor,material, equipment and incident insurance necessary therefor,in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 50 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site,plans,specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work,that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses,taxes,royalties,fees,etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. c-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/his 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. 1(PA of Accompanying this proposal of bid,find Bid Bond in the amount of total 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. (PIease 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: `Addendallo': . . I _ .�- a�'' 1 8/23/22 r-.A L u: , • _ t • • C-2 • • City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For the UTICA AVENUE BICYCLE BOULEVARD PROJECT from Main Street to Beach Boulevard CC NO. 1499 in the CITY OF HUNTINGTON BEACH August 23, 2022 Notice To All Bidders: Please note the following clarification to the Project Specifications and Contract Documents: 1) Page viii, APPENDIX I, PART 1 and PART 2 is replaced with the following: PART 1 —FEDERAL & STATE REQUIREMENTS FOR FEDERAL-AID CONSTRUCTION PART 2—FEDERAL LABOR RATES PART 3—STATE LABOR RATES 2) FEDERAL LABOR RATES The Federal Labor Rates contained in Appendix I, Part 2 of the specifications for the: Utica Avenue Bicycle Boulevard Project, CC-1499 shall be replaced with the following attached documents: The Federal Labor Rates dated August 23, 2022. These rates shall be the labor rates in effect for the subject project. 3) STATE LABOR RATES The State Labor Rates contained in Appendix I, Part 3 of the specifications shall be replaced with the following attached document: State Labor Rates dated August 23, 2022 The State Labor Rates Dated August 23, 2022 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum N 0 e, dat d bove. Select Electric, Inc. Company Name By 8/29/22 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. For Addendum questions, please call Darren Sam at(714)374-1619 within 3 days of posting. Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Item Estimated Item Unit Price Extended No. Quantity Amount 1 1 L.S. Mobilization. $ $ 3,3�a Per L.S. 2 1 L.S. Furnish Project Traffic Control. $ $ Per L.S. _ 3 1 L.S. Preparation of project Specific Storm Water Pollution Prevention Plan (SWPPP). $ O'��c11�1. $ Per L.S. 4 1 EA. Installation and maintenance of BMP's per the approved SWPPP. $ �150.� $ \7 - Per L.S. 5 21 LF Remove existing block wall and footing $ � �q. $ 6 1 EA Construct concrete island $ a\,01o3- $ 7 40 LF Construct 8" median curb $ 1�•_ $ 8 1,500 SF Remove and dispose existing A.C. and _base material $ $ 1 oQ,000._ 9 130 LF Remove and dispose of existing curb a and gutter $ o`�O ." $ 3 s - O 10 76 LF Construct 6" curb and gutter $ U5.— $ -1°1$0.- 11 33 LF Construct 6" curb $ %a.- $ a;10io. C-2.1 Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Item Estimated Item Unit Price ' Extended No. . Quantity Amount 12 1 LS Reconstruct existing improvements $ r 5%05a.- $ ►S,oSa. 13 1 EA Adjust manhole to grade $ 3?�%Lt. $ 3 sc6,'-k- 14 2 EA Finish raw edge of wall with matching existing material and color $ 5e3313 _ $ 11000_ 15 113 SF Remove and dispose existing sidewalk $ Oa- $ a;-v%10.- 16 70 TONS Construct new 2"type III-C3-PG 64-10(1/2") surface course over 4" class B- $ .6+`4. $ ) 4‘0$O — PG 70-10 (3/4") base course over 1.0' C.M.B. 17 100 TONS Construct 1' crushed miscellaneous $ `b`6.' $ `6%%00. base 18 3 EA Construct Curb Access Ramp on northwest, northeast and southeast corners at Lake Street/Utica Ave per $ $ 4 3,15cJ• _ Caltrans Standard Plan No. RSP A88A, Case A and Details on Sheets 3 and 4. (Item includes all appurtenances, curb and gutter, depressed curb, sidewalk, domes, retaining curb, slot pave, etc.) Per EA. C-2.2 Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Item Estimated Item . Unit Price Extended No Quantity . Amount 19 1 EA Construct Curb Access Ramp on southwest corner Lake St/Utica Ave per Caltrans Standard Plan No. RSP A88A and Detail on Sheet 4 (Item includes all $ 1y 5%5 $ It 415 Y-J- appurtenances, curb and gutter, depressed curb, sidewalk, domes, retaining curb, slot pave, etc.) Per EA. 20 1 L.S. Install traffic signal at the intersection of Lake Street and Utica Avenue (excludes curb ramps and city furnished equipment) $ $ a-1-0501._ Per L.S. 21 1 L.S. Furnish and install signing and striping. $ 5.- $ (OOvo5 C-2.3 Project Bid Schedule Utica Avenue Bicycle Boulevard From Main Street to Beach Boulevard CC-1499 CML-5181(191) Total Amount Bid Total Amount Bid in Figures: $ SIoQ,CSs/-3 . " Total Amount Bid in Words: sv-\ e una r-ed Six n� �hov S3�1d ,�\ r� z1G\Y 1�o\\o.srs ae, 2X'D cexc-S. Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (also includes anchor bolts) to the contractor. The contractor is to pick up the materials, with its own labor, at the City Yard, 17371 Gothard Street. Contact traffic signal maintenance two working days in advance for pick up at (714) 536-5530. 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. • F : t1-},Bid. ` = Ndife#nd Addy . qof 1ks i 5.iate i 3 . Qss ti P.:DXR y,C -Dolar� F , %'of ; I:Ie ( %Ma ,,fliS tt , " }� } L s ,{ST � N R ' straori# Au Citac nits Piu e +n'rac ;74,, i, cesa it } ,{i g1 J li naou t onr}N,�'Ip} a 1,. ll i a '0 .7 7r 'I,i E-1 I 1 'T- ! ,'yJSr }.I ly1 .,:@ i f 'w. f I4i ..1�!!),I� 4 ,_Ji .lry :x.,,aMI, 2.-1-6, qil .ht. 4yuntufir, 4.,,;... :, 'oi.! 9A Ivi Z .1'2, _ y a ,I-. sN iti.!d�. , Sv C-3l ��Uri or 1��?mrt!• C.3Z 1 oono014-1 to t50?,000." a 1 531a.C iwty> sh . 111;6oto c.-w lost C�pvcsS, C . • �10t030 .4,S-1`1 IE. electxoJ Er5tft.artruN R • 1440 Beau..mort'r",A c,. IN 1000043t 8liItalgl.." sic.Pa--13U Io153$0 C-53 'p c0.wMuM,Cp,.92Z23 tY trerZ- varr e. Cun+,roll+w C-� . `i`�` �- 10114F1 C-31 10000'41135 %t41I00`0 a,��nve�\:v�r4,6e-Qh KccAl wka.k IN pim l�r►. 83��'11 C'1� 4001CA1to-1-1a '� a0 8\�9 15,aoo. 'Kv0rs_69...,c .14250% • -3)—S'toic4n' Ottr nSutlwdS 3_ c1-145 e - • {•''203 NIA 10000110141 %41000ij° • a0 10832 at -e"^ ihrv-er . 15154A C-+o 10oouo1-11L1 {qsiSao.`/o crcitn g.,rant,C1..41843 C-32. -T'c1K �ervlceS,1_UC-. ale,�n at fix. aog a, v ,aw'.ao yt .1-6.d.a ,CA-ckanS 1Pr slip\leA✓ . 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 8/29/22,at Vista , CA Date City State Sam Passanisi , being first duly sworn, deposes and says that he or she is Asst. Secretary of Select Electric, 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. Select Electric Inc. Name of Bid' • Signature of Bider 2790 Business Park Dr. Vista, CA. 92081 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 UTICA AVENUE BICYCLE BOULEVARD,(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. Select Electric, Inc. Contractor • By Asst. Secretary Title Date: 8/29/22 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? C!Yes ®No If the answer is yes,explain the circumstances in the space provided. • Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Select Electric, Inc. Contractor By Asst. Secretary Title Date: 8/29/22 C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Select Electric, Inc. Bidder Name 2790 Business Park Dr. Business Address Vista CA 92081 City, State Zip ( 562 ) 584-1766 estimating@selectelectricinc.com Telephone Number Email Address 297034 - A, B, C-7, C-10 State Contractor's License No. and Class 08/09/1974 Original Date Issued 10/31/2022 Expiration Date The work site was inspected by Landon Smith of our office on August 15th , 2022. The following are persons, firms, and corporations having a principal interest in this proposal: Select Electric, Inc. 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. Select Electric Com y e • Signature of Bid er Sam Passanisi. Asst. Secretary Printed or Typed Signature C-8 NOTARY CERTIFICATE Subscribed and sworn to before me this PYI day of 4.10. , 2022! 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 elk ) County of S/NN 1) ) On Pi 20yZ before me, ?"1114t /1$ksG./ /I� � 12‘4$(1.4" onth, Da/, and Year Insert Name and Title of Notary Y personally appeared ' PA6ctf !!SI 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. • RUTH MASAICHI WITNESS my hand and official seal. Notary Public•California I : r San Diego County :r,T.yq f° Commission N 2356962 My Comm.Expires May 10,2025 4„ivia Signature ' 4 Signature of Notary Public (PLACE NOTARY SEAL ABOVE) C-9 Bidder's Project History ' I For the purposes of this project, the bidder shall provide project history of similar work, specifically referencing the construction of traffic signals,curb&gutter and sidewalk. 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 Oceanside - 300 North Coast Hwy. Oceanside, CA. 92054 Name and Address of Public Agency Name and Telephone No. of Project Manager: Darra Woods - 760-435-5094 Rebid Mission Ave. Fiber& 4/2018 • $752,175.00 Traffic Signal Modification Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Install Conduit and Fiber, Upgrade Traffic Signal Poles. Traffic Signal Modificatnn 2. CALTRANS - 100 S Main St, Los Angeles, CA 90012 Name and Address of Public Agency Name and Telephone No. of Project Manager: _Paul Wang - 562-345-3144 $4.885,380.00 Fiber, Communication System 4/2019 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Upgrade Existing Communication System, Fiber Optic 3. City of Los Angeles - 200 N. Spring St. Los Angeles. CA. 90012 Name and Address of Public Agency j Manager:and Telephone No. of Project Mana er: Max Eftekhari 951-741-3403 $2,563,285.00 Fiber Optic, Traffic Signal 10/2018 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Traffic Signal Modification, Fiber Optic, CCTV c-it) • • 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. Raudel Martinez Name of proposed Project Manager Telephone No. of proposed Project Manager: 562 807-1860 Traffic Signal and Bike CEY South & Tiverton $546.916 lane Modification 2/2019 ` I Completed Project Name&Contract Amount Type of Work Date Traffic Signal,Communication System • ITS Communication ATSAC Upgrades.Conduit installation,pull boxes, and$4,928,460 7/2020 fiber optic cable installation and terminations. Project Name&Contract Amount Type of Work Date Completed Thousand Oaks Streetscape Traffic Signal, Street $932,400 lighting Modification 3/2021 • Project Name&Contract Amount Type of Work Date Completed 2. Tom Meyers Name of proposed Superintendent • Telephone No. of proposed Superintendent: 562-807-1860 Traffic Signal and Bike 2/2019 CEY South & Tiverton $546.916 lane Modification • Project Name&Contract Amount Type of Work Date Completed Traffic Signal,Communication System ITS Communication ATSAC Upgrades.Conduit installation,pull boxes, and • $4,928,460 fiber optic cable installation and terminations. 7/2020 • Project Name&Contract Amount Type of Work Date Completed • Traffic Signal, Street • • Thousand Oaks Streetscape•• $932,400 lighting Modification 3/2021 • 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 1 through June 30 state fiscal year) with the California Department of Industrial Relations (DIR). Currently the annual non-refundable registration fee for Contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 http://www.dir.ca.gov/DLSE/PublicWorks/SB854FactSheet 6.30.14.pdf DIR's Contractor Registration Link—Call (844) 522-6734 https://efiling.dir.ea.gov/P W CR/ActionS ervlet?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 1771.1(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. Select Elect '_- - Contractor fp OP) By estimating@selectelentricinc corn Email Asst. Secretary Title Date: 8/29/22 PWC Registration#: 1 000001 036 C-12 7 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: Select Electric, Inc. • Contact Person: Sam Passanisi Contact Phone: 562-58 -1766 Signed: Date: 8/29/22 *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 EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder X ,proposed subcontractor ,hereby certifies that he has X has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. C-14 PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder, has been X has not been convicted within the preceding three years of any offenses referred to in that section,including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon,award of, or performance of,any public works contract,as defined in Public Contract Code Section 1101,with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term"bidder"is understood to include any partner,member,officer,director,responsible managing officer,or responsible managing employee thereof,as referred to in Section 10285.1. Note: The bidder must place a checkmark after "has" or"has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of s Sta -meat.Bidders are cautioned that making a false certification may subject the certifier to criminalpr saution pO . Sam Passanisi 8/29/22 .ignature Print Name Date PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury,the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal,state, or local government project because of a violation of law or a safety regulation? Li Yes X No If the answer is yes,explain the circumstances in the following space. C-15 PUBLIC CONTRACT CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232,the Contractor,hereby states under penalty of perjury,that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. • Note:The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. r f Sam Passanisi 8/29/22 ature Print Name Date C-16 Noncollusion Affidavit - (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY of Huntington Beach DEPARTMENT OF PUBLIC WORKS. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person,partnership, company,association, organization,or corporation;that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived,or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder,or to fix any overhead,profit, or cost element of the bid price,or of that of any other bidder,or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto,or paid,and will not pay, any fee to any corporation, partnership,company association,organization,bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Non-collusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereo :.. also constitute signature of this Non-collusion Affidavit. Bidders are cautio ed that making a false certification may subject the certifier to criminal •ro - utio • 8,1 Sam Passanisi 8/29/22 Signa 1t• Print Name Date C-17 DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS,PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: • is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any Federal agency; • has not been suspended,debarred,voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted,convicted,or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification,insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above,indicate below to whom it applies, initiating agency,and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute - e of this Certification. Sam Passanisi 8/29/22 Si��• Print Name Date C-18 NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS I j The prospective participant certifies,bysigning and submittingthis bid or proposal,to the best of his or her p P P p � g p P > knowledge and belief,that: (1) No Federal appropriated funds have been paid or will be paid,by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension,continuation,renewal,amendment,or modification of any Federal contract,grant,loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities,"in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts,which exceed$100,000 and that all such subrecipients shall certify and disclose accordingly. • I �1, Sam Passanisi 8/29/22 Si:,. e Print Name Date C-19 Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities • EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract a. bid/offer/application 17 a. initial b. grant b, initial award n b. material change c. cooperative agreement c. post-award d. loan For Material Ch::ge Only: e. loan guarantee year quarter f. loan insurance date of : t report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. is Subawardee, Enter Name and Addr•: of Prime: ❑ Prime n Subawardee Tier ,if known Congressional District,if known Congressio•al District,if known 6. Federal Department/Agency: 7. Feder. 'rogram Name/Description: I A Number,if applicable 8. Federal Action Number,if known: '. Award Amount,if known: 10. Name and Address of Lobby Entity 11.Individuals Performing Services (If individual,last name,first name,MI) (including address if different from No.10) (last name,first name,MI) (attac 'ontinuation Sheet(s)if necessary) 12. Amount of Payment(check all t.,t apply) 14. Type of Payment(check all that apply) $ ❑ actual 1 planned a. retainer b. one-time fee 13. Form of Payment(ch: all that apply): c, commission B a. cash d. contingent fee b. in-ki :,specify:nature e deferred Value f. other,specify 15. Brief D�.cription of Services Performed or to be performed and Date(s)of Service,including offi • (s),employee(s),or member(s)contacted,for Payment Indicated in Item 12: (attach Continuation Sheet(s)if necessary) 1.. Continuation Sheet(s)attached: Yes No 17.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: Saml5kas a n i s i 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any Asst. Secretary who fails to file the required disclosure shall be subject Title: to a civil penalty of not less than$10,000 and not more than $too,000 for each such failure. Telephone No.: 562-584-1766 Date: 8/29/22 Authorized for Local Reproduction Federal Use Only: Standard Form-LLL Standard Form ILL Rev.04-28-06 Distribution: Orig-Local Agency Project Files C-20 Page 1 LPP 13-01 May 8,2013 Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities INSTRUCTIONS FOR COMPLETING EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime federal recipient at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is or has been secured to influence,the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which the change occurred, Enter the date of the last,previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name,address,city,state,and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to: subcontracts,subgrants,and contract awards under grants. 5. If the organization filing the report in Item 4 checks"Subawardee"then enter the full name,address,city,state,and zip code of the prime federal recipient. Include Congressional District,if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name,if known. For example,Department of Transportation,United States Coast Guard. 7. Enter the federal program name or description for the covered federal action(item 1). If known,enter the full Catalog of Federal Domestic Assistance(CFDA)number for grants,cooperative agreements,loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item I (e.g.,Request for Proposal(RFP)number,Invitation for Bid(IFB)number,grant announcement number,the contract grant.or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes,e.g.,"RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency,enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. Enter the full name,address,city,state,and zip code of the lobbying entity engaged by the reporting entity identified in Item 4 to influence the covered federal action. 11. 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(M1). 12. 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. 13. Check all boxes that apply. If payment is made through an in-kind contribution,specify the nature and value of the in-kind payment. 14. Check all boxes that apply. If other,specify nature. 15. 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. 16. Check whether or not a continuation sheet(s)is attached. 17. The certifying official shall sign and date the form,and print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30-minutes per response,including time for reviewing instruction,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project(0348-0046),Washington,D.C.20503,SF- LLL-Instructions Rev.06-04 C-21 Page 2 LPP 13-01 May 8,2013 • Local Assistance Procedures Manual Exhibit 15-G Construction Contract DBE Commitment EXHIBIT 15-G CONSTRUCTION CONTRACT DBE COMMITMENT 1 • 1.Local Agency: The City of Huntington Beach 2.Contract DBE Goal: 6% 1 3.Project Description: Utica Avenue Bicycle Boulevard • I 4.Project Location: Utica Avenue(Main Street-Beach Blvd) i 5.Bidder's Name: Select Electric.Inc 6.Prime Certified DBE: 0 7.Bid Amount: $569,850.00 • 8.Total Dollar Amount for ALL Subcontractors: $256.272.20 9.Total Number of ALL Subcontractors: 7 i 10.Bid 12.DBE 13.DBE Contact Information 14.DBE 11.Description of Work,Service,or Materials Certification Dollar ' Item Number Supplied Number (Must be certified on the date bids are opened) Amount Global Road Sealing i 20 Loops 031176 10832 Dorothy Ave $9,820.00 • Garden Grove(714)893-0845 . i Riverside Directional Drilling • i 20 Directional Drilling 45543 8179 Angel Lane $15,200.00 Riverside,CA 92508(951)453-2382 JL Storm Water Consultants 3&4 WPCP 37409 9745 Prospect Ave#203 $4,000.00 Santee,CA(619)938-2420 Maneri Traffic Control i 4949 2nd Street $4,100.00 I, 2 Traffic Control 38078 I Fallbrook,CA 92028(951)695-5104 TEK Services,LLC 5680 Van Gogh Way $10,360.20 20 Material Supplier 40540• Yorba Linda,CA 92887(714)336-0536 Material:$17,266.20 i 60%Allowed:$10,360.20 I _ _ , -`,'LocaliA`enc`to''Complete:ibis'Se onmpon.Ei ecution.Qf;Elward`>'ahz: y r,a pp R I $43,480.20 • i t ''.1"''' 1•'Y.. ,1:!-" :J;y'h i ,nCt'Y• .lit it 4' .x'"-ir 1,.•'1"tft1141 21,Loom pigency Contrac rvumber., .:,,, _._fyt^-i_ q. M t'.a, ,,tip of•.: 15.TOTAL CLAIMED DBE PARTICIPATION ,. rw Ai -Project.r `'1..:...1.i+tti. '�'3.r.•�=''-.`?iFi tta,4t.il4 q `}� 22:.Federal-AidProjectNuinbar^�;.:,,y• ; `�C:,; a:i�a:;, :�; •tti1 1! } % en;g h4J : '*�'. L5_ ti1 i .y� ' ,l• T.3;2v;n • 23.Bidtd�Openittg'Date L �'��"'`lV ..+4s;'l:,r,r:1 �i�?'{1..Z i 1.1�.�$,,*�,:ti'+:if.�•_�r,; • `•i1j"�{�s',l•';. _�T,;irtk=:.?�a.:,i:?ii!_,.�1i43.i ri-i.i'.`�'y.a . _•.p:;..`„-t:ta:.�c s',•ipy.�t���. '•24•:;Coitiract'Award D:atet•,r1-44:W Ee -4 :,'h ictt�rds:.j�cb em s:„ti,=,:Y 9tliM:6?iti•t . Award Amount: tiff IMPORTANT: Identify all DBE firms being claimed for credit, 25' wi regardless of tier.Names of_the First Tier DBE Subcontractors and ;,• _t• 's;- .�rc,;,ti; �> "`' r 3; `•.�.'.!f- i'-tint=`t`_-' i..`•"i. {' their respective items)o,orti'sted above must be consistent,where ' `t4111 a'Ie`i:!`_� rd ill*.`; � ' 3 ;x' {=-�r'.144 *-54 1; i r VI, ;`' applicable with -•'es an! ems of the work in the"Subcontractor •:� opa,i gen_.y?ce;1fies that ,c_ �^r.,• ''_are y d 1 v •-Loyal Agency certifies that all DBE Iflc�at�ions a�eyr�afd��d��pformau�n-am• Lisi'submitte•with ..our bia-%' ritten confirmation of each listed DBE 4thts,forrq is complete and accurate,r9 ,��i!, .'�,��'-it�aS,.Ar Sxtc�r h� ij` !f^ �required. / i t,.i5 1,.(.('i f 'i114'1' r;13 1,4 it K t iY {1,T ".'ac{r4,,VKl. - - i i13t14si q'4 t,,,X..St 41 `..{ir:Ii.uv: '.+T:s,ic E--.I7 '.i!4 .1iI., 1:-.l, r5tO __ ' / 8/30/2022 ° .r2fi•-LocatA eni Re resentative's_Signature;_{" I-,27•'Date,as E: y...,t4`d�,ri /6.Pre!'=rers Signature 17.Date " ..'^7`ltwt1 rr 4 ,�p I i-•4•- y b .54 �-10.4,,1:Tr +Ft! ", 4, ; 4&.ri; xVipi 1r sr�r ' '4 U -ritiiiiii �t,4.,.4riti'` i 9 Z^"t I-5..,1;r-.: La,.on Smith (562)807-1860 Ott` 1'i °e' '"' eta ' 4 v eZ.a`t(1 .-re arers Name 19.Phone .4�.:�9.Phon@zt4'i7;3'a�,U..}, ,,.,`. '+.+i P 2b tLocaN,tm-I icy. Representative's Name r. t `t erc,!c,,�*lai,g `�: j15 4't4, xi P'.: !i "t i <� ' r a c �(t i'�•�.1�,;,,,�,,tt!�‘ -a,' VP of Preconstruction i.: 4 r Tai ra?#. ! i'S' t4' t!k,.•yi 1 oir f 4- q, 20.Preparers Title y},.,.30.}:ocatAgencyrRepresentatr'esTitle, .:r ... " 0.•ip},.•' •s.”-...: DISTRIBUTION: 1.Original-Local Agency 2.Copy-caftans District Local Assistance Engineer(DLAE).Failure to submit to DLAE within 30 days of contract execution may result In de-obligation of federal funds on contract. 3.Include additional copy with award package. • ADA Notice: For Individuals with sensory disabilities,this document is available in alternate formals. For information call(a16)654-6410 or'MD(918)854-3880 or write Records and Forms Management,1120 N Street,MS-89,Sacramento,CA 95914. Page 1 of 3 C-22 January 2019 GLOBAL ROAD SEALING, INC. APIA 111.11101 dba G.R.S.I Union Signatories I UDBE and MBE Certified CT#-031176 CA SBE#2001305 I CA License#757584 A,C-10,C-32 I DIR#1000007714 IMMO 10832 Dorothy Ave. ( Garden Grove I CA 92843 _� '� P 714-893-0845 I F 714-893-0945 Estimator: Tri La tri@globalroadsealing.com Project: Utica Ave Bycycle Blvd Main St to Beach Blvd Contract: Location: City of Huntington Beach,Orange County Bid Date: 08-30-2022 @ 2PM Quote Date: SUBCONTRACT QUOTATION ITEM# DESCRIPTION QUANTITY UNIT PRICE TOTAL Traffic Loops Type E 14.00 EA 380.000 $ 5,320.00 Traffic Loop Type E Modified and D Loops 10.00 EA 450.000 $ 4,500.00 Prices are good for 45 days from the date of this proposal Total Bid $ 9,820.00 INCLUSIONS: Sawcut and install traffic loops per plan Splice loops to existing DLCs DLCs must in be place at time of loop cutting or additional mobilization charge applied for Global to return to splice the loops Furnish and install electrical equipment per plan All quantities are based off of estimates.Additional quantities will be billed at unit price Using this quote as part of your bid will constitute as agreement to all verbiage incorporated with the quote including the use of unit price Any disagremeents to the verbiage on this quote must be communicated and resolved with the estimator before bid time or this quote will not be honored This quote will need to be incorporated into the subcontract A Four week notice is required for scheduling Traffic control for our scope of work One mobilization. Additional move ins will cost$2500 ea EXCLUSIONS: Insurance premium in excess of$2M, bonding not available at this time Utility permits and fees, inspection fee Traffic Control Plan,CMS,Speed Radar,Prewarning sign,Attenuator Truck,Rumble Strip,Light Tower,posting of any kinds Lane closure submittal Concrete and asphalt restoration Items not specifically listed under inclusions Contact:grs@globalroadsealing.com(document requests relating to bid) ***Four week notice required for scheduling ACCEPTED BY Date GRSI# Skip to Main Content Back To Query Form (IicenseForm.htm). Search Returned 1 Records Tue Aug 30 11:17:40 PDT 2022 Query Criteria Certification Types: DBE Firm ID: 31176 Firm ID 31176 DBA Name GLOBAL ROAD SEALING, INC Firm Name GLOBAL ROAD SEALING, INC Address Line1 10832 DOROTHY AVE Address Line2 City GARDEN GROVE State CA Zip Codel 92843 Zip Code2 Mailing Address Line1 Mailing Address Line2 Mailing City Mailing State Mailing Zip Code1 Mailing Zip Code2 Certification DBE Type EMail grs@globalroadsealing.com Contact Name TRI LA Area Code 714 Phone Number 893-0845 Extension Alt Area Code Alt Phone Number Extension Fax Area Code 714 Fax Phone 893-0945 Number Agency Name DEPARTMENT OF TRANSPORTATION 01: 02; 03; 05; 07: 09; 10; 13; 14; 15; 16; 17; 19; 20; 21; 22; 24; 26; 27; 28; 30; 33; 34; 35; 36; 37; 38: Counties 40; 41; 42; 43; 44;48; 49; 50; 51; 54; 55; 56; 57; 58; Districts 01; 03; 04; 05; 06; 07; 08; 09; 10; 11; 12; DBE NAICS 238210; 238910; 561990; ACDBE NAICS C1201 TRAFFIC CONTROL SYSTEM; C1601 CLEARING & GRUBBING; C1901 ROADWAY EXCAVATION; C1920 STRUCTURE EXCAVATION; C1930 STRUCTURE BACKFILL; C1940 DITCHi EXCAVATION; C3701 SEAL COAT; C4040 CLEAN &SEAL PAVEMENT JOINTS-ROUT&SEAL Work Codes CRACKS; C4101 PAVEMENT SUBSEALING &JACKING; C8501 PAVEMENT MARKER; C8601 MAINTENANCE EXISTING TRAFFIC MGMT SYSTEM ELEMENTS DURING CONSTRUCTION; C81 SIGNAL& LIGHTING; C8605 MESSAGE SIGNS, LIGHTING &SIGN ILLUMINATION; C8608 DETECTOR; C8609 TRAFFIC COUNT STATION; C8611 RAMP METERING SYSTEM; C9858 RESIDENTIAL ELECTRICAL; A General Engineering Contractor; C10 Electrical Contractor; C32 Parking and Highway Improvemen Licenses Contractor; Trucks Gender M Ethnicity ASIAN PACIFIC Firm Type DBE Toni A. Wright From: Toni A.Wright Sent: Tuesday,August 30, 2022 11:02 AM V To: 'rddrill@charter.net Ore t 41 L. Cc: Landon C. Smith;Ashley M. Brisbin Subject: City of Huntington Beach - Utica - Bidding 8-30-22 Victor Good morning per our conversation this morning @ 7:43am today Tuesday 10-30-22 regarding the project City of Huntington Beach-Utica- Bidding 8-30-22.You had verbally given me a price of$3,800.00 a day. Select Electric, Inc will be listing you for 4 Days. 74,144 you. Toni Wright , Senior Estimator Select Electric, Inc. 110603 Midway Avenue Cerritos,CA 90703 Office: 562-807-1860 I Fax:562-658-2201 I Mobile: 619-247-8700 Toni.Wright@selectelectriclnc.com/www.SelectElectriclnc.com CA License 297034 estimating@selectelectricinc.com SELECT E I E C T R I C. INC . Select...The Right Choice! Select Electric, Inc.has been certified as a Minority Business Enterprise(MBE). 1 Skip to Main Content Back To Query Form (licenseForm.htm). Search Returned 1 Records Tue Aug 30 07:47:57 PDT 2022 Query Criteria Certification Types: DBE Firm Name: Riverside Directional Firm ID 45543 DBA Name RIVERSIDE DIRECTIONAL DRILLING Firm Name RIVERSIDE DIRECTIONAL DRILLING Address Linel 8179 ANGEL LANE Address Line2 City RIVERSIDE State CA Zip Codel 92508 Zip Code2 Mailing Address Linel Mailing Address Line2 Mailing City Mailing State Mailing Zip Codel Mailing Zip Code2 Certification DBE Type EMail RDDRILL@CHARTER.NET Contact Name DENISE CUEN Area Code 951 Phone Number 453-2382 Extension Alt Area Code Alt Phone Number Extension Fax Area Code 951 Fax Phone 789-6654 Number Agency Name LOS ANGELES COUNTY METRO TRANSPORTATION AUTHORITY(MTA) 01; 02; 03; 04; 05; 06; 07; 08; 09; 10; 11; 12; 13; 14; 15; 16; 17; 18; 19; 20; 21; 22; 23; 24; 25; 26; 27; Counties 29; 30; 31; 32; 33; 34; 35; 36; 37; 38; 39; 40; 41; 42; 43; 44;45; 46; 47;48;49; 50; 51; 52; 53; 54; 55; 57; 58; Districts 01; 02; 03; 04; 05; 06; 07; 08; 09; 10; 11; 12; DBE NAICS 237990; ACDBE NAICS Work Codes C8720 CIVIL ENGINEERING; Licenses A General Engineering Contractor; C12 Earthwork and Paving Contractor; Trucks Gender F Ethnicity CAUCASIAN Firm Type DBE STORMWATER State Certified SBE/DBE/WBE/SLBE/SB-PW LCor SULTANTS, INC. DBE Certification Number 37409 SLBE Certification Number 14JL1316 „�► 1111F,c 4‘,411r DIR No. 1000036291 WWw jlstormwater.com 9745 Prospect Ave,Suite 203,Santee,CA P 619.938.2420 F 619.334.6750 August 18 , 2022 RE: UTICA AVE BETWEEN BEACH BLVD AND MAIN ST, HUNTINGTON BEACH, CA BID DATE 08/30/2022 JL StormWater Consultants, Inc. is a State Certified SBE/DBE/WBE/SLBE/SB-PW. We have certified professionals who bring 30 years of experience, including former California Regional Water Quality Control Board and the U.S. Army Corps of Engineers employees. We are trained in Wetlands Delineation, Title 22 Hazardous Waste Management, and in air quality requirements by the San Joaquin Valley Air Pollution Control District and the South Coast Air9Quality Management District. JL StormWater Consultants,Inc's staff holds the following certifications: • Certified Professionals in Storm Water Quality(CPSWQ) • Qualified SWPPP Develop (QSD) • Qualified SWPPP Practitioner(QSP) • Trainer of Record for the QSD/QSP Certifications • Trainer of Record for the Industrial Storm Water Permit (QISP,CGL) BID ITEMS: Prepare Storm Water Pollution Prevention Program (SWPPP) $2,500.00 Amend Storm Water Pollution Prevention Plan $500.00/Amendment Prepare Storm Water Annual Report $1,500.00/Report Notice of Termination $400.00 This Bid is good for 90 days from the date of this document. Assumptions: This scope assumes the project is at least a Risk Level 1 or 2, and only one Storm Water Pollution Prevention Plan (SWPPP) is needed. In order to prepare the SWPPP, we may require additional information about the project including but not limited to:the electronic files, recent topographic information, a copy of the Phase I and II Environmental Assessment and the Environmental Impact Report(EIR). Additionally,we will need a copy of the drainage study. We will need copies of all issued environmental permits (404, 401, 1600) to make sure BMPs in the SWPPP are consistent with the requirements of any issued permits. Exclusions: Engineering calculations and design (including preparing storm water run-on Q's), and sizing of temporary desilt basins. These services may be available for an extra cost but were not included in the Proposal items listed above. If additional insurance is required, including but not limited to a Waiver of Subrogation, it can be obtained for an additional fee. Jane Ledford Principal PROPOSALS/ALL BIDS/2022/BID DUE 08 AUGUST/UTICA AVE BETWEEN BEACH BLVD AND MAIN ST 05.18.2022 Skip to Main Content Back To Query Form (IicenseForm.htm) Search Returned 1 Records Tue Aug 30 11:19:28 PDT 2022 Query Criteria Certification Types: DBE Firm ID: 37409 Firm ID 37409 DBA Name JL STORMWATER CONSULTANTS, INC Firm Name JL STORMWATER CONSULTANTS, INC Address Line1 1720 BRIDGEHAMPTON PLACE Address Line2 City EL CAJON State CA Zip Code1 92019 Zip Code2 Mailing Address 2650 JAMACHA RD., STE 147, PMB 127 Line1 Mailing Address Line2 Mailing City EL CAJON Mailing State CA Mailing Zip 92019 Code1 Mailing Zip Code2 Certification DBE Type EMail jane.ledford@jlstormwater.com Contact Name JANE LEDFORD Area Code 619 Phone Number 938-2420 Extension Alt Area Code Alt Phone Number Extension Fax Area Code 619 Fax Phone 334-6750 Number Agency Name DEPARTMENT OF TRANSPORTATION Counties 19; 30; 33; 37; Districts 07; 08; 11; 12; DBE NAICS 541620; ACDBE NAICS Work Codes C8700 CONSULTANT, NON ENGINEERING; C8852 SWPPP Planning; Rt TRAFFIC CONTROL SERVICES GUARDRAIL SERVICES ' EQUIPMENT&MATERIAL SALES LIC:1017741 ' DIR:1000043135 DBE:38078 SB:2003406 RESALE:SR EH 102-984007 UNION SIGNATORY MANERI TRAFFIC CONTROL INC 44949 2m)STREET FALLBROOK CA 92028 BIDIQUOTE 0:951-695-5104 F:951-695-5105 COVER SHEET estimating@maneritraMccontrol.com ATTN:ESTIMATOR PROJECT: I Utica Ave I BID 08/30/22 DATE: IF YOU HAVE ANY QUESTIONS REGARDING ANY PORTION OF THIS QUOTE,PLEASE CALL JOHNNY MANERI®760-535-7881 SCHEDULING: A MINIMUM OF 3 WEEK ADVANCED NOTICE IS REQUIRED(VIA EMAIL OR FAX) ITEM# DESCRIPTION UNIT PRICE TRAFFIC CONTROL:2 MAN CREW,1 TRUCK&EQUIPMENT,350 CONES,2 FLASHING LS $1,690.00 ARROW SIGNS(1-8HR shift) • OPERATED ATTENUATOR(1-8hr Shift) $1,250 • OVERTIME:Per laborer,After 8hr shift $125 • ADDITIONAL WEEKEND RATE DIhtERENCE:per laborer(NO $350 EXCEPTIONS) • EACH ADDITIONAL FLASHING ARROW SIGN SUBJECT TO PICK UP $200 AND DELIVERY FEES(MOBILIZATION/DEMOBILIZATION) • MTC REQUIRES A MINIMUM OF 1HR SET UP 1HR PICK-UP PORTABLE RADAR SPEED FEEDBACK SIGN MONTHLY EA $740.00 PORTABLE CHANGEABLE MESSAGE SIGN MONTHLY EA $950.00 • DELIVERY,EA $150 I PICK-UP,EA $150 UPON AVAILABILITY OF LISTED MONTHLY ITEMS:Contractor assumes full responsibility for placement,theft,vandalism&any damages incurred. Charges are for time/days out not time/days used. MT. C MANERI TRAFFIC CONTROL,INC. BID/QUOTE ADDITIONAL PRICE SHEET TRAFFIC CONTROL:2 MAN CREW,I TRUCK&EQUIPMENT,350 CONES,2 FLASHING ARROW SIGNS(1-RHR SHIFT) $1,690.00 OPERATED TRUCK MOUNTED ATTENUATOR $1,250.00 ,FLAGGING OPERATION,2 LABORERS(1-8 HOURS) $1,650.00 PILOT CAR OPERATION,3 LABORERS(1-8 HOURS) $2,650.00 RUMBLE STRIPS,PER SHIFT $300.00 ONE LABORER W/TRUCK AND EQUIPMENT(1-8 HOURS) $1,250.00 ADDITIONAL LABORER(1-8 HOURS) $775.00 **MTC REQUIRES MINIMUM OF 1 HOUR FOR SET UP AND 1 HOUR FOR PICK UP** OVERTIME:(AFTER 8 HOUR SHIFT) • HOURLY RATE PER LABORER $125.00 WEEKEND RATE:(FIRST 8 HOURS ON A SATURDAY OR SUNDAY)**NO EXCEPTIONS** • RATE PER LABORER $350.00 CANCELLATION:(ORDERING MTC PERSONNEL TO REMAIN ON STANDB-BY ON SITE WILL BE BILLED AS A FULL SHIFT) • 4 HOURS PRIOR TO START TIME NO CHARGE • DIRECTLY AFTER 4 HOURS PRIOR TO START TIME UNTIL SHOW UP(2 HOURS PER LABORER) $100.00/HR • DIRECTLY AFTER SHOW UP(4 HOURS PER LABORER) $100.00/HR CANCELLATIONS:(100+MILES FROM COMPANY ADDRESS) • LESS THAN 24 HOURS PRIOR TO START TIME(4 HOURS PER LABORER) $100.00/HR RAMP NOTIFICATION SIGN,EA $250.00 FUNDING SIGNS,EA $2500.00 RENTALS Rental units provided upon availability and ONLY BY REQUEST(advance notice required) MTC Delivery Personnel will only deliver rental units to a central location and do not place rental units per plan. Contractor assumes full responsibility for theft,vandalism&any damages incurred. All units on rent shall remain on rent unless"called off"by the contractor. PORTABLE RADAR SPEED FEEDBACK SIGN,(EACH) • MONTHLY $740.00 • DELIVERY,EACH $150.00 • PICK UP,EACH $150.00 PCMS BOARDS,(EACH) • DAILY $245.00 • WEEKLY $530.00 • MONTHLY $950.00 • DELIVERY,EACH $150.00 • PICK-UP,EACH $150.00 ITRAFFIC CONTRfll: pekedlumpIIIor.I erewper I-ShrsM/t I "MTC REQUIRES MINIMUM OF RR FOR SET UP AND 1 RR FOR PICKUP" SEE ATTACHED PRICE LIST FOR CANCBLATION CBARGPS EXCLUDES 1 • Traffic comol plans.LCS training.submittal.calling in.cancelling closures through TMC CONSTRUCTION ARRA SIGNS: All signs&materiel used are the property of MTC upon completion of correct. INCLUDES: • INSTALL&REMOVAL • BLACK PLASTIC COVERS FOR STANDARD DETOUR PACKAGES IF REQUESTED AT INITIAL THE OF INSTALL(OPTIONAL:if requested at initial time of instal,2x4 plywood coven far srad eed detour packages:SIO each EXCLUDES, • Maintenance,date changes,relocation,replacement if damaged • Mast arm installation,installation&removal of overhead signs • Funding Signs,unless otherwise stated above(see attached price list for additional costs) -PRICING VALID FOR 30 DAYS •PLEASE SEE ATTACHED PRICE UST FOR ADDITIONAL SERVICE,MATERIAL,EQUIPMENT COSTS -MTC DOES NOT DO TRAFFIC CONTROL PLANS -ANY CCO WORK IS A MINIMUM OF 8 HOURS. NO EXCEPTIONS! •IF REQUIRED,ADDITIONAL INSURANCE,LICENSE,PERMITS WILL BE AT THE CONTRACTORS EXPENSE- -IF BOND IS REQUIRED.FEES TO ACQUIRE BOND WILL.BE ADDED TO CONTRACT&BILLED TO CONTRACTOR. -ANY ITEMS SOLD ARE SUBJECT TO ADDITIONAL SALES TAX -NO RETENTIONS ARE TO BE HELD ON ITEMS SOLD OR TRAFFIC CONTROL SERVICES PROVIDED -ALL SALES ARE NET 30 MTC MANERI TRAFFIC CONTROL,INC. BID/QUOTE ;skin to jerk To Query Form Main (licenseForm•htm) Content Search Returned 1 Mon Sep 0914:46:15 PDT 2019 Records Query Criteria Certification Types:DBE Firm ID:38078 Finn ID 38078 DOA Nam. MANERI TRAFFIC CONTROL Firm Name MTC Address LInel 47423 RAINBOW CANYON RD Address Line2 City TEMECULA State CA Zip Code1 92592 Zip Code2 Mailing Address 4949 2ND STREET Unel Mailing Address Une2 Mailing City RAINBOW Mailing State CA Messing Zip 92028 Coded Mailing Zip Code2 Certification DBE IYPe EMafl mmaneri®maneritrafficconkol.com; Contact Name MARIA MANERI Area Code 951 Phone Number 695-5104 Extension Alt Area Code Alt Phone Number Extension Fax Area Code 951 Fax Phone 695-5105 Number Agency Name DEPARTMENT OF TRANSPORTATION Counties 01;13;19:30;33;36:37:40:42;56; Districts 04;05;07;08;11;12; OBE NAICS 238990;532411;561990; ACDBE NAICS C9907 CONSTRUCTION EQUIPMENT RENTAL;Cn0o0 FENCING;C5620 ROADSIDE SIGN;C8390 Work Codes METAL RAILING:C1211 TRAFFIC FLAGGERS;C1200 CONSTRUCTION AREA SIGNS;C1201 TRAFFIC CONTROL SYSTEM;r.00320 METAL BEAM GUARD RAILING; LicensesC13 Fencing Contractor,C31 Construction Zone Traffic Control Contractor,C61 Limited Specialty Contractor;042 Sign Installation; Tuoke Gender M Ethnics y HISPANIC Firm Type DBE TRAFFIC(ONdRrx• Priced lamp suns.I crew per I-4hr shift •I aMTC REQUIRES MINIMUM OF I HR FOR SET UP AND I ER FOR PICK UP.. SEE ATTACHED PRICE LIST FOR CANCEIATION CHARGES EXCLUDES • Traffic control plans.LCS training.submittal.cell!ng in.<mooning downs through INC CONSTRUCTION AREA SIGNS: All sign&I mo ai used are the property of MTC upon complete of contract. INCLUDES: • INSTALL&REMOVAL • BLACK PLASTIC COVERS RA STANDARD DETOUR PACKAGES IE REQUESTE11 AT INITIAL TIME OF INSTALL(OPTIONAL.R.requested at initial time of install.2z4 plywood rovers for saalanl daour Widget,SIO each EXCLUDES: . Maintenance,date changes,relocation,replacement if damaged • Mast arm installation,installation&removal of overhead signs • Funding Signs,unless otherwise stated above(see attached price list for additional costs) -PRICING VAUD FOR 30 DAYS •PLEASE SEE ATTACHED PRICE LIST FOR ADDITIONAL SERVICE,MATERIAL,EQUIPMENT COSTS -MTC DOES NOT DO TRAFFIC CONTROL PLANS •ANY CCO WORK IS A MINIMUM OF 8 HOURS.NO EXCEPTIONS! •IF REQUIRED,ADDITIONAL INSURANCE,LICENSE,PERMITS WILL BE AT THE CONTRACTORS EXPENSE. -IF BOND IS REQUIRED.FEES TO ACQUIRE BONO WILL BE ADDED TO CONTRACT 8t BILLED TO CONTRACTOR. •ANY ITEMS SOLD ARE SUBJECT TO ADDITIONAL SALES TAX •NO RETENTIONS ARE TO BE HELD ON ITEMS SOLD OR TRAFFIC CONTROL SERVICES PROVIDED -ALL SALES ARE NET 30 PO Box 2096 Quote Yorba Linda,CA 92885 • Ph.(714)336-0536 Fax(714)694-0116 Date Quote# Email:k ��» .�.!" im.TEKServ@gmail.com S v E 8/30/22 0506 Name/Address Ship To Select Electric Inc. City of HB 11250 E.Firestone Blvd. Norwalk,CA 90650 Lead Time Terms Rep Project Name/# 8-12 WEEKS ARO Net 30 KI,K City of HB Description Qty Each Price Total BI 20 Utica Ave&Lake St 1 EA 17,266.20 17,266.20 Signals,LED's,Countdowns,Lingo Boxes&Type B PPB's *Controller/Cabinet,BBS&Opticom not included. Delivery:8 to 12 Weeks ARO&Submittal Approval Quote valid for 30 Days. Terms:Net 30, Price subject to change,if order not released within 60 days from the purchase order date. Freight:included Sales tax is not included. Subtotal $17,266.20 Sales Tax (9.5%) $0.00 Total $17,266.20 Skip to Main Content Back To Query Form (IicenseForm.htm). Search Returned 1 Records Tue Aug 30 11:53:43 PDT 2022 Query Criteria Certification Types: DBE Firm Name: TEK Services Firm ID 40540 DBA Name TEK SERVICES, LLC Firm Name TEK SERVICES, LLC Address Line1 5680 VAN GOGH WAY Address Line2 City YORBA LINDA State CA Zip Code1 92887 Zip Code2 Mailing Address 5680 VAN GOGH WAY Line1 Mailing Address Line2 Mailing City YORBA LINDA Mailing State CA Mailing Zip 92887 Code1 Mailing Zip Code2 Certification DBE Type EMail kim.tekserv@Gmeil.com Contact Name KIM KING Area Code 714 Phone Number 336-0536 Extension Alt Area Code Alt Phone Number Extension Fax Area Code 714 Fax Phone 694-0116 Number Agency Name LOS ANGELES COUNTY METRO TRANSPORTATION AUTHORITY(MTA) Counties 19: 30: 33; 37: Districts 07; 08; 11; 12; DBE NAICS 423610;423840; ACDBE NAICS Work Codes C0600 MISC SUPPLIERS; C0686 ELECTRICAL&SIGNALS SUPPLIER; Licenses Trucks Gender F Ethnicity CAUCASIAN Firm Type DBE Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors(DBE and Non-DBE) Exhibit 12-B: Bidder's List of Subcontractor (DBE and Non-DBE) - Part 1 As of March 1, 2015 Contractors(and sub-contractors) wishing to bid on public works contracts must be registered with the State Division of Industrial Relations and certified to bid on Public Works contracts. Please register at https://www.dir.ca.gov/Public-Works/Contractor- Reg istration.html.The local agency will verify registration of all contractors and subcontractors on public works projects at bid and thereafter annually to • assure that yearly registration is maintained throughout the life of the project. In accordance with Title 49,Section 26.11 of the Code of Federal Regulations,and Section 4104 of the Public Contract Code of the State of California, as amended,the following information is required for each sub-contractor who will perform work amounting to more than one half of one percent(0.5%) of the Total Base Bid or$10,000(whichever is greater). FEDERAL PROJECT NUMBER: Photocopy this form for additional firms. ei !1-»'cj\ISk(,q 1) Subcontractor Name&Location Line Item&Description Subcontract Percentage of Contractor License Number DBE DBE cart Number Annual Gross Receipts Amount Bid Item (Y/N) Subcontracted DIR Reg Number NAME ^t <$1 million O� �••�1,,601,, <$5million E�0►�IeNheY� ♦ O 1 W i7�►W <$lomillion Cii1tyn, tal J\�� �� "�+� �' IO 1 ,L-r — <$15million 1 ` IQ��SS � ,Qn 1 OOODO%'T 1 Age years in eCet NAME q ^ $1 million I �\ ` oC-�49e G <$5million 'I`�`t� - 14Nd -Ici n Ii GAR=451°lu �0,53�0 7-a$10 million City,Stale \�\�/\\ r ` <$15 million � � 1� 0 000430Sp D r�l Age of Firm in `� y years N++A''M,E,--uu p •�♦, <$1 million T` �'SAW.eu�Y01 d 101„4 ' <$10miion /� �L4 OO. 5� ,<$lo million City,State T'aN�Le.unk„(\ 1O �A '6�V t S <$15 million F•A\kArlg,`C . lr l aei��a+\ 10W0A3135 YYY Age of Firm in u years NAME r <$1 million YtY +Q1Y'Q[t% t o E ♦7su�` p <$5million t.�N\\` - v♦7 Y 455') <$10 million City,State � litect.M ) %taoo:'� 561p (�(�(� ¢g \JJ <$15millicn 4�%v?xS�dEe.♦CA lbY\\\‘�1 ®o0D��1�O Age years In l& NAME <$1 million 6—Lk ,...<$5 million ‘17Cetia S � ,S �y�LO a$10million City,State �``_`pfl� 1\JIdJ' 8�O 1 Y,Lk0q <$15million cbsr♦}ems`CA. vrV` c 1 poot�3tPaq► Age of m in years NAME <$1 million ei1lyoea Kcal ;' 0 a ‘,,LA 151 S <$5 million <$10 million ���,° e <$15million City,State LOOPS yr� p Li)L—_CJL7l`J J O �y —7 4 v 1 ` A Age$of1 Firm In 4(041.0 Ob0 W� I l 1 years �� NAME l!� �n ,^ <$1 million -Ati� r♦JtCJib 1..1-$•. piNgUp•A ♦ 1Q�1�% <L •(i---<$5 milli n I „ / ii.4O �Tt) <$10million City,State 11�°1�►10�� `,QOIO p.,.,�.n`\e./ �lA <$10million 'SAW L� Age of Firm in 10V10. 1ara01.♦()% years NAME <$1 million <$5million <$10 million City,Slate <$15 million Age of Firm in years NAME <$1 million <$5million <$10 million City,State <$15 million Age of Firm in years Distribution-Original:Local Agency File;Copy:DLAE w/Award Package C-26 Page 1 of2 September 2021 Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors(DBE and Non-DBE) Exhibit 12-B: Bidder's List of Subcontractor (DBE and Non-DBE) - Part 2 In accordance with Title 49,Section 26 of the Code of Federal Reg ulations,the Bidder sh all list all subco ntractors who provided a quote o r bid but were notselected to participate as a subcontractor on this project. FEDERAL PROJECT NU MBE : Photocopy this form for additional firms. CAL— 5\C6 bo0 Subcontractor Name&Location Line Item&Description Subcontract Percentage of Contractor License Number DBE DBE Cert Number Annual Gross Receipts Amount Bid Item (YIN) Subcontracted DIR Reg Number NAME <$1 million EIS Caarep 1 —1 1 9 OO1�v 1 n <$5 million Ettvyp ",y� , �1\fl1 2.5V <$lomilllon City,State <$15 million Co�,�a,CA' Gv' 'OOO003 Age of Firm in .�-�_�.J years NAME <$1 million 9 4 J c11 <$5 million on City,State `CT VINO3c VAS:t <$15million Pa Usf; t CA- %y- ,,1 Oo1`613S3b Age or Firm in 1 y` p1 years NAME <$1 million <$5 million <$10 million City,State <$15 million Aged Firm in years NAME <$1 million <$5 million <$10 million City,Stale <$15 million Age of Firm In years NAME <$1 million <$5 million • <$10 million City,State <$15 million Age of Firm in years NAME <$1 million <$5 million <$10 million City,State <$15 million Aged Firm In years NAME <$1 million <$5 million <$10 million City,State < million Aged$15Firm in years NAME <$1 million <$5 million <$10 million City,Stale <$15 million Aged Firm in years NAME <$1 million <$5 million '<sin million City,State <$15million Age of Firm In years Distribution—Original:Local Agency File;Copy:DLAE w/Award Package C-27 Page 2 of 2 September 2021 N VI 1-1w LN. C C r y o ti N cl 0 d C a) O bA N a o 0� E, a) E E CO k c°0 O .� . a t �° a ,� W U E a o o U v U y 0 o` O N C (is. y a a) asa) I 0 — O O ° n co ii3 ill CC itg Q S.'..0 0 E o - 6 4 a) U c 0.1 N 'c u3 b CIO A t C C C o ea o N. o LL ro ro rt i. 3 o m CACl, '+ CO Y cc C d CL R ca, W p o Z Z o CO �« a) a) -o C Q U _c Z .c W .-,, csic Q p IZ W d W Z ° m 0) m ri a N M/�/� �pa d h+l V1 N F n�0ic F a at II CO p.4O Uj c -J , co K in— < ^c C/] W•� ° 1— m C 0 wto a y i-. can O o3 0 a o 0 a v= H �L 0 W -J y Z Qu. CO' 0 W U O W 0 W _N .p H y W W sh W 'cs o o v N C d Cmp nt D•A r4 o To w a< � 0 Eo W -o W 0 rnso 0 z � � W° Z 0 p N 0; u w 4 +: c is-2 w C c Z c € N W a�i N C a) OO y O in a E U -4 U` EO oo` 3 a .? L `o 0 H T¢ 0 m W N Z is S' y o Z 3 C 0 ti aoi m Q Z co cy Q a Eo ce m c € — a a I . a C. a no E w em ' W ! 0 m d °r 0 0 A 0 w C c W 12 o TQ Q m o > E c C co .-. E 4 o C� o Z C w w A U j r) V < N O ° m m o F c v SV m Q 3 o V ul U 0 —' o m ao H 'D =m - 06 W N wuo Q N oa 6 �a Q La I- -I m O N is E 17 � o ~E 2 0 'F ►i � � o � E O �m �- C L E N LL i ai o cz to F m F u m m o, Cl i a"i`" a .aEio Z 0J (n V 0 U -ro�`` 0 (n.N C N - T Nth ai ` W V! >"i W a 2 1 Ca C 0 a . rx O 7 Q a C 0 >.N w y 3 Op a) U) C C UI N Q O N W C N N N N Z L Z C E 2 U-0 a , Q 00 C H E 5.is ♦- ° cr,C a, 1-tz 44 7 .0 2 2 N a1 IZ' E O 1) C. rN-1 ` co P U mC 5 o Sv Ow or') mo C . ca) � N f °to 0 oC O imC y E U rd1 c U Zti ` Q v 0' I 0 o Z d u < V o O FL.) 0 CO 0 W roro 0. 0 cd 8 O �I° E O m� U J 1 Z u J U U-Z Tn 3 to in 0 Local Assistance Procedures Manual Exhibit 17-F Final Report-Utilization of Disadvantaged Business Enterprises(DBE) and First-Tier Subcontractors INSTRUCTIONS—FINAL REPORT-UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES (DBE) AND FIRST-TIER SUBCONTRACTORS 1. Local Agency Contract Number-Enter the Local Agency contract number or identifier. 2. Federal-Aid Project Number-Enter the Federal-Aid Project Number, 3. Local Agency-Enter the name of the local or regional agency that is funding the contract. 4. Contract Completion Date -Enter the date the contract was completed. 5. Contractor/Consultant-Enter the contractor/consultant's firm name. 6. Business Address-Enter the contractor/consultant's business address. 7. Final Contract Amount-Enter the total final amount for the contract. 8. Contract Item Number-Enter contract item for work, services, or materials supplied provided. Not applicable for consultant contracts. 9. Description of Work, Services, or Materials Supplied -Enter description of work, services, or materials provided. Indicate all work to be performed by DBEs including work performed by the prime contractor/consultant's own forces, if the prime is a DBE. If 100% of the item is not to be performed or furnished by the DBE, describe the exact portion to be performed or furnished by the DBE. See LAPM Chapter 9 to determine how to count the participation of DBE firms. 10. Company Name and Business Address -Enter the name, address, and phone number of all subcontracted contractors/consultants. Also, enter the prime contractor/consultant's name and phone number, if the prime is a DBE. 11. DBE Certification Number - Enter the DBE's Certification Identification Number. Leave blank if subcontractor is not a DBE. 12. Contract Payments - Enter the subcontracted dollar amount of the work performed or service provided. Include the prime contractor/consultant if the prime is a DBE. The Non-DBE column is used to enter the dollar value of work performed by firms that are not certified DBE or for work after a DBE becomes decertified. 13. Date Work Completed - Enter the date the subcontractor/subconsultant's item work was completed. 14. Date of Final Payment -Enter the date when the prime contractor/consultant made the final payment to the subcontractor/subconsultant for the portion of work listed as being completed. 15. Original DBE Commitment Amount-Enter the"Total Claimed DBE Participation Dollars" from Exhibits 15-G or 10-02 for the contract. 16. Total-Enter the sum of the "Contract Payments"Non-DBE and DBE columns. 17. Contractor/Consultant Representative's Signature-The person completing the form on behalf of the contractor/consultant's firm must sign their name. 18. Contractor/Consultant Representative's Name- Enter the name of the person preparing and signing the form. 19. Phone-Enter the area code and telephone number of the person signing the form. 20.Date -Enter the date the form is signed by the contractor's preparer. 21. Local Agency Representative's Signature-A Local Agency Representative must sign their name to certify that the contracting records and on-site performance of the DBE(s)has been monitored. 22. Local Agency Representative's Name-Enter the name of the Local Agency Representative signing the form. 23. Phone-Enter the area code and telephone number of the person signing the form. 24.Date -Enter the date the form is signed by the Local Agency Representative. C-29 Page 2 of 2 July 23,2015 Document A310 TM — 2010 Conforms with The American Institute of Architects AiA Document 310 Bid Bond CONTRACTOR: SURETY: (Name,legal status and address) (Name,legal status and principal place 4-business) Fidelity and Deposit Company of Maryland Select Electric, Inc. 1299 Zurich Way, 5th Floor This document has important 2790 Business Park Drive Schaumburg, IL 60196-1056 legal consequences.Consultation Vista, CA 92081 Mailing Address for Notices with an attorney is encouraged 1299 Zurich Way, 5th Floor with respect to its completion or OWNER: modification. Schaumburg, IL 60196-1056 (Name,legal status and address) Any singular reference to Cityof Huntington Beach Contractor,Surety,Owner or 9 other party shall be considered 2000 Main Street plural where applicable. Huntington Beach, CA 92648 BOND AMOUNT: 10% Ten Percent of Amount Bid PROJECT: (Name,location or addres.and Project number,!law) ) Utica Avenue Bicycle Boulevard Project on Utica Avenue between Beach Boulevard and Main Street CC No. 1499 The Contractor and Surety arc 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 arc such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents,or within such time period as may be agreed to by the Owner and Contractor,and the Contractor either(1)enters into a contract with the Owner in accordance with the terms of such bid,and gives such bond or bonds as may be specified in the bidding or Contract Documents,with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Owner,for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof:or(2)pays to the Owner the difference,not to exceed the amount of this Bond,between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perlurm the work covered by said hid,then this obligation shall be null and void,otherwise to remain in lull Ibree and effect.The Surety hereby waives any notice or an agreement between the Owner and Contractor to extend the time in which the Owner may accept the hid.Waiver of notice by the Surety shall not apply to any extension exceeding sixty(60)days in the aggregate beyond the time fur acceptance of bids specified in the bid documents,and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty(60)days. If this Bond is issued in connection with a subcontractor's bid to a Contractor,the term Contractor in this Bond shall be deemed to be Subcontractor and the tern 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 herel'rom and provisions conlbrming to such statutory or other legal requirement shall be deemed incorporated herein.When so furnished,the intent is that this Bond shall be construed as a statutory bond and not as a common low bond. Signed and scaled this 22nd day of August, 2022. Select Electric, I . • (Prime 1) ,(Seal) e /sf tat r� ,.VD P p,rrpot r Fidelity and Deposit Company of Maryland '4 ,F�' ited d, (Sur e09 (.Sea Z a eo,n (Win►ecr) Kim Luu 7:14 /�d/l,i ' S1IUtJX21 SOByU,� �r 1W��1 tTrile)Heather Saltarelli,Attorney-in-Fact q,vr111,014g 5.0054/AS 8/10 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 ..a.f':�Ns�<'e:f'.:e/s:<%rt.aCl f.t i vte'ANi.<Tc!•.!T<%f�Ni+e/y�t!s </ <fiN::: �i�c�Y::f•:�ta�<•-a�f::C•,ri<•:t!::<".f•-::c.t:<:..••.:.N-<.e�ait: -.t!a�N.•�N A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of Orange On AUG 2 2022 before me, Leigh McDonough,Notary Public Date Here Insert Name and Title of the Officer personally appeared Heather Saltarelli 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. >„ MCDONOUGH Notary Public-California my WITNESShand and official seal. _,,�,�:� P = - ?_ Orange County ,AVa4cs3 Commission#2352964 '• L My Comm.Expires Mar 25,2025 Signature Signature of Notary Publ 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 — f_; Limited f1 General Partner -- 'Limited General Individual x Attorney in Fact Individual f. Attorney in Fact Trustee C;Guardian or Conservator Trustee Guardian or Conservator Other: Other: Signer Is Representing: Signer Is Representing: 's:�ssE�.'7.d<•SE�E4'SiclT:eti7eC'SeZY!r.'C�itAe43itSSiG<�siYSeGs:dlSsGSe�11Gt.Set<'TAl7�(<'T+icajv'SecSLv-SitSSeGsevSeZZ ©2014 National Notary Association•www.NationalNotary.org• 1-800-US NOTARY(1-800-876-6827) Item#5907 CALIFORNIA ACKNOWLEDGMENT CIVIL CODE§ 1189 r. -c-ac ,r," s, c r<;rc:�..r >,.at..r-r c�-oer-.,,r-N,�r� e,ax>s.(rs,NN-r ..rc ,4-oc-<>. c.cc, aesev.F•as-C— n c rc acYc�rc A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of San Diego On Aug 29,2022 before me, Ruth Masaichi, Notary Public Date Here Insert Name and Title of the Officer personally appeared Sam Passanisi 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. 45�. .`ti MpSAICHI Notaryri Ca Public lifornia WITNESS my hand and official seal. 1 San Diego County ~` w r Commission M 2356962 My Comm.Expires May 10,2025 Signature 44-1-t- - Signature of Notary Public Place Notary Seal and/or Stamp 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 P---s: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Si•• 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 - servator ❑Trustee ❑Guardian or Conservator ❑Other: ❑ Other: Signer Is Representing: Signer Is Representing: ©2015 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 Bond Number Bid Bond Obligee City of Huntington Beach ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That the ZURICH AMERICAN INSURANCE COMPANY,a corporation of the State of New York,the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY,a corporation of the State of 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 Heather Saltarelli its true and lawful agent and Attorney-in-Fact,to make,execute, seal and deliver,for,and on its behalf as surety,and as its act and deed: any and all bonds and undertakings,and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes,as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland.,in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V,Section 8,of the By-Laws of said Companies,and is now in force. IN WITNESS WHEREOF, the said Vice-President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND,this 19th day of June,A.D.2019. ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND ie MN. SEAL By: Robert D.Murray Itt, " a '.7 Vice President 1.0 By: Dawn E.Brown i,`1'a�r 10°° �a,#' Secretary 4. * •�+ State of Maryland County of Baltimore On this 19th day of June, A.D.2019, before the subscriber,a Notary Public of the State of Maryland,duly commissioned and qualified,Robert D. Murray,Vice President and Dawn E.Brown,Secretary of the Companies,to me personally known to be the individuals and officers described in and who executed the preceding instrument,and acknowledged the execution of same,and being by me duly sworn,deposeth and saith,that he/she is the said officer of the Company aforesaid,and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies,and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed my Official Seal the day and year first above written. ,trump,,, '10 t;r its on.. ,/ Constance A.Dunn,Notary Public `p' My Commission Expires:July 9,2023 ���rrrntl ttt EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V,Section 8,Attorneys-in-Fact. The Chief Executive Officer,the President,or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys-in-fact with authority to execute bonds, policies, recognizances,stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney-in-fact to affix the corporate seal thereto;and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate;and I do further certify that Article V,Section 8,of the By-Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney...Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th day of May,1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice-President, Secretary,or Assistant Secretary of the Company,whether made heretofore or hereafter,wherever appearing upon a certified copy of any power of attorney issued by the Company,shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF,I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this 22nd day of August ,2022 w�ltlur�� g cJs�k�ytb �`jA REAL Ass° Brian M.Hodges,Vice President TO REPORT A CLAIM WITH REGARD TO A SURETY BOND,PLEASE SUBMIT A COMPLETE DESCRIPTION OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BOND,THE BOND NUMBER,AND YOUR CONTACT INFORMATION TO: Zurich Surety Claims 1299 Zurich Way Schaumburg,IL 60196-1056 www.reportsfclaims@zurichna.com 800-626-4577 1, 6 Q O 2 ' , W) GC z M x 5 o Q, . .. d = w 0- u. LUJ F- °_ Li u>', ce r-1 = z O U (v) y..►-0 , Q al al I.- Q LU c2 1-V- c+a ' J 00 O ec..r _ = LEA W O o CO a0 u o u p W —J 0 L. V `� W Z U Qo Lu Z ° c p U V) Z U 0 U = F- Q LU O 1 Cr Q z LLJ LN 0 U p p * L1 Z 0 1-- o D H II 0 •E., _,.,(„,„„) . 7,_ ot ,.. p_, ,___, cn r, ,c, W ijilt CA"3 0 CZ1 2 'r) N a a YY `Y