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All American Asphalt - 2023-06-20 (2)
Recorded in Official Records, Orange County Hugh Nguyen,Clerk-Recorder IF IOI011 III I 11111I IIIIHFI I II III NO FEE * S R '0 0 1 4: 6 2 '8, 7 6 2 •.$. .* PLEASE COMPLETE THIS INFORMATION 2023000264923:1.1:50 am"1.0130123 371 NC-5 N12 1 RECORDING REQUESTED BY: 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:Joseph Fuentes 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 Ail American Asphalt,who was the company thereon for doing the following work to-wit • Arterial Rehabilitation,Project#CC 1690 That said work was completed 10/26/2023 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 10/26/2023,per City. Council Resolution No.2003=70 adopted October 6,2003. That upon said contract Fidelity.and Deposit Company of Maryland,was surety for the bond given by the said company as required 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. Ce t6? /0.130/23 Director of PfiblIc Works or City Engineer Date City of Huntington Beach,California STATE OF CALIFORNIA) • County of Orange. ),ss: City of Huntington Beach .) I,the undersigned,say:.I am an Agent of the City of Huntington Beach,owner in fee,in the foregoing NOTICE OF COMPLETION: I have read said NOTICE OF COMPLETION and know the contents thereof;the same is true of my knowledge. I declare under penalty of perjury that the foregoing Is true and correct,and that said NOTICE OF COMPLETION was duly and regularly,ordered to be recorded in the Office of the County Recorder of Orange County. This document Is solely the official business of • .z . . . 45 the Clay. of Huntington Beach,as contemplated � under Government code section 27383 and Dire ore b ie Works or City Engineer Date should be recorded free of charm. 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:Joseph Fuentes 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 All American Asphalt,who was the company thereon for doing the following work to-wit: Arterial Rehabilitation,Project#CC 1690 That said work was completed 10/26/2023 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 10/26/2023, per City Council Resolution No. 2003-70 adopted October 6,2003. That upon said contract Fidelity and Deposit Company of Maryland,was surety for the bond given by the said company as required 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. /1.:e2 Public �7 Cityor Director of Pu is Works Engineer Date City of Huntington Beach, California STATE OF CALIFORNIA) County of Orange )ss: City of Huntington Beach I,the undersigned, say: I am an Agent of the City of Huntington Beach,owner in fee, in the foregoing NOTICE OF COMPLETION. I have read said NOTICE OF COMPLETION and know the contents thereof;the same is true of my knowledge. I declare under penalty of perjury that the foregoing is true and correct,and that said NOTICE OF COMPLETION was duly and regularly ordered to be recorded in the Office of the County Recorder of Orange County. This document is solely the official business of177, ) J30/ the City of Huntington Beach,as contemplated / under Government code section 27383 and Diredor f ublic Works or City Engineer Date should be recorded free of charge. City of Huntington Beach, California THIS PAGE IS ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION (Additional recording fee applies) RECEIVED BY: cm CITY CLERK RECEIPT COPY �) \ Return DUPLICATE to J I a City Clerk's Office (Name) after signing/dating -11(Date) z, 12� CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: City Treasurer FROM: City Clerk DATE: SUBJECT: Bond Acceptance I have received the bonds for 7-4//,/ini r /I 7 —4114' ! (Company Name) CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. - -0L/3L/ Payment Bond (Labor and Materials) Bond No. �13 hf 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 te/20/'?3 (Council Approval Date) CC No. (7(—/0ela Agenda Item No. c 3 •y5S MSC No. City Clerk Vault No. 00 0.CD Other No. SIRE System ID No. c '35?/.55.2, g:/forms/bond transmittal to treasurer FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND ALL AMERICAN ASPHALT FOR SAYBROOK LANE REHABILITATION,CC-1690 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 ALL AMERICAN ASPHALT , a California corporation ,hereinafter referred to as "CONTRACTOR." • WHEREAS, CITY has solicited bids for a public works project,hereinafter referred to as "PROJECT,"more fully described as SAYBROOK LANE REHABILITATION,CC-1690 in the City of Huntington Beach;and CONTRACTOR has been selected to perform said services, NOW, THEREFORE, in consideration of the promises and agreements hereinafter made and exchanged,the parties covenant and agree as follows: 1. STATEMENT OF WORK;ACCEPTANCE OF RISK CONTRACTOR shall complete and construct the PROJECT pursuant to this Agreement and the Contract Documents (as hereinafter defined)and furnish, at its own cost and expense, all labor, plans, tools, equipment, supplies, transportation, utilities and all other items, services and facilities necessary to complete and construct the PROJECT in a good and workmanlike manner. CONTRACTOR agrees to fully assume the risk of all loss or damage arising out of the nature of the PROJECT, during its progress or prior to acceptance by CITY, from the action 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/CatTrans-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 ONE MILLION FIVE HUNDRED FIFTY NINE THOUSAND THREE HUNDRED SIXTEEN Dollars ($ 1,559,316.00 ),as set forth in the Contract Documents,to be paid as provided in this Agreement. 4. COMMENCEMENT OF PROJECT CONTRACTOR agrees to commence the PROJECT within ten(10)working days after the Notice To Proceed is issued and diligently prosecute the PROJECT to completion within Forty ( 40 )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 4 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 Contract Documents. CONTRACTOR shall coordinate its work with the work of all other contractors, subcontractors, and CITY forces working on the PROJECT in a manner that will facilitate the efficient completion of the PROJECT and in accordance with the terms and provisions of this Agreement. CITY shall have complete control of the premises on which the work is to be performed and shall have the right to decide the time and order in which the various portions of the work shall be performed and the priority of the work of other contractors, subcontractors and CITY forces and, in general, all matters concerning the timely and orderly conduct of the work of CONTRACTOR on the premises. 6. CHANGES CONTRACTOR shall adhere strictly to the plans and specifications set forth in the Contract Documents unless a change therefrom is authorized in writing by DPW. CONTRACTOR agrees to make any and all changes, furnish materials and perform all work necessary within the scope of the PROJECT as DPW may require in writing. Under no condition shall CONTRACTOR make any changes without the prior written order or acceptance of DPW,and CITY shall not pay any extra charges made by CONTRACTOR that have not been agreed upon in writing by DPW. When directed to change the work, CONTRACTOR shall submit immediately to DPW a written cost proposal reflecting the effect of the change. Should DPW not agree to such cost proposal, the work hall 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. • SFF:17-5732/158097/CalTrans-Federal Contract 6/17 7. NOTICE TO PROCEED No work, services, material, or equipment shall be performed or furnished under this Agreement unless and until a Notice to Proceed has been given to CONTRACTOR by CITY. CITY does not warrant that the work will be available on the date the Notice to Proceed is issued. In the event of a delay in commencement of the work due to unavailability of the job site,for any reason,relief to CONTRACTOR shall be limited to a time extension equal to the delay due to such unavailability. 8. BONDS Only bonds issued by California admitted sureties will be accepted. CONTRACTOR shall, prior to its performance of this Agreement, furnish the following two (2) bonds approved by the City Attorney: One in the amount of one hundred percent(100%) of the Agreement price to guarantee the CONTRACTOR's faithful performance of the work, and one in the amount of one hundred percent of the Agreement price to guarantee payment of all claims for labor and materials furnished. In addition, CONTRACTOR shall submit to CITY a bond in the amount of one hundred percent(100%)of the final Agreement price,including all change orders,to warrant such 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 6 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 items. Upon expiration of such ten- (10) day period, CITY may then make appropriate repair or replacement at CONTRACTOR's risk and own cost and expense. 10. INDEPENDENT CONTRACTOR It is understood and agreed that CONTRACTOR is,and shall be,acting at all times hereunder as an independent contractor and not an employee of CITY. CONTRACTOR shall secure at its own cost and expense, and be responsible for any and all payment of all taxes, social security, state disability insurance compensation, unemployment compensation and other payroll deductions for CONTRACTOR and its officers, agents and employees and all business licenses, if any, in connection with the PROJECT and/or the services performed hereunder. 11. LIQUIDATED DAMAGES/DELAYS It is agreed by the parties hereto that in case the total work called for hereunder is not in all parts and requirements finished or completed within the number of calendar days as set forth herein, damage will be sustained by CITY; and that it is, and would be, impractical and extremely difficult to ascertain and determine the actual damage which CITY would sustain in the event of and by reason of such delay. It is, therefore, agreed that CONTRACTOR will pay to CITY, as liquidated damages and not as a penalty, the sum of One Thousand Dollars($ 1,000 )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 7 SFF:17-5732/155097/CalTrans-Federal Contract 6/17 CONTRACTOR hereunder. For projects on the National Highway System (NHS), the local formula for liquidated damages will be provided. CONTRACTOR will be granted an extension of time and will not be assessed damages for any portion of the delay in the completion of the work due to unforeseeable causes beyond the control and without the fault or negligence of CONTRACTOR, including, but not limited to, acts of God or of the public enemy, fire, floods, epidemics, quarantine restrictions, strikes,unsuitable weather,or delays of subcontractors due to such causes. CONTRACTOR shall, within fifteen (15) days from the beginning of any such delay(unless 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 8 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 • other contractors or subcontractors,will be allowed and an extension of time for completion shall be the sole remedy of CON TRACTOR. 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 physical 9 SFF:17-5732/158697/CalTrans-Federal Contract 6/17 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 notify the DPW, in writing, either within fifteen (15) days of receipt of the DPW's response or 10 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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 1 of the Government Code. For purposes of those provisions,the running of the period of time within which a claim must be filed shall be tolled from the time the time 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 adjustment, upwards or downwards, in payment to CONTRACTOR where the actual quantities 11 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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 drawn in the manner required by law,each payment to be accompanied by a certificate signed by 12 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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. 18. INDEMNIFICATION,DEFENSE,HOLD HARMLESS CON TRACTOR hereby agrees to protect, defend, indemnify and hold harmless CITY, its officers, elected or appointed officials, employees, agents, and volunteers from and 13 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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. 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. 14 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 • 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 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 15 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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 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 16 SFF:17-5732/158097/CaITrans-Federal Contract 6/17 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 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 17 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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. 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. 18 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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. B. Pursuant to the Federal Cargo Preference Act (46 CFR Part 381), the CONTRACTOR agrees: 19 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 (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 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 20 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 (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 etseq.), 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 States Environmental Protection Agency (EPA) List of Violating Facilities, pursuant to 40 CFR 15.20. 21 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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 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 22 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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, 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. 23 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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; provided that CITY and CONTRACTOR, by notice given hereunder, may designate different addresses to which subsequent notices,certificates or other communications will be sent: 24 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 TO CITY: TO CONTRACTOR: City of Huntington Beach ALL AMERICAN ASPHALT ATTN: Joseph Fuentes ATTN:Edward J.Carlson 2000 Main Street 400 East Sixth Street Huntington Beach,CA 92648 Corona,CA 92879 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 CON I1(ACTOR and CITY agree that CITY is not liable for payment of any subcontractor work involving legal services,and that such legal services are expressly outside the scope of services contemplated hereunder. CONTRACTOR understands that pursuant to Huntington Beach City Charter Section 309, the City Attorney is the exclusive legal counsel for CITY; and CITY shall not be liable for payment of any legal services expenses incurred by CONTRACTOR. 25 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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. 43. GOVERNING LAW This Agreement shall be governed and construed in accordance with the laws of the State of California. 26 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 44. DUPLICATE ORIGINAL The original of this Agreementand 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 r 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 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 27 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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 June 20 , 20 23 CONTRACTOR CITY OF HUNTINGTON BEACH,a municipal corporation of the State of California By: .�- .-- Edward J. Carlson ,.-/ �� print name ITS: (circle one)Chairman/PresidentNice President City C erk ' INIT • i D • 'PROVED. AND ffSA _ By: W Dire tor o Public Works Michael Farkas wt.11 ANDA' 'RO ED: print name ITS: (circle one)Secretary/Chief Financial Officer/Asst. Secretary-Treasurer WC; � nager APPROVED • 1 :tk k` ",• ole City Attorney AJ , 28 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached and not the tnithfulness accuracy, or validity of that document. State of California County of Riverside on June 16, 2023 before me, Kenona Nazari, Notary Public Date Here Insert name and Title of the Officer personally appeared Edward J. Carlson and Michael Farkas Name(s)of Signer(s) 1 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/the/their 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. •f rH KENONA NAZARI ; Notary Public•California I certify under PENALTY OF PERJURY under the laws of the State of Riverside County California that the forgoing paragraph is true and correct. ! Commission#2318601 My Comm.Expires Jan 10,2024 WITNESS my h. d .r d official seal. Signature Al- Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law,it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document Federally Funded Construction Contract—City of Huntington Beach Document Date: June 16, 2023 Number of Pages: 28 Signer(s)Other Than Named Above: None Capacity(ies)Claimed by Signer(s) Signer's Name: Edward J. Carlson Signer's Name: Michael Farkas o Individual o Individual X Corporate Officer—Title(s): Vice President X Corporate Officer—Title(s): Secretary ❑ Partner ❑ ❑ Limited o General ❑ Partner ❑ o Limited ❑General RIGHT THUMBPRINT RIGHT THUMBPRINT ❑Attorney in Fact OF SIGNER ❑Attorney in Fact OF SIGNER ❑Trustee Top of thumb here Top of thumb here ❑Trustee o Other: o Other: Signer is Representing: Signer is Representing: All American As'halt All American As•halt EXHIBIT A (Contractor's Proposal) • 29 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 CxH if►vAl SECTION C PROPOSAL for the construction of SAYBROOK LANE REHABILITATION from HELL AVENUE TO EDINGER AVENUE CC No. 1690 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting ELECTRONIC 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 40 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 undersignef agrees that in the-event of the B.IDDER.fS default in executing the, required contract and filing the necessary bonds and:insurance certificates?withio.l0 workingFdays.after the date of the AGENCY'S _notice: of,award of contract to the BIDDEN the;,proceeds of-the security' accompanying tliis::bid shall become the property of the .AGENCY and:this bid.;an:d the acceptance hereof .inay,at the.AGEN•C 'S o ption;die cpnsiteret ult:arid yiiid Accompanying this proposal of bid,find 10%Bidder's Bond ti the,nmoua t of ia ram.::,:; which said amount is not'less,than 10% of the.aggregate of the total; bid price, ,4.t00 red by=the Notice,I.vitro ., ELECTRONIC Bids, payable to the AGENCY (Please insert'the words "Cash", "oertifies Check.", or }'Bidder's Bond for o�",as the;case maybe} Any staridard:Surety Bid Bond form is acceptable B•idder shall signify:�receipt of all Addeer da here3 i£rany : Aitdenda.No., Date.;Receivel Bxdlyde,#VSignatrtre . .... C:2 SAYBROOK LANE (EDINGER TO HEIL) CC-1690 • PROJECT BID SCHEDULE Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount 1 -- MOBILIZATION 1 LS $ 57,000 $ 57,000 2 -- TRAFFIC CONTROL PLAN 1 LS $ 3,200 $ 3,200 3 -- FURNISH PROJECT TRAFFIC CONTROL 1 LS $ 125,000 $ 125,000 4 -- FURNISH AND INSTALL SIGNING AND 1 LS $ 115,200 $ 115,200 STRIPING PROJECT SPECIFIC WPCP(WATER 5 -- POLLUTION CONTROL PLAN)TO 1 LS $ 1,500 $ 1,500 ADDRESS CONSTRUCTION BMP'S. 6 __ INSTALL AND MAINTAIN CONSTRUCTION 1 LS $ 9,100 $ 9,100 BMP'S PER APPROVED WPCP. REMOVE TREE AND ROOTS;GRIND TREE STUMP AND ROOTS TO 24"BELOW TOP 7 2 OF SIDEWALK/GRADE. PULL OUT ALL 23 EA $ 800.00 $ 18,400 - ROOTS WITHIN PROPOSED IMPROVEMENTS. REMOVE STUMP AND ROOTS (NO TREE, ONLY STUMP AT THIS LOCATION);GRIND 8 3 TREE STUMP AND ROOTS TO 24"BELOW 2 EA $ 300.00 $ 600.00 TOP OF SIDEWALK/GRADE.PULL OUT ALL ROOTS WITHIN PROPOSED IMPROVEMENTS. FURNISH AND PLANT NEW 24"BOX TREE, KING PALM-ARCHONTOPHOENIX ALEXANDRAE, PER HB STD.PLANS 714, 715,716,718&719 AS SHOWN ON PLANS. (ITEM INCLUDES EXISTING LANDSCAPE AND IRRIGATION REMOVAL TO $ 1,900.00 $ 47,500.00 9 4 ACCOMMODATE NEW TREE; 25 EA REPLACEMENT OF IRRIGATION IN KIND, BACKFILLING WITH CLASS A TOP SOIL, AND INSTALLATION OF ARBOR-GARD OR APPROVED EQUAL AT BASE OF NEW TREE; 1 YEAR MAINTENANCE AND GAURANTEE) C-2.1 SAYBROOK LANE (EDINGER TO HEIL) CC-1690 PROJECT BID SCHEDULE Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount SAWCUT AND REMOVE EXISTING SIDEWALK AND CONSTRUCT TREE WELL WITH SIDEWALK PER DETAIL ON SHEET 5. 10 5 (ITEM INCLUDES REMOVAL OF SIDEWALK, 25 EA $ 1,190.00 $ 29,750.00 82 SF OF NEW SIDEWALK,NON-CHEMICAL WEED CONTROL BARRIER TO BE DUPONT LANDSCAPE MAX OR APPROVED EQUAL AND MULCH.) 11 6 REMOVE AND RECONSTRUCT SIDEWALK 5525 SF $ 12.60 $ 69,615.00 PER HB STD PLAN 207. , REMOVE AND RECONSTRUCT CURB AND 12 7 GUTTER PER HB STD. PLAN 202(CF=8")• 980 LF $ 108.00 $ 105,840.00 (ITEM INCLUDES CMB, SLOT PAVEMENT AND LOT DRAIN.) REMOVE AND RECONSTRUCT DRIVEWAY CURB AND GUTTER PER HB STD.PLAN 13 8 209 WITH#4 EPDXY DOWEL AT 12"OC. 123.00 53 LF $ (ITEM INCLUDES ALL APPURTENANCES, $ 6,519.00 DEPRESSED CURB&GUTTER,SLOT PAVE,AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT CURB ACCESS RAMP,DEPRESSED CURB,AND GUTTER PER CALTRANS STD PLAN RSP A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). (INCLUDES ALL 9,228.00 • 14 9 APPURTENANCES,CURB GUTTER, 9 EA $ $ 83,052.00 DEPRESSED CURB, SIDEWALK,DOMES, RETAINING CURB, CMB, SLOT PAVEMENT, AND ALL ITEMS FROM ECR TO BCR NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT CONCRETE CURB AND CROSS GUTTER PER HB STD. • PLAN 205.(INCLUDES CONCRETE CURB, 15 10 SPANDRELS,TRANSITIONS,SLOT 1,975 SF $ 21.00 $ 41,475.00 PAVEMENT,CMB,AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) COLD MILL EXISTING AC PAVEMENT TO A 16 11 DEPTH OF 0.1T FROM EXISTING 9,560 SF $ 0.30 $ 2,868.00 SURFACE. COLD MILL EXISTING AC PAVEMENT TO A 17 12 MINIMUM DEPTH OF 0'AND TAPER FROM 74,300 SF $ 0.29 $ 21,547.00 0'TO 0.17'PER DETAILS ON SHEET 5. C-2.2 SAYBROOK LANE (EDINGER TO HEIL) CC-1690 PROJECT BID SCHEDULE Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount CONSTRUCT A 0.17'ASPHALT RUBBER 18 13 HOT MIX(ARHM-GG-C PG 64-16)WET 2,275 TN $ 136.00 $ 309,400.00 PROCESS OVERLAY. REMOVE EXISTING AC PAVEMENT AND AB TO A DEPTH OF 0.67'AFTER COLD MILL. CONSTRUCT NEW 0.67'B-PG 70-10 AC 19 14 DEEP LIFT OVER 95%COMPACTED 3,090 TN $ 155.00 $ 478,950.00 SUBGRADE PRIOR TO PLACING 0.17' ARHM PER PLANS AND DETAIL ON SHEET 5. REPLACE WATER VALVE BOX ASSEMBLY 20 15 AND ADJUST TO GRADE PER HB STD 8 EA $ 1,500.00 $ 12,000.00- PLAN 612. FURNISH AND INSTALL COMPOSITE 21 16 SEWER MANHOLE FRAME AND 5 EA $ 1,900.00 $ 9,500.00 COMPOSITE COVER AND ADJUST TO GRADE PER HB STD.PLAN 513(b). REMOVE EXISTING,FURNISH AND INSTALL NEW TRAFFIC PULL BOX PER CALTRANS STD.ES-8& HB STD.PLAN 422 22 18 AND ADJUST TO GRADE. PULL BOXES 5 EA $ 1,500.00 $ 7,500.00 W/FIBERLYTE LID SHALL BE"CHRISTY FIBERLYTE"OR CITY APPROVED EQUAL. SIZE PER PLAN. LOCATION IS TO BE DETERMINED BY ENGINEER. ADJUST EXISTING SURVEY MONUMENT 23 19 WELL TO FINISHED GRADE.PROTECT 2 EA $ 1,100.00 $ 2,200.00 EXISTING SURVEY MONUMENT IN PLACE. REMOVE EXISTING,FURNISH AND INSTALL NEW WATER METER BOX PER 24 20 HB STD.PLAN 601/603 AND GRADE. PULL 1 EA $ 1,600.00 $ 1,600.00 BOXES W/FIBERLYTE LID SHALL BE "CHRISTY FIBERLYTE"OR CITY APPROVED EQUAL. Total Amount Bid in Figures: $1,559,316.00 C-2.3 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104,the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in - excess of one-half of one percent of the total bid or$10,000,whichever is greater,and the portion of the work to be done by such subcontractor. Bid Name and Address of State Class DIR PWC Dollar %of Item(s) Subcontractor License Registration# Amount Contract Number 22 California Professional Engineering,Inc. 793907 A 1000377609 La Puente,CA C-10 $7,000 .45% C-20 Global Road Sealing • A N/A Garden Grove, CA 757584 C10 1000007714 $9,100 .58% C32 Treesmith Ent. 7, 8 Anaheim, CA 802705 C27 1000001838 $17,750 1.14% 9-Partial Kato Landscape 10-Partial Fountain Valley, CA 806122 C27 1000000086 $47,500 3.05% Chrisp Co. 4 Fremont, CA 374600 C13 1000000306 $108,750 6.97% C32 3- Partial Maneri Traffic Control 1017741 C31 1000043135 $27,000 0 Fallbrook, CA 1.73/o By submission of this proposal,the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY•will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 'NONCVLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER ANI) SUBMITTED WITH Eli) I declare under penalty of penury under the laws of the State of Ca.hfornia that the forregoin as true and correct and that this dectarat>on is executecdd'bn:5111 x3,at are°Coroa ,t 'CA D :City. Steite Edward.! Carlson _ ; eili g��. ,first duly sworn, :deposes and :says that he or .she 1s-. Vice F!esfdent` o AU American Asphai the.party uiakmng;the foregoing 'bid that the'`bid is'not imaade in`the interest of; or on the behalf of, any-undisclosed.per`son,:pership,; company,association,organization,or corpolaiioil,that the bid is genuine.a d not n :collusiye or.-shartnam,tl at the°. bidder has not dire tly of indirectly induced or solicited any other bidder:to putin a false or sham li d, and: has.riot directly or ndirectly colluded,conspired, connived„(*agreed witti any bidder.or anyone else to1)ut •• in a sham.bid, or that anyone;ss`hall refrain ftom bidding;that the bidder:lhas not,in any°manner,directly or. induectly,4so fight by agreeipent;`:communication, or conference with anyone to fix the bid price, or.that of any other bidder, :or to secure any advantage against the public bodi awarding the contract of anyone. interested in.:t}ie proposed;contract, drat:all statements contained in the.bid aree!true, and,further titatcihe bidder has not,directly or iidiredtly,sut ixiitted Ins or her bid price or any breakdown thereof,or the co itents thereof', or d vuj e4 information.or data relative thereto, or,paid, and will not day fee to any corporation ; partnership, 'company association, organization, bid,depository`„ or to any inemher'or agent thereof to: effectuate a collusive or shaixi,brel.. .:... JARI 6meri'csn Asphart _. ... ame of Bidder N ture , , -�- _ • Sign o rider ' Edward J Carr Qr ra President PO Box`2229,,";caroria; CA'92878' .:_ Address;.of Bidder w CALIFORNIA JURAT A notary ptttiltc of other officer cam lettng•thts certificate•veciftes only the identity of the individual W o•sighed•the: docuitientto which this.certificate;is attached,and rigtthe t uthfulness,accuracy,or aridity ol'that document,. • State of'Ca ifornia County-of Riverside: Subscribed andsworfn to (or affirmed) before me on this. 11th da of May Y . .Date . tv oo#1. t: ('I:�` Edward J: Carlson . ;$Iameof,Signer .. • Proved:to me ;on the'oasts;of satisfactory evidence: be the person who appeared''before me(.) (�) and. (2); :Name ofSigner . '�* KENpNA N R1 w{I••• Notary•Pubtic Cahforni0 rayed tc s me) :•. meon osatifactory evidence!nce: Q comlison# be;theperson who appeared ibefOre• , ••• Ai.Camm Expires Jan t o,1024 Signature ', Radii NetarYSnai Above Stgpsture'gf,Nota y Public OPTIONAL. `Though the_information below;Is not required bylaw,i#may prove valuable to person relying on;the documentaiid.coul(prevent.• fraudulent removal and rea"ttachment of this forte to another documents Further Descrription of Any Attached.Document: RIGHT THUMBPRINT RIGHT THUMBPRINT OF SIGNER OF SIGNER Title•or•Type of Document 'Nfln<Collusion Affidavit Top of ijlucrllshete: Top of lhum�x here` Document Date. `5=11-2i323 .-.Number of;Pages.. 1 • • • • $100,06) hOf Than Named,Above" •None. • :.._. • . "�� :�.�"- ' �'��gr-'p-- ' -^�.�= ate. 3—"�' •'� , �, . . A§ipHALT: : . IttN.• •• •, ::•••:....'•: - . ALL,AW ... .•:,,,•• •, ... • AMER..: •----.-.i•.cAN.,AG:01fg.i. Tr•:-,•,:$;:,,. A-i.,t AMER '..--- :. '-' .• ...,-, .:•.- i 7 §467.1 .4.1.,-;,,,4::• :7,----• •• _,' ----7600:,`F 951. .. I9?1=7cr:-:••,.:•:,•::,&. -084•.Vr 116k220idokt)IsiA , .P.9,:. ..,•••. ...., .,,2.6701.3 4c12, '‘‘ ...c.„.,....,, . , . : : AivtIRI_ 'L ., ., ..: ,, ..., :: , , ..... - • —c,,,,....pliArr,......„...,.,_ C, AN ,,---,- .,.,.?. kiTy ENII!!-PY"' AN.EktjX!,OPIPigq , .LICE s11.)1..1;. ,,...:.- . . .„. . . . ..." : N. -UTIO.' . . . . •. „ .., . •.- - • thtirtze ivr...ii. -4•,•-2(W.:•",:6•14.•••.-:•,..:-- i.. ...ii,,..„ .. „., h It Oil:,---': ::‘• ' Company in'44s' ,t,...i.,6,tiltpoiat404,.A1t ,h... fo.., r:i'i,,- -D., 4P.,.'„,:a. - 0 ,..b.eh:ajt.:5fth......e.2,...:,10-2-1 .,and agreements ...•:..: -,,moy... ..--: J:-.. i hat.',,,,,,, ' ..,.t ;66fitt4c,,,,,,::.... --,..:.c.,, .,,,..,.. ,thititighTli J., . - :..R.o." 0.!y .....1.„...,,, ... 0., ..-.,,eke.c12...q... -....,....; ..,::: .:0,.....',4.();,:•=!,..t.:-:, .,.'......: . - 'Edvar4.:1:.'.C41'1siir!.iiit:',•tiOil' '-.11/14)F. I,„....ofPtO!!, -.-- . Monday capacity • ,:. ,.. .. . :.: . • ,•,. . . ,.., ' •,,,. " . • • . ,. -- . - - .,. hail Par ' ' ' ::'. .titeidrit, .:..-.- lqik.1,11.eri-• ,Wiic',.,...... :..1: kas‘ t'e'crei..dry... ... UTILJTY AGREEMENT . EONO.EA 3IL,E M4 OI+`AND C11` 'COUIVCTL CITY`bl: ITTNGTOI REAcx, CALIoRN A • Gettletuei The undersigned hereby promises and agrees that in rthe performance of the work specified to the contrae`t' •Eikn mi as the SA'r ROOK,LANE REIIABILTTATXO? {I)twe)(it)will employ and utilize only qualified° persons, as'hereinafter defined,to work�.tn proxinuty`to any elects oaL secondary or transmission facilitiesY: The term"Qualified Person." ts:definedin,Title;8,California Admii i.stratrve Code,Section 2700,as follows "Quallhiec.;Person ' A pers rulz on o, by neasorr:of exper nice or rnstrtrctron, rs fotr;rlhoY wit 11ic opet'lu to,.be pe#forrneci.q4.4 rhe`4axa,rds im'o1ve w The undersigned also promised nd agrees tbat all such work shad be perfofn ed.to.accorcla�nce vi ith.,all; applicable .elcctracal utility cote says requ remeeits, PublicUtility Co hniissit n orders, tend Mate of'` Cali_ ornta.Cal-OSHA requirements. The thnderstgned further prone e,'s and agrees'that the pro'iistons herein shall be`and afire bi4d ng upon any subcontractor nr subaeontractcirs:;that may be retained or.etriployed h the,'undersigned,.:ra.nd tl afi.the, nnderstgn d shall take stops as are xnecessary to:assure compliance by any said subcontractor of,subcontractors;; with the re9 lrements con tained:lhereit Ail AmericanAsphalt Contractor .:: E gard`.J Carlson„Vice President . Title Date:. 5Ji// . c_s DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder,any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑Yes k21 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 iNS ,tA.NQ CtRTIFLCATE Pursuant to Sectrozx;L 6J.of the State Labor Code, each contractor to whoxri a public works contract has b ey ' awardedshall signthe.fol owixig.certificate I am a vare©fthe provas aps o£ cstion 3 t3(f �flbe labor ode which requue eery employer robe insured against liability for worker's compensation cr to undertake self insurance znaecordance with, that evade, ,and I !all ,comply p ovisr ni }xe£ore commencing the performance ofthe work;of thi t oflr.'act.; All American Asphalfi. Contractor y • Edward J Carlson, Vice President'' Vile •Date;, • / c_ B. DER'S'INFORMATION BIDDER certifies tha' the2.followwin;rnforanation is:ti ue and correct; Al!:American Asphalt Bidder Name • PQ Box'2229'. .., Busuiss:Add ress', Corona,C 92878 :• . City, . :State Zip: 95 736 76QQ . ......... p0.171i rk@ oilattiet.rtanaphaltxc in= ....... - , Telephone Nurtmber• Email A.ddr`ess 267Q73 Class A . State Coritractor';s LieereNo :and Class . Q11.39/19Ti ,:.. Original D!ate-Issued; .. 01/3 �i2O , • ... Expiration•Date' The work site was.ns ected b , Jim f icGee 23 P Y �bf our ofticerriy Mai 9' ;•20lfi' The following are persons;-firms;and corporations haumg a principal interest io t is proposal; Edvard J Catlsoti::. •Vice President : Michael Farkas:: Secretary:_ Mark LUer' President: The undersigned is,.prepared to satisfy't xe Council•of the City of Huntington Beach of'its ability,financially or otierwise,to.perform the contract for the proposed work and Improvements in,,accoriance with the plans: and.speci cations set forth;.'Y ConiAl[AtlOrld. t AA; halt: „: tpany N.am 7 . _. :.:,,. . .,.:, ,,, Signature ofBi der Edward J; Carlson,.Viice,Presrdent Printed.or T ed Si ature • • CALIF.!O►RNIA JURAr•,. Gov cede g il2oz �',- ..' �, J ^` ,.a�""," -y" '`,s.�'•n- 17- T� iL �"'�-.erg. ` �'�' _,°,.,.--s %. ,c:,� e • notary public or other officer completing this certtifIeate verifies only the identity of the intii+iivai�vho.signed'the docutt eitt o t;filch#1iis Cert�fiate is attached,and riot Otto fruthlulriess accuracy,or validity o f that document.;. State.of.Callforn a. • County;of . `Riverside Subscribed •and•sworn'to (or affirmed) before' me on this T:1"th day of May 2O23- Crate Morith`. .. • By(1)• Edward JCarlson' `Namne;of'Signer.. .... Proved fo me on The basis of satisfactory ev Bence be the person who appeared`before me( (and. , itENONANATARt. . • Name of Sinner ' Notary Public California L. Riverside County Proved to me;on the;basis of satisfactory 0Vidence Commission bta601 be:,the erson.who a eared before'me "_°`.. sMy Comm,:Expires Jan tp,2024. Pp • ignatur• • Plae�Kota yS�al Above Signature oNotary pupip OPTIONAL Though the=infonnabon below.is not required by:law It may prove- valuable to person relying omtite document and;tould•prevent fraudulent Temoval;and reattachment'of this•form to another document: Further Description of Any Attached`Document RIGHT-THUMBPRINT RIGHT THUMBPRINT OF SIGNER. OF SIGNER Title;orT ype.of Document ,Bidder s information Top of rhumb here'; Top of lhuaib here DocumentDate. 5-.11.2023 Number of Pagan 1 • Signers)"Other Than Named Above; None. NOTARY' CERTIFICATE: Subscribed and sworn to before me t is dad of :202 .. , A nota[ty public=or other officer completing this :certificate verifies only the;identity of ttie° inividu } who to. whih: .this cetificate is aached nd not the a s h cu trthfln .�accutacy, r valdityo hatdocumnt. ,n • . State of County of ),"... Oa : before . 11rlontti,Dayx ai d Year Insert Nanxe and Title ofNotaryy. personally appeared tames)of Signer(a), who proved to me•on the b i f satisfactory.evtdence to be:the persbn(s)i.hose narne(s)is/are subscribed; to the within insti;umen .; d acknowledged.'to me,that h'e/s40.ili y executed:the same in his/her/their° authorized`ca aci p tyae0 and that,by his/liar/theei spiature(s.) on the•i11St11iment:,the person(s} or tha;entit}�' upon.behatf`of whicli'the person(s) acted,,executed the instrument. .:,f certify i rider PENALTY OF:P.ERJURX under the laws of the $iiter or California that the fo• regoing; paragraph is;true and correct.: WITLESS mY#hand a1id.cif;iciat:seal-; ,. i ` gnahire. .., , Signature'of Notary Public (PLACE 1 CQTA .Ir SEAL ABOVE): • • C. • • • • • • • CONTRACTORS =cal STATE LICENSE BOARD _-.,;4 : '"` ACTIVE LICENSE f7 wi CORP • ..i...4...ALL AMERICAN ASPHALT 4,...w..u.4.1 A C12 4161 • • ' E....O..DO 01/31/2024 www.cslb.ca.gov Luz • • • • • • • • • • • • • .• it • Bidder's Project History For the purposes of this project, the bidder shall provide project history of similar work, specifically referencing the construction of {Describe specific work and experience necessary for project. For example, "Sanitary sewer line installation of at least of 1,000 of 8-inch and greater in public right-of- way. Sanitary sewer lift stations of similar size,project work within public streets,an area containing high ground water and pipeline construction in high ground water regions with trench depths of 8-feet to the invert."}. Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: 1. County of Orange;601 N Ross Street,4th Floor,Santa Ana,CA 92701 Name and Address of Public Agency Albert Rodriguez Name and Telephone No. of Project Manager: Albert.Rodriguez@OCPW.ocgov.com $2,584,747.69 Pavement Maintenance 08/2020 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: JOC Pavement Maintenance 2. City of Huntington Beach:2000 Main Street,Huntington Beach,CA 92648 Name and Address of Public Agency Name and Telephone No. of Project Manager: Joe Fuentes:714-536-5259 $5,181,955.00 Arterial Rehabilitation 11/2020 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Arterial Rehabilitation of Graham St,Slater Ave,Newland Street and Atlanta Avenue 3. County of Venutra:501 Poll Street,Ventura,CA 93001 Name and Address of Public Agency Name and Telephone No.of Project Manager: Christopher Solis;(805)654-2054 $3,919,808.95 Resurfacing Project 12/2019 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Yerba Buena Resurfacing Project C-10 2022 PAST WORK REFERENCES City of Manhattan Beach Slurry Seal of Central Area of Sands Section 1400 Highland Ave. Contract Amount:$730,251.42 Manhattan Beach,CA 90266 Start Date:12/2021 Contact:Bianca Cardenas(310)802-5357 End Date:7/2022 bcardenas@manhattanbeach.gov RMV Realty,Inc. Planning Area 3.1 Street Improvement 28811 Ortega Hwy Contract Amount:$3,996,996.00 San Juan Capistrano,CA 92693 Start Date:4/2021 Contact:Kelly Haymes End Date:4/2022 Ichavmes@ranchomv.com City of Westlake Village Dales Dr.and Parkridge Ave Street lmprov. 31200 Oak Crest Dr. Amount:$1,025,336.00 Westlake Village,CA 91361 Start Date:5/2022 Contact:Roxanne Hughes(805)890-8885 End Date:6/2022 rhughes@willdan.com City of Burbank Local Residential St.lmprov.Project 275 E Olive Contract Amount:$7,761,320.00 Burbank,CA 91502 Start Date:1/2022 Contact:Artin Megerdichian(818)238-3942 End Date:12/2022 amegerdichian@burbankca.gov • City of Highland Pavement Management Program 27215 Base Line St. Contract Amount:$2,082,099.00 Highland,CA 9234 Start Date:10/2021 Contact:Amanda Perez(909)864-6861 End Date:12/2022 aperez@citvofhighland.org • 2022 PAST WORK REFERENCES Toll Bros,Inc. The Metro Heights 725 W.Town&Country Road,Ste 200 Contract Amount:$2,675,250.00 Orange,CA 92868 Start Date:11/2021 Contact:Brandon Haskell(714)347-1360 End Date:04/2022 bhaskell@tollbrothers.com City of Fullerton Miscellaneous Rehab FY 21-22 303 W.Commonwealth Ave Contract Amount:$704,080.00 Fullerton,CA.92632 Start Date:06/2022 Contact:Nick Esposito(714)738-6851 End Date:12/2022 Nick.esposito@citvoffullerton.com City of Norco Corporate Yard Pavement Rehab 2870 Clark Ave Contract Amount:$612,755.33 Norco,CA 92860 Start Date:10/2021 Contact:Chad Blais(951)270-5678 End Date:12/2022 cbkaus@cu.norco.ca.us City of Newport Beach E.Coast Highway&Marguerite Avenue 100 Civic Center Drive Pavement Rehabilitation Contract No.7807-2 Newport Beach,CA.92660 Contract Amount:$3,363,056.00 Contact:Ben Davis(949)644-3311 Start Date:01/2022 bdavis@newportbeachca.gov End Date:10/2022 City of Villa Park FY2021-2022 Slurry Seal Project 17855 Santiago Blvd. Contract Amount:$128,497.60 Start Date:02/2022 Villa Park,CA 92667 End Date:12/2022 Contact:Hamid Torkamanha(714)998-1500 hamid@villapark.org 2022 PAST WORK REFERENCES Local St.Rehabilitation Project City of Norwalk Contract Amount:$1,041,470.00 12700 Norwalk Blvd. Norwalk,CA 90650 Start Date:01/2021 Contact:Damian Rosales(562)929-5527 End Date:12/2022 ilopez2@norwalkca.gov City of Buena Park Eighth Street Rehab Project 6650 Beach Blvd. Contract Amount:$510,000.00 Buena Park,CA 90621 Start Date:1/2021 Contact:Cesar Ortiz(714)562-3689 End Date:12/2022 cortiz@buenapark.com City of Santa Clarita Dales Dr.and Parkridge Ave Street lmprov. 23920 Valencia Blvd.#120 Valencia,CA 91355 Amount:$1,025,336.00 Contact:Juana Alfaro(661)255-4942 Start Date:5/2022 ialfaro@santa-clarita.com End Date:6/2022 Lewis Operating Corp. Meridian Phase 3 Street Improvements 1156 N.Mountain Ave. Contract Amount:$4,947,887.50 Upland,CA 91786 Start Date:11/2021 Contact:Bill Hanson(909)985-0971 End Date:12/2022 Bill.hanson@lewismc.com City of La Mirada Neighborhood Slurry Seal Area 3 15515 Phoebe Avenue Contract Amount:$799,151.00 La Mirada,CA 90638 Start Date:6/2022 Contact:Priscilla Yi(562)902-2374 End Date:12/2022 Priscilla.vi@citvoflamirada.ora 2021 PAST WORK REFERENCES Colony Commerce Archibald St.Improvements C/O Caprock Partners Contract Amount: $1,949,000.00 1300 Dove Street Suite 200 Start: 12/2019 Newport Beach, CA 92660 Completed: 12/2021 Contact: Eric Nutter(949)428-1400 Ext.209 enutter@moote.com Lennar Homes Merrill&Haven Street Improvement 25 Enterprise#300 Contract Amount: $1,481,832.15 Aliso Viejo,CA 92656 Start: 6/2020 Contact:Diane Hannon(949)349-8000 Completed: 12/2021 Diane.hannon@lenn ar.com City of Norco Wayne Makin Park Slurry Seal Project 2870 Clark Ave. Contract Amount: $52,725.89 Norco,AC 92860 Start: 10/2021 Contact: Todd Shank(951)270-5603 Completed: 12/2021 Todd.shank@norco.ca.us Los Angeles Department of Water and Power Pine Tree Power Plant Access Road Repair 111 North Hope Street,L-43 Improvements Los Angeles,Ca 90012 Contract Amount: $810,400.00 Contact:Joelle Morisseau(213) 367-0123 Start: 5/2021 Joelle.morisseau@LADWP.com Completed: 7/2021 City of Dana Point Slurry Seal Project 19/20 33282 Golden Lantern Contract Amount: $1,897,897.00 Dana Point,CA 92629 Start:04/2020 Contact: Scott Fisher(949)248-3577 Completed: 05/2021 sfisher@DanaPoint.org City of Corona Street Pavement Maintenance 400 South Vicentia &Rehabilitation Project No.2020.01 Corona,CA 92852 Contract Amount: $3,471,178.00 Contact:Barry Ghaemi(951)736-2400 Start: 6/2021 bghaemi@Coronaca.gov.Coronaca.gov. Completed: 1/2022 2021 PAST WORK REFERENCES City of Anaheim State College Boulevard Improvement 200 S.Anaheim Boulevard from Ball Road to SR 91 Freeway Anaheim,CA 92805 Contract Amount: $484,848.00 Contact:Jose Cortez(714)765-5039 Start: 8/2021 icortez@anaheim.net Complete: 4/2022 County of Orange Rossmoor Collectors Grind&Overlay 601 North Ross Street Contract Amount: $2,148,320.90 Santa Ana, CA 92701 Start:4/2021 Contact: Stephen Clayton(714)995-0206 Complete: 12/2021 Stephen.clavton@ocpw.ocgov.com . City of Norwalk Local Streets Rehabilitation 12700 Norwalk Blvd. Zone 27 East of Gard—No. 7925.3 Norwalk,CA 90650 Contract Amount: $1,051,330.00 Glen W. C.Kau(562) 929-5723 Start: 6/2021 ulcau@norwalkca.gov Complete& 12/2021 City of Garden Grove Arterial STS.Rehabilitation 11222 Acacia Pkwy Contract Amount: $3,185,281.00 Garden Grove, CA 92840 Start: 6/2022 Navin Mara(714)741-5180 Complete: 12/2021 nmam@ggcitv.org 2020 PAST WORK REFERENCES City of Ontario 2020 Fall Pavement Rehabilitation Project 303 East B Street Contract Amount: $2,499,333.00 Ontario, CA 91764 Start Date: 07/2020 Contact:Ariana Kern (909)395-2129 End Date: 12/2020 akeme.ontarioca.gov City of Loma Linda Pavement Rehabilitation—Barton Road 25541 Barton Road Contract Amount: $768,677.00 Loma Linda, CA 92354 Start Date: 04/2020 Contact: T.Jarb Thaipejr(909)799-4400 End Date: 12/2020 jthaipeir lomalinda-ca.gov City of Jurupa Valley Granite Hill Drive Pavement Rehabilitation 8920 Limonite Avenue Contract Amount: $999,777.00 Start Date:04/2020 Jurupa Valley, CA 92509 End Date: 10/2020 Contact: Chase Keys(951)332-6464 ckevs(a,iurupavalley.orq JOC Pavement Maintenance County of Orange Contract Amount: $2,584,747.69 601 N. Ross Street,4th Floor Start Date:07/2020 Santa Ana, CA 92701 End Date: 08/2020 Contact:Albert Rodriguez albert.rod riquez(a�ocpw.ocoov.com Annual Residential Street Rehabilitation— City of Compton Phase 1 205 S.Willowbrook Avenue Contract Amount: $5,295,068.00 Compton, CA 90220 Start Date: 05/2020 Contact: Brittany Duhn (Z&K Consultants) End Date: 11/2020 bduhnc zandkconsultants.com City of Huntington Beach Arterial Rehabilitation of Graham St, Slater 2000 Main Street Ave, Newland St and Atlanta Ave Huntington Beach, CA 92648 Contract Amount: $5,181,955.00 Start Date: 05/2020 Contact:Joe Fuentes (714) 536-5259 End Date: 11/2020 ifuentesCa.surfcity-hb.orq 2020 PAST WORK REFERENCES City of Newport Beach Cameo Highlands Street Reconstruction 100 Civic Center Drive Contract Amount: $2,425,694.00 Newport Beach, CA 92660 Start Date: 07/2020 Contact: Patricia Kharazmi (949)644-3344 End Time: 11/2020 pkharazmienewportbeachca.gov City of Westminster Citywide Overlay Street Improvements 8200 Westminster Boulevard Contract Amount: $1,131,621 Westminster, CA 92683 Start Date: 02/2020 Contact:Theresa Tran (714)548-3460 End Date: 06/2020 ttranawestminster.ca.gov Crescenta Valley Water District Final Paving of Pennsylvania Ave 2700 Foothill Boulevard Contract Amount: $82,620.00 La Crescenta-Montrose, CA 91214 Start Date: 02/2020 Contact: Brook Yared (818)236-4117 End Date: 04/2020 bvared aOcvwd.com City of Alhambra 2020 HUD Street Improvements Project 111 S. 1st Street Contract Amount: $300,433.00 Alhambra, CA 91801 Start Date: 06/2020 Contact: Robert Bias (626)580-5000 End Date: 10/2020 rbiasacitvofalhambra.oro County of Ventura Yerba Buena Rd. (South) Pavement 800 S.Victoria Avenue, #1600 Resurfacing Ventura, CA 93009 Contract Amount: $2,298,467.40 Contact: Matt Maechler(805)477-1911 Start Date: 03/2020 matthew.maechlerCa�.ventura.orq End Date: 06/2020 Earl Joseph Drive Paving City of Camarillo Contract Amount:$681,901.50 601 Carmen Drive Start Date: 06/2020 Camarillo, CA 93010 End Date: 07/2020 Contact:-Mang Tran (805)388-5345 ttrana citvofcamari l lo.oro 2020 PAST WORK REFERENCES City of Norco 2870 Clark Avenue FY 2019-2020 Slurry Seal Project Norco, CA 92860 Contract Amount: $147,708.97 Contact: Sam Nelson (951)270-5607 Start Date: 0 /20 snelsonci.norco.ca.us End Date: 12/2020 City of Orange Annual Slurry Seal FY 19-20 Various 300 E. Chapman Avenue Locations Orange, CA 92886 \ Contract Amount: $377,737.78 Contact: Martin Varona (714)744-5563 Start Date: 06/2020 mvarona a(�,citvoforange.orq End Date: 12/2020 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. Jim McGee Name of proposed Project Manager Telephone No.of proposed Project Manager: '(951) 736-7600 Edinger Avenue&Atlanta Avenue Project#CC1565 $2,392,858.55 Pavement Rehabilitation 7/16/2019 Project Name& Contract Amount Type of Work Date Completed Santa Ana Canyon Road Rehab $534,553.00 Road Rehab 12/31/2019 Project Name& Contract Amount Type of Work Date Completed Citywide Overlay Street Improvements $1,131,621.00 Street Improvements 6/14/2020 Project Name& Contract Amount Type of Work Date Completed 2. Rick Selph Name of proposed Superintendent Telephone No.of proposed Superintendent: (951) 736-7600 Firestone Blvd Street Improvements $1,648,493.00 Street Improvements 7/18/2020 Project Name&Contract Amount Type of Work Date Completed Prima Deschecha Land Fill $886,663.25 Paving & Grinding 11/3/2019 Project Name&Contract Amount Type of Work Date Completed Bristol Street& Edinger Avenue Class II Bike Lanes $807,839.99 Street Improvements 12/26/2020 Project Name&Contract Amount Type of Work Date Completed C-11 . „ • . . . : ..„ _ :,.coNviacToRt61:$10krtioN.:::waft,co1v0.10440tp.Aitts4tistiT.,,ok:: 1:..* TIST:111AL.:OttATioNS:.(olit) cERTrEicALIk. Purs ,4* .60647 2014, establibed a ew public works Contractor Registration Progrm bich reqiufes all contractors and subeontiactors bidding and performing work oaPub1ic Works Projects tg register 00,111:*1-4340tii.t541kok.o July 1. through June 30 state fisca1 year) with the :Cal:eoiolipop*ttootito Industrial *614060, (DIR) Currently the animal nonrefundable registration fee for Contractors i $ 00 Each contractor to whom a p4b110,w.otksttitiltoot..hs:ii0s'41*.4404:41Atti$40.Ih40110*ifitcertificate pdf • 'I*ti)'--§-:#4Ifilziiiit';•o;kg6M*OWAeti'otf, *): ,t4ioji*aOf?*MOAOgj: ,4tfC46iiii,-' . „ DILs Contractor Registration searchabje database.. 04;40/0.1;.YOR/$*.itcli;:04ip'4' I am aware and will comply with the provisions f Labor Code Section 771 1(a)which statesA contractor or subcontractor shall notl,e qualified to bid on, . . . . . . be listed in a bid proposal,subject to the requiretnents of Section 4104 ofthe Ptiblic Contract Codes or otgggPIIT'tfie;PO10#P#0 of any contract fQr public work as defined in tins chapter, unless currently registered 440 qualified to petform public wQrkpursuantte Section 1725 5 Itis not a vlQlatjon of this section for an unregistered or by SectiOn 10144 or 20103.Sof the Public Contract Cod proyided tim contractor is rgistcred to P• • • _ „ Th popgry coxAtrge.tp.rt,.a5.,well a fOfAtt,-,:$'4000#404ifk:'it the.iii.ii0,.04$1AtOviiitiAt.0,0::40All American AsphIt -;: By Edward J Canaan, Vcë President Date j5 Title . „ . . : . ;P:Ubticheork•$@altaiiiet:100)10sPhOltddriii • . •,, 'PWC Iteii$tektion4k1900091:.051.:' . . . 1/25/23,10:18 AM https://cadir.secure.force.com/ContractorSearch/PrintRegDetails Contractor Information Registration History 1 Legal Entity Name Effective Date Expiration Date ' ALL AMERICAN ASPHALT I Legal Entity Type 5/11/2018 6/30/2019 Corporation ____ _._. _ _ __ _ _ Status 5/8/2017 6/30/201'8 r Active - --- - Registration Number 5/2/2016 6/30/20117 • ' 1000001051 �__ _t _ , _ A. Registration effective date 6/9/2015 6/30/2016 • 7/1/2020 • Registration expiration date • 8/25/2014 6/30/2015 ` 6/30/2023 ___ - -- ,_„ _ - Mailing Address 7/1/2019 6/30/2020 PO BOX 2229 CORONA 92878 CA United States... - - - _- Physical Address 7/1/2020 6/30/2023 400 E SIXTH ST CORONA 92879 CA United State... ,.__ _ Email Address Trade Name/DBA ' i License Number(s) CSLB:267073 CSLB:267073 • Legal Entity Information • Corporation Number: 057879 • Federal Employment Identification Number: President Name: ; MARK LUER t Vice President Name: , EDWARD J CARLSON Treasurer Name: • MICHAEL FARKAS Secretary Name: MICHAEL FARKAS CEO Name: Agent of Service Name: MICHAEL FARKAS Agent of Service Mailing Address: 400 E SIXTH ST CORONA 92879 CA United States of America https://cadir.secure.force.com/ContractorSearch/PrintRegDetalis 1/2 **UPON CONTRACT AWARD** STATE OF CALIFORNIA DEPARTMENT OF RESOURCES RECYCLING AND RECOVERY(CalRecycle) RELIABLE CONTRACTOR DECLARATION CalRecycle 168(Revised 7/13) This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalRecycle) prior to authorizing a contractor(s)to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of funds to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Unreliable List requirement of their Terms and Conditions. The Unreliable List provision requires the following: Prior to authorizing a contractor(s)to commence work under the Grant,the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractor(s)stating that within the preceding three(3)years,none of the events listed in Section 17050 of Title 14,California Code of Regulations,Natural Resources,Division 7,has occurred with respect to the contractor(s). Please see the reverse of this page,or refer to www.calregs.com If any of the events listed in Section 17050 have occurred, disclosure is required but will not necessarily result in CalRecycIe refusing to approve the contractor. A signed statement explaining the facts and circumstances of the events must be attached to and submitted with this form. Contractor: Complete the form and send original to the Grantee. Grantee: Scan the form and upload it to the grant in CalRecycle's Grant Management System(GMS). For further instruction about logging into GMS and uploading this form, reference the Procedures and Requirements. Retain the original form in your grant file. GRANTEE INFORMATION GRANTEE NAME: GRANT NUMBER: PRIMARY CONTACT NAME: CONTRACTOR INFORMATION CONTRACTOR NAME: AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: MAILING ADDRESS: As the authorized representative of the above identified contractor,I declare under penalty ofperjury under the laws of the State of California that within the preceding three(3)yeas,none of the events listed in Section 17050 of Title 14,California Code ofRegulations,Natural Resources,Division 7,has occurred with respect to the above identified contractor. Alternatively,as the authorized representative of the above identified contractor,I declare under penalty of pedwy under the laws of the State of California that within the preceding three(3)years, if any of the events listed in Section 17050 of Title 14, California Code ofRegulations,Natural Resources,Division 7,has occurred with respect to the above identified contractor,I have disclosed all such occurrences in an attached signed statement that explains the facts and circumstances of the listed events. Signature Date STATE OF CALIFORNIA DEPARTMENT OF RESOURCES RECYCLING AND RECOVERY(CalRecycle) • RELIABLE CONTRACTOR DECLARATION C-13 **UPON CONTRACT AWARD** **UPON CONTRACT AWARD** CalRecycle 168(Revised 7/13) Title 14 CCR,Division 7,Chapter 1 Article S.Unreliable Contractors,Subcontractors,Borrowers ana Grantees Section 17050.Grounds for Placement on Unreliable List The following are grounds for a finding that a contractor,any subcontractor that provides services for a CalRecycle agreement,grantee or borrower is unreliable and should be placed on the CalRecycle Unreliable Contractor,Subcontractor,Grantee or Borrower List("Unreliable List").The presence of one of these grounds shall not automatically result in placement on the Unreliable List.A finding must be made by the Executive Director in accordance with section 17054,and there must be a final decision on any appeal that may be filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s)to CalRecycle due to fraudulent claims or reporting;or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act,Government Code section 12650 et.seq; or (c) Default on a CalRecycle loan,as evidenced by written notice from CalRecycle staff provided to the borrower of the default;or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycle;or (e) Filing voluntary or involuntary bankruptcy,where there is a finding based on substantial evidence,that the bankruptcy interfered with the CalRecycle contract,subcontract,grant or loan;or (I) Breach of the terms and conditions of a previous CalRecycle contract,any subcontract for a CalRecycle agreement,grant,or loan, resulting in termination of the CalRecycle contract,subcontract,grant or loan by the CalRecycle or prime contractor,or (g) Placement on the CalRecycle's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility;or (h) The person,or any partner,member,officer,director,responsible managing officer,or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud,bribery,collusion,conspiracy,or any act in violation Of any state or federal antitrust law in connection with the bidding upon,award of or performance under any CalRecycle contract; subcontract,grant or loan;or (i) The person or entity is on the list of unreliable persons or entities,or similar list,of any other federal or California state agency;or (j) The person or entity has violated an Order issued in accordance with section 18304;or, (k) The person or entity has directed or transported to,has or accepted waste tires at,a site where the operator is required to have but does not have a waste tire facility permit;or, (I) The person or entity has transported waste tires without a waste tire hauler registration;or, (m) The person or entity has had a solid waste facility or waste tire permit or a waste tire hauler registration denied,suspended or revoked; or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRecycle to remediate,clean,or abate a nuisance at the site;or (o) The following am additional grounds for a finding that,a person or entity described below should be placed on the Unreliable List: (1) The person or entity owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director,manager,partner,trustee,or any other management position with significant control(Principal Manager)in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person who owns 20%or more of the entity,if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (5) The entity has another entity which owns 20%or more of the entity,if that other entity: 1. Is on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (6) Subsection(o)is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-14 **UPON CONTRACT AWARD** HOUSiNG`AND URBAN DE ELO1�.IV.IENT'ACT`OP 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24�Code ofFederal Regulations,1'art 135* Epptio arc-.Opporl i fies or Low and Very+Low Ihcorne P.e sons The `i lder,under pezt lty of perjury,certifies than except as noted below,:any person nssoctafed theret nlh in-:'thc-capacity of o vuer partner;direetor, 4 cer? or plft.eager(ii.4..4g:lie a has ile 4relee4s zs);: • • **NOT APPLICABLE** Will eiisttra#fiat 14�/o"of a7t;new hires as reiiIt. of this j roject shall,m eet all;requirements of Sectior3= of Part 135 of thexHUID Act of I68,or-; **NOT APPLI CAB LE** Ua11 hire no ribs eniproees'ut copjunctioin{l ; >this eject **NOT APPLICABLE** 'Will avward 14°O of is sub=contracts to Setion`3` ltts�nes`ses, Arts certrfcation shall apply#o the pxtzne cont3ractor',s;;sub contracts:telatet to this project< Cant ecfo All,Arner� an Asp aIt .-.. Contact Person. .r=dwarci J anson' Vice President Confect Phony 9a�1,73 76OC1 Signed. � '. Gate ; -�1 f • *Not'e The above cetti icatroti rs required by Elie Department-,of Housing and Urban Development(�4 CPR: 135;and Sut title er al}° and rhust-tie submitted by th brdders and propose¢ sub'=contractors only in connection.with contracts.and subcontracts which are':s#ibj eet to°Section 3 of the 1968 Housing and:Urban; Da . elopment Act,as amended iA T992=.(RUD. ev. I revious n+rn=com iiancewith Sectfon.3 could.result in di�scin bfcntron EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION All American Asphalt 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-16 x. PU 4.BLIC CONT T,CODE PUBLIC CON XRAGT cot SEGUON t.028S 1 STATEMENT: : Ttr conformance ith t1 lio Contract Code Section TO 85 . (Chap e '16, Stats 1985), the.bidder hereby: declares; under penalty of pO.Pury,uttter tie laws;of the Stateof Caltfornma;tliat the bidder.:,. has been, asnot bear;couvtetecl within the preceding three years cif any offenses referred to in°that seetLon,including and ohar0 offrad, brabt�ry, collusion,. cons racy :or anys other"act�n:vtolati n .of any state or Federal antitrust law connection with t e bidd ng upon,awar d of, or.perfortnatice of,,any public vror1cs contract,as efined: n;. l'ttbl c Contract Cede Section 11,01,with any p tblie en tty,a defi edx rn Public: orttract Code ection= l.l005,tnclt ding thy;Regents of the Un verst j+ of Caltforti a or the Trustees of,the California Mate; Uniwexstty.:The.t "erm bidder"tsunderstood toainclude any partner,.nembe officer,director,responsible' managing officer,of t espoustble managing emplFoyee thereo f;as re ferred tt to eetwn 10285,1, .R Nate'; The.bidder nicfst plact a clteokmtirk after "had" ar'14s noi'r in one of the blank spac0s ptovtsled,Th ::: ove Statement ts:pan of the Proposal Si g this Propo at on the signature portion4hereof shall also constitute iguature af`ilus Statement,Bidders are Cautioned that;:ttialCttrg°afolse ertihcat on:may subject."the.cer[ffei to: Crtttt nrtl rosecution • / <" ..>C dvractll CartsAn,rVre PreS�de�it .._ Stgna ;PrmtName pate° : PtiJ3Uc CONS r Cony SEcrrol� 1G2�?tJESTZONNAIRI ln.cpnfgrmance ith Public Contract Corte Section :10162s the Bidder shaft complete under penalty of . perj uy--he follo ing gitestiot nacre: Has�t`he bidder,ati officer of t fie bidden,or any employee of the bidder ii has;a proprietary:interest in the bttider„'ever been. drsqualt ed remove or oil etwtse preventocl from bidding tin; or completing a- federal;ystate,ar local govex iilie ltprolect bea us ova violation n law or a safety rtrg latton? Li Yes' No If the ans�c et°is yes,;explain the circumst ances;:in e followi space . • PUBLIC CONTRACT CODE 1:0132 STATTMEJT • Ini conformance w thPudic Contract Code Section 10232,the Contractor,4erebystates underpen>aity:of perjuxsi that no ore tha one f riat una�peafatal,firrdingof coutesnpt`o court by a feder l courthas be n issued against the Contractor .ithi.n;the; uzimediately, preceding two year period"because of ttie' Contractors:failur to cotr ply with an order of if federal count which orders the;Contractor to comply *ith an order of th6:National Labor I elatiQns Board:; Note The-abase Statement and-Questtortua1:earepartoftn.ePxoposai Signing thisProposaloo. the signature portion:thereof shalt also constitute signature-of this;Statement a:n ' Questionnaire Bidders are cautioned that making a$als+ certification may subject the certif er to er mutual osecu xon.• i=4war J C.Oripon,Mice Preside it . i I $iguiifON. Print Name . Dire; rC1$. • „ . ',$00.011.4001J!Affi44*.k: (Title'23 Uiited States Code Section 112 and Fubhc Contract Code Section 7106) •to,,f40;'ett*:''..itit:t tijtiittiikiiiit:116a6h, , . • ., - • -•„, DEROPMEAT OFPIJELIC lfrOMT, ',Irt-tiOhfartiiittod:;*ith:Titk-aamtitt4:slaitoti,000$4:40#11g*o.pigli00....44744p.04* 7:106,:f46,:,iii440...:;061.00*.tii0,140"1-!id;j*::iiOf:madein the interest of or on behalf of: the b.1,44:kogui0.**x)ffig':00iii$WO;*' '114*;:lS4.t..,!:::00:*100)*',74..o '4*owy induced or s9hcited aiiy other bidder'to ut in a fklse or sham bid, and has not directly or or indirectly indirectly conspired, 0oxiiiied,;!i*igt*t*ftit.gosr.bfctctof,:orAily444A.tg:to..,put : . • m a4iam bid, or that . .anyone shall refrain from bidding,•. . „ anyone to ix thee bid price of the ;lifoa07,.6i,•*Ay other bidder,or to 1ic or cost element of the bid puce or of that of any other bidder,or'to sectire any advantage agam lic body . : " • •• : . J not;,directly or ct1y submitted his or her bid price or any breakdown thereof:or the contents the,reof: ordivulged information or data relative therto or paid,and will not pay, i'•a",tiY:feeto(diikottp-otAtioti, 0:00:** .fAiP0(*15.4.0Y:c0$4,44tio4'i,,t)fg0,W#00:0 bid depository, or to any member or agent thereof tQ effectuate i colhisive or shata bidN.*c The above Nonco1lusjon AftiaviLi pain pf the Proposal Sgnmg This Proposal on the signature ii0004g140pf4oktocr00*.i..i.440.4g000:0,-„olfti4N04, 04,1,000,Affidavit • Edward iLtartsom':Vica:Eresident::: • lit 123 " CALIFORNIA ALL-PURPOSE ACKNOWIEDGEMENT. °CIVIL.'CODE§118 A notaiy pltbll,C tar other of teer t.ompletin this certificate verifies only the identity of.the individual who signert.tht:, document to whiich this'certifiicate is attach era;and'nnt th etitithftiln c.aeriiracv nr`validiiv f:.that•document: :State of California. County of Riverside ,. . on May 11,2023 before m' e, .._ 'Keftona 'azari,Notary Public r. Date Here ins eti naSne and Tttie;af the Ortrcer . µ0.*.ri ilty�appeared . Edward J Carlson'..... . t Nan etsl ots tWr(t): who;,proved;to me bn the:basis of satisfactory evidence to be the:: persons) whose ath ne(e) is/a subscribed to the..,'within:instrument and ac(no"wledged :to me"that heist ey executed the samein hi *eS4 a author.'ized capac1ty(ies), and that: by hisiher�eii slgnature(s)(on the instrumeritthe person(s)�orthe.entity upon-bettalf : pt*i ich the.perso,,h(s)acted executed tits instrtitnenf< KENONANAZARI Notary.Pliblic*Caiifornia , _` ' Riverside county 1 certify under PENALTY OF:PERJURY under the laws oftfie State of= = Commissfonk23i85G1 California#ttetthe forgotng:paregteph is trUe,arsd,corredL .. 'hfy O92-i-Xiiires Jail 10 2024 ` ... WITNESS.my h rid a d.offic al seal;• Signatur . #talcs Notary Seal A1?9 : ' •' ,, Signature or_(+;otary,Pubfc ' O.PTfONAL • Though the information below is not required•by law it;may prove valuable to peisan relying on the document o and could prevent:fraurdulent removal and reattachment f thin form to;another;docum ent 'Description of•Attached;Document Ti'.tle-or Type,of Document- Non-Collusion Affidavit City of Huntington 3each�•. : • Document::Date: _ May 11;:2023 °Number ofPeges :1° Signer(s):Other Titan Named Above None . Cepacity(ies) Sigrn Claimed by er(s) Signers Name: Edward'J Carlson signer's i ame a Individual o Individual f.X Corporate Officer Titie(s) Vice-President' a Corporate•.—... r-`Ti .:. . a Partner 0 a Limited ci C3enertl ci Partner Q,a;Limited u Generai . RIGHT THUMBPRINT ' '• • RIGHT THUMBPRINT o Attorney in f act; AAtfarneyrn l=aot or SIGNER of siGNFR ; ta'Trustee TY�p of t*b hero Tog tlt`#humb he+ie a Trustee:: ' ❑`'Other, p Other:; Signer is,l epresenting: • Signer is)3epresenlJng: All Ameritert At Their, :: -.^s,°sue, oz.� �" '—.i z�a _> � �- �; n - . m a . ,. fDEBARME' NTAND',$ITSPEtsISION'CORTIVICATION':: I1ria49 CODE,0P FEDERAL ObtAli(*§..'PART,.2 ': lhoi.bitl(1i,,i),)40:OppoAkt:Ot prjury%-e6.01116i44:except 4. ''4iio-feiti,belii*:.iieiiiii or ..--:. ,..... .; ., 00,YI4.110:04.004,* 040.t0:1;1.4007040.40!"00::otiog eity.orowitgillartfteki diittedbf. officer,iri1404 .:0';,, i s .-.ii...iiqt,0400.440q.# 1400*.debarment;:voluntary oxatigol #'40.0tit***of i#06,ibi*.i*OY 44411$000Y • 'has not 1*.e.iiistitOodect(i)014i*&*ottiiitkills:40004:o:46totitiliiod,iii. by f.,e6r.atak6ne '.. ir?itliik:010.P#$ti3';-yo.arg .; .44,*-)ii00.A04.44-44160iiii4iiiiiinaitiiedfid:: . . ,' „has'iiotiiitooitliialeted,06ii*lotott or had a. ivitiefitgii4iitt4iidei:64:4Afirtfit it69' court of tciiii0feilt. ji.OdktiOil;'OYoy::itdtto;ii.iypiyfog,o*tit0pftWitv.004:44§t*taijfkg*i*t'3Ae.*. ''tf-i40k2.40-*.'-400.#0.*041iii'kee#.i..40410041*.0,#:*:(C#4500.4:'iA..i,ha:*liowi#g$04.00.,:' **N/A** Exceptions will not:iiee*o.til.y. .i- tiiiii,,iii -denial: of: award, but will -1)0,-.y.,Ocitl:ii4001 iii-'0010r34144,.041.* • responsibility For*W.OXPOPOP.O40i40:abPv0i,inglioto.1?.49w:40.*hOglit'4p1i0iiiAtioipg.4gotioy,400.4at-4'.01•-..'..- .,..: ..,: -..p:"tio'il- . ::• : ' Notes f::Pjxiviclu,g 4ilgelitiftiknIttian*AY:f0<ilf40"ijuli01',0i90-004igy4t-di-iiitiitrativp sanctions 111 •APY: 00408#00.-iPir,;of 4,,ii$Ttp0$61:•-SitiOg'14*.:Pt0044Y0it(0*::44.100**-6,4,41i*Olf shalt also(;,0i3Oiti4t0if$03.1tiltO.Of:.01.ik'Ctti.,i'kaiititi.-, ......- ,, . , , . 4412'i Z z, Edward.I..corton,.VIcitt..Poitidow .,5 .,. , ,......,:. ..., . . 0:" ' ,'',•Viiti„04:onds' . . ..:.. :- "'Y- . ,_ ,__, .„, , •: . :: ,. ...„„„.,.. • • . NONLOBBYINO CERTIFICATION FOR•FEDER J;L Ati.CONTRACTS:: The4prosp 1:00.piii# .4.1i i if es;.by signs xgand siibmitting this id oi'proposal,to:the best"ófhis orher: kno ledge arid. belief,.dial; . ,:(1) No Federal appropriated funds:have been paid or grill be paid,by:or on;bekhalf of the undersigned;; to any person for u fluencmng or attemptingto influence pan officer or employee ofAny Fe4era1:.: agency,a Member of Congress,:a i. off cer or employee of Congress,or an employee ofa Member of Congress tri connection witf then awarding of any Federal contract,the making of any Federal • grant, the puking of any Federal loan, the entering;into of any oopperative agreement,.and:the extension,continua i':cik renew, il,ameiidment,of modification of ariyFederaL co itract,grant,leap,. or-cpo .e*rive 0graemeut; (2) Ifany funds other than Federal appropriated funds:have beenn paid or wil l be paid.td any person lot:iotio nc or attempting to influence-an officer orpemployee of arty Federal agency, ,. Member of Congress, an officer or -employee of;Cotigress, oran eu pl4yee:of a.Member,of Congress in connection with this Federal contract,.;grant, loan,.or cooperative'•agreement, the undersigned shall, complete and submit. Standard Form,,-.14.:'Disclosure* of Lobbying= Activities;"ire conformance with its Instructions : . This certification is'a material represe ntattion of fact upon Which reliance �'as placed'ihen this.t ransact on;, was or:;entered into Subnmission of this certification is:a prera utsrte forma Ling or;entering into this; transaction imposed,by Section 1352 `Title 31,, LTA, Code Any person"*ho 'fails to%file.the regnued< certification shall,l%e'subject to a:civil.penalty,of not less °than,$10,QQQ a id not,more,than. 10Q?D0Q foi" each suchfailure The prospective participant also agresbye ub itt mg has or het bid orproposal that lie or•she shall require that th'e larrgnage of this certifaeatioi he included in all4lower tieris tbeantracts,*hich e cceed$:1QQ;Q00, and ihat all.s ch sul recipients shall .certify and disclose accordingly;: - I � -... ./1/ Edwards GaFt0 Vice[fr.i0.0.§. t gnotii : Print Name' "Date . Cf2I F. Local Assistance Procedures Manual Exhibit 15-G 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 ❑ a. initial b. grant b. initial award b. material change c. cooperative agreement c. post-award d. loan For Material Change i nly: e. loan guarantee year quarter f. loan insurance date of last :.ort 4. Name and Address of Reporting Entity 5. If Reporting Entity in No.4 is S .awardee, Enter Name and Address of ' ire: ❑Prime ❑Subawardee Tier ,if known Congressional District,if known Congressional Dis •ct,if known 6. Federal Department/Agency: 7. Federal Progra Name/Description: CFDA Nu• .er,if applicable 8. , Federal Action Number,if known: 9. Award :41.ount,ifknown: 10. Name and Address of Lobby Entity n. 'duals Performing Services (If individual,last name,first name,MI) cluding address if different from No.10) (last name,first name,Mi) (attach Continuatio S. et(s)if necessary) 12. Amount of Payment(check all that apply) 14. Type of Payment(check all that apply) S ❑ actual ❑planned a. retainer b. one-time fee 13. Form of Payment(check all that apply): c. commission ea. cash d. contingent fee b. in-kind;specify:nature e deferred Value f, other,specify 15. Brief Description of Services P• ormed or to be performed and Date(s)of Service,including officer(s),employee(s),or m•.,ber(s)contacted,for Payment Indicated in Item 12: (attach Continuation Sheet(s)if necessary) 16. Continuation Sheet(s •ttached: Yes ❑ No 17.Information requested . .•gh this form is authorized by Title 31 U.S.C.Section 1352 .is disclosure of lobbying reliance Signature: was placed by the ti .above when his transaction was made or entered into. .s disclosure is required pursuant to 31 Print Name: U.S.C.1352. .• information will be reported to Congress semiannually a•a will be available for public inspection.Any person who . s to file the required disclosure shall be subject Title: to a civil r •ally of not less than S10,000 and not more than S100,00'for each such failure. Telephone No.: Date: Authorized for Local Reproduction F• •eral Use Only: Standard Form-LLL Standard Form LLL Rev.04-28.06 Distribution: Orig-Local Agency Project Files EXHIBIT 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 C-22 January 2019 • Local Assistance Procedures Manual Exhibit 15-G 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-- of reported,enter the year and quarter in which the change occurred. Enter the date of the last,previously submitted report by this reporting enti yror 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. any 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. iply 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name,if igc[ 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 a" 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),, ii number,Invitation for Bid(IFB)number,grant announcement number,the contract grant.or loan award number,the application/proposal con�ro). number assigned by the federal agency). Include prefixes,e.g.,"RFP-DE-90-001." ' 'r 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. .'nv 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 arfed Middle Initial(Ml). rat' 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). 1=;'t 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. i 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. I,.. 17. The certifying official shall sign and date the form,and print his/her name title and telephone number. one Public reporting burden for this collection of information is estimated to average 30-minutes per response,including time for reviewing instruction,searc1i#rg existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send comments regardinglthe burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden,to the Office ofManagement and Budget; Paperwork Reduction Project(0348-0046),Washington,D.C.20503.SF-ILL-Instructions Rev.06-04 Construction Contract DBE Commitment r: 't lhg mire feet, C-23 January2019 ' 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 shall be registered with the State Division of Industrial Relations and certified to bid on Public Works contracts. Please register at:https://efiling.dir.ca.gov/PWCR/ActionServlet?action=displayPWCRegistrationForm 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). Photocopy this form for additional firms. Federal Project Number: Subcontractor Name and Line Item&Description Subcontract Percentage of Contractor DBE DBE Cert Annual Gross Receipts Location Amount Bid Item Sub- License Number (Y/N) Number contracted DIR Reg Number Name: California Professional Engineering,Inc. 793907 (� <$1 million ❑ <$5 million City,State: 22- Electrical $7,000 0 45/o Y 31'277 Di < 10 million Le Puente,CA 1000377609 <$15 million Age of Firm: 25 yrs. ato Landscape 9-Partial King Palm - ❑ 1 million 806122 <$5 million City,State: Install $47,500 3.05% N **N/A**. <$10 million Fountain Valley, CA 10-Partial Weed 1000000086 0 <$15 million Barrier Age ofFirm:30 yrs. Name: - Global Road Sealing N/A 757584 • ❑ <$1 million ❑ City,State: Crackseal $9,100 .59% s _ Y �331176 � Fio millionmiill Garden Grove, CA 100007714 0 <$15 million Age irm: 20 yrs. Name: 1 million Treesmtih Ent. Remove Tree 802705 5 million City,State: Remove Stump $17,750 1.14% Y 35817 ®lo million Anaheim, CA 1000001838 CI <$l5 million Age irm: 10 yrs. Name: I million Chrisp Company 4-Signing&Striping 374600 El 5 million City,State. $108,750 6.97% N **N/A** sr l0 million Fremont, CA 1000000306 15 million Age of Firm:20 yrs. Name: ❑ <$1 million Maneri Traffic Control 3-Partial Traffic Cily,State. Control $27,000 1.73% • 1017741 El <$5 million Y 38078 . � Flo milli on <$15 million Fallbrook, CA 1000043135 Age of Firm: 20yrs. Distribution: 1)Original-Local Agency File 2)Copy-DLAE w/Award Package C-28 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 subcontractor who provide a quote or bid but were not selected to participate as a subcontractor on this project.Photocopy this form for additional firms. Subcontractor Name and Line Item&Description Subcontract Percentage of Contractor DBE DBE Cert Annual Gross Receipts Location Amount Bid Item Sub- License Number (Y/N) Number contracted DIR Reg Number Name: 0 Rubberized Crackfiller Sealant,Inc <$1 million City,State: Crackseal $13,000 .59% 998877 _ p <$5 million N **N/A** � <<$10 million Fullerton, CA 1000010726 n <$15 million • Age ofFirm:_0yrs. Name: Superior Pavement Markings 776306 ❑ <3 million City,State: 4 - Striping 6.99% **N/A** ❑ <$5 million $126,844 N ❑ <$10 million Cypress, CA 1000001476 6 <$15 million Age of Firm: I 5yrs. Name: PCI ❑ <$1 million In o 415490 ❑ <$5 million City,State: 4 - Striping g $168,175 6.99/o N **N/A** 6� <$to million Azusa, CA 100813536 - 0 <$15 million Age of Firm: 24rs. Name: ❑ 41 million City,State: ❑ <$5 million El <$10 million ❑ <$15 million Age of Firm:_yrs. Name: ❑ <$1 million El <$5 million City,State: ❑ . <$I0 million ❑ <$15 million Age of Firm: yrs. Name: ❑ <$1 million City,State: CI million ❑ <$10 million ❑ <$15 million Age of Firm: yrs. Distribution:1)Original-Local Agency File 2)Copy-DLAE w/Award Package C-29 Local Assistance Procedures Manual **UPON CONTRACT AWARD** 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 5.Contractor/Consultant 6.Business Address 7.Final Contract Amount 8. Ite Contract 9.Description of Work,Service,or 10.Company Name and i1.DBE 12.Contract Payments 13.Date 14.Date of Number Materials Supplied Business Address Certification Worts Final Number Non-DBE DBE Completed Payment 15.ORIGINAL DBE COMMITMENT AMOUNT $ 16.TOTAL List all first-tier subcantractors/subconsultants and DBEs regardless of tier whether or not the fines were originally listed for goal credit.If actual DBE utilization(or item of work)was different than that approved at the time of award,provide comments on an additional page.List actual amount paid to each entity.If no subcontractors/subconsullants were used on the contract,Indicate on the form. I CERTIFY THAT THE ABOVE INFORMATION IS COMPLETE AND CORRECT 17.Contractor/Consultant Representative's Signature 18.Contractor/Consultant Representative's Name 19.Phone 20.Date I CERTIFY THAT THE CONTRACTING RECORDS AND ON-SITE PERFORMANCE OF THE DBE(S)HAS BEEN MONITORED 21.Local Agency Representative's Signature 22.Local Agency Representative's Name 23.Phone 24.Date ' DISTRIBUTION: Original—Local Agency,Copy—Caltrans District Local Assistance Engineer.Include with Final Report of Expenditures ADA NOTICE: For individuals with sensory disabilities,this 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. **UPON CONTRACT AWARD** C-30 Q Fria . _ , , , Fideli, . and De�� osit Copan of:Marla BID:',BONA:F KNOW ALL MEN BY TxESE PRESENT$t.hat we: • _AU,. AItERICAN AS I,LT ;.$OND Na,00:97423 as Principal,(hereinafter called;the"PnicipaF),and PiDELiTY:A1 D DEPOSIT COMPANY OF MAR'YLAND .. ,.. corporation duly organized under thelaws of the:State o f.littnols as Surety,(hereinafter-called the"Sta ety"),are held andbmily bbound unto' CITY OF i-31N.TINGTO d BEACH as.Obbgee,(heretnafter;calied the"Obligee°).in the sum:of Ten Percent of Totat Amount Bid Dollars($ 10%of Bid. ),for the payment of which sum welLand truly-to be•made,the said Pnncipal°F,: and the said Surety,bind ou serves, our"heirsi,_executors,•administrators;•successors••and•assigns jointly acid severally,; irm1yby these presenter:. WHEREAS,tie Pxmcipal has submitted a bidfor SAYBROOK 0.*REHABIIJTATIOI`1-Project No 1 H94 Bid Dates. ;Maki'16;2023 NOW,TIIER$FORE if the Obliges shall accept thebid•of the Pnnclpal•and the Principal shall enter into a contract' -with the:Obliges in accordance with the terms of such bid and give such bond orbonds as maybe specified iu`the bidding .or contact docu rents wi good and sufficient surety far:the faithful performance':of such oritract and for;the prompt .payment of labor and metered furimhed i the prosecutwn:thereof,;:ox.m the event of the failure of the Principal to•enter. :into surd,contract and give such,k and or bonds,if,the rincipalshall pay to.the.Obliges the>difference.not to:exceed..:the ;penalty jiereof beEween the amount specified to said bid and such:larger amount for whicchthe Obligee may in good;faith contract with another party to perform"the•work covered:bysaid b i, e thn:this obligation shall be nt l:and void,otherwise `ao remain in frill force$rid:effect: Sig•nedaudsealedthus 9th day of MaY,'' AD 2023 :. ... (--- AL.T AME121G'AN ASPHALT•~`- Pxtnet i c ae: . may :$� tYttness � (SAL) FIDE.LITY, ND:DEPOSIT COMPANY`OF MAT&'YLAND. -Surety ..: itt rt z.i A ;)' Rebecca Haas Bales -' x. .._ .�srsv�,nrrY��n.Fact B,ID7oaooug7. f::;. .CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT CIVIL'CODE §1189; f5.notary public or other o1 icer'eon pletiiig thrs certificate verifies only the identity of.the indhhdualwho.signed the` dacumcntMwhtch,this.certiffcatei§attac1tod 8nc1:ttritth4,trnitiAitneca accuracy prValtdify,nfthat.doctiment: SfBte ot4?alifatni ,, County of Rrvertideri . on May TI .:2O23` before rrre, IKenonaNazari,Notary Public- Date: .. Hite inse[cname enQ7lte of.fhe 105.ei. •p ared ersoaatiy Edward J n�Cariso .and.M.chael Parkas : a `'ppe i.40*)orSugntf(s) who;provefrfo rrie:fan ttte basis of satWactoty evidence to iae tiffs persons) Whose names) is/are subscribed.to the:within instnimeht and;acknowledged,to me that' tielsheftheir.executed the .same it: hisl their.:; authorized capacity(zes), and that by t 1e3thei signature();on the Instrument the person(s)F:or the entity upon behalf, " '` " " " ` "` of which the persons)acted;executed the instrttrrient }f HO NAZpRi Natgi abut_:California" s y'. I certify under PENALTY OF PERJURYunder the„laws of the State.o•f j.,�,� ;Riversde County . rr.� Coinmission#2318601 California#hatthafbrgoingparagraphtstrueandcorrect.` -," htY Cat tm Expires.Jan 10 2024 .:: WITNESS:my icialseal. Stgtiiatur ' ".PiaceNotarySeai;bava • gignaiureofNotaryPublic, ' OPTIONAL . ..._.... 'Though the mformatron be►o*is not required by law,it may prove valuable to person relying on the document . and.:could prevent fraudulente rmoval and reattach"ment of this-forrrt to anpfher:dgcuiiient:: . ;Description of`Attachet Document tle or Type of Document BidLBond=City. o.Ti f Huntington`Beach D Document ate; May 99.2G23' .. Number.of-Pages.;:. :3 • Signer(sj Ottter'1`han Named Above-:..Rebecca'Ha at Bates,'Attorney-in Fact;... . Capacity(ies)Claimed by Signer()". • Signer's Name Edward-:) Carlson Signers Nartia. .°M'iahaal`Fark'a's: ❑individual' x Corporate Officer Titles) Hite President. .. . X Corporate affiser-:Ttte.(s):. Saarefari:: a Partner t]a f.imited a;General a Partner U a;Limited a:General RtGHT THUS;SPRINT RIGHT THUNIVR[NT :a Attorney in Fact n�strh�-RSIGNER.. >?Atfarney•iri Fact` of a Trustee; Tof+�,ii,Umbhote: Top afttium{3here a TrUSteE. o Other.. .. ti Other_ Signer is:;Representing Signer Is epresenting. All A eritan As. tt::.� Amen ,i`.� al .... .. .. . 6 z CALIFORNIA ALL.-PURPOSE ACKNOI.00.EDGMEN'T CIVIL COD eJ 1189; A notary pudic or other officer comi7lehng this certificate verifies only the identity of the Individual who storied the document•to which this certificate is attached,,and not the tn.ithfuiness,accuracy,or Validity•of that,documennt,:., State,of California . ). County of Orange .... On:05/00/2021 . before me�L Gon ez,I' otaiy Public, • :: Date:; Here Insert Name afro Title of the':;Gib er' personally,appeared ebecca.Haas=;Bates :, Namef$,,of Sgne11$: who proved:to me on the basis of satinfactnry evidence to be the person'.whose:name( .is1; e.. hsusecr bedto hhe withn insrument and acknowledg,edto me that /she/tzsy executed te:sam in,. sherriptsrautorize capacty,adthat ay hhe/thersigrtattir.0 ontheinstillment•the pesons or th entty:upnbeaf fwhichtheeiiiris acted execethe instruent:o t m . t certify under PENALTY OF PERJURY under:�the laws ''r'..':.'.•,,'„0'',t.1.--2..,.-..,4...,1.1 6.7••.•4:,-.,11i,6i,.'6.11.-. of the State of California that the foregoing peeepeepl coMi is trice.and. correiat K ` Notary 4i t)ii Catirorn : is true:n m Hand arils at se I. orangeCounry. ,.. Y ffiof._.... a. Commission'24i3fi&2 em s'" My Gomm t xpite#A,iE 2t:2026 Signi�ture .. Si"-nature of;IV ryPyblic: Place Notary Seal Above OPTIONAL Though this sectio 0 is oational, completing this•-information can deter alteration>of the clbcumerit or fraudulent reatfachmeiit.of this form to an•unintended Description'of Attached Document Title or Type`of Document , Bid Bond Document Date: 05/09f2023. .. Number of Pages :One(11, Signer{s) Other Than Named Above: .All American Asphalt. Capacitylies):Claimed by Signer(s)':' • Signer's Name Rebecca Naas-Bates ; Signer's Nam: . Q Corporate Officer--•Title(s) .. Q Corporafe`Officer`—Titfe(s) •Q Partner ,p Limited , ii.General : Q Partner Q Limited 0'Generaf o:in,...,. l:v:.i,,d,,pel•� , ififiAttorney in Fact 17 individual Q Attorney in Fact o Trustee =[.'Guardian or.GonserVator 3.T4fde. aUardian tE ZOn s- ervator:' Q Other D Other• Signer:Is Representing: Signer 1s Representing Fidelity and Deposit Company of'Ma yland - . Q2014 National Notary Association•www.NetionalNotary org.1-800 US VDTAR1 (1800=876-6827) ltet r. 907;, 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, iecognizances,stipulations,undertaldngs,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,Secretary of the ZURICH AMERICAN INSURANCE COMPANY,the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FJD13LITY 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 ofthe ZURICHAMERICAN 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 ofthe Company may be affixed by facsimile on any Power ofAttorney...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 orviechanically reproduced seal ofthe 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 9th day of May • 2023 • ...40071141IN, cum. issa to, 4r 17fa,eyati'1��� 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.rcnortsfclaimst@zurichna.corn 800-626-4577 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 William SYRRIN, Rebecca HAAS-BATES, Sergio D. BECHARA and Richard ADAIR, all of Irvine, California,EACH,its true and lawful agent and Attomey-in-Fact,to make,execute,seal and deliver,for,and on its behalf as surety,and es 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 Yoric 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, MaryIand.,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 11thi day of June,A.D.2019. e+rwt4..4 .°46 1. j cure 46 Y � s: (RAI I. titoAnn 01441' ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND By: Robert D.Murray Vice President 44Rg j et:4 teT S w°,a By:DawnE.Brawn � ¢ ▪ rtl Secretary (+?s� (' x 4 1 0+. State of Maryland r`b.S,°J 4T County of Baltimore r' On this 11th day of Sun; A.D.2019, before the subscriber,a Notary Public of the State of Maryland,duly commissioned and qualil-re Rbb• "d 6 Murray,Vice president and Dawn E.Brown,Secretary of the Companies,to me personaltylnown to be the individuals and officers described in and who executed the preceding instrument,and acknowledged the execution of same,and beingby me duly sworn,deposetit and saitb,that he/she is the said officer of the Company aforesaid,and that the seals affixed to the preceding instrument me 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 WIffiffiOF,I have hereunto set rnyhand and affixed my Official Seal the day and year fast above written. • !uw b r%Y�s. Ce'►►do-414 •cA+r _fit u�,s<,1J . , ?;�� > Constance A.Dunn,Notary Public ++;k�'�.�`� My Commission Expires:Iuly 9,2023 gtrgittp' city of Hu itington Beach Public Work ar s De tmEent 00`Main w: Stre Tel, (714) 536=:5431:' ADDENbU•M:NUMBE ONE SAYBRoOK LAN t l~ Aa>�Ir, �rla�N FROM HE:1.AVENUE TO ED1NGER AVENUE !op:No 169O Federal`Projec"t Ci Fll a111 i 85 [ntte.: iTY.OF fllf N' I•NG1 O 4 BEACH' May 11,2Q23: Notiee :All Eiddets:• Please n the fatlowin ; latification tb the Project Pla ts,Specifications,and Special Pravisioris • 1) Mai The bid late liar beers extended ftpite Q>)OA M,ofT'x►esday,May16,202 'r to"1C Qp A M:.on i fiuesiaY,,f1aj+ i,2t323'.. • • . • •RaplaeedSianma end Striping Plans:: 0gning.and striping plans have bent replaced in Planet Bids and titteel'`CC •esp Signing ar c Stiiping;Plans anal A-1'1 i'' -"these plans should:ka used for lfdcling<project,. This is tag aeknowlerl a receipt skid review of Alden um tstum$r Orte;dated above.« Rlf YNner eats sphalt g ,E • CampatiY•Name By : wa J Garlsor, ice President Date. ...... ......m.. ... rill:.bidders:mustaikilewtedge and,include the receipt of•thi Addendum.with-your bid proposal: EXHIBIT B (Required Contract Provision For All Federal Aid Construction Contracts FHWA 1273) 30 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 FHWA-1273—Revised July 5,2022 REQUIRED CONTRACT PROVISIONS FEDERAL-AID CONSTRUCTION CONTRACTS performed on the contract by the contractor's own organization I. General and with the assistance of workers under the contractor's II. Nondiscrimination immediate superintendence and to all work performed on the III. Non-segregated Facilities contract by piecework,station work,or by subcontract. 23 IV. Davis-Bacon and Related Act Provisions CFR 633.102(d). V. Contract Work Hours and Safety Standards Act Provisions 3. A breach of any of the stipulations contained in these VI. Subletting or Assigning the Contract Required Contract Provisions may be sufficient grounds for VII. Safety:Accident Prevention withholding of progress payments,withholding of final VIIi. False Statements Concerning Highway Projects payment,termination of the contract,suspension/debarment IX. Implementation of Clean Air Act and Federal Water or any other action determined to be appropriate by the Pollution Control Act contracting agency and FHWA. X. Certification Regarding Debarment,Suspension, Ineligibility and Voluntary Exclusion 4. Selection of Labor:During the performance of this contract, Xl. Certification Regarding Use of Contract Funds for the contractor shall not use convict labor for any purpose Lobbying within the limits of a construction project on a Federal-aid XII. Use of United States-Flag Vessels: highway unless it is labor performed by convicts who are on parole,supervised release,or probation. 23 U.S.C.114(b). ATTACHMENTS The term Federal-aid highway does not Include roadways functionally classified as local roads or rural minor collectors. A.Employment and Materials Preference for Appalachian 23 U.S.G.101(a). Development Highway System or Appalachian Local Access Road Contracts(included in Appalachian contracts only) II. NONDISCRIMINATION(23 CFR 230.107(a);23 CFR Part 230,Subpart A,Appendix A;EO 11246) I. GENERAL The provisions of this section related to 23 CFR Part 230, 1. Form FHWA-1273 must be physically incorporated in each Subpart A,Appendix A are applicable to all Federal-aid construction contract funded under title 23,United States construction contracts and to all related construction Code,as required in 23 CFR 633.102(6)(excluding subcontracts of$10,000 or more. The provisions of 23 CFR emergency contracts solely intended for debris removal). The Part 230 are not applicable to material supply,engineering,or contractor(or subcontractor)must insert this form in each architectural service contracts. subcontract and further require its inclusion in all lower tier subcontracts(excluding purchase orders,rental agreements In addition,the contractor and all subcontractors must comply and other agreements for supplies or services). 23 CFR with the following policies:Executive Order 11246,41 CFR 633.102(e).` Part 60,29 CFR Parts 1625-1627,23 U.S.C.140,Section 504 of the Rehabilitation Act of 1973,as amended(29 U.S.C.794), The applicable requirements of Form FHWA-1273 are Title VI of the Civil Rights Act of 1964,as amended(42 U.S.C. incorporated by reference for work done under any purchase 2000d et seq.),and related regulations including 49 CFR Parts order,rental agreement or agreement for other services. The 21,26,and 27;and 23 CFR Parts 200,230,and 633. prime contractor shall be responsible for compliance by any subcontractor,lower-tier subcontractor or service provider. 23 The contractor and all subcontractors must comply with: the CFR 633.102(e). requirements of the Equal Opportunity Clause in 41 CFR 60- 1.4(b)and,for all construction contracts exceeding$10,000, Form FHWA-1273 must be included in all Federal-aid design- the Standard Federal Equal Employment Opportunity build contracts,In all subcontracts and in lower tier Construction Contract Specifications in 41 CFR 60-4.3. subcontracts,(excluding subcontracts for design services, purchase orders,rental agreements and other agreements for Note:The U.S.Department of Labor has exclusive authority to supplies or services)In accordance with 23 CFR 633.102. The determine compliance with Executive Order 11246 and the design-builder shall be responsible for compliance by any policies of the Secretary of Labor including 41 CFR Part 60, subcontractor,lower-tier subcontractor or service provider. and 29 CFR Parts 1625-1627. The contracting agency and the FHWA have the authority and the responsibility to ensure Contracting agencies may reference Form FHWA-1273 in compliance with 23 U.S.C.140,Section 504 of the solicitation-for-bids or request-for-proposals documents, Rehabilitation Act of 1973,as amended(29 U.S.C.794),and however,the Form FHWA-1273 must be physically Title VI of the Civil Rights Act of 1964,as amended(42 U.S.C. incorporated(not referenced)in all contracts,subcontracts and 2000d et seq.),and related regulations including 49 CFR Parts lower-tier subcontracts(excluding purchase orders,rental 21,26,and 27;and 23 CFR Parts 200,230,and 633. agreements and other agreements for supplies or services related to a construction contract). 23 CFR 633.102(b). The following provision is adopted from 23 CFR Part 230, Subpart A,Appendix A,with appropriate revisions to conform 2. Subject to the applicability criteria noted in the following to the U.S.Department of Labor(US DOL)and FHWA sections,these contract provisions shall apply to all work requirements. 1 J 1.Equal Employment Opportunity:Equal Employment d. Notices and posters setting forth the contractor's EEO Opportunity(EEO)requirements not to discriminate and to policy will be placed In areas readily accessible to employees, take affirmative action to assure equal opportunity as set forth applicants for employment and potential employees. under laws,executive orders,rules,regulations(see 28 CFR Part 35,29 CFR Part 1630,29 CFR Parts 1625-1627,41 CFR e. The contractor's EEO policy and the procedures to Part 60 and 49 CFR Part 27)and orders of the Secretary of Implement such policy will be brought to the attention of Labor as modified by the provisions prescribed herein,and employees by means of meetings,employee handbooks,or imposed pursuant to 23 U.S.C.140,shall constitute the EEO other appropriate means. and specific affirmative action standards for the contractor's project activities under this contract.The provisions of the 4.Recruitment:When advertising for employees,the Americans with Disabilities Act of 1990(42 U.S.C,12101 et contractor will include in all advertisements for employees the seq.)set forth under 28 CFR Part 35 and 29 CFR Part 1630 notation:"An Equal Opportunity Employer." All such are incorporated by reference in this contract.In the execution advertisements will be placed in publications having a large of this contract,the contractor agrees to comply with the circulation among minorities and women in the area from following minimum specific requirement activities of EEO: which the project work force would normally be derived. a.The contractor will work with the contracting agency and a. The contractor will,unless precluded by a valid the Federal Government to ensure that it has made every bargaining agreement,conduct systematic and direct good faith effort to provide equal opportunity with respect to all recruitment through public and private employee referral of its terms and conditions of employment and in their review sources likely to yield qualified minorities and women. To of activities under the contract. 23 CFR 230.409(g)(4)&(5). meet this requirement,the contractor will identify sources of potential minority group employees and establish with such b.The contractor will accept as its operating policy the Identified sources procedures whereby minority and women following statement: applicants may be referred to the contractor for employment consideration. "It Is the policy of this Company to assure that applicants are employed,and that employees are treated during . b. In the event the contractor has a valid bargaining employment,without regard to their race,religion,sex, agreement providing for exclusive hiring hall referrals,the sexual orientation,gender identity,color,national origin,age contractor is expected to observe the provisions of that or disability. Such action shall include:employment, agreement to the extent that the system meets the contractor's upgrading,demotion,or transfer;recruitment or recruitment compliance with EEO contract provisions. Where . advertising;layoff or termination;rates of pay or other forms implementation of such an agreement has the effect of of compensation;and selection for training,including discriminating against minorities or women,or obligates the apprenticeship,pre-apprenticeship,and/or on-the-job contractor to do the same,such implementation violates training." Federal nondiscrimination provisions. 2. EEO Officer.The contractor will designate and make c. The contractor will encourage its present employees to known to the contracting officers an EEO Officer who will have refer minorities and women as applicants for employment. the responsibility for and must be capable of effectively Information and procedures with regard to referring such administering and promoting an active EEO program and who applicants will be discussed with employees. must be assigned adequate authority and responsibility to do so. 5. Personnel Actions:Wages,working conditions,and employee benefits shall be established and administered,and 3. Dissemination of Policy:All members of the contractor's personnel actions of every type,including hiring,upgrading, staff who are authorized to hire,supervise,promote,and promotion,transfer,demotion,layoff,and termination,shall be discharge employees,or who recommend such action or are taken without regard to race,color,religion,sex,sexual substantially Involved in such action,will be made fully orientation,gender identity,national origin,age or disability. cognizant of and will implement the contractor's EEO policy The following procedures shall be followed: and contractual responsibilities to provide EEO in each grade and classification of employment. To ensure that the above a. The contractor will conduct periodic inspections of project agreement will be met,the following actions will be taken as a sites to ensure that working conditions and employee facilities minimum: 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 not less often than once every six months,at which time the wages paid within each classification to determine any contractor's EEO policy and Its implementation will be evidence of discriminatory wage practices. reviewed and explained. The meetings will be conducted by the EEO Officer or other knowledgeable company official. c. The contractor will periodically review selected personnel actions In depth to determine whether there Is evidence of b. All new supervisory or personnel office employees will be discrimination. Where evidence is found,the contractor will ,N. given a thorough indoctrination by the EEO Officer,covering promptly take corrective action. If the review Indicates that the all major aspects of the contractor's EEO obligations within discrimination may extend beyond the actions reviewed,such thirty days following their reporting for duty with the contractor. corrective action shall Include all affected persons. c. All personnel who are engaged in direct recruitment for d. The contractor will promptly investigate all complaints of the project will be instructed by the EEO Officer in the alleged discrimination made to the contractor In connection contractor's procedures for locating and hiring minorities and with its obligations under this contract,will attempt to resolve women. such complaints,and will take appropriate corrective action 2 within a reasonable time. If the Investigation indicates that the sufficient referrals(even though it is obligated to provide discrimination may affect persons other than the complainant, exclusive referrals under the terms of a collective bargaining such corrective action shall include such other persons. Upon agreement)does not relieve the contractor from the completion of each investigation,the contractor will Inform requirements of this paragraph. In the event the union referral every complainant of all of their avenues of appeal. practice prevents the contractor from meeting the obligations pursuant to Executive Order 11246,as amended,and these 6.Training and Promotion: special provisions,such contractor shall immediately notify the contracting agency. a. The contractor will assist in locating,qualifying,and increasing the skills of minorities and women who are 8. Reasonable Accommodation for Applicants I applicants for employment or current employees. Such efforts Employees with Disabilities: The contractor must be familiar should be aimed at developing full journey level status with the requirements for and comply with the Americans with employees in the type of trade or job classification involved. Disabilities Act and all rules and regulations established thereunder. Employers must provide reasonable b. Consistent with the contractor's work force requirements accommodation in all employment activities unless to do so and as permissible under Federal and State regulations,the would cause an undue hardship. contractor shall make full use of training programs(i.e., apprenticeship and on-the-job training programs for the 9.Selection of Subcontractors,Procurement of Materials geographical area of contract performance). In the event a and Leasing of Equipment:The contractor shall not special provision for training is provided under this contract, discriminate on the grounds of race,color,religion,sex,sexual this subparagraph will be superseded as indicated in the orientation,gender Identity,national origin,age,or disability In special provision. The contracting agency may reserve the selection and retention of subcontractors,Including training positions for persons who receive welfare assistance procurement of materials and leases of equipment. The in accordance with 23 U.S.C.140(a)_ contractor shall take all necessary and reasonable steps to ensure nondiscrimination in the administration of this contract. c. The contractor will advise employees and applicants for employment of available training programs and entrance a. The contractor shall notify all potential subcontractors, requirements for each. suppliers,and lessors of their EEO obligations under this contract. d. The contractor will periodically review the training and promotion potential of employees who are minorities and b. The contractor will use good faith efforts to ensure women and will encourage eligible employees to apply for subcontractor compliance with their EEO obligations. such training and promotion. 7.Unions:if the contractor relies in whole or in part upon 10.Assurances Required: unions as a source of employees,the contractor will use good faith efforts to obtain the cooperation of such unions to a. The requirements of 49 CFR Part 26 and the State increase opportunities for minorities and women. 23 CFR DOT's FHWA-approved Disadvantaged Business Enterprise 230.409. Actions by the contractor,either directly or through a (DBE)program are incorporated by reference. contractor's association acting as agent,will include the procedures set forth below: b. The contractor,subreciplent or subcontractor shall not discriminate on the basis of race,color,national origin,or sex a. The contractor will use good faith efforts to develop,In in the performance of this contract.The contractor shall carry cooperation with the unions,joint training programs aimed out applicable requirements of 49 CFR part 26 in the award toward qualifying more minorities and women for membership and administration of DOT-assisted contracts.Failure by the in the unions and increasing the skills of minorities and women contractor to carry out these requirements is a material breach so that they may qualify for higher paying employment. of this contract,which may result in the termination of this contract or such other remedy as the recipient deems b. The contractor will use good faith efforts to incorporate an appropriate,which may include,but is not limited to: EEO clause into each union agreement to the end that such (1)Withholding monthly progress payments; union will be contractually bound to refer applicants without (2)Assessing sanctions; regard to their race,color,religion,sex,sexual orientation, (3)Liquidated damages;and/or gender identity,national origin,age,or disability. (4)Disqualifying the contractor from future bidding as non- responsible. c. The contractor is to obtain information as to the referral c. The Title VI and nondiscrimination provisions of U.S. practices and policies of the labor union except that to the DOT Order 1050.2A at Appendixes A and E are incorporated extent such information is within the exclusive possession of by reference. 49 CFR Part 21. the labor union and such labor union refuses to furnish such information to the contractor,the contractor shall so certify to 11.Records and Reports:The contractor shall keep such the contracting agency and shall set forth what efforts have records as necessary to document compliance with the EEO been made to obtain such information. requirements. Such records shall be retained for a period of three years following the date of the final payment to the d. In the event the union is unable to provide the contractor contractor for all contract work and shall be available at with a reasonable flow of referrals within the time limit set forth reasonable times and places for inspection by authorized in the collective bargaining agreement,the contractor will, representatives of the contracting agency and the FHWA. through independent recruitment efforts,fill the employment vacancies without regard to race,color,religion,sex,sexual a. The records kept by the contractor shall document the orientation,gender Identity,national origin,age,or disability; following: making full efforts to obtain qualified and/or qualifiable minorities and women. The failure of a union to provide • I 3 (1)The number and work hours of minority and non- Projects funded under 23 U.S.C.117,and National Highway minority group members and women employed In each work Freight Program projects funded under 23 U.S.C.167. classification on the project; (2)The progress and efforts being made in cooperation The following provisions are from the U.S.Department of with unions,when applicable,to increase employment Labot regulations in 29 CFR 5.5"Contract provisions and opportunities for minorities and women;and related matters"with minor revisions to conform to the FHWA- 1273 format and FHWA program requirements. (3)The progress and efforts being made in locating,hiring, training,qualifying,and upgrading minorities and women. 1. Minimum wages(29 CFR 5.5) b. The contractors and subcontractors will submit an annual a. All laborers and mechanics employed or working upon report to the contracting agency each July for the duration of the site of the work,will be paid unconditionally and not less the project indicating the number of minority,women,and non- often than once a week,and without subsequent deduction or minority group employees currently engaged in each work rebate on any account(except such payroll deductions as are classification required by the contract work. This information is permitted by regulations Issued by the Secretary of Labor to be reported on Form FHw . The staffing data should under the Copeland Act(29 CFR part 3)),the full amount of represent the project work forcerce on on board in all or any part of wages and bona fide fringe benefits(or cash equivalents the fast payroll period preceding the end of July. If on-the-job thereof)due at time of payment computed at rates not less training Is being required by special provision,the contractor than those contained in the wage determination of the will be required to collect and report training data. The Secretary of Labor which Is attached hereto and made a part employment data should reflect the work force on board during hereof,regardless of any contractual relationship which may all or any part of the last payroll period preceding the end of be alleged to exist between the contractor and such laborers July. and mechanics. III.NONSEGREGATED FACILITIES Contributions made or costs reasonably anticipated for bona fide fringe benefits under section 1(b)(2)of the Davis-Bacon This provision is applicable to all Federal-aid construction Act on behalf of laborers or mechanics are considered wages contracts and to all related construction subcontracts of more paid to such laborers or mechanics,subject to the provisions than$10,000. 41 CFR 60-1.5. of paragraph 1.d.of this section;also,regular contributions made or costs incurred for more than a weekly period(but not As prescribed by 41 CFR 60-1.8,the contractor must ensure less often than quarterly)under plans,funds,or programs that facilities provided for employees are provided in such a which cover the particular weekly period,are deemed to be manner that segregation on the basis of race,color,religion, constructively made or incurred during such weekly period. sex,sexual orientation,gender identity,or national origin Such laborers-and mechanics shall be paid the appropriate cannot result. The contractor may neither require such wage rate and fringe benefits on the wage determination for segregated use by written or oral policies nor tolerate such use the classification of work actually performed,without regard to by employee custom. The contractor's obligation extends skill,except as provided in 29 CFR 5.5(a)(4).Laborers or further to ensure that Its employees are not assigned to mechanics performing work in more than one classification perform their services at any location under the contractor's may be compensated at the rate specified for each control where the facilities are segregated. The term"facilities" classification for the time actually worked therein:Provided, includes waiting rooms,work areas,restaurants and other That the employer's payroll records accurately set forth the eating areas,time clocks,restrooms,washrooms,locker time spent in each classification in which work is performed. rooms and other storage or dressing areas,parking lots, The wage determination(including any additional classification drinking fountains,recreation or entertainment areas, and wage rates conformed under paragraph 1.b.of this transportation,and housing provided for employees. The section)and the Davis-Bacon poster(WH-1321)shall be contractor shall provide separate or single-user restrooms and posted at all times by the contractor and its subcontractors at necessary dressing or sleeping areas to assure privacy the site of the work in a prominent and accessible place where between sexes. It can be easily seen by the workers. IV. DAVIS-BACON AND RELATED ACT PROVISIONS b.(1)The contractinglofflcer shall`requlre that any class of - laborers or mechanics,including helpers,which is not listed in the wage determination and which is to be employed under the This section is applicable to all Federal-aid construction contract shall be classified in conformance with the wage projects exceeding$2,000 and to all related subcontracts and determination.The contracting officer shall approve an lower-tier subcontracts(regardless of subcontract size),in ' additional classification and wage rate and fringe benefits accordance with 29 CFR 5.5. The requirements apply to all therefore only when the following criteria have been met: projects located within the right-of-way of a roadway that is functionally classified as Federal-aid highway. 23 U.S.C.113. (i)The work to be performed by the classification This excludes roadways functionally classified as local roads requested is not performed by a classification in the wage or rural minor collectors,which are exempt. 23 U.S.C.101. determination;and Where applicable law requires that projects be treated as a project on a Federal-aid highway,the provisions of this subpart will apply regardless of the location of the project. Examples (ii)The classification is utilized in the area by the include:Surface Transportation Block Grant Program projects construction industry;and funded under 23 U.S.C.133[excluding recreational trails projects],the Nationally Significant Freight and Highway 4 1 (iii)The proposed wage rate,including any bona fide including apprentices,trainees,and helpers,employed by the fringe benefits,bears a reasonable relationship to the contractor or any subcontractor the full amount of wages wage rates contained In the wage determination. required by the contract. In the event of failure to pay any laborer or mechanic,including any apprentice,trainee,or If the contractor and the laborers and mechanics to be helper,employed or working on the site of the work,all or part (2) employed If .in the classification(if known),or their of the wages required by the contract,the contracting agency, representatives,and the contracting officer agree on the may,after written notice to the contractor,take such action as may be necessary to cause the suspension of any further classification and wage rate(including the amount designated for fringe benefits where appropriate),a report of payment,advance,or guarantee of funds until such violations the action taken shall be sent by the contracting officer to the have ceased. Administrator of the Wage and Hour Division,U.S. Department of Labor,Washington,DC 20210.The 3. Payrolls and basic records(29 CFR 5.5) Administrator,or an authorized representative,will approve, modify,or disapprove every additional classification action a. Payrolls and basic records relating thereto shall be within 30 days of receipt and so advise the contracting maintained by the contractor during the course of the work and officer or will notify the contracting officer within the 30-day preserved for a period of three years thereafter for all laborers period that additional time is necessary. and mechanicsworking at the site of the work.Such records shalt contain the name,address,and social security number of (3)In the event the contractor,the laborers or mechanics each such worker,his or her correct classification,hourly rates to be employed in the classification or their representatives, of wages paid(including rates of contributions or costs and the contracting officer do not agree on the proposed anticipated for bona fide fringe benefits or cash equivalents classification and wage rate(including the amount thereof of the types described In section 1(b)(2)(B)of the designated for fringe benefits,where appropriate),the Davis-Bacon Act),daily and weekly number of hours worked, contracting officer shall refer the questions,Including the deductions made and actual wages paid.Whenever the views of all interested parties and the recommendation of the Secretary of Labor has found under 29 CFR 5.5(a)(1)(iv)that contracting officer,to the Administrator for determination. the wages of any laborer or mechanic Include the amount of The Administrator,or an authorized representative,will issue any costs reasonably anticipated in providing benefits under a a determination within 30 days of receipt and so advise the plan or program described in section 1(b)(2)(B)of the Davis- contracting officer or will notify the contracting officer within Bacon Act,the contractor shall maintain records which show the 30-day period that additional time is necessary. that the commitment to provide such benefits is enforceable, that the plan or program is financially responsible,and that the (4)The wage rate(including fringe benefits where plan or program has been communicated in writing to the appropriate)determined pursuant to paragraphs 1.b.(2) laborers or mechanics affected,and records which show the ro)of thissecrion, all pai to all worphs orperforming costs anticipated or the actual cost incurred in providing such 1.b.work in the classification under this contract from the first benefits.Contractors employing apprentices or trainees under day on which work is performed in the classification. approved programs shall maintain written evidence of the registration of apprenticeship programs and certification of trainee programs,the registration of the apprentices and c.Whenever the minimum wage rate prescribed in the trainees,and the ratios and wage rates prescribed in the contract for a class of laborers or mechanics includes a fringe applicable programs. benefit which is not expressed as an hourly rate,the contractor shall either pay the benefit as stated in the wage determination b.(1)The contractor shall submit weekly for each week in or shall pay another bona fide fringe benefit or an hourly cash which any contract work is performed a copy of all payrolls to equivalent thereof. the contracting agency. The payrolls submitted shall set out accurately and completely all of the information required to be d.If the contractor does not make payments to a trustee or maintained under 29 CFR 5.5(a)(3)(i),except that full social other third person,the contractor may consider as part of the security numbers and home addresses shall not be included wages of any laborer or mechanic the amount of any costs on weekly transmittals.Instead the payrolls shall only need to reasonably anticipated in providing bona fide fringe benefits include an individually identifying number for each employee under a plan or program,Provided,That the Secretary of (e.g.,the last four digits of the employee's social security Labor has found,upon the written request of the contractor, number).The required weekly payroll information may be that the applicable standards of the Davis-Bacon Act have submitted in any form desired.Optional Form WH-347 Is been met.The Secretary of Labor may require the contractor available for this purpose from the Wage and Hour Division to set aside in a separate account assets for the meeting of Web site.The prime contractor Is responsible for the obligations under the plan or program. submission of copies of payrolls by all subcontractors. Contractors and subcontractors shall maintain the full social CFR 5.5) security number and current address of each covered worker, 2. Withholding(29and shall provide them upon request to the contracting agency for transmission to the State DOT,the FHWA or the Wage and The contracting agency shall upon Its own action or upon Hour Division of the Department of Labor for purposes of an written request of an authorized representative of the investigation or audit of compliance with prevailing wage Department of Labor,withhold or cause to be withheld from requirements.It is not a violation of this section for a prime the contractor under this contract,or any other Federal contractor to require a subcontractor to provide addresses and contract with the same prime contractor,or any other federally- social security numbers to the prime contractor for its own assisted contract subject to Davis-Bacon prevailing wage records,without weekly submission to the contracting agency. requirements,which is held by the same prime contractor,so much of the accrued payments or advances as may be (2)Each payroll submitted shall be accompanied by a considered necessary to pay laborers and mechanics, "Statement of Compliance,"signed by the contractor or 5 i subcontractor or his or her agent who pays or supervises the Apprenticeship Agency(where appropriate)to be eligible for payment of the persons-employed under the contract and shall probationary employment as an apprentice. certify the following: The allowable ratio of apprentices to journeymen on the Job (i)That the payroll for the payroll period contains the site in any craft classification shall not be greater than the ratio information required to be provided under 29 CFR permitted to the contractor as to the entire work force under 5.5(a)(3)(ii),the appropriate Information is being the registered program.Any worker listed on a payroll at an maintained under 29 CFR 5.5(a)(3)(i),and that such apprentice wage rate,who is not registered or otherwise information is correct and complete; employed as stated above,shall be paid not less than the applicable wage rate on the wage determination for the (ii)That each laborer or mechanic(including each classification of work actually performed.In addition,any apprentice performing work on the job site in excess of the helper,apprentice,and trainee)employed on the contract ratio permitted under the registered program shall be paid not during the payroll period has been paid the full weekly less than the applicable wage rate on the wage determination wages earned,without rebate,either directly or Indirectly, for the work actually performed.Where a contractor Is and that no deductions have been made either directly or indirectly from the full wages earned,other than performing construction on a project In a locality other than permissible deductions as set forth in 29 CFR part 3; that in which its program is registered,the ratios and wage rates(expressed in percentages of the journeyman's hourly rate)specified in the contractor's or subcontractor's registered (iii)That each laborer or mechanic has been paid not program shall be observed. less than the applicable wage rates and fringe benefits or cash equivalents for the classification of work performed, Every apprentice must be paid at not less than the rate as specified in the applicable wage determination specified in the registered program for the apprentice's level of incorporated into the contract. progress,expressed as a percentage of the journeymen hourly rate specified in the applicable wage determination. (3)The weekly submission of a properly executed Apprentices shall be paid fringe benefits in accordance with certification set forth on the reverse side of Optional Form the provisions of the apprenticeship program.If the WH-347 shall satisfy the requirement for submission of the apprenticeship program does not specify fringe benefits, "Statement of Compliance"required by paragraph 3.b.(2)of apprentices must be paid the full amount of fringe benefits this section. listed on the wage determination for the applicable classification.If the Administrator determines that a different practice prevails for the applicable apprentice classification, (4)The falsification of any of the above certifications may subjectfringes shall be paid in accordance with that determination. the contractor or subcontractor to civil or criminal prosecution under 18 U.S.C.1001 and 31 U.S.C.231. In the event the Office of Apprenticeship Training,Employer and Labor Services,or a State Apprenticeship Agency c.The contractor or subcontractor shall make the records required under paragraph 3.a.of this section available for recognized by the Office,withdraws approval of an apprenticeship program,the contractor will no longer be inspection,copying,or transcription by authorized permitted to utilize apprentices at less than the applicable representatives of the contracting agency,the State DOT,the predetermined rate for the work performed until an acceptable FHWA,or the Department of Labor,and shall permit such program is approved. representatives to Interview employees during working hours on the job.If the contractor or subcontractor fails to submit the required records or to make them available,the FHWA may, b.Trainees(programs of the USDOL). after written notice to the contractor,the contracting agency or the State DOT,take such action as may be necessary to Except as provided in 29 CFR 5.16,trainees will not be cause the suspension of any further payment,advance,or permitted to work at less than the predetermined rate for the guarantee of funds.Furthermore,failure to submit the required work performed unless they are employed pursuant to and records upon request or to make such records available may individually registered in a program which has received prior be grounds for debarment action pursuant to 29 CFR 5.12. approval,evidenced by formal certification by the U.S. Department of Labor,Employment and Training 4. Apprentices and trainees(29 CFR 5.5) Administration. a.Apprentices(programs of the USDOL). The ratio of trainees to journeymen on the job site shall not be greater than permitted under the plan approved by the Apprentices will be permitted to work at less than the • Employment and Training Administration. predetermined rate for the work they performed when they are employed pursuant to and individually registered in a bona fide Every trainee must be paid at not less than the rate specified apprenticeship program registered with the U.S.Department of In the approved program for the trainee's level of progress, Labor,Employment and Training Administration,Office of expressed as a percentage of the journeyman hourly rate Apprenticeship Training,Employer and Labor Services,or with specified in the applicable wage determination.Trainees shall a State Apprenticeship Agency recognized by the Office,or if a be paid fringe benefits in accordance with the provisions of the person is employed in his or her first 90 days of probationary trainee program.if the trainee program does not mention employment as an apprentice in such an apprenticeship fringe benefits,trainees shall be paid the full amount of fringe program,who Is not Individually registered in the program,but benefits listed on the wage determination unless the who has been certified by the Office of Apprenticeship Administrator of the Wage and Hour Division determines that Training,Employer and Labor Services or a State there is an apprenticeship program associated with the 6 corresponding journeyman wage rate on the wage set forth in 29 CFR parts 5,6,and 7.Disputes within the determination which provides for less than full fringe benefits meaning of this clause include disputes between the contractor for apprentices.Any employee listed on the payroll at a trainee (or any of its subcontractors)and the contracting agency,the rate who is not registered and participating in a training plan, U.S.Department of Labor,or the employees or their approved by the Employment and Training Administration shall representatives. be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed. 10.Certification of eligibility(29 CFR 5.5) In addition,any trainee performing work on the job site in excess of the ratio permitted under the registered program shalt be paid not less than the applicable wage rate on the a.By entering into this contract,the contractor certifies that wage determination for the work actually performed. neither it(nor he or she)nor any person or firm who has an interest in the contractor's firm is a person or firm Ineligible to In the event the Employment and Training Administration be awarded Government contracts by virtue of section 3(a)of withdraws approval of a training program,the contractor will no the Davis-Bacon Act or 29 CFR 5.12(a)(1). longer be permitted to utilize trainees at less than the applicable predetermined rate for the work performed until an b.No part of this contract shall be subcontracted to any person acceptable program is approved. or 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). a.Equal employment opportunity.The utilization of apprentices,trainees and journeymen under this part shall be c.The penalty for making false statements is prescribed in the in conformity with the equal employment opportunity U.S.Criminal Code,18 U.S.C.1001. requirements of Executive Order 11246,as amended,and 29 CFR part 30. V. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT d. Apprentices and Trainees(programs of the U.S.DOT). Pursuant to 29 CFR 5,5(b),the following clauses apply to any Apprentices and trainees working under apprenticeship and Federal-aid construction contract In an amount in excess of $100,0skill training programs which have been certified by the Contract00 and subject to the overtime provisions of the Secretary of Transportation as promoting EEO in connection ssall bek insertedours and Safety ontothe Standards aAust.These with Federal-aid highway construction programs are not clauses shall)or in addition to the clauses required by subject to the requirements of paragraph 4 of this Section IV. 29 CFR 5.5(a) 29 CFR 4.6. As used in this paragraph,the 23 CFR 230.111(e)(2).The straight time hourly wage rates for terms laborers and mechanics include watchmen and guards. apprentices and trainees under such programs will be established by the particular programs.The ratio of 1.Overtime requirements. No contractor or subcontractor apprentices and trainees to journeymen shall not be greater contracting for any part of the contract work which may require than permitted by the terms of the particular program. or involve the employment of laborers or mechanics shall require or permit any such laborer or mechanic in any 5.Compliance with Copeland Act requirements. The workweek in which he or she is employed on such work to contractor shall comply with the requirements of 29 CFR part work in excess of forty hours in such workweek unless such than rer mechanic receivesmse compensationbasic at a rate not less 3,which are incorporated by reference in this contract as one and one-half times the rate of pay for all hours provided in 29 CFR 5.5, worked in excess of forty hours in such workweek. 29 CFR 5.5. 6.Subcontracts. The contractor or subcontractor shall insert Form FHWA-1273 In any subcontracts and also require the 2.Violation;liability for unpaid wages;liquidated subcontractors to include Form FHWA-1273 in any lower tier damages. In the event of any violation of the clause set forth subcontracts.The prime contractor shall be responsible for the in paragraph 1 of this section,the contractor and any compliance by any subcontractor or lower tier subcontractor subcontractor responsible therefor shalt be liable for the with all the contract clauses in 29 CFR 5.5. unpaid wages.In addition,such contractor and subcontractor shall be liable to the United States(in the case of work done 7.Contract termination:debarment. A breach of the under contract for the District of Columbia or a territory,to such contract clauses in 29 CFR 5.5 may be grounds for termination District or to such territory),for liquidated damages.Such of the contract,and for debarment as a contractor and a liquidated damages shall be computed with respect to each subcontractor es provided In 29 CFR 5.12. individual laborer or mechanic,including watchmen and guards,employed in violation of the clause set forth in 8.Compliance and Act paragraph 1 of this section,in the sum currently provided in 29 8.Compliance Alf withrangs and Davis-Baconintnrand Relatedens of theA Davis- CFR 5.5(b)(2)*for each calendar day on which such individual requireBacon and Related Acts contained In 29 CFR parts 1,3,and 5 wasr wreq k ofd or pehoursrmitted withoutt work in excesst of of the standardrode are herein incorporated by reference in this contract as wages equied byty heclause setpf forth in of the aophri of provided in 29 CFR 5.5. wages required the clause in paragraph i of this section. 29 CFR 5.5. 9.Disputes concerning labor standards.As provided in 29 *$27 as of January 23,2019(See 84 FR 213-01.218)as may CFR 5.5,disputes arising out of the labor standards provisions be adjusted annually by the Department of Labor;pursuant to of this contract shall not be subject to the general disputes the Federal Civil Penalties inflation Adjustment Act of 1990). clause of this contract.Such disputes shall be resolved in accordance with the procedures of the Department of Labor 7 3.Withholding for unpaid wages and liquidated damages. equipment not ordinarily available in the type of contracting The FHWA or the contacting agency shall upon its own action organizations qualified and expected to bid or propose on the or upon written request of an authorized representative of the contract as a whole and in general are to be limited to minor Department of Labor withhold or cause to be withheld,from components of the overall contract. 23 CFR 635.102, any moneys payable on account of work performed by the contractor or subcontractor under any such contract or any 2.Pursuant to 23 CFR 635.116(a),the contract amount upon other Federal contract with the same prime contractor,or any which the requirements set forth in paragraph(1)of Section VI other federally-assisted contract subject to the Contract Work is computed includes the cost of material and manufactured Hours and Safety Standards Act,which is held by the same products which are to be purchased or produced by the prime contractor,such sums as may be determined to be contractor under the contract provisions. necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages as 3.Pursuant to 23 CFR 635.116(c),the contractor shall furnish provided in the clause set forth in paragraph 2 of this section. (a)a competent superintendent or supervisor who is employed 29 CFR 5.5. by the firm,has full authority to direct performance of the work in accordance with the contract requirements,and is in charge 4. of all construction operations(regardless of who performs the Subcontracts. The contractor or subcontractor shall insert work)and(b)such other of its own organizational resources in any subcontracts the clauses set forth in paragraphs 1 through (supervision,management,and engineering services)as the 4 of this section and also a clause requiring the contracting officer subcontractors to include these clauses in any lower tier determines Is necessary to assure the subcontracts.The prime contractor shall be responsible for performance of the contract. compliance by any subcontractor or lower tier subcontractor 4.No portion of the contract shall be sublet,assigned or with the clauses set forth in paragraphs 1 through 4 of this otherwise disposed of except with the written consent of the section. 29 CFR 5.5. contracting officer,or authorized representative,and such consent when given shall not be construed to relieve the contractor of any responsibility for the fulfillment of the VI.SUBLETTING OR ASSIGNING THE CONTRACT contract. Written consent will be given only after the contracting agency has assured that each subcontract is This provision is applicable to all Federal-aid construction evidenced in writing and that it contains all pertinent provisions contracts on the National Highway System pursuant to 23 CFR and requirements of the prime contract.(based on long- 635.116. standing interpretation of 23 CFR 635.116). 1.The contractor shall perform with its own organization 5.The 30-percent self-performance requirement of paragraph contract work amounting to not less than 30 percent(or a (1)Is not applicable to design-build contracts;however, greater percentage if specified elsewhere in the contract)of contracting agencies may establish their own self-performance the total original contract price,excluding any specialty items requirements. 23 CFR 635.116(d). designated by the contracting agency. Specialty Items may be performed by subcontract and the amount of any such specialty items performed may be deducted from the total VIi.SAFETY:ACCIDENT PREVENTION original contract price before computing the amount of work required to be performed by the contractor's own organization This provision is applicable to all Federal-aid construction (23 CFR 635.116). contracts and to all related subcontracts. a. The term"perform work with its own organization"In 1. In the performance of this contract the contractor shall paragraph 1 of Section VI refers to workers employed or comply with all applicable Federal,State,and local laws leased by the prime contractor,and equipment owned or governing safety,health,and sanitation(23 CFR Part 635). rented by the prime contractor,with or without operators. The contractor shall provide all safeguards,safety devices and Such term does not include employees or equipment of a protective equipment and take any other needed actions as it subcontractor or lower tier subcontractor,agents of the prime determines,or as the contracting officer may determine,to be contractor,or any other assignees. The term may include reasonably necessary to protect the life and health of payments for the costs of hiring leased employees from an employees on the job and the safety of the public and to employee leasing firm meeting all relevant Federal and State protect property in connection with the performance of the regulatory requirements. Leased employees may only be work covered by the contract. 23 CFR 635.108. included in this term If the prime contractor meets all of the following conditions:(based on longstanding interpretation) 2. It Is a condition of this contract,and shall be made a condition of each subcontract,which the contractor enters into (1)the prime contractor maintains control over the pursuant to this contract,that the contractor and any supervision of the day-to-day activities of the leased subcontractor shall not permit any employee,in performance employees; of the contract,to work in surroundings or under conditions (2)the prime contractor remains responsible for the quality which are unsanitary,hazardous or dangerous to his/her of the work of the leased employees; health or safety,as determined under construction safety and (3)the prime contractor retains all power to accept or health standards(29 CFR Part 1926)promulgated by the exclude individual employees from work on the project;and Secretary of Labor,in accordance with Section 107 of the (4)the prime contractor remains ultimately responsible for Contract Work Hours and Safety Standards Act(40 U.S.C. the payment of predetermined minimum wages,the 3704). 29 CFR 1926.10. submission of payrolls,statements of compliance and all other Federal regulatory requirements. 3. Pursuant to 29 CFR 1926.3,it is a condition of this contract that the Secretary of Labor or authorized representative b."Specialty Items"shall be construed to be limited to work thereof,shall have right of entry to any site of contract that requires highly specialized knowledge,abilities,or performance to inspect or investigate the matter of compliance 8 with the construction safety and health standards and to carry or regulations issued pursuant to the Clean Air Act(42 U.S.C. out the duties of the Secretary under Section 107 of the 7401-7671q)and the Federal Water Pollution Control Act,as Contract Work Hours and Safety Standards Act(40 U.S.C. amended(33 U.S.C.1251-1387).Violations must be reported 3704). to the Federal Highway Administration and the Regional Office of the Environmental Protection Agency. 2 CFR Part 200, Appendix II. VIII.FALSE STATEMENTS CONCERNING HiGHWAY PROJECTS The contractor agrees to Include or cause to be included the requirements of this Section in every subcontract,and further This provision is applicable to all Federal-aid construction agrees to take such action as the contracting agency may contracts and to all related subcontracts. direct as a means of enforcing such requirements. 2 CFR 200.326. In order to assure high quality and durable construction in conformity with approved plans and specifications and a high degree of reliability on statements and representations made by engineers,contractors,suppliers,and workers on Federal- X.CERTIFICATION REGARDING DEBARMENT, aid highway projects,it is essential that all persons concerned SUSPENSION,INELIGIBILITY AND VOLUNTARY with the project perform their functions as carefully,thoroughly, EXCLUSION and honestly as possible. Willful falsification,distortion,or misrepresentation with respect to any facts related to the This provision Is applicable to all Federal-aid construction project is a violation of Federal law. To prevent any contracts,design-build contracts,subcontracts,lower-tier misunderstanding regarding the seriousness of these and subcontracts,purchase orders,lease agreements,consultant similar acts,Form FHWA-1022 shall be posted on each contracts or any other covered transaction requiring FHWA Federal-aid highway project(23 CFR Part 635)in one or more approval or that is estimated to cost$25,000 or more— as places where it Is readily available to all persons concerned defined in 2 CFR Parts 180 and 1200. 2 CFR 180.220 and with the project: 1200.220. 18 U.S.C.1020 reads as follows: 1.instructions for Certification—First Tier Participants: "Whoever,being an officer,agent,or employee of the United a.By signing and submitting this proposal,the prospective States,or of any State or Territory,or whoever,whether a first tier participant is providing the certification set out below. person,association,firm,or corporation,knowingly makes any false statement,false representation,or false report as to the b.The inability of a person to provide the certification set out character,quality,quantity,or cost of the material used or to below will not necessarily result in denial of participation in this be used,or the quantity or quality of the work performed or to covered transaction.The prospective first tier participant shall be performed,or the cost thereof in connection with the submit an explanation of why it cannot provide the certification submission of plans,maps,specifications,contracts,or costs set out below.The certification or explanation will be of construction on any highway or related project submitted for considered in connection with the department or agency's approval to the Secretary of Transportation;or determination whether to enter Into this transaction.However, failure of the prospective first tier participant to furnish a Whoever knowingly makes any false statement,false certification or an explanation shall disqualify such a person representation,false report or false claim with respect to the from participation in this transaction. 2 CFR 180.320. character,quality,quantity,or cost of any work performed or to be performed,or materials furnished or to be furnished,in c.The certification in this clause is a material representation connection with the construction of any highway or related of fact upon which reliance was placed when the contracting project approved by the Secretary of Transportation;or agency determined to enter into this transaction.If it Is later determined that the prospective participant knowingly rendered Whoever knowingly makes any false statement or false an erroneous certification,in addition to other remedies representation as to material fact in any statement,certificate, available to the Federal Government,the contracting agency or report submitted pursuant to provisions of the Federal-aid may terminate this transaction for cause of default. 2 CFR Roads Act approved July 11,1916,(39 Stat.355),as 180.325. amended and supplemented; d.The prospective first tier participant shall provide Shall be fined under this title or imprisoned not more than 5 Immediate written notice to the contracting agency to whom years or both." this proposal is 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 IX.IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL circumstances. 2 CFR 180.345 and 180.350. WATER POLLUTION CONTROL ACT(42 U.S.C.7606;2 CFR 200.88;EO 11738) e.The terms"covered transaction,""debarred," "suspended,""Ineligible,""participant,""person,""principal," This provision is applicable to all Federal-aid construction and"voluntarily excluded,"as used in this clause,are defined contracts in excess of$150,000 and to all related in 2 CFR Parts 180,Subpart i,180.900-180.1020,and 1200. subcontracts. 48 CFR 2.101;2 CFR 200.326. "First Tier Covered Transactions"refers to any covered transaction between a recipient or subreciplent of Federal By submission of this bid/proposal or the execution of this funds and a participant(such as the prime or general contract). contract or subcontract,as appropriate,the bidder,proposer, "Lower Tier Covered Transactions"refers to any covered Federal-aid construction contractor,subcontractor,supplier,or transaction under a First Tier Covered Transaction(such as vendor agrees to comply with all applicable standards,orders subcontracts). "First Tier Participant"refers to the participant 9 who has entered into a covered transaction with a recipient or (2) Have not within a three-year period preceding this subrecipient of Federal funds(such as the prime or general proposal been convicted of or had a civil judgment rendered contractor). "Lower Tier Participant"refers any participant who against them for commission of fraud or a criminal offense in has entered into a covered transaction with a First Tier connection with obtaining,attempting to obtain,or performing Participant or other Lower Tier Participants(such as a public(Federal,State,or local)transaction or contract under subcontractors and suppliers). a public transaction;violation of Federal or State antitrust statutes or commission of embezzlement,theft,forgery, f.The prospective first tier participant agrees by submitting bribery,falsification or destruction of records,making false this proposal that,should the proposed covered transaction be statements,or receiving stolen property,2 CFR 180.800; entered Into,it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, (3) Are not presently indicted for or otherwise criminally or suspended,declared ineligible,or voluntarily excluded from civilly charged by a governmental entity(Federal,State or participation in this covered transaction,unless authorized by local)with commission of any of the offenses enumerated in the department or agency entering into this transaction. 2 paragraph(a)(2)of this certification,2 CFR 180.700 and CFR 180.330. 180.800;and g.The prospective first tier participant further agrees by (4) Have not within a three-year period preceding this submitting this proposal that it will include the clause titled application/proposal had one or more public transactions "Certification Regarding Debarment,Suspension,Ineligibility (Federal,State or local)terminated for cause or default. 2 and Voluntary Exclusion-Lower Tier Covered Transactions," CFR 180.335(d). provided by the department or contracting agency,entering into this covered transaction,without modification,in all lower (5)Are not a corporation that has been convicted of a felony tier covered transactions and in all solicitations for lower tier violation under any Federal law within the two-year period covered transactions exceeding the$25,000 threshold. 2 CFR preceding this proposal(USDOT Order 4200.6 implementing 180.220 and 180.300. appropriations act requirements);and h.A participant in a covered transaction may rely upon a (6)Are not a corporation with any unpaid Federal tax liability certification of a prospective participant in a lower tier covered that has been assessed,for which all judicial and transaction that Is not debarred,suspended,ineligible,or administrative remedies have been exhausted,or have lapsed, voluntarily excluded from the covered transaction,unless it and that is not being paid in a timely manner pursuant to an knows that the certification Is erroneous. 2 CFR 180.300; agreement with the authority responsible for collecting the tax 180.320,and 180.325. A participant is responsible for liability(USDOT Order 4200.6 implementing appropriations act ensuring that its principals are not suspended,debarred,or requirements). otherwise ineligible to participate in covered transactions. 2 CFR 180.335. To verify the eligibility of its principals,as well b. Where the prospective participant is unable to certify to as the eligibility of any lower tier prospective participants,each any of the statements in this certification,such prospective participant may,but is not required to,check the System for participant should attach an explanation to this proposal. 2 Award Management website(https:l/www.sam,nov/). 2 CFR CFR 180.335 and 180.340. 180.300,180.320,and 180.325. i. Nothing contained in the foregoing shall be construed to 3.Instructions for Certification-Lower Tier Participants: require the establishment of a system of records in order to render in good faith the certification required by this clause. (Applicable to all subcontracts,purchase orders,and other The knowledge and information of the prospective participant lower tier transactions requiring prior FHWA approval or is not required to exceed that which is normally possessed by estimated to cost$25,000 or more-2 CFR Parts 180 and a prudent person in the ordinary course of business dealings. 1200). 2 CFR 180.220 and 1200.220. j.Except for transactions authorized under paragraph(f)of a.By signing and submitting this proposal,the prospective these instructions,if a participant in a covered transaction lower tier participant is providing the certification set out below. knowingly enters into a lower tier covered transaction with a person who is suspended,debarred,ineligible,or voluntarily b.The certification In this clause is a material representation excluded from participation in this transaction,in addition to of fact upon which reliance was placed when this transaction other remedies available to the Federal Government,the was entered into.If it is later determined that the prospective department or agency may terminate this transaction for cause lower tier participant knowingly rendered an erroneous or default. 2 CFR 180.325. certification,in addition to other remedies available to the Federal Government,the department,or agency with which ***** this transaction originated may pursue available remedies, including suspension and/or debarment. 2. Certification Regarding Debarment,Suspension, Ineligibility and Voluntary Exclusion—First Tier c.The prospective lower tier participant shall provide Participants: immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant a. The prospective first tier participant certifies to the best of learns that its certification was erroneous by reason of its knowledge and belief,that it and Its principals: changed circumstances. 2 CFR 180.365. (1) Are not presently debarred,suspended,proposed for d.The terms"covered transaction, "debarred," debarment,declared Ineligible,or voluntarily excluded from "suspended,""ineligible,""participant,""person,""principal," participating in covered transactions by any Federal and"voluntarily excluded,"as used In this clause,are defined department or agency,2 CFR 180.335;. in 2 CFR Parts 180,Subpart I,180.900—180.1020,and 1200. You may contact the person to which this proposal is 10 • submitted for assistance in obtaining a copy of those regulations. "First Tier Covered Transactions"refers to any (a)is presently debarred,suspended,proposed for debarment, covered transaction between a recipient or subrecipient of declared ineligible,or voluntarily excluded from participating in Federal funds and a participant(such as the prime or general covered transactions by any Federal department or agency,2 contract). "Lower Tier Covered Transactions"refers to any CFR 180.355; covered transaction under a First Tier Covered Transaction (such as subcontracts). "First Tier Participant'refers to the (b)is a corporation that has been convicted of a felony participant who has entered into a covered transaction with a violation under any Federal law within the two-year period recipient or subrecipient of Federal funds(such as the prime or preceding this proposal(USDOT Order 4200.6 implementing general contractor). "Lower Tier Participant"refers any appropriations act requirements);and participant who has entered into a covered transaction with a First Tier Participant or other Lower Tier Participants(such as (c)is a corporation with any unpaid Federal tax liability that subcontractors and suppliers). has been assessed,for which all judicial and administrative remedies have been exhausted,or have lapsed,and that is e.The prospective lower tier participant agrees by not being paid in a timely manner pursuant to an agreement submitting this proposal that,should the proposed covered with the authority responsible for collecting the tax liability. transaction be entered into,it shalt not knowingly enter into (USDOT Order 4200.6 implementing appropriations act any lower tier covered transaction with a person who is requirements) debarred,suspended,declared Ineligible,or voluntarily excluded from participation In this covered transaction,unless 2.Where the prospective lower tier participant is unable to authorized by the department or agency with which this certify to any of the statements in this certification,such transaction originated. 2 CFR 1200.220 and 1200.332. prospective participant should attach an explanation to this proposal. f.The prospective lower tier participant further agrees by submitting this proposal that it will Include this clause titled "Certification Regarding Debarment,Suspension,Ineligibility and Voluntary Exclusion-Lower Tier Covered Transaction," Xl.CERTIFICATION REGARDING USE OF CONTRACT without modification,in all lower tier covered transactions and FUNDS FOR LOBBYING in all solicitations for lower tier covered transactions exceeding the$25,000 threshold. 2 CFR 180.220 and 1200.220. This provision Is applicable to all Federal-aid construction contracts and to all related subcontracts which exceed g.A participant in a covered transaction may rely upon a $100,000. 49 CFR Part 20,App.A. certification of a prospective participant in a lower tier covered transaction that is not debarred,suspended,ineligible,or 1.The prospective participant certifies,by signing and voluntarily excluded from the covered transaction,unless it submitting this bid or proposal,to the best of his or her knows that the certification is erroneous.A participant is knowledge and belief,that: responsible for ensuring that its principals are not suspended, debarred,or otherwise Ineligible to participate In covered a.No Federal appropriated funds have been paid or will be transactions. To verify the eligibility of its principals,as well as paid,by or on behalf of the undersigned,to any person for the eligibility of any lower tier prospective participants,each influencing or attempting to Influence an officer or employee•of participant may,but is not required to,check the System for any Federal agency,a Member of Congress,an officer or Award Management website(httos://www.sam.gov/),which is employee of Congress,or an employee of a Member of compiled by the General Services Administration. 2 CFR Congress in connection with the awarding of any Federal 180.300,180.320,180.330,and 180.335. contract,the making of any Federal grant,the making of any Federal loan,the entering into of any cooperative agreement, h.Nothing contained in the foregoing shall be construed to and the extension,continuation,renewal,amendment,or require establishment of a system of records in order to render modification of any Federal contract,grant,loan,or in good faith the certification required by this clause.The cooperative agreement. knowledge and information of participant is not required to exceed that which is normally possessed by a prudent person b.If any funds other than Federal appropriated funds have in the ordinary course of business dealings. been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal i.Except for transactions authorized under paragraph e of agency,a Member of Congress,an officer or employee of these Instructions,if a participant in a covered transaction Congress,or an employee of a Member of Congress in knowingly enters Into a lower tier covered transaction with a connection with this Federal contract,grant,loan,or person who is suspended,debarred,ineligible,or voluntarily cooperative agreement,the undersigned shall complete and excluded from participation in this transaction,In addition to submit Standard Form-LLL,"Disclosure Form to Report other remedies available to the Federal Government,the Lobbying,"in accordance with Its instructions. department or agency with which this transaction originated may pursue available remedies,including suspension and/or 2.This certification is a material representation of fact upon debarment. 2 CFR 180.325. 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 31 U.S.C.1352. Any person who fails to file the required Certification Regarding Debarment,Suspension, certification shall be subject to a civil penalty of not less than Ineligibility and Voluntary Exclusion—Lower Tier $10,000 and not more than$100,000 for each such failure. Participants: 3.The prospective participant also agrees by submitting its 1.The prospective lower tier participant certifies,by bid or proposal that the participant shall require that the submission of this proposal,that neither it nor its principals: language of this certification be included In all lower tier 11 subcontracts,which exceed$100,000 and that ail such recipients shall certify and disclose accordingly. XII. USE OF UNITED STATES-FLAG VESSELS: , This provision is applicable to all Federal-aid construction contracts,design-build contracts,subcontracts,lower-tier subcontracts,purchase orders,lease agreements,or any other covered transaction. 46 CFR Part 381. This requirement applies to material or equipment that is acquired for a specific Federal-aid highway project. 46 CFR 381.7. It is not applicable to goods or materials that come into inventories independent of an FHWA funded-contract. When oceanic shipments(or shipments across the Great Lakes)are necessary for materials or equipment acquired for a specific Federal-aid construction project,the bidder,proposer, contractor,subcontractor,or vendor 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 contract,to the extent such vessels are available at fair and reasonable rates for United States-flag commercial vessels. 46 CFR 381.7, 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 Office of Cargo and Commercial Seallft(MAR-620),Maritime Administration,Washington,DC 20590.(MARAD requires copies of the ocean carrier's(master)bills of lading,certified onboard,dated,with rates and charges.These bills of lading may contain business sensitive information and therefore may be submitted directly to MARAD by the Ocean Transportation Intermediary on behalf of the contractor). 46 CFR 381.7. 12 ATTACHMENT A-EMPLOYMENT AND MATERIALS PREFERENCE FOR APPALACHIAN DEVELOPMENT HIGHWAY SYSTEM OR APPALACHIAN LOCAL ACCESS ROAD CONTRACTS(23 CFR 633,Subpart B,Appendix B) This provision is applicable to all Federal-aid projects funded under the Appalachian Regional Development Act of 1965. 1.During the performance of this contract,the contractor undertaking to do work which is,or reasonably may be,done as on-site work,shall give preference to qualified persons who regularly reside In the labor area as designated by the DOL wherein the contract work is situated,or the subregion,or the Appalachian counties of the State wherein the contract work is situated,except: a.To the extent that qualified persons regularly residing in the area are not available. b.For the reasonable needs of the contractor to employ supervisory or specially experienced personnel necessary to assure an efficient execution of the contract work. c.For the obligation of the contractor to offer employment to present or former employees as the result of a lawful collective bargaining contract,provided that the number of nonresident persons employed under this subparagraph(1c)shall not exceed 20 percent of the total number of employees employed by the contractor on the contract work,except as provided in subparagraph(4)below. 2.The contractor shall place a job order with the State Employment Service indicating(a)the classifications of the laborers,mechanics and other employees required to perform the contract work,(b)the number of employees required In each classification,(c)the date on which the participant estimates such employees will be required,and(d)any other pertinent information required by the State Employment Service to complete the job order form. The job order may be placed with the State Employment Service in writing or by telephone. If during the course of the contract work,the information submitted by the contractor in the original job order is substantially modified,the participant shall promptly notify the State Employment Service. 3.The contractor shall give full consideration to arqualified Job applicants referred to him by the State Employment Service. The contractor is not required to grant employment to any Job applicants who,in his opinion,are not qualified to perform the classification of work required. 4.If,within one week following the placing of a job order by the contractor with the State Employment Service,the State Employment Service is unable to refer any qualified job applicants to the contractor,or less than the number requested,the State Employment Service will forward a certificate to the contractor indicating the unavailability of applicants. Such certificate shall be made a part of the contractor's permanent project records. Upon receipt of this certificate,the contractor may employ persons who do not normally reside in the labor area to fill positions covered by the certificate,notwithstanding the provisions of subparagraph(1c) above. 5. The provisions of 23 CFR 633.207(e)allow the contracting agency to provide a contractual preference for the use of mineral resource materials native to the Appalachian region. 6.The contractor shall include the provisions of Sections 1 through 4 of this Attachment A in every subcontract for work which is,or reasonably may be,done as on-site work. 13 xx� '" CITY OF HUNTINGTON BEACH `[1/1j• / BUSINESS LICENSE ,„-^-* P.O.Box 190 Huntington Beach,CA 92648-2702 (714)536-5267 Sunny Han Acting Chief Financial Officer ® HNY04178 4000000299 299/1 r.umm IIIIIy1Ihh1I1(I111'II11JI1I'419IIJIhltbjll,I'IIIIIPI611nI .ptAii.1 ALL AMERICAN ASPHALT i P0 BOX 2229 I' -; CORONA CA 92878-2229 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 r 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 il i 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 1' 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, t; 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 I Huntington Beach Chamber of Commerce-(714)536-8888 Fictitious Business Name Information-(714)834-2889 i CA Department of Tax and Fee Administration-(949)440-3473 Community Development-(714)536-5271 f. If you have any questions, please call a Business License representative at(714) 536-5267. S' ( 3 I. : I'. City of Huntington Beach ; } i Business License a i License Number '` Business Name/Service Address POST IN PUBLIC VIEW A016726 1'-; ALL AMERICAN ASPHALT • i' i f; �'''�.``" Effective Date t lt! �NTf 1' ,,,. 11, , h i; 05/01/2023 , Owner/Corporation ,�4t ALL AMERICAN ASPHALT INC ;ice Expiration Date d ;q 04/30/2024 ' • License Type : p`z` 0 ��g IL,,,, " Amount Paid I CONTRACTOR COUi $106.56 G I, 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. $'' i ....r......_..-. `.�L..^........ _.,t _....n...." ' k' ...s...., _,..:..aL�..�._E ..._wta,,...'' M1................,«m....-u.........:w.. .,............-.''........t...-' ...,,.........._......... ........._.....,_.._....._.._..=._.r..._.L......�.,.........:.. .,.. No. 2479-4 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, Fidelity and Deposit Company of Maryland oflllinois,organized under the laws oflllinois,subject to its Articles of Incorporation or otherfiindamental organizational documents,is hereby authorized to transact within this State,subject to all provisions ofthis Certificate, the following classes of insurance: Fire,Marine,Surety,Plate.Glass,Liability,.Workers'Compensation, Boiler and Machinery,Burglary,Credit,Sprinkler,Team and Vehicle, Automobile,Aircraft and Miscellaneous as such classes are now or may'hereafter be defined ill 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 12'h day of March, 2019,I have set my hand and caused my official seal to be affixed this e 126 day of March,2019. • .j♦m4R 4b6 Ricardo Lara +x a ti Insurance Commissioner ell Ay' zf 1' JJjjJf/y�11) By Valerie Sarfaty for Catalina Hayes-Bautista • Insurance Chief Deputy NOTICE: Qualification with the Secretary ofState 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 grounds for revoking this Certificate of Authority pursuant to the covenants made in the application therefor and the conditions contained herein. • • • CONTRACTOR'S SWORN STATEMENT AND WARRANTY REGARDING CONTINUING INSURANCE OBLIGATIONS FROS: All American Asphalt pRojEc-r: Saybrook Lane Rehabilitation (Contractor flame) CC No. 1690 • PO Box 2229 Federal Project Number CRAL-5181 (195) (Street Address) Corona, CA 92878 (City,State and Yip) TO: .CrIT OF t9tDNTINGTON BEACH • • DECLARATION AttadWd hereto Is a true and correct copy of the current Certificate Of Insurance and Additional Insured Endorrernent CG 2010 1185, which Certificate complies with the insurance requirements of the Contract by and between the City of Huntington Beach Mite)and the above-named Contractor("Contractor")for the above-described project("Project"). I declare tinder penalty of perjury under the laws of the State of California that the above statement is true and correct Signed on ,zo a Corona, CA (Date) (City,State) (Signs a of Indivi 1 Who Is Making Declaration) Edward J. Carlson, Vice President • WARRANTY Contractor hereby warrants and agrees to maintain Products and Completed cperationa 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 20101.18S,naming(ty as an additional Insured, Contractor shall supply to(Ity,on at least an annual basis,a Certificate of Insurance and the aforementioned Endorsement evidencing continued coverage which meets the Contract requirements. • Signed on, ,za at Corona, CA (Date) (Cityr Slate) CONTRACTOR: Name:* All American Asphalt • ay Name; Eci ard J arlson Trtlet VicePresident 247421.2 , , , ® DATE(MMIDD/YYYY) A`co D CERTIFICATE OF LIABILITY INSURANCE 6/12/2023 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(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 Certificates Department Edgewood Partners Insurance Center PHONE FAX P.O.Box 5003 (AIC.No.Exit559-451-3200 Ric.No): 925-901-0671 San Ramon, CA 94583 A MAIL E-MAIL s: EPICcertsaeplcbrokers.com INSURER(S)AFFORDING COVERAGE NAIC S www.epicbrokers.com CA LICENSE#0B29370 INSURER A: Arch Specialty Insurance Company 21199 INSURED INSURER B: Zurich American Insurance Company 16535 All American Asphalt P.O.Box 2229 INSURER C: Great American Insurance Company 16691 Corona CA 92878 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 74809967 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. 1 INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDIYYYY) (MMIDD/YYYY) LIMITS A i COMMERCIAL GENERAL LIABILITY DPC100585606 8/1/2022 8/1/2023 EACH OCCURRENCE $1,000,000 DCLAIMS-MADE n OCCUR PREMISES SES(MAGE Es RENTED $100,000 MED EXP(My one person) $ PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY 1-7JEOT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY BAP557108810 8/1/2022 8/1/2023 (Ea osentntSINGLE LIMIT $2,000,O00 ✓ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ L. AUTOS ONLY V AUTOS ONLY (Per accident) $ C UMBRELLA LIAB y OCCUR TUE347483602 8/1/2022 8/1/2023 EACH OCCURRENCE $5,000,000 ,/ EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED ✓ RETENTION S10,000 Following-Form $ B WORKERS COMPENSATION WC593205709 8/1/2022 8/1/2023 t/ STATUTE OTH- ER AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNERIEXECUTIVE Y[7 N t A E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? I I (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1.000.000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be atlached If more space Is required)APPROVED AS TO FORM #35352/RE:Saybrook Lane Rehabilitation/ ' PYt- MICHAEL E.GATES Certificate Holder is Additional Insured if Required by Written Contract Excluding Workers Compensation CITY ATTOAN9Y CITY OP HUNTINGTON BEACH 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 IN 2000 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Huntington Beach CA 92648 AUTHORIZED REPRESENTATIVE I Maleah Cantrell ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD l ; 74809967122[01]Standard with S5mnt XS I Sicra Landreth I.6't2/2023 11:54:58 AM(PST)I Page I of II 1 ±1 _ IIAI To: Whom it may concern ii ii PO Box 5003 Regarding: Notice of Cancellation tt,, San Ramon,CA 94583 Phone: 925.244.7700 Date Issued: 6/12/2023 kV Fax: 925.901-0244 Email: EPICcerts@epicbrokers.com Named Insured(s): All American Asphalt Policy Number(s): DPC100585606 BAP557108810 _1 CERTIFICATE HOLDER: WC593205709 . I. TUE347483602 City of Huntington Beach _ ,' 2000 Main Street Huntington Beach CA 92648 e Should the above described policy be cancelled before the expiration date thereof, we will mail 30 days written notice to the above referenced Certificate Holder; except, 10 days notice for non-payment of premium. I i. 1 I Sincerely, 2)4.-------- : • • Maleah Cantrell t ..M.1f • epicbrokers.com edgewood partners insurance center ca license 0B29370 74809967 122[01]Standard with$5mm XS I Siera Landreth 16/12/2023 11:54:58 AM(PST)I Page 2 of 11 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 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): Any person or organization where the Named Any location where required by written contract or Insured has agreed to add as an additional insured agreement, provided the contract or agreement is by written contract or agreement, provided the executed prior to any"occurrence"or offense. contract or agreement is executed prior to any "occurrence"or offense Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II — Who Is An Insured is broader than that which you are amended to include as an additional required by the contract or insured the person(s) or organization(s) agreement to provide for such shown in the Schedule, but only with additional insured. respect to liability for "bodily injury", "property damage" or "personal and B. , With respect to the insurance afforded to advertising injury" caused, in whole or in these additional insureds, the following part, by: additional exclusions apply: 1. Your acts or omissions; or This insurance does not apply to "bodily • injury" or "property damage" occurring 2. The acts or omissions of those after: acting on your behalf; 1. All work, including materials, parts in the performance of your ongoing or equipment furnished in operations for the additional insured(s) at connection with such work, on the the location(s)designated above. project (other than service, maintenance or repairs) to be However: performed by or on behalf of the additional insured(s) at the location 1. The insurance afforded to such of the covered operations has been additional insured only applies to completed; or the extent permitted by law;and 2. That portion of "your work" out of 2. If coverage provided to the which the injury or damage arises additional insured is required by a has been put to its intended use by contract or agreement, the any person or organization other insurance afforded to such than another contractor or additional insured will not be subcontractor engaged in CG 2010 04 13 ©Insurance Services Office, Inc., 2012 Page 1 of 2 74809967 122[01]Standard with$5mm XS I Siera Landreth 16/12/2023 11:54:58 AM(PST)I Page 3 of 11 performing operations for a 1. Required by the contract or principal as a part of the same agreement; or project. 2. Available under the applicable C. With respect to the insurance afforded to Limits of Insurance shown in the these additional insureds, the following is Declarations; added to Section III — Limits Of Insurance: whichever is less. If coverage provided to the additional This endorsement shall not increase the insured, is required by a contract or applicable Limits of Insurance shown in agreement,the most we will pay on behalf the Declarations. of the additional insured is the amount of insurance: All other terms and conditions of this policy remain unchanged. Endorsement Number: This endorsement is effective on the inception date of this policy unless otherwise stated herein. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Policy Number: DPC100585606 Named Insured: All American Asphalt Endorsement Effective Date:08/01/2022 REFERENCE: • SCHEDULE: #35352/RE:Saybrook Lane Rehabilitation/ City of Huntington Beach,its officers,elected or appointed officials, employees,agents,and volunteers CG 2010 0413 ©Insurance Services Office, Inc.,2012 Page 2 of 2 74809967 22[01]Standard with$5mm XS I Siam Landreth 16/12/2023 11:54:58 AM(PST)I Page 4 of 11 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization where the Named Insured All locations where required by contract. has agreed to add as an additional insured by written contract or agreement, provided the contract or agreement is executed prior to any "occurrence" or offense Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II — Who Is An Insured is additional insured. amended to include as an additional insured the person(s) or organization(s) B. With respect to the insurance afforded to shown in the Schedule, but only with these additional insureds, the following is respect to liability for "bodily injury" or added to Section III — Limits Of "property damage" caused, in whole or in Insurance: part, by "your work" at the location designated and described in the Schedule If coverage provided to the additional of this endorsement performed for that insured is required by a contract or additional insured and included in the agreement, the most we will pay on behalf "products-completed operations hazard". of the additional insured is the amount of insurance: However: 1. Required by the contract or 1. The insurance afforded to such agreement; or additional insured only applies to the extent permitted by law; and 2. Available under the applicable Limits of Insurance shown in the 2. If coverage provided to the Declarations; additional insured is required by a contract or agreement, the whichever is less. insurance afforded to such additional insured will not be This endorsement shall not increase the broader than that which you are applicable Limits of Insurance shown in required by the contract or the Declarations. agreement to provide for such CG 20 37 0413 ©Insurance Services Office, Inc., 2012 Page 1 of 2 74809967 122[01]Standard with$5mm XS I Siera Landreth 16/122023 11:54:58 AM(PST)I Page 5 of 11 • All other terms and conditions of this Policy remain unchanged. Endorsement Number: This endorsement is effective on the inception date of this policy unless otherwise stated herein. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Policy Number: DPC100585606 Named Insured: All American Asphalt Endorsement Effective Date: 08/01/2022 REFERENCE: SCHEDULE: #35352/RE:Saybrook Lane Rehabilitation/ City of Huntington Beach,its officers,elected or appointed officials, employees,agents,and volunteers , CG 20 37 0413 ©Insurance Services Office, Inc., 2012 Page 2 of 2 74809967 l 22[01]Standard with$5mm XS I Siam Landreth I 6/12/2023 11:54:58 AM(PST)l Page 6 of 11 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (1) The additional insured is a Named Condition and supersedes any provision to the Insured under such other insurance; contrary: and Primary And Noncontributory (2) You have agreed in writing in a Insurance contract or agreement that this insurance would be primary and This insurance is primary to and will not would not seek contribution from seek contribution from any other any other insurance available to the insurance available to an additional additional insured. insured under your policy provided that: All other terms and conditions of this policy remain unchanged. REFERENCE: SCHEDULE: #35352/RE:Saybrook Lane Rehabilitation/ City of Huntington Beach,its officers,elected or appointed officials, employees,agents,and volunteers Endorsement Number: • This endorsement is effective on the inception date of this policy unless otherwise stated herein. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Policy Number: DPC100585606 Named Insured:All American Asphalt Endorsement Effective Date:08/01/2022 CG 20 01 0413 ©Insurance Services Office, Inc., 2012 Page 1 of 1 74809967 1 22[01]Standard with$5mm XS I Siam Landreth 16/12/2023 11:54:58 AM(PST)I Page 7 of 11 COMMERCIAL GENERAL LIABILITY CG24040509 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: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization where the waiver of our right to recover is permitted by law and is required by written contract or agreement, provided the contract or agreement is executed prior to any occurrence or offense Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The following is added to Paragraph 8.Transfer for injury or damage arising out of your ongoing Of Rights Of Recovery Against Others To Us operations or "your work" done under a contract of Section IV—Conditions: with that person or organization and included in the "products-completed operations We waive any right of recovery we may have hazard". This waiver applies only to the person against the person or organization shown in the or organization shown in the Schedule above. Schedule above because of payments we make All other terms and conditions of this policy remain unchanged. Endorsement Number: This endorsement is effective on the inception date of this policy unless otherwise stated herein. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Policy Number:DPC100585606. Named Insured:All American Asphalt Endorsement Effective Date: 08/01/2022 REFERENCE: SCHEDULE: • #35352/RE:Saybrook Lane Rehabilitation/ City of Huntington Beach,its officers,elected or appointed officials, employees,agents,and volunteers CG 24 04 05 09 ©Insurance Services Office, Inc., 2008 Page 1 of 1 74809967 122[01]Standard with$5mm XS I Siera Landreth i 6/12/2023 11:54:58 AM(PST)I Page 8 of 11 6/12/2023 POLICY NUMBER: BAP557108810 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s)or organization(s)who are "insureds"for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: All American Asphalt Endorsement Effective Date:08/01/2022 SCHEDULE Name Of Person(s)Or Organization(s): ANY PERSON OR ORGANIZATION TO WHOM OR WHICH YOU ARE REQUIRED TO PROVIDE ADDITIONAL INSURED STATUS ON A PRIMARY, NON-CONTRIBUTORY BASIS, IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT EXECUTED PRIOR TO LOSS, EXCEPT WHERE SUCH CONTRACT OR AGREEMENT IS PROHIBITED BY LAW. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but SCHEDULE: only to the extent that person or organization qualifies City of Huntington Beach,its officers,elected or appointed officials, as an "Insured" under the Who Is An Insured provision employees,agents,and volunteers contained in Paragraph A.1. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. • CA 20 48 10 13 ©Insurance Services Office, Inc.,2011 Page 1 of 1 • 74809967 122[01]Standard with$5mm XS I Siera Landreth 16/12/2023 11:54:58 AM(PST)I Page 9 of 11 , ` 6/12/2023 POLICY NUMBER:BAP557108810 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured:All American Asphalt Endorsement Effective Date: 08/01/2022 SCHEDULE Name(s) Of Person(s)Or Organization(s): ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY • Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the SCHEDULE: person(s) or organization(s) shown in the Schedule, City of Huntington Beach,its officers,elected or appointed officials, but only to the extent that subrogation is waived prior employees,agents,and volunteers to the "accident" or the "loss" under a contract with that person or organization. CA 04 4410 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 74809967 l 22[Ol]Standard with$5mm XS l Siera Landreth I 6/12/2023 11:54:58 AM(PST)I Page 10 of 11 WORKERS'COMPENSATION AND EMPLOYERS'LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT- CALIFOR NIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 0.00 % of the California workers' compensation pre- mium otherwise due on such remuneration. Schedule Person or Organization Job Description ALL PERSONS AND/OR ALL CA OPERATIONS ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER_OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION SCHEDULE: REFERENCE: #35352/RE:Saybrook Lane Rehabilitation/ City of Huntington Beach, its officers, elected or appointed officials, employees, agents, and volunteers Policy Number: WC593205709 Named Insured:All American Asphalt Endorsement Effective Date: 08/01/2022 WC 252(4-84) Page 1 of 1 WC 04 03 06(Ed.4-84) 74809967 122[01]Standard with$5mm XS I Siera Landreth 16/12/2023 11:54:58 AM'(PST)I Page 11 of 11 Bond No.7670434 Premium: $6,159.00 Premium is for contract term and is subject to adjustment based on final contract price Executed in:2 Counterparts PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS: WHEREAS,City of Huntington Beach(hereafter referred to as"City") has, by written agreement dated June 20 ,2023,entered into a contract with All American Asphalt 400 East Sixth Street,Corona,CA 92879 (name and address of Contractor) (hereinafter referred to as"Principal"),for performance of the work described as follows: Saybrook Lane Rehabilitation-CC-1690 • (Project Title) WHEREAS, said contract, and all documents referenced therein (hereinafter collectively "Contract"), are incorporated herein by this reference made a part hereof as though set forth herein in full;and Said Principal is required under the terms of the Contract to furnish a bond guaranteeing the prompt,full and faithful performance of said Contract, by a duly admitted surety insurer under the laws of the State of California(hereinafter referred to as"Surety");and Surety is certified and listed in the U.S. Department of the Treasury Circular 570, and has provided proof of • sufficient bonding limitations as shown in said circular to provide bonds in the amount required by said Contract;and Surety has provided financial strength ratings from reputable companies,such as from A.M.Best,Moody's, or Standard&Poor's,to validate that Surety has positive ratings of being secure or Stable;and Surety is registered and listed with the California Department of Insurance, • NOW,THEREFORE,we,the undersigned,as Principal,and •• Fidelity and Deposit Company of Maryland 777 S.Figueroa Street,Suite 3900,Los Angeles,CA 90017 • (name and address of Surety) • • as Surety,are held and firmly bound unto City in the penal sum of One Million Five Hundred Fifty Nine Thousand Three Hundred Sixteen and 00/100 Dollars ($ 1,559,316.00 ),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 No. 7670434 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: June 20,2023 • ATTEST All American Asphalt • (Corporate Seal) (Principal • By: ✓� , Name: u)ov J. CoriJc -s Title: VO4 C.e. ?eta 44.4.. ' ATTEST Fidelity and Deposit Company of Maryland (Corporate Seal) (Surety Name) • By: Name:Rebecca Haas-Bates,Attorney-in-Fact (Signature of Attorney-in-Fact for Surety) (Attach Attorney-in-Fact Certificate) (213)270-0600 (Area Code&Telephone Number for Surety) APPROVED AS TO • By:. 4`_ //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 15-4584/117174 CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached.and not the tnithfiilness.accuracy.or validity of that document. State of California County of Riverside On June 16, 2023 before me, Kenona Nazari,Notary Public Date Here Insert name and Title of the Officer personally appeared Edward J. Carlson and Michael Farkas 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/their 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. rd"1°if-inilb"a6dilr"16411641.416100y NAZARINotary Public-CaliforniaZ I certify under PENALTY OF PERJURY under the laws of the State of Riverside County California that the forgoing paragraph is true and correct. Commission q 2318601 My Comm.Expires Jan 10,2024 WITNESS my •.nd : Icial seal. Signs ,e -Id Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law,it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document Performance Bond—City of Huntington Beach Contract Document Date: June 20, 2023 Number of Pages: 5 Signer(s) Other Than Named Above: Rebecca Haas-Bates, Attorney-in-Fact Capacity(ies)Claimed by Signer(s) Signer's Name: Edward J. Carlson Signer's Name: Michael Farkas o Individual o Individual X Corporate Officer—Title(s): Vice President X Corporate Officer—Title(s): Secretary ❑Partner D o Limited❑General ❑ Partner 0 o Limited o General RIGHT THUMBPRINT RIGHT THUMBPRINT ❑Attorney in Fact OF SIGNER ❑Attorney in Fact OF SIGNER ❑Trustee Top of thumb here Top of thumb here ❑Trustee o Other: ❑Other: Signer is Representing: Signer is Representing: All American As•halt All American As•halt CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of Orange On 06/12/2023 before me, L.Gomez,Notary Public Date Here Insert Name and Title of the Officer personally appeared Rebecca Haas-Bates NameKof Signerts). who proved to me on the basis of satisfactory evidence to be the person* whose name*. is/are subscribed to the within instrument and acknowledged to me that iae/she/they[ executed the same in Tits/her/their authorized capacity(lbs),and that by hie/her/their signaturee.on the instrument the personas), 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.GOMEZ WITNESS my hand and official seal. . Notary Public-California s Orange County > /� =- �` Commission.,"2413682 '`My Comm Expires Aug 23,zoz6 Signature Si nature of Not Public Place Notary Sea!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: Performance Bond No.7670434 Document Date: 06/20/2023 Number of Pages: Two(2) Signer(s) Other Than Named Above: All American Asphalt Capacity(ies) Claimed by Signer(s) Signer's Name: Rebecca Haas-Bates Signer's Name: ❑Corporate Officer — Title(s): El Corporate Officer— Title(s): ❑Partner — ❑ Limited ❑General ❑ Partner — ❑ Limited ❑General ❑Individual ['Attorney in Fact ❑ Individual ❑Attorney in Fact O Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other: ❑ Other: Signer Is Representing: Signer Is Representing: Fidelity and Deposit Company of Maryland ©2014 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attorneys -in-Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may,by written instrument under the attested corporate seal,appoint attorneys-in-fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such 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 Attomey...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 20th day of June,2023. `...la ^ry O O T a c s�: i r'SEALmio'_ _ (� `^ krsEALmis_ _ �(,, sEAL ,i' _ __ IUNI inn .N�pp'h p • • 7149 P0/4/64_, By: Mary Jean Pethick 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 800-626-4577 If your jurisdiction allows for electronic reporting of surety claims,please submit to: reportsfcl aims(c,zuri chna.corn Authenticity of this bond can be confirmed at bondvalidator.zurichna.com or 410-559-8790 PRF7670434 Bond Number City of Huntington Beach Obligee 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 appointRebecca Haas-Bates, 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 20th day of June,A.D.2023. „r ; .;,, IV C°°p:r„y . rrrnlrrrr y,, -ti IN311q•_4Q° , ; �° '` �" ;u'°s�T _ ATTEST: �SvSEALm _ _ vsEAL`"i _ m o_ ZURICH AMERICAN INSURANCE COMPANY rrrll,i, ,Irlin,,,Ar d Irrrl COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND C`� By: Robert D. Murray By: Dawn E. Brown Vice President Secretary State of Maryland County of Baltimore On this 20th day of June,A.D. 2023 ,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. sv- ckLegto,, Ym ]DI 'a N BOO/[fir; ,�� � c Iva Bethea,Notary Public My Commission Expires: September 30,2023 GEN00011 Ed.(12/22) Authenticity of this bond can be confirmed at bondvalidator.zurichna.com or 410-559-8790 • No. 2479-4 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, Fidelity and Deposit Company of Maryland ofliinois,organized under the laws oflllinois,subject to its Articles ofIncoiporation or other f tndamental organizational documents, is hereby authorized to transact within this State,subject to all provisions ofthis Certificate, the following classes of insurance: Fire,Marine,Surety,Plate Glass,Liability,Workers'Compensation, 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 12" day of March, 2019,1 have set my hand and caused my official seal to be affixed this _ 12`h day of March, 2019. - •5.• :. I'll Ricardo Lara • Insurance Commissioner =` By Valerie Sarfaty for Catalina Haves-Bautista • Insurance 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 grounds for revoking this Certificate of Authority pursuant to the covenants made in the application therefor and the conditions contained herein. Bond No.7670434 Premium is included in the performance bond Executed in:2 Counterparts • PAYMENT BOND (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS: WHEREAS,City of Huntington Beach(hereafter referred to as"City")has awarded to All American Asphalt-400 East Sixth Street,Corona,CA 92879 (name and address of Contractor) (hereinafter referred to as"Principal"),a contract("Contract")for the work described as follows: Saybrook Lane Rehabilitation-CC-1690 (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 Fidelity and Deposit Company of Maryland 777 S. Figueroa Street, Suite 3900, Los Angeles,CA 90017 (name and address of Surety) as Surety,are held and firmly bound unto City in the penal sum of One Million Five Hundred Fifty Nine Thousand Three Hundred Sixteen and 00/100 dollars($1,559,316.00 ),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 1 5-45 84/1 1 73 5 7 Surety stipulates and agrees,for value received,that no change,extension of time,alteration, addition or modification to the terms of the Contract,or any contract document or any work to be • performed thereunder,whether made after notice or not,shall in any way affect, impair or release the obligations of Surety under this bond. Surety hereby waives notice of any such change, • extension of time,alteration,addition,or modification to the terms of the Contract,the contract documents or the work thereunder. Surety also waives the provisions of California Civil Code§§ 2845 and 2849. IN WITNESS WHEREOF,each party represents and warrants that this instrument has been duly executed by Principal and Surety, on the date set forth below,that the name of each corporate party being affixed hereto is such party's proper legal name and that the individuals signing this instrument have been duly authorized pursuant to the authority of its governing body, Surety,by execution of • this bond,waives any defense which Surety has or may have by reason of any failure of the Principal to execute or properly execute this bond. Dated: June 20, 2023 • • ATTEST. All American Asphalt • (Corporate Seal) (Principal Na • By: Name: Ed14i0.r • Cn�lt��1L Title: V.'C.G ?ire;:�t•'_f ATTEST Fidelity and Deposit Company of Maryland (Corporate Seal) (Surety Name) By. p��� .. Name:Rebecca Haas-Bates,Attorney-in-Fact (Signature of Attorney-in-Fact for Surety) (Attach Attorney-in-Fact Certificate) (213)270-0600 (Area Code&Telephone Number for Surety) APPROVED AS T fiRM: • By: Nfi6hael E.Gates,-City ttorney • 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 B OND Page 2 of 2 15-4584/117357 • CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached.and not the tnithfitlness_accuracy.or validity of that document. State of California County of Riverside On June 16, 2023 before me, Kenona Nazari,Notary Public Date Here Insert name and Title of the Officer personally appeared Edward J. Carlson and Michael Farkas 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/their 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 4 >,f KENONA NAZARI of which the person(s)acted,executed the instrument. ate Notary Public•California I certify under PENALTY OF PERJURY under the laws of the State of = W•�- Riverside County Commission '2318601 California that the forgoing paragraph is true and correct. Comm.Expires Jan 10,2024 WITNESS • and official seal. Signatte �•� �r� Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law,it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document Payment Bond—City of Huntington Beach Contract Document Date: June 20, 2023 Number of Pages: 5 Signer(s) Other Than Named Above: Rebecca Haas-Bates, Attorney-in-Fact Capacity(ies)Claimed by Signer(s) Signer's Name: Edward J. Carlson Signer's Name: Michael Farkas ❑ Individual ❑ Individual X Corporate Officer—Title(s): Vice President X Corporate Officer—Title(s): Secretary o Partner 0 o Limited o General o Partner 0 o Limited❑General RIGHT THUMBPRINT RIGHT THUMBPRINT ❑Attorney in Fact OF SIGNER ❑Attorney in Fact OF SIGNER o Trustee Top of thumb here Top of thumb here ❑Trustee o Other: ❑Other: Signer is Representing: Signer is Representing: All American As shalt All American As.halt CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of Orange On 06/12/2023 before me, L.Gomez,Notary Public Date Here Insert Name and Title of the Officer personally appeared Rebecca Haas-Bates Namei'$.of Signerrs). who proved to me on the basis of satisfactory evidence to be the person$ whose name* is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in its/her/their authorized capacity ids),and that by his/her/their signature .on the instrument the person*),. or the entity upon behalf of which the person(s).acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph yE•' � is true and correct. r. .-c. „ L.GOMEZ , ; Notary Public-California WITNESS my hand and official seal. i ` ` = Orange County -` Commission 4'2413682 ` L.•0%••' My Comm.Expires Aug 23,2026 Signature >f./4721-4 *- Signature of Nota ublic 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: Payment Bond No.7670434 Document Date: 06/20/2023 Number of Pages: Two(2) Signer(s) Other Than Named Above: All American Asphalt Capacity(ies) Claimed by Signer(s) Signer's Name: Rebecca Haas-Bates Signer's Name: ❑Corporate Officer— Title(s): ❑Corporate Officer — Title(s): ❑Partner — ❑Limited ❑General ❑ Partner — ❑ Limited ❑General ❑Individual ['Attorney in Fact ❑ Individual ❑Attorney in Fact ❑Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other: ❑ Other: Signer Is Representing: Signer Is Representing: Fidelity and Deposit Company of Maryland cVc�.cL.c�.tic`.c�.cti.c��`+`�tic`.''/G'✓.�:�'.`.:`.c�c�.c\✓i.�.cC✓S`y«.H✓cam✓'.\'!c�✓.Ouch%:�✓c�✓cam✓..��:�✓4�✓i.�✓c�.c'✓�✓'i:✓c'ei..�ric�✓i.u:. ©2014 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attorneys -in-Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may,by written instrument under the attested corporate seal,appoint attorneys-in-fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such 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 Attomey...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 20th day of June,2023. .P`C�aJilly 'i. .•,Ull.Ill.,���/,', `�,,�''"'py'py:i SEAL )171 o ' in Hi SEAL 1,- 714 9 Petrzt&L By: Mary Jean Pethick 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 800-626-4577 If your jurisdiction allows for electronic reporting of surety claims,please submit to: reportsfclaims@ zurichna.com Authenticity of this bond can be confirmed at bondvalidator.zurichna.com or 410-559-8790 • PRF7670434 Bond Number City of Huntington Beach Obligee 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 appointRebecca Haas-Bates, 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 20th day of June,A.D.2023. .';V Xy rrri h� 1`15\S C OT'�'ii. ,,f1 I".W,"�"qq',.�,,�iii ,r— ob , o�.�eQ°f 0 `a?'.y JSv4�,'..eO�`igy+.$°'c ``CI PP�Rq��k .`O P4 hiy :•/0 ti,c `t SEAL mmt. "i°SEALZVO m,;= `u( SEALk6,55 ATTEST: y''•'",` ` "`J ZURICH AMERICAN INSURANCE COMPANY rullm rulr "NErY `` COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND aw7L E GG}�— — By: Robert D. Murray By: Dawn E. Brown Vice President Secretary State of Maryland County of Baltimore On this 20th day of June,A.D. 2023 ,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. _11,r1Y11IrH", ,•1P4Ery .koTkq p % JLeí�/ %f.Y `, Iva Bethea,Notary Public „Ir.,rr. My Commission Expires:September 30,2023 GEN00011 Ed.(12/22) Authenticity of this bond can be confirmed at bondvalidator.zurichna.com or 410-559-8790 No. 2479-4 STATE OF CALIFORNIA DEPARTMENT OF INSURANCE SAN FRANCISCO Amended Certificate of Authority THIS IS TO CERTIFY that,pursuant to the Insurance Code of the Stale of California, Fidelity and Deposit Company of Maryland oflllinois,organized under the laws oflllinois,subject to its Articles of Incorporation or otherfundanrental organizational documents,is hereby authorized to transact within this State,subject to all provisions ofthis Certificate, the following classes of insurance: Fire,Marine,Surety,Plate Glass,Liability,Workers'Compensation, 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 12rh day of March, 2019,I have set my hand and caused my official seal to be affixed this _ 12'h day of.March, 2019.. a s.�:� `l � Ricardo Lara S' v -3 Insurance Commissioner 11 ✓ By Valerie Sazfaty for Catalina Hayes-Bautista Insurance 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 grounds for revoking this Certificate of Authority pursuant to the covenants made in the application therefor and the conditions contained herein. 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 TO: City Treasurer FROM: City Clerk • DATE: 9'/ SUBJECT: Bond Acceptance I have received the bonds for /Mt:ATV-in' 9)i'*/11.e (Company Name) CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. Payment Bond (Labor and Materials) Bond No. -3'"6, y3 L/ 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 te7/20/"?3 (Council Approval Date) CC No. CC 40'70Agenda No. LiSg MSC No. City Clerk Vault No. (OD 0.5D Other No. SIRE System ID No. ("3,5S7/52/ g:/forms/bond transmittal to treasurer ®/ NCT0�o Cityof Huntington �00 �••��oaPoerFo Beach OU 2000 Main Street ♦ Huntington Beach, CA 92648 o (714) 536-5227 ♦ www.huntingtonbeachca.gov ‘k-9� '• el ,�*Pa � E o 0 ••,:'�„9ag •:• \S 00 Office of the City Clerk c°LINTY �"�/® Robin Estanislau, City Clerk s®s4® July 27, 2023 All American Asphalt Attn: Edward J. Carlson 400 East Sixth Street Corona, CA 92879 Dear Mr. Carlson: Enclosed is a fully executed copy of the Federally Funded Construction Contract between the City of Huntington Beach and All American asphalt for Saybrook Lane Rehabilitation, approved by City Council on July 18, 2023. Sincerely, ir4071i 9,61-4441Ad Robin Estanislau, CMC City Clerk RE:ds Enclosure Sister City: Anjo, Japan 2000 Main Street, v �TCti Huntington Beach,CA o ' '4.ea • City of Huntington Beach 92648 COUNTV File #: 23-455 MEETING DATE: 6/20/2023 REQUEST FOR CITY COUNCIL ACTION SUBMITTED TO: Honorable Mayor and City Council Members SUBMITTED BY: Al Zelinka, City Manager VIA: Chau Vu, Acting Director of Public Works PREPARED BY: Joseph Fuentes, Senior Civil Engineer Subject: Accept the lowest responsive and responsible bid, approve appropriations, and authorize execution of a construction contract with All American Asphalt in the amount of $1,559,316 for the Saybrook Lane Rehabilitation Project, CC-1690. Statement of Issue: On May 23, 2023, bids were publicly opened for the Saybrook Lane Rehabilitation Project. City Council action is requested to award the construction contract to All American Asphalt, the lowest responsive and responsible bidder Financial Impact: Total cost for the project, including contingency and supplemental, is estimated at $1,785,000. Funds for this project are available in the current fiscal budget in the Pavement Management Relief Funding (PMRF) 127385201.82300 ($578,011), Measure M Account 21390033.82300 ($1,133,760.27), and the Road Maintenance and Rehabilitation Account (RMRA) Account 124790006.82300 ($73,228.73). Recommended Action: A) Accept the lowest responsive and responsible bid submitted by All American Asphalt in the amount of $1,559,316.00, and; B) Authorize the Mayor and City Clerk to execute a construction contract in a form approved by the City Attorney. Alternative Action(s): Reject all bids, and rebid the project. Analysis: The rehabilitation of Saybrook Lane from Heil Avenue to Edinger Avenue will provide localized base City of Huntington Beach Page 1 of 2 Printed on 6/15/2023 powere1 LegistarT"^ File #: 23-455 MEETING DATE: 6/20/2023 asphalt repairs, an asphalt overlay for the entire street consisting of 2-inches of rubberized asphalt concrete (RAC), manholes, monitoring wells, survey monuments, and water valve assemblies that will be adjusted to the new finished surface; traffic loops, and striping improvements; and limited replacement of concrete curb, gutter, sidewalk, driveway approaches, access ramps, and trees. The Saybrook Lane street segment has an existing Pavement Condition Index (PCI) ranging from 39 (Very Poor) to 57 (Poor) and warrants rehabilitation now to avoid considerable higher reconstruction costs. This project uses a sustainable paving material, RAC, which contains crumb rubber derived from 100% California waste tire rubber. A 2-inch layer of RAC includes over 2,000 waste tires per lane mile. This project will divert approximately 20,000 waste tires that would otherwise end up in a landfill. Including this project, the use of RAC in the rehabilitation of the City's arterial streets has resulted in the diversion of almost 400,000 waste tires. Reimbursement from the CalRecycle RAC grant in the amount of $42,000 is anticipated upon project completion. The project is scheduled to start construction in July 2023 and should be completed within 40 working days. Bids were opened on May 23, 2023, with the following results: BIDDER'S NAME BID AMOUNT All American Asphalt $1,559,316.00 R.J Noble Company $1,656,354.00 Hardy & Harper, Inc. $2,098,841.00 Staff recommends awarding a contract to All American Asphalt in the amount of $1,559,316. All American Asphalt has successfully completed similar arterial construction projects in the City. The total project cost is estimated to be $1,785,000, which includes the construction contract, construction contingency, inspection, and supplemental services (inspection, labor compliance monitoring, and construction geotechnical testing.) Public Works Commission Action: The Public Works Commission reviewed the project on April 19, 2023 and approved the project with a vote of(7 Ayes - 0 Noes). Environmental Status: Caltrans NEPA determination has determined no significant impacts on the environment and is categorically excluded from the requirements under Section 23 CFR 771 activity (c) (26). Strategic Plan Goal: Infrastructure & Parks Attachment(s): 1. Vicinity Map 2. PowerPoint Presentation City of Huntington Beach Page 2 of 2 Printed on 6/15/2023 poweretnii LegistarTM / 1 .eO • G • Os v~i c~n N BOLSA AVE O U N NTS Mc FADDEN AVE.o Q ) 14, J o EDINGCR AVE. O/„ J N m < U) U) > b0 ? HEIL i o AVE. m 0 - CC z < I a J- O c� liiU r o WARNER a Z_o AVE. c� N Q a J SLATER g_ AVE. 405 TALBERT AVE. PACIFIC 4 9 — �� ELLIS AVE. O J GARFIELD AVE. 0 H 2 (I) U) cn ccnn t \CO9s *. YORKTOWN AVE. \ z 0�, ^'�� I 3 ADAMS AVE. CI O� �� w w z ,'6'F g = INDIANAPOLIS AVE. 1_ cn qo v' 00 ATLANTA AVE. _ S. Q p Y J cc O HAMILTON z = a ? co 6*)- 2 BANN NG PROJECT LOCATION • OCEAN AVE. 0 SAYBROOK (EDINGER - HEIL) LEGEND ARTERIAL STREET LOCATIONS REV 6/6/22 FY 21 -22 ARTERIAL REHABILITATION, CC-1690 PROJECT LOCATION MAP '..4. p CITY OF HUNTINGTON BEACH 0 P DEPARTMENT OF PUBLIC WORKS 1 OF 1 i 110 �►0..►/�►.•.► ir 'TIN G TD ••, oaybrook . ,,pRP0RgTF ••• •• v 0 • • _ _ . p � Rehabilitation ..__ __ ...._ t . °1° k Project __ • - - - Ti_ __ __...,_ _ _ . , : .4,. $ _,_ .__ ...._. ,,_ _____ „., ,i,,,,, . ),„,, • , A 2022/23 ... .. . _---„, . ,,, ._ : _ ________ . * 0 •. Fe. P• .• June 20, 2023 1 - n••••;7, 190;:••• l ••..••0UNTNt ,#' 111 Io erE;i .-,_ BAC KG ROU N D , BOLSA AVE U NiS Mc FADOEN VI AVE. s94, EDINGHR AVE. 0/(', ' W Z N 3� Q VI N N c \ z HEIL 3 o _o i AVE.m Ir a WARNER m w w F AVE. SLATER o AVE. CO • Approximately one half-mile of construction on PACIFIC A90 T IERT AVE �\ 9c ELLIS AVE. r Saybrook Lane from Edinger Avenue to Heil GARFIELD 5 AVE. o Z VI4~1 � IA Avenue °o� �4� Y.RKTOWN AVE o 3 r 0`90 ♦ ADAMS •VE. ,O '''. ' z ; = INDIANAPOLIS AVE. 9T2` w �' m ATLANTA AVE. s a O Y • Public Bid Opening held on May 23, 2023 HAMILTONz 5219- BANN NG PROJECT LOCATION OCEAN AVE. pl SAYBR00K(EDINGER-HEIL) -� LEGEND N ARTERIAL STREET LOCATIONS REV 5/0/22 //�//I.,,I 00 Ii l7 TING 0 T <<II • ,, •. 0 . _ `' __ • 0- ' ` — �—. S j =°°UNTY�,�i 112 NEEDS/WHY/ BENEFITS • New asphalt overlay required to existing pavement for extending life of street • Replace damaged and uneven concrete • Landscape enhancement with tree replacement • Drainage improvements • Striping and signage improvements • Utility adjustments and cover replacements v.a ry, *'" _ � , - '- ''b Q 1 ' R i o (y r ., 5 ,g i 1,€ k as eir 9 l ,..,fr f a ,;.l rt-r � - ,� '.'- .p l4� -� 4I. . .r to .„ i 'w Y ,*Z, r f EV s i/ j > /���i�i TING � •,,,PORAt.% *.c''',,, (.;::',.'"'.)".*1''str.-•''''. <''''''. ZT:Cr' "7. - 0 Lt../ --—7:—:: ',...-:-I'.V \ �' , ` err- irii�e p, .,, �$&„' v e'te.4�" rs` f, ,•x;.• \CD i�„011 /��,,.,,�• , r -] s \... `.4" a "' ". yf v5e..:„ ,, 'at 1 •• ,t O UNT' 011 —,.�,I.I / 113 FUNDING , , • Arterial CIP Fund . ,:„ 2 . . , ..,-,, :__ ing $1 ,559,31 ( ... 6 • Road Maintenance and Rehabilitation - ..F Account (RMRA) $73,228.73 t . . • Pavement Management Relief 4 � Fund (PMRF) $578,011 • Measure M Account $1 ,133,760.27 �ti„NTINGT CIS n ca: .. _ �DuNTY C�1i11 114 SCHEDULE • Construction to commence in Summer 2023 • Construction to finalize in Fall 2023 �,f``1`�•NTING /f,n :r -rr % O.UNTY t# F 115 RECOMMENDATION • Accept the lowest responsive and responsible bid submitted by All American Asphalt in the amount of $ 1 ,559,316 • Authorize the Mayor and City Clerk to execute a construction contract in a form approved by the City Attorney. ��<-�....�' �. / ' ` .•' ORAre�'.'s: ,da .. - • ce \ COUNTY A/ 116 L-Tmai/: hipoP3 6111112 SECTION A /fl/23 NOTICE INVITING ELECTRONIC' BIDS for the construction of SAYBROOK LANE REHABILITATION CC No. 1690 in the CITY OF HUNTINGTON BEACH PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites electronic bids for the above stated project and will receive such bids prior to 10:00 a.m. on Tuesday,May, 16,2023,on the City's PlanetBids System Vendor Portal,at which time or thereafter bids will be opened and made available online.Bids received after this time will be considered non-responsive. Prospective bidders must first register as a vendor and then bid on this project via the City's PlanetBids System Vendor Portal website at: https://www.planetoids.com/portal/portal.cfm?CompanylD=15340 Copies of the bid documents, including instructions to bidders, bidder proposal form, and specifications may be downloaded free at: https://www.planetbids.com/portal/portal.cfm?CompanylD=15340. Bidders must first register as a vendor on the City of Huntington Beach PlanetBids system to view and download the Contract Documents,to be added to the prospective bidders list,and to receive addendum notifications when issued. Any contract entered into pursuant to this notice will incorporate the provisions of the State Labor Code. Pursuant to the provisions of the Labor Code of the State of California, the minimum prevailing rate of per diem wages for each craft, classification or type of workman needed to execute the contract shall be those determined by the Director of Industrial Relations of the State of California, which are available online at www.dir.ca.gov/DLSR and also 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. For electronic submittal of bids, the bid security must be received at the City of Huntington Beach Public Works Office,2000 Main Street,no later than the bid opening date and time.The bid security must be submitted in a sealed envelope bearing the name and address of the bidder, and the outside of the envelope must read as follows: OFFICIAL BID SECURITY- DO NOT OPEN Project Name: SAYBROOK LANE REHABILITATION CC#: 1690 Bid Opening Date: Tuesday, May 16 at 10:00 a.m. The successful bidder shall be licensed in accordance with provisions of the Business and Professions Code and shall possess a State Contractor's License Class A, at the time of the bid opening. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. All extension of unit prices will be subject to verification by the AGENCY. In case of a variation between the unit price and the extension,the unit price will govern. Project Description: The project consists primarily of cold milling of the existing pavement,deep lift removal of failed roadway sections, asphalt base paving, rubberized asphalt concrete (RAC) surface course paving, limited removal and installation of concrete curb and gutter, concrete sidewalk, curb access ramps, cross gutters, landscaping, adjusting manholes, and valves to grade, and installing traffic loops with striping and signage. The contract shall allow the Contractor 40 working days to complete the contract. The Notice of Proceed will be issued no later than Monday,July 10,2023 and the working days will commence for this project. This is a federal project and the Project Disadvantage Business Enterprises (DBE) goal is 12%. All questions related to this bid solicitation must be submitted through the City's PlanetBids System Vendor Portal per the information provided in the Instructions to Bidders.Any other contact to City staff regarding this bid solicitation will be referred back to the PlanetBids system. 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 30 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, April 20, 2023 11:44 AM To: Switzer, Donna Cc: Fuentes,Joe;Tanio, Chris;Janusz, Bill; Moore, Tania Subject: Re: Request for Publication - NIEB CC-1690 - Group Account# 5190751 Okay! New cost is $2,274.20 OC Register Legal Advertising Sales Coordinator Chrissy Gonzalez 1920 Main St, Suite 225 Irvine, CA, 92614 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, Apr 20, 2023 at 11:42 AM Switzer, Donna<Donna.Switzer@surfcity-hb.org> wrote: Hi Chrissy, This ad needs to run on May 11th as well, please. Thank you! Donna Switzer, CMC ! Senior Deputy City Clerk City of Huntington Beach,City Clerk's Office 1 2000 Main Street,Huntington Beach,CA 92648 Main (714)536-5227 Work (714)3741649 Email Donna.Switzer@surfcity-hb.org From: Christine Gonzalez<cgonzales@scng.com> Sent:Thursday,April 20, 2023 11:29 AM To: Switzer, Donna <Donna.Switzer@surfcity-hb.org> Cc: Fuentes,Joe<jfuentes@surfcity-hb.org>;Tanio,Chris<chris.tanio(Wsurfcity-hb.org>;Janusz, Bill <WJanusz@surfcity-hb.org>; Moore,Tania <Tania.Moore(Wsurfcity-hb.org> Subject: Re: Request for Publication - NIEB CC-1690-Group Account#5190751 cost $1,561.80, pub 4/27 5/4 Wave OC Register Legal Advertising Sales Coordinator Chrissy Gonzalez 1920 Main St. Suite 225 Irvine, CA, 92614 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,Apr 20, 2023 at 10:14 AM Switzer, Donna<Donna.Switzer@surfcity-hb.org>wrote: Hi Chrissy, Please publish the attached notice, in The Wave, on 4/27, 5/4 and 5/11. Thank you. Sincerely, Donna Switzer, CMC Senior Deputy City Clerk City of Huntington Beach,City Clerk's Office 2000 Main Street,Huntington Beach,CA 92648 13 Main (714)536-5227 Work (714)3741649 Email Donna.SWitZerga,surfcity-hb.org 3 SECTION A NOTICE INVITING ELECTRONIC BIDS for the construction of SAYBROOK LANE REHABILITATION CC No.1690 in the CITY OF HUNTINGTON BEACH PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH,as AGENCY, invites electronic bids for the above stated project and will receive such bids prior to 10:00 a.m. on Tuesday, May, 16, 2023, on the City's PlanetBids System Vendor Portal, at which time or thereafter bids will be opened and made available online. Bids received after this time will be considered non-responsive. Prospective bidders must first register as a vendor and then bid on this project vice the City's PlanetBids System Vendor Portal website at:littps://www.planetbids.com/portal/PortaI.cfm?Companvl D=15340 Copies of the bid documents, including instructions to bidders, bidder proposal form, and specifications may be downloaded free at: httos://www.planetbids.com/portal/portal.cfm?CompanvID=15340, Bidders must first register as a vendor on the City of Huntington Beach PlanetBids system to view and download the Contract Documents, to be added to the prospective bidders list, and to receive addendum notifications when issued.. Any contract entered into pursuant to this notice will incorporate the provisions of the State Labor Code. Pursuant to the provisions of the Labor Code of the State of California, the minimum prevailing rate of per diem wages for each craft, classification or type of workman needed to execute the contract shall be those determined by the Director of Industrial Relations of the State of California, which are available online at www.dir.ca.gov/DLSR and also 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,cashiers check,or bidder's bond made payable to the AGENCY for an amount no less than 10% of the amount bid. For electronic submittal of bids,the bid security must be received at the City of Huntington Beach Public Works Office, 2000 Main Street, no later than the bid opening date and time. The bid security must be submitted in a sealed envelope bearing the name and address of the bidder,and the outside of the envelope must read as follows: OFFICIAL BID SECURITY-DO NOT OPEN Project Name: SAYBROOK LANE REHABILITATION CC#: 1690 Bid Opening Date: Tuesday,May 16 at 10:00 a.m. 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 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 proiect consists primarily of cold milling of the existing pavement,deep lift removal of failed roadway sections, asphalt base paving, rubberized asphalt concrete (RAC) surface course paving, limited removal and installation of concrete curb and gutter, concrete sidewalk,curb access ramps,cross gutters,landscaping,adjusting manholes,and valves to grade,and installing traffic loops with striping and signage. The contract shall allow the Contractor 40 working days to complete the contract. The Notice of Proceed will be issued no later than Monday,July 10,2023 and the working days will commence for this project. This is a federal proiect and the Project Disadvantage Business Enterprises (DBE) goal is 12%. All questions related to this bid solicitation must be submitted through the City's PlanetBids System Vendor Portal per the information provided in the Instructions to Bidders. Any other contact to City staff regarding this bid solicitation will be referred back to the PlanetBids system. 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 30 days. BY ORDER of the CITY COUNCIL of the CITY OF HUNTINGTON BEACH,CALIFORNIA, the Zth day of June 2022,by Resolution No.2022-28. Attest: /s/Robin Estanislau CITY CLERK OF THE CITY OF HUNTINGTON BEACH Huntington Beach Wave 1920 Main St., Suite 225 Irvine, Ca 92614 714-796-2209 5190751 HUNTINGTON BEACH, CITY OF PROOF OF PUBLICATION CITY CLERK DEPARTMENT 2000 MAIN ST Legal No. 0011598683 HUNTINGTON BEACH, CA 92648-2763 FILE NO. SECTION A CC-1690 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: 04/27/2023,05/04/2023,05/11/2023 I 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: May 11, 2023. Signature r.LPI-12115115 H 4,4.00*/#1474.404#CF00.0-10#00:-Arl, *Cf44404. qtrittifittkdtAktiitAti4?,= 0.--OtItte•ApPTICE 1$41,-P,.garTi:•-•:PIYEW,Tnatire•A;wir.„114-04•INATImoivx.:•54tir".. .441k AG5X.V., ..te4forAiwt-004,idltAtki*,,*:421.11biligs, ! r r,$iraV'tl-t14jtttrlt3R-t' tirtrt000fton,bioc,mvbt'.,fi,:porsol;owregtttkttfYO-ttble,t#14BId receiv.44',;t11Nt 4-11): ;4infiq..Milt".-te7tolititikrOtt ,J56,etkveibidiiitts*.tOstlitst te.gi-§t-0,0s'tiVritIcit4;itiaz.41t#WttlitLoollitS.'Oroitiitt4Y, PP#0190:01#1,0tAtIOW-AmAl#0,01014-NOVV.004:Aci..,,ft‘......,...:t0:,m004.qttP494.'-' pow.o.fliwbr..4: 0041,4*-Aoolottiticiorroitio04011100.1"-,,,,ht00.0,4toppikorititeopoild t..0.srlyiyotopltanet 4:Aprrtip,o or f -?.,cqtylkolly:11)11.113:14:.,,Elidde.rsAtiliaqrt-st Fer§:f0,r,44,1.*::tOktfOr.,72ort4iWi-Ofx •:totIt1iiftTCTOgddif!.1. Stbil);i104,i0iiitlflA 4k9:.eti:Ktdd:tWt4ttttOttAX,etj.rrf,SrIS"!10.JS40;f0,g-Al2fAtWfi.rk;t:C:PgOgt:*P,1jAfti,*!tClil - - • • • d P 111117.014reCIIV4040,):'10.0470r,":-rOrtd.i0r0#0004ft it "--001ic.i'.kiOif -;ciiii„1:00eigiff4:***"et(t1414fietatltroct:ttitiit:40,40;,,ttefkrtitowitritoothe":::,PkecickiA0 ftidut4eJFthiotrog of the WYMigt-Irc40.-.40;Y,R4§RIVit.446i4ttlijk:411 tt.*I;),Ilfottelyoff-orpqprl,0t:Polty5,,yotow::: . Th0.04.4Agt.-4,!..),Y01:14.0.40ct-,4010,1.-..:OntArpmpU..1gov14.:010tc-Lrfr,t,,,, ..kr.RMAtrOV.P1--,m4k *.iibttittgp411,-;,,eKrowthoicier4$0,0 00.044:4.soulkitt.Robliglodytto44.4.!..§.0.01.04,.a-u261..;nTttectkottittomthoitte,,bant.fitioi lw.pp-y,ztgjftfIqot,y,:.ptt,,lh#!t..eo.oiyftpv•nteot.tlhtopitv,,' dttordttr 1:6trioototottvi;1*1;40.broilkAtitiO$,#00$0orooe':;,14,4t1W':,0011,0,;4400-Ilmilt,,tiokin Ono1dorotl*i sb,.0 tiictiroitiokittziagailittooliiktdAipflittetco;golowtotioottlittlitogOrtcOtiv%..Oxii4r409•104 cc#7400000.v.11KIWTSteticliOW.40,13014.m.', ,trot.'et*inffidtkIhwAGEOP--(4-1101..ct:mmf be•,.d .tabitisimileik.by•woortilitdXtr-okth-retlt heOke:,..0•1$440.1116i1041itidkpokitoct.01$10 AGENCCff-tir bItt-gf t dri,*_tegfrit.t.tittibrtlfttbillof buds bid sq«t.v,':irflo:g,..,b6.41.0401ViditiVOro ttlsokip.ziOtolV Ptacrfr, iObitgtitii0110!Pri(ce%. rOfiA41,111Stire,0,7k4,itritd,Wt.400141,i6OlitikliporiffiffOitC,0 41„roe ,TtiolgolotOrtswroOtili0 it;itit.f.#,trio",*,1;o0,#),140,444watto##t „ NOTPEN PrOleatititii0151,4,,VIT.00iKLANStRef,May417#7101C 1.3.1tctqOqj#*PeitWPsdiWP)tfOA*VY*;*:'-11*'., T‘igucc;cssitirbiri4ere-th-qit gerige.MtitictliAGErSIPJAre*terikfittift.tuffitViitAslittY46'ttib.6tflli'.yerjf-ittitftrit.OA.oLttte Aqs,titcY4,:i4obisc:Orfiii'itoticittOrril$06V001411#01144;10.04nat*O)000411601)*(ibitOdok*.i.1.1 0,0Vetit ThostbigcttotiOftft-IittracItil?"0Cc00:11pliinwatme'•*ilitisnsi. cut. giplittreirn-6.0** VAIJ04,00046,,,I,OttiOns:i410..P.Aktbsofg.,:folosqlobri6e,[2604iotitof ..1.10.0te'PACRApkgologt.. cotix*kPomol§ia *rtornoyor,lxtlotlf.:iO4jsafuoo:5WVo:qc.rp.pe4ur i:Orgt:‘,.4.0tteW=Acincr*le, §1dvoldikattb:;:octoWrittrop:4iNer.qss,;01.01-6r$AartcfgocwrOw:,)tailOttitiwititinhoie,V.:ttratirtiltisitt 140004itidii140#41tIOVIlffjp„`-j.**Pidt.rtstripyizt,ferg-M0904,05z: •-••-•••..„„•,,„••••••• •‘•••,.• ,• Ikatfovklog•I,coroopor,,=41kwapcmg,;p.9Y4,1w4,4111,111.4r9Y:41!Frc4;,'IAJ.- Ndti,-:.00f,.0.0,2k4:Willdi044,s00400411,01,e,A440140.040144.0.1.Y.,1A40,2„4%01104,, 004!Wis 0.11:,-061$000440.1410ArtioM' ' • ' • " • • ' " 111i1C1441(eitOtit,-0400*fiva,Tifik.pitaitt:110-cooiitag#: systottytott6rpo.etrtiko#e•lIh ':,--litfoqootiotylxi.vodett:*i6.thcp.00tottiow,Warttdet# • .t* OthOC,totitOgt _isollettrstiarvfili be,-fitferrEtt.ibtkW:46:-',•::the PjeofBidsVs t#Y01,19:!,140.00.i,' 000t-#)-k*4-XkirlalfrP.I.tg040W - ' BrORPERfOt.40:CirKQUNC.ILFOttt.t0:CITVOFFEIUNTINGTONfBEACK,CALMORNIAi tlit-7t4100)404urik.44271W Rts,411#40044.10:12.1.47.-AU riPi-12/15/16 2 t , F D Fidelity and Deposit Company of Maryland (94 BID BOND KNOW ALL MEN BY THESE PRESENTS:That we, ALL AMERICAN ASPHALT BOND NO. 085 97 423 as Principal,(hereinafter called the"Principal"),and FIDELITY AND DEPOSIT COMPANY OF MARYLAND ,a corporation duly organized under the laws of the State of Illinois ,as Surety,(hereinafter called the"Surety"),are held and firmly bound unto CITY OF HUNTINGTON BEACH as Obligee,(hereinafter called the"Obligee"),in the sum of Ten Percent of Total Amount Bid Dollars($ 10% of Bid ),for the payment of which sum well and truly to be made,the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns,jointly and severally, firmly by these presents. WHEREAS,the Principal has submitted a bid for SAYBROOK LANE REHABILITATION-Project No. 1690 Bid Date: May 16, 2023 NOW,THEREFORE,if the Obligee shall accept the bid of the Principal and the Principal shall enter into a contract with the Obligee in accordance with the terms of such bid and give such bond or bonds as may be specified in the bidding or contract documents with good and sufficient surety for the faithful performance of such contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter into such contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the work covered by said bid,then this obligation shall be null and void,otherwise to remain in full force and effect. Signed and sealed this 9th day of May A.D., 2023 ALL AMERICAN ASPHALT �1 Princi 1 Fa✓kafi See C, Witness /�'� (SEAL) E9/44 "✓ol J. lSo+7 ✓/7 FIDELITY AND DEPOSIT COMPANY OF MARYLAND Surety By t gA2 ,tfLQ a (SEAL) Rebecca Haas-Bates _,Attorney-in-Fact BID70000ZZO701f CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached.and not the truthfulness.accuracy_or validity of that document. State of California County of_ Riverside On May 11, 2023 before me, Kenona Nazari,Notary Public Date Here Insert name and Title of the Officer personally appeared Edward J. Carlson and Michael Farkas Name(s)of Signer(s) f who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/their 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. SE,>L Of Ty KENONA NARI Notary Public-AZ California I certify under PENALTY OF PERJURY under the laws of the State of = W � Riverside County z ' Commission 2318601 California that the forgoing paragraph is true and correct. `� My Comm.Expires Jan 10,2024 4 OR` WITNESS my fficial seal. Signatur Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law,it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document Bid Bond—City of Huntington Beach Document Date: May 9, 2023 Number of Pages: 3 Signer(s)Other Than Named Above: Rebecca Haas-Bates, Attorney-in-Fact Capacity(ies)Claimed by Signer(s) Signer's Name: Edward J. Carlson Signer's Name: Michael Farkas ❑Individual ❑ Individual X Corporate Officer—Title(s): Vice President X Corporate Officer—Title(s): Secretary o Partner 0 o Limited o General o Partner 0 o Limited o General RIGHT THUMBPRINT RIGHT THUMBPRINT ❑Attorney in Fact OF SIGNFR ❑Attorney in Fact OF SIGNER ❑Trustee Top of thumb here Top of thumb here o Trustee o Other: ❑Other: Signer is Representing: Signer is Representing: All American As•halt All American As•halt CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California ) County of Orange ) On 05/09/2023 before me, L.Gomez,Notary Public Date Here Insert Name and Title of the Officer personally appeared Rebecca Haas-Bates Name .of Signer'$ who proved to me on the basis of satisfactory evidence to be the person'* whose name* is/ace subscribed to the within instrument and acknowledged to me that he/she/they executed the same in R1s/her/their authorized capacity(l ),and that by his/her/their signature3.on the instrument the person(s),. or the entity upon behalf of which the personK acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph .,E•`.0°ry L.GOMEZ is true and correct. ::`` "• Notary Public-California .�<�= c Orange County > WITNESS my hand and official seal. Commission i<2413682 •4,,ow"'�`My Comm.Expires Aug 23,2026 Signature /1 .. Signature of N ry Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Bid Bond Document Date: 05/09/2023 Number of Pages: One(1) Signer(s) Other Than Named Above: All American Asphalt Capacity(ies) Claimed by Signer(s) Signer's Name: Rebecca Haas-Bates Signer's Name: ❑Corporate Officer — Title(s): ❑Corporate Officer — Title(s): E Partner— ❑Limited ❑General ❑ Partner — ❑Limited ❑General ❑ Individual L Attorney in Fact ❑ Individual ❑Attorney in Fact ❑Trustee ❑Guardian or Conservator El Trustee ❑Guardian or Conservator ❑Other: ❑ Other. Signer Is Representing: Signer Is Representing: Fidelity and Deposit Company of Maryland L ©2014 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item #5907 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V,Section 8,Attorneys-in-Fact. The Chief Executive Officer,the President,or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys-in-fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such 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, Secretary 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 9th day of May , 2023 , "GIntp autvi 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.reportsfclaimsQzurichna.com 800-626-4577 41 • rc 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 William SYRKIN, Rebecca HAAS-BATES, Sergio D. BECHARA and Richard ADAIR, all of Irvine, California,EACH,its true and lawful agent and Attorney-in-Fact,to make,execute,seal and deliver,for,and on its behalf as surety,and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies,as fully and amply,to all intents and purposes,as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York,New York.,the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills,Maryland.,and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland.,in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V,Section 8,of the By-Laws of said Companies,and is now in force. IN WITNESS WHEREOF,the said Vice-President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND,this 11th day of June,A.D.2019. \rol figp ti to SEAL ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND By: Robert D.Murray Vice President r 0..u/7L 4 fit' LAGG>ti.� • By: Dawn E.Brown Secretary State of Maryland County of Baltimore On this 11th 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. +b . 7•1:, / Constance A.Dunn,Notary Public My Commission Expires:July 9,2023 '�,11111ioi" t r arc-- ,„ * !'.. .-''- _ _� ,� © .w..T s r _.... s 1 a r ,� j w ‘•‘..‘N s* _. ALL AMERICAN ASPHALT AN EQUAL OPPORTUNITY EMPLOYER ic. z PO. BOX 2229, CORONA, CA 92878-2229 TO: C'iiY of ys,��l�*-f 71744 .aeac!,� • . w O �� €x �w�;.� to..t ae.c4, =` # RETURN REQUE;° STED ` �_v, J ?R; - ..#.x M.,x +.` "" Y..=s: >. ... a�az.', ,Eu d010.4.esu1?►1 _.. it ORIGIN ID:ONTA (951)7364600 AARON FREIRE 7SHIPUATE'18MAY23. " ALL AMERICAN ASPHALT ACTWGT:1.00 LB _ ' 400 EAST SIXTH STREET CAD:9489849/INET4610 CORONA CA 92879 UNITED ST TES US BILL SENDER TO ATTN: JOSEIH FUENTES — CITY OF HUNTINGTON BEACH 2000 MAIN STREET ciq HUNTINGTON BEACH CA 92648 c714)536-5431 U' IV : REF:;OFFICIALBIDBOND=`.CCtk9690._; DEPT: �"`,,a m '0';:p.::::"Shvzvs =t, -'1, '., I I 4 11 I 1177 d 11 1 ti d 1 CD FRI - 19 MAY 10:30A I `# 77218781 p680 PRIORITY OVERNIGHT I WZ A P 92648 I CA-US SNA I . ' I I ¢ I I I co •• • j I DI 0 =saga i Envelope 0 FT femi-i_. BID Sieogirr - Do A/07 opEA,/ rive- cf- Alaigie : 54y 8g/we himiE REgA8/Li zif-xe,04, _ AA eseem;" 'DJ* : •Zaclay, 414y /6 eut A0:40 ea-ii•i_ UNSUCCESSFUL BIDS CC No. 1690 Saybrook Lane Rehabilitation ; NTIN.. 047311, City of Huntington Beach q�� r T ,• 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov cp �'•..o B ; - o"o��� Office of the City Clerk Fc��NTY Oit, Robin Estanislau, City Clerk July 31, 2023 All American Asphalt P.O. Box 2229 Corona, CA 92878-2229 RE: Saybrook Lane Rehabilitation — CC No. 1690 Enclosed please find your original bid bond for CC No. 1690 Sincerely, R0401) ‘ 4) -41/7141111") Robin Estanislau, CMC City Clerk RE:ds Enclosure Sister City: Anjo, Japan N1iNCTo ® City of Huntington Beach �� O r-DR�onarFo.q,•63 o o -LAC 2000 Main Street ♦ Huntington Beach, CA 92648 U° _ _ - m (714) 536-5227 • www.huntingtonbeachca.gov • ®®F-4 :���O�os� Office of the City Clerk Coj f � ,l, Robin Estanislau, City Clerk July 31, 2023 Palp, Inc. dba Excel Paving 2230 Lemon Ave. Corona, CA 92878-2229 RE: Saybrook Lane Rehabilitation —CC No. 1690 Enclosed please find your original bid bond for CC No. 1690 Sincerely, o'ik fit 9.6"44 17,0.14 d Robin Estanislau, CMC City Clerk RE:ds Enclosure Sister City: Anjo, Japan City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431 ADDENDUM NUMBERVNE For SAYBROOK LANE REHABLITATION FROM HEIL AVENUE TO EDINGER AVENUE CC No. 1690 Federal Project CRAL-5181 (195) in the CITY OF HUNTINGTON BEACH May 11,;2023 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications,and Special Provisions: 1) Extend Bid Opening to 10:00 A.M.on Tuesday,.-May 23,,2023. The bid date has been extended from"10:00 A.M.on Tuesday, May 16,2023"to"10:00 A.M.on Tuesday, May 23,2023",; 2) Replaced_Signing-and:Stripinq Plans:. Signing and striping plans have been replaced in Planet Bids and titled"CC-1690 Signing and Striping Plans Final 5-11-23". These plans should be used for bidding project. This is to acknowledge receipt and review of Addendum Number O dated above. PALP, INCDBA : compgjri i I'INC COMPANY Curtis P. Brown Ill President „253,,z:z. All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. SECTION C PROPOSAL for the construction of SAYBROOK LANE REHABILITATION from BEM AVENUE TO EDINGER AVENUE CC No. 1690 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In with the Notice Inviting ELECTRONIC 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 40 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 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. "TEN PEBGENT OF AlliOUNT 8117 Accompanying this proposal of bid,find :3 gy p, 81:>.90 in the amount of w- which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting ELECTRONIC 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" 5 lt. 23 c-2 SAYBROOK LANE (EDINGER TO HEIL) CC-1690 . PROJECT BID SCHEDULE Bid Const "" Contract Unit Extended • No. No Description. Quantity .Unit, Price Amount 1 -- MOBILIZATION 1 LS $ l R$ ,— — $ t 48ax�. • 2 TRAFFIC CONTROL PLAN 1 LS $... .+_CJCO - $ .-4�. 3 FURNISH PROJECT TRAFFIC CONTROL 1 LS , $ Rs $ 9$DOO, FURNISH AND INSTALL SIGNING AND 1 LS $ /!2.00e).r $ //ZG - — STRIPING PROJECT SPECIFIC WPCP(WATER 5 ( -- POLLUTION CONTROL PLAN)TO 1 LS $: 2c cO. $ 20::0. ADDRESS CONSTRUCTION BMP'S. 6 INSTALL AND MAINTAIN CONSTRUCTION 1 • LS $ !v 005. $ {oCXX), . BMP'S PER APPROVED WPCP. REMOVE TREE AND ROOTS; GRIND TREE STUMP AND ROOTS TO 24"BELOW TOP 7 2 OF SIDEWALK/GRADE. PULL OUT ALL 23 EA. $ $.2.0 .'-" $ 18 86 c ROOTS WITHIN PROPOSED ;IMPROVEMENTS. ,. �.. REMOVE STUMP AND ROOTS(NO TREE, ONLY STUMP AT THIS LOCATION); GRIND 8 3 TREE STUMP AND ROOTS TO 24"BELOW 2 EA $ 8°0, $ b , TOP OF SIDEWALK/GRADE. PULL OUT ALL ROOTS WITHIN PROPOSED IMPROVEMENTS "FURNISH AND PLANT NEW 24"BOX TREE, KING PALM.-ARCHONTOPHOENIX ALEXANDRAE, PER HB STD. PLANS 714, 715,716,718&719 AS SHOWN ON PLANS. (ITEM INCLUDES EXISTING LANDSCAPE AND IRRIGATION REMOVAL TO 9 ' 4 ACCOMMODATE NEW TREE; 25 EA $ /£500 $ 4S `.-- REPLACEMENT OF IRRIGATION IN KIND, BACKFILLING WITH CLASS A TOP SOIL, AND INSTALLATION OF ARBOR-GARD OR APPROVED EQUAL AT BASE OF NEW TREE; 1 YEAR MAINTENANCE AND GAURANTEE): . . C-2.1 SAYBROOK LANE (EDINGER TO HEIL) CC-1690 PROJECT BID SCHEDULE Bid Const - Contract'' Unit ' Extended No. No. Description Quantity Unit:... Price Amount SAWCUT AND REMOVE EXISTING SIDEWALK AND CONSTRUCT TREE WELL WITH SIDEWALK PER DETAIL ON SHEET 5. 'ZCOCa 10 5 (ITEM INCLUDES REMOVAL OF SIDEWALK, 25 EA $ tgco. $ n. 82 SF OF NEW SIDEWALK, NON-CHEMICAL WEED CONTROL BARRIER TO BE DUPONT LANDSCAPE MAX OR APPROVED, EQUAL AND MULCH.) REMOVE AND RECONSTRUCT SIDEWALK 11 6 5,525 SF $;.... 2 -* $ PER HB STD PLAN 207. REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD. PLAN 202(CF=8"). 12 7 980! LF $ t O• $ -- (ITEM INCLUDES CMB,SLOT PAVEMENT AND LOT DRAIN.) REMOVE AND RECONSTRUCT DRIVEWAY CURB AND GUTTER PER HB STD. PLAN 209 WITH#4 EPDXY DOWEL AT 12"OC. 13 8 (ITEM INCLUDES ALL APPURTENANCES, 53 LF $,., t 'O $ 7(3$G, "— DEPRESSED CURB&GUTTER,SLOT PAVE,AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB,AND GUTTER PER CALTRANS STD PLAN RSP A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). (INCLUDES ALL 14 9 APPURTENANCES, CURB GUTTER, 9 EA ;$...C/000. $ .19tX DEPRESSED CURB,SIDEWALK, DOMES, RETAINING CURB,CMB,SLOT PAVEMENT, AND ALL ITEMS FROM ECR TO BCR NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT CONCRETE CURB AND CROSS GUTTER PER HB STD. PLAN 205.(INCLUDES CONCRETE CURB, 15 10 SPANDRELS,TRANSITIONS, SLOT 1,975 SF $ 4 b. $ 79 c, PAVEMENT,CMB,AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) COLD MILL EXISTING AC PAVEMENT TO A 16 11 DEPTH OF 0.17'FROM EXISTING 9,560 SF $ O. 35 $ ..✓3 4�. SURFACE. COLD MILL EXISTING AC PAVEMENT TO A 17 12 MINIMUM DEPTH OF 0'AND TAPER FROM 74,300 ; SF $ O. 33 $ 2-b QO..c 0'TO 0.17'PER DETAILS ON SHEET 5. C-22 SAYBROOK LANE (EDINGER TO HEIL) CC-1690 PROJECT BID SCHEDULE Bid Const , Contract 1 Unit Extended No. No. . Description ... Quantity Unit Price Amount CONSTRUCT A 0.17'ASPHALT RUBBER 4 18 13 HOT MIX(ARHM-GG-C PG 64-16)WET 2,275 TN $ f '• ' $ 312./,Sa PROCESS OVERLAY. REMOVE EXISTING AC PAVEMENT AND AB TO A DEPTH OF 0.67'AFTER COLD MILL. CONSTRUCT NEW 0.67'B-PG 70-10 AC 19 14 DEEP LIFT OVER 95%COMPACTED 3,090 TN $__�-�- $.._"7._107O — SUBGRADE PRIOR TO PLACING 0.17' ARHM PER PLANS AND DETAIL ON SHEET 5. REPLACE WATER VALVE BOX ASSEMBLY 20 15 AND ADJUST TO GRADE PER HB STD 8 EA $ /qCZ. $ 1 S 2c0 PLAN 612. ........ FURNISH AND INSTALL COMPOSITE SEWER MANHOLE FRAME AND 21 16 5 EA $ 3 200 $ Ito OtO, COMPOSITE COVER AND ADJUST TO GRADE PER HB STD.PLAN 513(b). REMOVE EXISTING, FURNISH AND INSTALL NEW TRAFFIC PULL BOX PER CALTRANS STD. ES-8&HB STD. PLAN 422 22 18 AND ADJUST TO GRADE. PULL BOXES 5' EA $ 1 iOC '— $ (o Oc0 W/FIBERLYTE LID SHALL BE"CHRISTY FIBERLYTE"OR CITY APPROVED EQUAL. SIZE PER PLAN. LOCATION IS TO BE DETERMINED BY ENGINEER. ADJUST EXISTING SURVEY MONUMENT 23 19 WELL TO FINISHED GRADE. PROTECT 2 EA $ $ ..._SUt •.._'"'_...;. EXISTING SURVEY MONUMENT IN PLACE. REMOVE EXISTING,FURNISH AND INSTALL NEW WATER METER BOX PER 24 20 HB STD. PLAN 601/603 AND GRADE. PULL 1 EA $ 80• $ 80. BOXES W/FIBERLYTE LID SHALL BE "CHRISTY FIBERLYTE"OR CITY APPROVED EQUAL. Total Amount Bid in Figures: $ ' -0°18 get i s C-2.3 . LIST OF SUBCONTRACTORS In accordapce with Government Code Section 4104,the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or$10,000,whichever is greater,and the portion of the work to be done by such subcontractor. Bid Name and Address of State DIR PWC� class Dollar %of Item(s) Subcontractor License Registration# Amount Contract Number ... i f g TaF.F.f rr4 SNIT. cri Ic o 8 155i Ni. AAl11cv Sr 602105 Gbl t038 i-t7s-c) O P\4L1 t'L1'0la QLIA ALL +AMarrsca l ArPe4A+-T tvo,t� 340o 6 611A 4br 2�1013 1U tq i t761 ai/ P i5 CM- Cav tt (.4 411,018 I0032- 3u41ua+.d tir @tit vo L0000000 $b 2.2,;, j►aA'1 ►_n V`etlt 110 ':: ..._._ 145 Li '0 so 00 OS 64o0 124 A l 'De 1 D 5.1 `iyrcGYh M t G+ 1.31- OS tJ-6(AT 1 i` 01. t 20°'�, IVAS Cjavr1 �t t tol 6132'116 15` 16 ?+°• I. 5i 'L) dx1o6L1 0,40 inn 4 - C J0�3z arbTF4� -' 1 S10°i tla 1 v 4 1 tx� . �- 0.42 is cvi- Pr 5ywely TrfKG 641,01 mills-3 0, cry /�, b 3; ?j �3co tt/, u!a(n+�t i' - col 101`� • VMS Trurtuin JCt r ttC 2�` 1 231 Sit67 1LiEl 000 LL 5000 0.2- 1 O: t i1 r 42311u . T 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 , I at L()NG BEACH —CALL L3i;X:A khp " Date City State Curtis P. Brown HI beingp atiNtibBjciworn, deposes and says that he or she is President,.. of - EXr.PI PAVING COMPANY the party making the foregoing. bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company,association,organization,or corporation;that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not,directly or indirectly,submitted his or her bid price or any breakdown thereof,or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. PALP, INC BSA EXCEL PAVING COMPANY Name of Bidder Curtis P. Brown Ui - _ President s. nature of Bidder 2230 LEMON AVE LONG BEACH,CA 90806 Address of Bidder C-4 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 Los Angeles } On MAY 1 6 23 before me, R. Covington Notary Public , Sere insert name and tale af:t5le attieert personally appeared Curtis P. Brown III who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s)is/area subscribed to the within instrument and acknowledged to me that he/admit/my executed the same in his/bsodexitir authorized capacity(ies), and that by his/her 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. ` it CO tl € tON �~ WITNESS my hand and official seal. i �.. COWL 02339692 f;p Notaty Public'rliforni, ... ✓ L3;A NGELES COUNTY U, Notary Public Signature (Notary Public Seal) INSTRUCTIONS FOR COMPLETING THIS FORM ADDITIONAL OPTIONAL INFORMATION This form complies with current California statutes regar ingnotarywordingand, DESCRIPTION OF THE ATTACHED DOCUMENT if needed,should be completed and attached to the document.Acknowledgments from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary law. (Title or description of attached document) • State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) (Title or description of attached document continued) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her Number of Pages Document Date _....__ commission followed by a comma and then your tide(notary public). • Print the name(s) of document signer(s)who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms(i.e. ❑ Individual(s) heishe/they,-'is/ere)or circling the correct forms.Failure to correctly indicate this information may lead to rejection of document recording. XX Corporate Officer • The notary seal impression must be clear and photographically reproducible. President Impression must not cover text or lines.If seal impression smudges,re-seal if a Title sufficient area permits,otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of ❑ Partner(s) the county clerk. ❑ Attorney-in-Fact + Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. + Indicate title or type of attached document,number of pages and date. ❑ Other..:.. 4. Indicate the capacityclaimed bythe signer.If the claimedcapacityis a f;a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). 2015 Version www.NotaryClasses.com 800-873-9865 • Securely attach this document to the signed document with a staple. 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 SAYBROOK LANE REHABILITATION, (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. PALP INC DBA EXCEL PAVING COMPANY Contractor /1 Curtis P..BroAin III President Title Date:. MAY 1 6 2023 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. NIK 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. PALP, INN DBA EXCEL PAVING COMPANY Contractor B , Curtis P. Brown ill F:tecident Title Date;................MAY 16 2023 C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Bidder Name PALP, INC DBA EXCEL PAVING 2230 LEMON AVE Business Address I.CiNG BEACH, CA 9O806 City, State Zip 562)599-5841 ea/lingo {taingu gad Telephone Number STATE LIC#68865Pmail Address t\C122:C31 State Contractor's Lie No. and Class 6if ati Original Date Issued Expiration Date The work site was inspected by Lin$ ' `J ib S of our office on 51,01 1r"7 ,2022_. The following are persons,firms,and corporations having a principal interest in this proposal: PALP INC DBA EXCEL i'AVINU COMPANY David A.Drukker Vice President and Chief Financial Officer SMfeni`A''mo►erro Corporate Verdant Crissa.A Phillips Assistant Secretary The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability,fmancially or otherwise,to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. PALP INC DBA EXCEL PAVING COMPANY Company N ..e Sign of Bidder Curtis P. Brown III President Printed or Typed Signature c-s NOTARY CERTIFICATE Subscribed and sworn to before me this_day of MAY. 16 2023 ,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 Ci-V.AFO gX:A. ) County of Los Angeles __ ) MAY 16 2023 ° On before me Month,Day,and Year 'Inse ame and Title of Notary personally appeared,. Curtis P. Brown HI 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 myhand and official seal. c° € �"N ° 92 Ncstay Public•Ca::;amm (1414 Z`= • qq C�EP E{-S-CrNqV y ,y �} t .%t iTLl b 3 t.r4 �1tl E 1 jf � M 1 ,. / i My Cc;m i .t• 202A Signature, Signs e of Notary Public (PLACE NOTARY SEAL ABOVE) C-9 SEE ATTACHED Bidder's Project History For the purposes of this project, the bidder shall provide project history of similar work, specifically referencing the construction of {Describe specific work and experience necessary for project. For example, "Sanitary sewer line installation of at least of 1,000 of 8-inch and greater in public right-of- way. Sanitary sewer,lift stations of similar size,project work within public streets,an area containing high ground water and pipeline construction in high ground regions..with trench depths of 8-feet to the invert."). Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: 1. Name and Address of Public Agency Name.and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 2. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 3. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: c-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 Name of proposed Project Manager Telephone No. of proposed Project Manager: 562)599-5841 SEE ATTACHED 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. ac'ro. atv Name of proposed Superintendent Telephone No. of proposed Superintendent: 562)599-5841 SEE ATTACHED 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-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/PWCR/ActionServlet?action=displayPWCRegistrationForm DIR's Contractor Registration searchable database: https://efiling.dir.ca.gov/PWCR/Search.action I am aware and will comply with the provisions of Labor Code Section 1771.1(a)which states: "A contractor or subcontractor shall not be qualified to bid on,be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725.5.It is not a violation of this section for an unregistered contractor to submit a bid that is authorized by Section 7029.1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract Code,provided the contractor is registered to perform public work pursuant to Section 1725.5 at the time the contract is awarded." I furthermore will comply by providing proof of registration with DIR as the primary contractor, as well as for ALL subcontractors at the time of submitting the bid. PAIP INC MA EXCEL PAVING COMPANY Contractor Curtis P. Brown Ill By tmatingc exc pav'ng.fGt Email __.... .. ....... Date:. MAY 1 2023 Title PWC Registration#: @IRO 1000003331 C-12 STATE OF CALIFORNIA DEPARTMENT OF RESOURCES RECYCLING AND RECOVERY(CalRecycle) RELIABLE CONTRACTOR DECLARATION CalRecycle 168(Revised 7/13) This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalRecycle) prior to authorizing a contractor(s)to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of funds to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Unreliable.List requirement of their Terms and Conditions. The Unreliable List provision requires the following: Prior to authorizing a contractor(s)to commence work under the Grant,the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractor(s)stating that within the preceding three(3)years,none of the events listed in Section 17050 of Title 14,California Code of Regulations,Natural Resources,Division 7,has occurred with respect to the contractor(s). Please see the reverse of this page,or refer to.www.calregs.com If any of the events listed in Section 17050 have occurred, disclosure is required but will not necessarily result in CalRecycle refusing to approve the contractor. A signed statement explaining the facts and circumstances of the events must be attached to and submitted with this form. Contractor: Complete the form and send original to the Grantee. Grantee: Scan the form and upload it to the grant in CalRecycle's Grant Management System(GMS). For further instruction about logging into GMS and uploading this form, reference the Procedures and Re uirements...Retain the original form in. our t file. GRAPtTI;-INrOR ---^ , 4 4 Ti, 1 GRANTEE NAME: GRANT NUMBER: PRIMARY CONTACT NAME: I z ..0" x Asf zA ', z } ,ate, r 1 's ` ,,--g,""'r l CONTRACiroiti'dFORMATIo ,,, , d a CONTRACTOR NAME: � W.d ,,�..._.�:�,(:, _ FALP. I��C DBA ��� � . „,,,..,.. �„ aR EXCEL PAVING COMPANY AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: Curtis P. Brown III President MAILING ADDRESS: 2230 LEMON AVE LONG BEACH,CA 90806 As the authorized representative of the above identified contractor,I declare under penalty of perjury under the laws of the State of California that within the preceding three(3)years,none of the events listed in Section 17050 of Title 14, California 1 Code of Regulations,Natural Resources,Division 7,has occurred with respect to the above identified contractor. Alternatively, as the authorized representative of the above identified contractor,I declare under penalty of perjuty under the laws of the State of California that within the preceding three(3).years, if any of the events listed in Section 17050 of Title 14, California Code of Regulations,Natural Resources,Division 7, has occurred with respect to the above identified i contractor,I have disclosed all such occurrences in an attached signed statement that explains the facts and circumstances of the listed events. i Signature�, £ Date MAY 1 2 2 ':,. urns P. Brown Ill President — ....r.. STATE OF C_, IFORNIA DEPARTMENT OF RESOURCES RECYCLING AND RECOVERY(CalRecycle) RELIABLE CONTRACTOR DECLARATION C-13 CalRecycle 168(Revised 7113) Title 14 CCR,Division 7,Chapter 1 Article 5.Unreliable Contractors,Subcontractors,Borrowers and Grantees Section 17050.Grounds for Placement on Unreliable List The following are grounds for a finding that a contractor,any subcontractor that provides services for a CalRecycle agreement,grantee or borrower is unreliable and should be placed on the CalRecycIe Unreliable Contractor,Subcontractor,Grantee or Borrower List("Unreliable List").The presence of one of these grounds shall not automatically result in placement on the Unreliable List.A finding must be made by the Executive Director in accordance with section 17054,and there must be a final decision on any appeal that may be filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s)to CalRecycle due to fraudulent claims or reporting;or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act,Government Code section 12650 et.seq; or (c) Default on a CalRecycle loan,as evidenced by written notice from CalRecycle staff provided to the borrower of the default;or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycle;or (e) Filing voluntary or involuntary bankruptcy;where there is a finding based on substantial evidence,that the bankruptcy interfered with the CalRecycle contract,subcontract,grant or loan;or (f) Breach of the terms and conditions of a previous CalRecycle contract,any subcontract for a CalRecycle agreement,grant,or loan, resulting in termination of the CalRecycle contract,subcontract,grant or loan by the CalRecycle or prime contractor;or (g) Placement on the CalRecycle's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility;or (h) The person,or any partner,member,officer,director,responsible managing officer,or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud,bribery,collusion,conspiracy,or any act in violation of any state or federal antitrust law in connection with the bidding upon,award of,or performance under any CalRecycle contract, subcontract,grant or loan;or (i) The person or entity is on the list of unreliable persons or entities,or similar list,of any other federal or California state agency;or (j) The person or entity has violated an Order issued in accordance with section 18304;or, (k) The person or entity has directed or transported to,has or accepted waste tires at,a site where the operator is required to have but does not have a waste tire facility permit;or, (1) The person or entity has transported waste tires without a waste tire hauler registration;or, (m) The person or entity has had a solid waste facility or waste tire permit or a waste tire hauler registration denied,suspended or revoked; or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRecycle to remediate,clean,or abate a nuisance at the site;or (o) The following are additional grounds for a finding that,a person or entity described below should be placed on the Unreliable List: (1) The person or entity owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director,manager,partner,trustee,or any other management position with significant control(Principal Manager)in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person who owns 20%or more of the entity,if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (5) The entity has another entity which owns 20%or more of the entity,if that other entity: 1. Is on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (6) Subsection(o)is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-14 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. PALP; INC MA Contractor: EXCEL PAVING COMPANY Contact Person: Pam' Contact Phone: ..__ 562 599-5841 .Pultis P. Brown III Signed: . Pfe$ident Date: *Note: The above certification is required by the Department of Housing and Urban Development(24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub-contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act,as amended in 1992(HUD). Previous non-compliance with.Section,3 could result in.disqualification. C-15 EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder /,proposed subcontractor hereby certifies that he has.. / has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. C-16 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 / 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 checlanark 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 prosecutio Curtis P. Brown III �-- President I itty 6 2n 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 No If the answer is yes,explain the circumstances in the following space. C-17 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. Curtis P. Brown HI President HAY 16 202 Signature Print Name Date C-18 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. Curtis P. Brown III President MAY 16 2023 Signature Print Name Date C-19 CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notar y 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 . } MAY 1 282 On _ .- before me, R._Covington Notary Public , 1, g erefhseat name er t la Of e,atrcerl personally appeared Curtis P. Brown III who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/axe subscribed to the within instrument and acknowledged to me that he/skettl k ly executed the same in his/ jr authorized capacity(ies), and that by his/pewit air 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. yYt y TO N WITNESS my hand and official seal. $ `'�rl•rtzs9esaor � t< ;Pubtic-canfornta e I_C`� cl ES couNTY a ss` ,4if Comm.r.,. - &C ,202E1 Notary Public Signature (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM This form complies with =rent California statutes regarding notary wording and, DESCRIPTION OF THE ATTACHED DOCUMENT jlneeded should be completed and attached to the document Acknowledgments from other states may be completed for documents being sent to that state so long as the wording does not require the Cabfarnia notary to violate California notary law. (Title or description'of attached document) • State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s)personally appeared which (Title or description of attached document continued) must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her Number of Pages Document Date commission followed by a comma and then your title(notary public). • Print the names) of document signer®who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER • Indite the correct singular or plural forms by crossing off incorrect forms(i.e. ❑ Individual 9 heishe/they:-ts/ae)or circling the correct forms.Failure to correctly indicate this information may lead to rejection of document recording. 3r,X Corporate Officer • The notary seal impression must be clear and photographically reproducible. President Impression must not cover text or lines.If seal impression smudges,re-seat if a (Pie) sufficient area permits,otherwise complete a different acknowledgment form. ❑ Partner(s) • Signature of the notary public must match the signature on file with the office of the county clerk. ❑ Attorney-in-Fact S Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. Other 3 Indicate title or type of attached document,number of pages and date. ❑ + Indicate the capacity claimed by the signer.If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). 2015 Version www.NotaryClasses.com 800-873-9865 • Securely attach this document to the signed document with a staple. DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS,PART 29 The bidder,under penalty of perjury, certifies that,except as noted below, he/she or any other person associated therewith in the capacity of owner,partner, director, officer, manager: • is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any Federal agency; • has not been suspended,debarred,voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending;and • has not been indicted,convicted,or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification,insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies,initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Curtis P. Brown ill President MAY 1202 Signature Print Name Date C-20 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. Curtis P Brown III President MAY 18 2023 mature Print Name Date C-21 Local Assistance Procedures Manual Exhibit 15-G 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: al a. contract lig a. bid/offer/application Ki a. initial b. grant b. initial award b. material change c. cooperative agreement c. post-award d. loan For Material Change Only: e. loan guarantee year quarter f. loan insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No.4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier ,if known PALP,`I NC DBA EXCEL PAVIN 2230 LEMON nviffessionalDistrict,ifknown Congressional District if known LONG 'BB ACF-IEefieto nt/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 11.Individuals Performing Services (If individual,last name,first name,MI) (including address if different from No. 10) (last name,first name,MI) (attach Continuation Sheet(s)if necessary) 12. Amount of Payment(check all that apply) 14. Type of Payment(check all that apply) $ actual El planned - a. retainer b. one-time fee WNW 13. Form of Payment(check all that apply): c. commission ea, 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 El No 17.Information requested through this form is authorized by Title 31 U.S.C.Section 1352. This disclosure of lobbying reliance Signature — li*--_ was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 Curtis P Brown III Preside Print N U.S.C.1352. This information will be reported to Congress semiannually and will be available for public inspection.Any person who fails to file the required disclosure shall be subject Title: to a civil penalty of not less than$I0,000 and not more than ep 562)599-5841. . Date: MAY . 6 02 3 $100,000 for each such failure. Telephone No.:, Authorized for Local Reproduction Federal Use Only: Standard Form-LLL Standard Form LLL Rev.04-28-06 Distribution: Orig-Local Agency Project`Files EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES INSTRUCTIONS FOR COMPLETING EXHIBIT 1O-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 C-22 . _ _ January 2019 Local Assistance Procedures Manual Exhibit 15-G 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(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 Construction Contract DBE Commitment C-23 January 2019 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 shall be registered with the State Division of Industrial Relations and certified to bid on Public Works contracts. Please register at:https://efiling.dir.ca.gov/PWCR/ActionServlet?action=displayPWCRegistrationForm 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$10,000(whichever is greater). Photocopy this form for additional firms. Federal Project Number: Subcontractor Name and Line Item&Description Subcontract Percentage of Contractor DBE DBE Cert Annual Gross Receipts Location Amount Bid Item Sub- License Number (Y/N) Number ' contracted DIR Reg ,.. . , :' Number ' — wenri . . Name:TM y$.1.,•., , , 7_, •<$1 nulhon Cterart 4 &ave. , zig er,,,, ):, 9or Vo L;..1 n'a PI ' ',4Seirty',2' El <$10 naillion I"7-7S0 ' City,State: 0 - Nf.;,...,-, —Ei <$15 million PrA41,4%,‘ C4r 100000 le 38 '-!•,----'- . , ',,,, 'Age of Fum:10 yrs. .... Name:,ok.t. a Atc 4VcANJ :',$477,g' "] ' D <$1 million Agri ilas.'r CCic.neAT Lt.. , ' n" ' •El <.S5 million 1.61 01 7 . City,State: 1411 i/et -''. ' ci0% 0 lir <310 million 112,t1, (>15 (Ar ' ., <$15 million I 00000 IC61 ,. ' :N' 2 Age of Finn:453 yrs. Name. ,.t. , ,144: "t. 1 .'?"'''';':','",:., '..: t'',,,.,,!, ,;:lt. 1 <$1 million VVIgilIV LIA,Mifi 44pf-, L An.iio$ciaigii.- „ -` ' \ !.-:'1,:t.$4' El <$5 million CitY, tate: 141 500•-.- 61010/ 9 (" 0 1'L ?,1-41,.,,,' u -,...tuf, ., -__;.,- . ' r41,..::1.- - PT ,t r: tlialtirktA listile41 Cop 4:4 '"'"--- --' '').-iiV El <$15 million l00000 - ' ''"'ft:'',;' ' : - :, 60 6(o ---,INST: '1'-' ' Age in.45,.yrs. ,„„ /11\tikSt) CA) ST1211(4.4 G CV 0'61 SO 41 0*/. 314 P,, , ifj ,viA, 0 mil 0 milli," ' City,State: 'I 100090 030G ii-'4, ,, ' .,1,, 1 ra',F. 15 million CsittfiNtAk- Chr „:1-.5::,,,, - 4,1';'1):i Age irm:141 yrs. Name d , ''''-, ' '''-::-.:;:1 4 million : 'ri cot.—14 El-- .. .,, 5 million 01 g t.)11 ltbef AYIT. urzt-rry Aers„ :,- ..: ipt; INY f:, ,"Ivi.. 4:,-.4.-,i, D. iil million 6 C 0 iii -- 0aNe. Ak _: _ topooc)ittek ;,,,,,,-: ,,,,,--kii0-01, D 15 million , Age of Firm. If yrs. /0 k-c.,-"4-V,;,-f., In <$1 million A-0 I 1A (14 Sc - 0 g 4 pi I i a D <$5 million 1 s--1 s-e I tity•-kote. C.Art-(11,611 61 I CO IA,4 .t•,,s[ ' ,',1 hi ,,,,' ri <sio inillion 100000 g.f.! , ' ' ' -'''' 0 <$15 million 4/tit.6te Age of Firm:2,.? yrs. Distribution: 1)Original-Local Agency File 2)Copy-DLAE w/Award Package C-28 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 shall be registered with the State Division of Industrial Relations and certified to bid on Public Works contracts. Please register at https//efilin .dir.cagov/PWCR/ActionServlet?action=dlsplayPWCRegistrationForm 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). Photocopy this form for additional firms. Federal Project Number: Subcontractor Name and Line Item&Description Subcontract Percentage of Contractor DBE DBE Cert Annual Gross Receipts Location Amount Bid Item Sub-; License Number (Y/N) Number ' contracted DIR Reg Number Nam : ' Fv.c- �._. �� ■,r <$1 million ► , ri f 1 '-, �: . _ <$5..million P °I3._I i153 � City,ate. 1��, 30/, r ❑ <$10 million i11Qp0D, <$15 mullion �1�L - � '"'�C 9 �,,s. �...',)•t,k . Age of Finn:fa,,,,'�`ra. .. Name �r g,, 5: i. ;E , 11 <$1 million City,State: _ V 5�. ' `1)1 131 Sq '1 :� r s , ; = <$5 million V W i w tom"'Al I O L &' ■ <$10 million ► CA- ,13 r�_ � �+ off ' f$1 44 ❑ 5 million Firm: �rs; Name: . El .. <$1 million q t' g €1 • ,11 ❑ <$5 mullion City,State: p ■ .: <$10 million ' 's--4 ❑ . <$15 million ... i , ..�m Age irm: yrs. Name: te; (A • �•1 million City,State: ........ - f ,, (i 5 million $ ,a w lO million t Age um; yrs. Name: E —.1 million g .; ,. _ :- - .. (fit/�' itAA,I— 5 m•11hon tt ittt :.. w "4A 10 million t , million15 a Age of Firm: ■ Name: , Y Irlii € ,:Fy 1 million 7 arm 4 t ys .. .. • <$5 million +a Cl ..., <$10uulhon .. "*� _ �: ❑ ._ <$15 million ,< �. , I'A Abe of Firm: yrs. Distribution:1)Original-Local Agency File 2)Copy-DLAE w/Award Package , 1 I C-28 i I 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 subcontractor who provide a quote or bid but were not selected to participate as a subcontractor on this project.Photocopy this form for additional fines. Subcontractor Name and Line Item&Description Subcontract Percentage of Contractor DBE ; DBE Cert Annual Gross Receipts Location Amount Bid Item Sub- ::.License Number. (YIN)( Number contracted DIR Reg Number Name B6t tPi+a+E.sr ttt�cyca.LC if44-00 31'2 , 1 million v toaht tie.,17 r rig l ' � - C <$5 million City,Sate 1�19 41 to C{p D�o �� 10 million Vtl1l�l Coa.0ko,T�c. tbf10&) i`; Q _...$15 million of Firm� ilia r y y ,4 Age • Name: f;c AFfsc a <$1 million fF ti- g�y . City,State: 4 U C G+ 1 6e L =" ' El <$5;mt11ion ty, 12.1 02_2- �aa 7 W3-'z ❑. <$10million 5TA,Erz-)Cr 1. Tri <$15 million � R�i •:_ 1 aLo t , , ,, , Age of Firm:Si:yrs. ! Name: SvS aR Pa�Bww� - _ :_ . . -. I t-44 a1424 i 4 't'11�3 0 L 5 million City,State: I 24 8't`t 9p c� .. . . : , l0.tmlhon ST �s.J(� ° � � A 15trullton .. D C / o 00 .. 1 4 Cap* e EAge of Firm 14 s Name: w million C Pp 5 E City, Ci State: , ❑ <$ El $10 million million `.,. ❑Age ofyrs I Name: El . <$1:million ' $5 million City, ,(ate. • ..9,,,-4� .' < 10 million { ,,by El 5 million _. Age 0 fFfr Yrs.Name ❑ <$1...million I City,:'State: 0-Ace <$1 ❑ million I El 0 million million h ' ` Age ofFirm: yrs.. Distribution:1)Original-Local Agency File 2)Copy-DLAE w/Award Package C-29 i Local Assistance Procedures Manual Exhibit 17-F Final Report-Utilization of Disadvantaged Business Enterprises(DBE)and First-Tier Subcontractors Exhibit 17-1' Final Iteport-Utilization of Disadvantaged Buihresi Enterprises(DBE)and First-Tier Subcontractors 1.Local Agency Contract Number 2.Federal-Aid Project Number 3.Local Agency 4.Contract Completion Date 5.Contractor/Consultant 6.Business Address 7.Final.Contract Amount 8.Contract 11.DBE 12.Contract Payments 13.Date 14.Date of 9.Description of Work,Service,or 10.Company Name and Item Work Final Business Address Non-DBE DBE Materials Supplied Number Number Completed Payment 16.ORIGINAL DBE COMMITMENT AMOUNT $ 16.TOTAL List all first-tier subcontractorsfsubconsultants and DBEs regardless of tier whether or not the firms were originally listed for goal credit.If actual DBE utilization(or item of work)was different than that approved at the time of award,provide comments on an additional page.List actual amount paid to each entity.If no.subcontractors/subconsultants ware used on the contract,indicate on the form. I CERTIFY THAT THE ABOVE INFORMATION IS COMPLETE AND CORRECT 17.Contractor/Consultant Representative's Signature 18.Contractor/Consultant Representative's Name 19.Phone 20.Date 4g49' I CERTIFY THAT THE CONTRACTING RECORDS AND ON-SITE PERFORMANCE OF THE DBE(S)HAS BEEN MONITORED 21.Local Agency Representative's Signature 22.Local Agency Representative's Name 23.Phone 24.Date DISTRIBUTION: Original—Local Agency,Copy—Caltrans District Local Assistance Engineer.Include with Final Report of Expenditures ADA NOTICE: For individuals with sensory disabilities,this 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-30 PALP INC.OBA EXCEL PAVING COMPANY-PROJECT REFERENCES Job IP 'Job Horne_..... AgniW -. .. CN Zip Coda Nlnar� Emil._:.5337 twine Baler Beatty 2;20 Twin Start 1t . nobgyDr Stith. IMae 92618,, ` 5443 Long Beach Blvd.Pb.2 L Appleton __ (760! t 7130 mappleton�(ifarnc polar 06►OU16:OSfO J119 ;��41gggp Y► od.__ ll330 Bu Lynwood 90262 . Anbonb Perez (310)6030220 >9eloa@lfhlood ea.em 5492 .'N.San Femaid°Rd ._ Burbank i50 Matti Tlitq Sheet Bernath- 91510 VRdd D 03127117: 11f30liB.:: . $ 3,128 819 5503 Barrenca Chanel IMne Orange Omit.- (618)238 3985.."VDevB burbankca g°v 08/13117 091lOHB i" 1.158,, . ,1152 E null St Santa Ana 92701 Bnice Poma. : . 714-9550214 fruoe.pom 5510 D41Ot2sper. :. $anJuaaCa b 32400PaseoAdetanto San JrartCapisiarto 92675:. PeulMeshkin •oo rvoam` 08I0911S 08110118:,, $ 1,000,000 5535 Silvered°Canyon Bddga Mabdenanca -OCPW 1152 E.Fruit SL : Santa Ana 92701`: 'Robert Valle (714).245 4721 18 8 05/15! 10A5N $ iA99,801 5548 Uptown Paddtg Lot Whittier .13230 Penn Street yyhyg� gam. (714)87 95125 . robed r*hIfY.00m TBD TBD" i _ 929,734 '/teed°llenreidez -:.582587 8512 ahemaridez 5553 :Vadoue St Pevemad Rehab " : Campton 205 S Wi1owblook Ave .Compton .90220: Peter 949.232 6281'°' Peter.Sal r 03104/19 07/01/19 $ '.1614�000 ,. 5564 •Silber d°Canyon OCPW :.:" 1152. E.Fnrl.st. Santa Ana 92701 Robert (714)2454525 mbert rale@ocpw .ern `i. :'.1,554,971: '. 5570 SRTSfKertisat Ave..... •Sala Menke W 1;437 49n.... .300 Sarda'Monice 90401. Briar Odnoa 31 488 tltt32: Bdar.CiCtn° SMGOV NET 051D1H9 08A1118 i i54 971Y 5572 OSMC Lot Onlarlo 1425 S Bon.Vlerr Ave Ontarls 91764 Steve Grat idi 395.2680 7 S 5585 LiveOak7Trebrrco .. °chit etas 09/15/18 ...:. 2379,870 ACC/OG 2880 Vote CL Benicia 94510 izetg Van Note 742�8442 dean aocbcil:com `09115118 TBD .:: . . $ 379 0 5590 Cenhty Bed Motlaatlan . rid GreW Mmlchester 31 : i ewood . .,:: -90301. Nwiter Nguyen.: 310.412.768': J.hh tyoltngtewoad t._ 10/30/18 r. ` $ 18,422 8 5593.,:Commercial Sheets Rehab Redonde.thumh 415 Diamond Street Redondo Beach 90277 Danat Graze- '3104184661.:. 'DanktlGueao 5596 :Sheet br nuvamenta .. 8ert'Clementa 910 Calle Hood°Suite 100 San Clemente ";92873 •"Cary Vcborsky.. 949381.6132 vobadcyagean.clonente erg ' 12114H.8"03/29i19 $ 1,542,925 5599 .9 Modena Irvine Channel Rehab ... ..;OCPW 1152 E.FnitSt. Santa Ana 92101 R LM Veit: ,(7141245-4525 rotial:�:oop°v.com %•i 10101118 TBD :_5601 :City of Torrance SSP Torrance 20500 Median Ave Torrance 90503 Brenda Mote " -13104t183049_ bmoun6tara ceea4ov ./01102/19 12/31/19` S 889,9 5604 :Great Street San Gabriel:. 917 E.(brand Ave San Gabriel 91778 ,S eka'An then; 626.308.2825._ • 5607 La Patna/State Colese Whlenka . Anaheim 200 S.Anaheim Blvd Anaheim 92805 Rowena Dada ' 0 /4119 t020M9 I. 4111703 �{714)7854913 .Jr ardal�enelneim:eet 01/ 14flB TBD '. ffi ..: ,11 ,793 5609 _Anaheim Blvd l Ban Real lrdersedion .. .• Anaheim- .-200 S.Anahe r Blvd Anaheim:.... ._ 92805 Rowena Jarcla (lt4)7654913 ::tjerciaganaheim.net ... .„.-2.,......05120/19 T8D $ 4,197,281 5614 Rader SI Ieprt nts Baldwin Park E.Nett etc Ave Baldwin Pak 91705 °Chase Fktler'. 1625 960-4011 c9dl a lc.cam 01107/18 TBD $ 1,027,574'5818 Meboitk Parkig Lot Ph 2 :Pla .. '150 S.Peen Ave Rance 92378 'Jeff Schafer .. 909•120.2531 ischaferfittal 5620 .DM Bus 1ayMer Project .= Foothill Transit 100S Mutant Ave.Ste 200 West Covina 91790. _Vincent Sauoeda 620931-7268`' .'vseucede@t beta t eeatLorg,... _ 001/4/19 05)01119 $ :-1,72,77995 5623 San Fernando Road Improvame nts S nFanne do ",117 Mac nel St San Femaado 91340 Manuel Man " 81g4898-1243 fcky om`, ,:..:;02A1/19 05131/19` _,,$ .309,993' 15824 AradtlePallzadaSiduwafk , .:San Clerniente 910 Calla Ne oclo,Su'4a100 San Clemente, . 92873 GaryVoborsky: 94935143132. rob (r�aili ciem ' 02118119 05101119: $.:. ........540,738.; 5827 Slree(and Drainage im�novenne nt Santa Monica '14374th Street,Sule 300: Santa Monks- •90401. Nan*hoe3104558721 bdai. .net 08101/19 031311� $ 784 784 5828 Pavement Rehab Bell: .....1 8330 Pine Avenue Belt:. • •90231 Gregory 1kIds y - 32392322828 ➢ . 0504/19 051 1119 i ,...1.384,5 8,5638 lewood Ave Immovmnerd Ph 3 lawndale : 14717 Bulin Ave L.awndale" •90260 tfabono Oel `" 310.9733260.: Imelgleandeb ltyara 05101/19 02128120 •8'1,598,315.5645 Annual Paving,SNAP Lot. .. Santa Monica- 1437401 Street Suite 300 'Santa Monica 90401 ',.Jason H4 ,:, . 310458.2201 Jeson.Hoangg4MGCV NET. : 11115119:TBD . $ : 3,987,565 5654-SB 1 Sheet Rehab .. Alhambra _ 111 Barth Fket Street Attambra .. 91801 Stephanie Cer006tntg_a '626-570.5082 lhamlraorl ,<08/25/19 11114119: 5655 Annual Pavement Pieservaeon Yuba Node , 4845 Case Loma Ave Yorba Linda. 92886 Frady Cestlo 714-981.7100 yrrbteli Baca gcv 08103119.07/03/19 $ :. ,g3 5659 West Seaside Way Lag Beadi- 333 W.Ocean Blvd Lena Staab T '90802 George Ilex.,.. _562.5708525 ' •.� - ,$ 1,199,198:5681._i glavood Ara.end Roger Lana Redondo Beach 415 Dhrnnond Street Redondo Bead) 90277 lDanid Guezo: 31031843861.. Daiel.GotmoORalond°trg 09/03119'01/17/20 $•, .•1,187,801 5882 1lidway City North AC Repairs OCPW 1152 E.Pelt St. Santa Ana 92701 _Robert Vele 71 2454525 mIte Lveaa rr,00gav can__ 06/10119-1 1119 $ ' 1,035,309 4) 5669 Van Ness Ave iglaxoad One W ManchesterBlvd Inglewood 90301 _Hilnter 310412,768 I h4xiti` dtrolii9 ew°odd i 071�119 02P39f10 i`,: 838,8pp`.. 5874 Edinger Avenue Improvements ':Nurdigton Beads 2000 Ma1.n Sheet .. .Humurglon Be'soh• . 92848 Joe Fuentes 714-53135259 07831/19 02/29/20 $ 2,918;192 ; 5675 :WhitlerShelf Hetlena RdIntersection La Habra 110 E.La Habra Blvd La Habra 90631 ...._„Cuba 3834151 ._. TBD :: TBD"` i........ 1,693,285' 5676 CcutyotCrange PavomedMeiden nce OCf'W. 1152 E.FmritSL SedeAna �!� ��) rragel�ahelnraengov � 92701 Robert Vale '' (714)2454525 robatvatk�Aroogov.cann ,: •TBD •TBD $ 2,490;000� 5879 Street Rehab ..: .. Calabasas 100 Chic Cenler-Way_ Celatases 91302 Ache erinus 818-22411877: 5680 Zone 1 StreetSkmy Seal and Rehab LegunaBoedn ''. 505 Foreat`Ava Laguna Beach �,92651 Tan Sandefur::. 949497-3311` taande ul tlegunabeedtyrnet $ -seas-said aridAlkYtmpwemanta Beverly Hais 345FaotlnriRoad Beverly HOB 90210 ManePautDiialwe4 ' c310-285�513'. gafirg $ .. :1,418,729 5688...Amman Sheet SM emado, h 17 Maune9 St Sen•Ferrando : 91340 'Maaiut Fabian:. .:; 81 898.1243 09/23119 01/31/ZQ S 7 094, 76 ..5690. FB05 Hot . : ,. Pko.Rhin •6815 Parsons Blvd Pico Roma 90660. eN 1125119•01f31120 '$..':5,257`894+ Cfita Baca j316j 5024G35 cbaea�w9dano°m 11125119,07Atfif�0 #- 5,T37,894 5692_ Resklentlal Sliest Rehab Redordo Seedy 415 Diamond Street Redondo Beach 90277 Lauren Sablan' 31031841687 5696 Laguna Niue!tlaglonal Park OCPVII. ..: • 1152 E Fnit St Santa Ana :92701° Robert Vale .:. ° �°ov. ',... 1?102/19 06101l20 #,: 4,688LTI7;. • p1 "2454525, robnxt vsle'tx io ov.oan 11112/19.02tt013, 1t..:: 1,899,609 5698• Catty of Ore*,General 6ntixirdaa OCPW 9152E Rid St Santa Mir 92701 Robed Valle—..„ 14 -525 •o ovgo. :. . 01/2111920 06110120. g-, '1,970,6-'2: 5701.,.Traffic Mlamiigement System SUB m Partake Anansa ': �2t3 E.Fo°thD Blvd Azusa.: 91702 Chrl�CudeT"" 828.8125248. auniel�®iaara,gmr 01121/20 OBrwl0J20 3; :.'1 g78,612.: 5 094 Cyde 1 Sheet Rewvla Pra4ra n. fiariadarl Basal 3621 Bel Ave Manhattan Bead 90286 Arita M9Aer . " 310402.5353 b•Idb BldSewer&Pavemad LaPueIm.,; ;. 15900MakiSL La Puente ;91744 Adel Frea '582)760.7752 .con S - .1329,858 6716 Refitment iifraabechxe Morava :800$Mountain Ave MmnoNa 01J13119 TBD $ ' 1, 1293 91018 (Sean t,"tnlhran`" (6ZG 1g2 M +ad monimia ca nm "� TBp Tg( � �sL9,293 4 1. ' s Bond No. Bid Bond. BID BOND The American Institute of Architects, AIA Document No.A310(February, 1970 Edition) KNOW ALL MEN BY THESE PRESENTS,that we PALP Inc.dba Excel Paving Company as Principal hereinafter called the Principal,and Federal Insurance Company a corporation duly organized under the laws of the state of Indiana as Surety, hereinafter called the Surety, are held and firmly bound unto City of Huntington Beach as Obligee,hereinafter called the Obligee,in the sum of Ten percent of the total amount of the bid Dollars (S 1 o% ), 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 Saybrook Lane Rehabilitation • 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 28th day of April , 2023 PALP Inc.dba Excel Paving Company . Principal • (Seal)ims Orissa A. Phillips,Asst. Secretary By y� C rtis P.Brown III,President N anieffitle Federal Insurance Company Shy (Seal)WitnessBy: Q . nnP Douglas .Rapp Attorney-in-Fact ORSC 21328(5/97) 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 April 28, 2023 before me, Debra Swanson, Notary Public (insert name and title of the officer) personally appeared Douglas A. Rapp who proved to me on the basis of satisfactory evidence to be the person(e•)whose name(e)isfare subscribed to the within instrument and acknowledged to me that he/ohc,'4hey executed the same in hisfherttheir authorized capacity(ise), and that by hisfhedUheir signature(e)on the instrument the person(e•), or the entity upon behalf of which the person(e)acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. N „4�5�`orr,It% DEBRASWANSON N ., COMM.#2335630 , • i NOTARY ORANGE COUNTY N r °4 MY COMM.EXP.NOV 10,2024 Signature -4 Q (Seal) D.1 , U B B Power of Attorney Federal Insurance Company I Vigilant Insurance Company I Pacific Indemnity Company Westchester Fire Insurance Company I ACE American Insurance Company Know All by These Presents,that FEDERAL INSURANCE COMPANY,an Indiana corporation,VIGILANT INSURANCE COMPANY,a New York corporation,PACIFIC INDEMNITY COMPANY,a Wisconsin corporation,WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY corporations of the Commonwealth of Pennsylvania, do each hereby constitute and appoint Douglas A.Rapp and Timothy D.Rapp of Ladera Ranch,California---------------------------- ——----- —_____ each as their true and lawful Attorney-in-Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or otherwise,bonds and undertakings and other writings obligatory in the nature thereof(other than bail bonds)given or executed in the course of business,and any instruments amending or altering the same,and consents to the modification or alteration of any instrument referred to in said bonds or obligations. In Witness Whereof,said FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,PACIFIC INDEMNITY COMPANY,WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY have e on each executed and attested these presents and affixed their corporate seals on this(is 5th day of April,2 021. Dawn M.Chloros.Assistant Secretary Stephen M.Haney.Vice President fir.^'�' • STATE OF NEW JERSEY County of Hunterdon SS. On this sm day of April,2021 before me,a Notary Public of New Jersey,personally came Dawn M.Chloros and Stephen M.Haney,to me known to be Assistant Secretary and Vice President,respectively,of FEDERAL INSURANCE COMPANY VIGILANT INSURANCE COMPANY,PACIFIC INDEMNITY COMPANY,WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY,the companies which executed the foregoing Power of Attorney,and the said Dawn M.Chloros and Stephen M.Haney,being by me duly sworn, severally and each for herself and himself did depose and say that they are Assistant Secretary and Vice President,respectively,of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,PACIFIC INDEMNITY COMPANY,WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY and know the corporate seals thereof,that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of said Companies;and that their signatures as such officers were duly affixed and subscribed by like authority. Notarial Seal ;:t. KATHERINE J.ADELAAR OAR). 1 NOTARY PUBLIC OF NEW JERSEY • No.2310686 pUaLtt I Commission Expires July 16,2024 Noiary Public i CERTIFICATION Resolutions adopted by the Boards of Directors of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY on August 30,2016; WESTCHESTER FIRE INSURANCE COMPANY on December 11,2006;and ACE AMERICAN INSURANCE COMPANY on March 20,2009: "RESOLVED,that the following authorizations relate to the execution,for and on behalf of the Company,of bonds,undertakings,recognizances,contracts and other written commitments of the Company entered into in the ordinary course of business(each a'Written Commitment'): (1) Each of the Chairman,the President and the Vice Presidents of the Company Is hereby authorized to execute any Written Commitment for and on behalf of the Company,under the seal of the Company or otherwise. (2) Each duly appointed attorney-in-fact of the Company is hereby authorized to execute any Written Commitment for and on behalf of the Company,under the seal of the Company or otherwise, to the extent that such action is authorized by the grant of powers provided for in such person's written appointment as such attorney-In-fad. (3) Each of the Chairman,the President and the Vice Presidents of the Company is hereby authorized,for and on behalf of the Company,to appoint in writing any person the attorney-in- fact of the Company with full power and authority to execute,for and on behalf of the Company,under the seal of the Company or otherwise,such Written Commitments ofthe Company as may be specified in such written appointment,which specification may be by general type or class of Written Commitments or by specification of one or more particular Written Commitments. (4) Each of the Chairman,the President and the Vice Presidents of the Company is hereby authorized,for and on behalf of the Company,to delegate in writing to any other officer of the Company the authority to execute,for and on behalf of the Company,under the Company's seal or otherwise,such Written Commitments of the Company as are specified in such written delegation,which specification maybe by general type or class of Written Commitments or by specification of one or moreparticular Written Commitments. (5) The signature of any officer or other person executing any Written Commitment or appointment or delegation pursuant to this Resolution,and the seal of the Company,may be affixed by facsimile on such Written Commitment or written appointment or delegation. FURTHER RESOLVED,that the foregoing Resolution shall not be deemed to bean exclusive statement of the powers and authority of officers,employees and otherpersons to act for and on behalf of the Company,and such Resolution shall not limit or otherwise affect the exercise of any such power or authority otherwise validly granted or vested." I,Dawn M.Chloros,Assistant Secretary of FEDERAL INSURANCE COMPANY VIGILANT INSURANCE COMPANY,PACIFIC INDEMNITY COMPANY,WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY(the"Companies")do hereby certify that (i) the foregoing Resolutions adopted by the Board of Directors of the Companies are true,correct and in full force and effect, (ii) the foregoing Power of Attorney is true,correct and in full force and effect. Given under my band and seals of said Companies at Whitehouse Station,NJ,this April 28, 2023 ) F tai +.,..�' Dawn M.Chiuros.Ascist;mtSecretary? IN THE EVENT YOU WISH TO VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER,PLEASE CONTACT US AT: Telephone(90B)903-3493 Fax(909)903-3656 e-mail:surety@chubb.com Combined:FED-VIG-PI-WFIC-AAIC(rev.11-19) 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 Los Angeles } On MAY 10 2023 before me, R. Covington Notary Public (Here insert name and title of the officer) personally appeared Curtis P. Brown Ill and Crissa A. Phillips who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) iWare subscribed to the within instrument and acknowledged to me that he/Ake/they executed the same in hisriberitheir authorized capacity(ies), and that by higher/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. ,,;%` ` R.M.#23 TON ro/.:.._.,-, 1 COMM.4t?_339692 a .. „ :._.. I. ;.`i` ;�Notary Public California ., • ?yi�r LOS ANGELES COUNTY a • �l,^er m.E<pire_Dec 8,2024 Notary Public Signature (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR.COMPLETING THIS FORM This form complies with current California statutes regarding notary wording and, DESCRIPTION OF THE ATTACHED DOCUMENT if needed,should be completed and attached to the document Acknowledgments from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary law. (Title or description of attached document) • State and County information must be the State and County where the document • signer(s)personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s)personally appeared which (Title or description of attached document continued) must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her Number of Pages Document Date commission followed by a comma and then your title(notary public). • Print the name(s) 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/are)or circling the correct forms.Failure to correctly indicate this ❑ Individual (s) information may lead to rejection of document recording. ❑ Corporate Officer • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines.If seal impression smudges,re-seal if a (Title) sufficient area permits,otherwise complete a different acknowledgment form. ❑ Partner(s) • Signature of the notary public must match the signature on file with the office of the county clerk. O Attorney-in-Fact + Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. . Indicate title or type of attached document,number of pages and date. ❑ Other + Indicate the capacity claimed by the signer.If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). 2015 Version www.NotaryClasses.corn 800-873-9865 • Securely attach this document to the signed document with a staple. PALP, INC DBA EXCEL PAVIN9 2230 LEMON AVE LONG BEACH, CA gOM \\In,A,!,1‘1 \an &Ade, UJoru.J LWe45- 20ao 111/441-1n) �r \\, \A-1+.63\06 Pa_ q'thy6 OfCuIAL fw) cECmThI - Oo Nkr OPEW Wortek 4ivitr'y SPNBrooic. Uwe P-1-144411.weit-ev. CC. Vcnocto t in 8" "1ir�� ; Ttty F-A/ 16 e irc ,rvt ®#®®sum® �NTII ' NG --°°•°°•• NIL City of .untington Beach UY• _ w s F9=Q� 2000 Main Street ♦ Huntington Beach, CA 92648 = '_=" _ (714) 536-5227 • www.huntingtonbeachca.gov \-57;7--'•°.+ FF t r`�.: .;:a •�< $ ®Ge :�::ttt f� s Office of the City Clerk COUNTY CPS®� Robin Estanislau, City Clerk July 31, 2023 R.J. Noble 15505 E. Lincoln Avenue P.O. Box 620 Orange, CA 92856 RE: Saybrook Lane Rehabilitation —CC No. 1690 Enclosed please find your original bid bond for CC No. 1690. Sincerely, 94J444) Robin Estanislau, CMC City Clerk RE:ds Enclosure Sister City: Anjo, Japan SECTION C PROPOSAL, for the construction of SAYBROOK LANE REHABILITATION from HEIL AVENUE TO EDINGER AVENUE CC No. 1690 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance.with the Notice Inviting ELECTRONIC 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 40 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. 1 C.I If awarded the.Contract the undersigned agrees,that in the event of the BIDDER'S default in executing the required contract and tiling 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%a,BI"D`:BQ'ND ----- -_-- Accompanying this proposal of bid,find in the amount of which said amount is not less than. 10% of the aggregate of the total bid price, as required by the Notice Inviting ELECTRONIC 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 B "er's Signature #l_ 05/11/2023 JACOB ,SECRETARY C- : 5/11/23,8:38 AM I PlanetBids Vendor Portal. Addenda May 11,2023 Addendum No Addendum No 5-11-23 Addendum No.1 will move the bid date to Tuesday;May 23,2023 at 10 A.M.En addition the addendum also includes a revised"CC-169Q Signing and Striping Plans Final 5 1 1:-23"The project should be bid with these updated plans. hops://pbsystem.pianati Eds corn/portairisaawbo/ho-detaittiosisa#bidAdden iaAttdEmaiis 111 SAYBRC?OK LANE {EDINGER TO HEIL;) =690 PROJECT:IEi0:!SCHEDULE Bird Cow ' Corttreor Unit Extended No: NoDesciiiitiort • Quantity Unit 'Price Amount Or0 000 00 90,Oa0 01 TRAFFIC CONTROL PLAN 1 LS $ ,07O0:60 $ 3,000.00 • ` 30,00}00 30 000:0a 3, -; FURNISH_PROJECT TRAFFIC:CONTROL 1 LS $ FURNISHAND.INSTALL SIGNING ANG. . 1 L, .rt ,000140 $ 1 ,00r0;00 STRIPING; „S PROJECT SPECIFIC WPCP(WATER `£r 000.00 _ 6,aaa.0. " 5: • pt}LI,UTit)N CONTROL PLAN).TO 1. LS ► ADDRESS CONSTRUCTiON,SMP'S INSTALL AND MAINTAIN CONSTRUCTION 1 LS $ j,000.00 $3000 00 6 , BMP'S PERAPPROVED WPCP,> REMOVE TREE AND ROOTS.GRIND'TREE STUMP AND ROOTS TO 24"BELOW TOP 92s o0= 7 `2 :OF SIDEWALK/GRADE.. PULL OUT ALL 23 EA $ _ $ 21275 0a . ROOTS WITHIN PROPOSED" IMPROVEMENTS. REMOVE STUMP AND DOTS(NO~ ONLY STUMP AT THIS LOCAATION},GRIND s 8 3 TREE STUMP AND ROOTS TO 24"BELOW .aa $700 00 TOP OF SIDEWALK/GRADE PULL.OI:JTALL RCO`tS WITHIN PROPOSED tAiiPROVEMENTS. . . . FURNISH PLANT New 24"BOX TREE, KING PALM ARCHONTOPHOENIX` ALEXANDRAE,PER HB:STD PLANS 714,. 715.716,718&7'1 B AS"SHOD!ON,PL�4NS 1 (ITEM.INCLUDES FISTING L DSCAPE AND iRRIGAT ON:REMOVAL TO 9 4 'ACCOMMODATE NEWTREE 2$ .EA $ 2,100.0 $ $4000 00 REPLACEMENT OF IRRIGATION IN KIND, BACKFILUNG"WITH CLASS A SOIL; AND INSTALLATION OF ARBOR=GARi 4R APPROVED EQUAL AT BASE OF NEW TREE t YEAR MAINTENANCE ANf1 GAURANTEE) • • 1. 1:: • SAYB•ROOK LANE fEDINGER TO°HE11_). CC!4690 PROJECT DULE. Bid ;Cort�ct 3 ,-,. - IUnit No . . - .: .t an QuantityUnit Price Amoun t SAWCUT AND R VEEXISTING t SiDEWALiC AND CONSiRUCT TREE WELL V1TFt SIDEWALKPER DETAILQN SHEETS, (I'tEM INCLUDES-REMOVAL OF SID 2 EA $ . '10 82 SF OF NEW SiDEW ,NON CHEMICAL: • WEEDrCONTROL BARRIER TO BE DUpoNrLAI t08WE,M X OR.APPR_OVED . EQUALAND MULCH:)" r11 fi: Pf R3VE? ND 'LAN RECt21; IR T UCTSIDEEWALK 5 5. "SP:S1 {Q . s a i H . .REMOVE AND REC.ON UGT`CURB,AND fix GIiTTER.PER -STC? PLAN 2C (CF 8ry (ITEM INCLUDES CMB,SLOT PAVEMENT AND LOT:DRAIN.4 : ,. , REMOVE AND RECONSTRUC`F`DRIti EWA CURB AND GUTTER PER HB STD PLAN° - I; 209 UWITH#4 EPDXY'DO tELAT;12`"OC, ! 53, 1.F 145100,i a, as ao 3 8 , ..� �. (ITEM INCLUOES;ALLAPPURTENANCES, DEPRESSED,CURB&GUTTER,SLOT i Tr,'` PAVE,AND AU.ItEMS NECESSARY TO COMPLETE THE,WORKIN PLACi«y OVE AND RECONSTRUCT CU REM RS ACCESS RAMP,DEPRESSED CURB,AND GUTTER PER CAL1'RANS STD PLAN RSP •MBA FRO•M BCR TO ECR(CASE SH+b' N ON PLAN):(INCLUDES•ALL 7,zon:ao 14 9 APPURTENANCES,CUR$GUTTER, 8 EA $ S 0 : DEPRESSED CURB,SIDEWALK",ACMES; RETAINING CURB,CMB;;SLOT E Al T, AND ALL ITEM• S'FROMECR TOSCR 'NECE ARYTOCOMPTEWORK0 '',PtACE3 _ ... . . .. ...... REMOVE AND RECONSTRUCTCONCRETE- CURBAND CROSS GUt'TER PER HBSW PLAN205:(INCLUDES CONCRETE CURB, as: ?>,0 . QU ' '15 'I0 SPANDRELS,TRANSITIONS,SLOT' 1,975 SF 5- PAVEMEN ,CMB,AND,ALL'ITEMS Ei4 S -NECESSARY TO COMPPLETE.THE WORK IN PLACE COLD MILL EXISTING AC PAVEMENT TO A 48 11 IDEPTii OF'017"FRONT EXISTING 9,560 SF $ uc44 . $• ;.3s940 SURFACE. .. . COLD MILL E.XISTING AC PAVEMENT-TO A , . ' N HFY R F $ 0TO T, PERETAILS ONSHEET 5.O SAYBROOK LANE (EDINGER TO HEIL) CC-1690 PROJECTBID SCHEDULE Bid Cat Contract Unit k Extended N . Na. Dentin _ Quantity Unit...' Prfoa I Amount CONSTRUCT A 0.17'A PHALT RUBBER 150.00 341,250.00 18 13 HOT MIX(ARHi GC-C PG 64-16)WET Z,275 TN $ PRIDdESS,OVERLAY. REMOVE EXISTING AC PAVEMENT TO A DEP'Thh OF 0 67'AFTER COLD MILL . CONSTRUCT NEW 0.67 B-PG 70-10 AC 170.00 7y n n 19 14 DEEP LIFT OVER 95%COMPACTED 3,090.TN $ $-s SUSGRADE PRIOR TO PLACING0.17" ARHM PER PLANS AND DETAIL ON SHEET REPLACE WATER VALVE BOX ASSEMBLY ''. s °.n© ; 80 00 20 RA 15 AND ADJUST TO GRADE PER HB STD 8 EA'$ $PLAN 612. R+IISH AND INSTALL COMPOSITE. 21 i. SEWER MANHOLE FRAME AND 5 EA'$ is00,0o $ 9,500.00 COMPOSITE COVER AND ADJUST TO GRADE PER HB STD.PLAN.513 b). REMOVE EXISTING,FURNISH AND INSTALL NEW TRAFFIC PULL.BOX PER. CAL.ANDADJUST TO GRADE.B STD:PLAPi 422, TRANS STD,ES-8 PULL BOXES 5 $ f,snn 00 $ z,snn,00 38 WIFIBERLYTE LID SHALL BE;"CHRISTY FIBERLYTE OR CITY APPROVED EQUAL ' SIZE.PER PLAN:LOCATION IS TO BE DETERMINED BY ENGINEER. ADJUST EXISTING SURVEY MONUMENT 23 19 WELL TO FINISHED GRADE.PROTECT 2 EA $ sa�i'0 $ 140n.00 EXISTING SURVEY MONUMENT IN PLACE. REMOVE EXISTING,FURNISH AND INSTALL NEW WATER METER BOX PER HB STD PLAN 601/603 AND GRADE,PULL 1 EA $ soo oo $ seo:on 24 20 BOXES W/FIBERLYTE:LID SHALL BE '"CHRIS1Y FIBERLYTE".OR CITY APPROVED EQUAL. Total Amount;Bid in Figures:$ 16S6,35 00 tc.2.3 LIST OF SUBCONTRACTORS 1 In accordance with Government Code Section 4104,the Bidder shah set forth the name and business address I 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 1 to be done by such subcontractor, Bid .1Vont intidAdtbviss of Artie aass DM MC Dollar of It.em(s) Sadicontractor License Reesalities# 4autiaraii t Cotrtar(tict Ninnber 4 CHR'rsp co 374600 A,(32 1000000306 108,750 40 6. is 22 80 S.LILAC AV1' BLOOMINGTON, CA'92316 , NQBEST INC 11I 1 760i1ACACIA AVE . 35962a 1QU0012629 341344• G 121)EN,GROVE„.CA 92841 a. 00 209 MD 1W BERIZED CRACKPILL 0 18 32.RANCHOCIRCLE 986686 A 1000003438 S?436.0 );AIDE PORES•L.CA 92630 .596 7-9 V.&ETREE SERVICE 6�x450b C27 574,535.00 2425 N 8;3.1AVIA ST' 100000I936 4.5% ORANGE,CA 92865 33ppj 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 funiished by subcontractor•for this project C-3 N NCOLLUSIQN'.AFFT AVIT 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 05/16/23 at 15505 E.ITNCOLN AVE ORANGE A Date e r. State tncoE BREEDLot s , being first dully sworn, deposes .and says that he is" SEcxETAitx of R. NOBLE COMPANY the makingthe fore oin PAY „S g 1 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:aoy 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,o`the contents thereof,or divulged information or data relative thereto, or paid, and will not p a fee to any corporation, artnersh* 'company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. ILL NOBLE COMPANY ..... Name of Bidder 1 i Sngna* r of . a 7AGC}BiL',' ED SECRETARY L5505E,LINCOLN:AVE ORANG GA52865 Address of Bidder t } C-4 } CALIFORNIA ACKNOWLEDGMENT CIVIL CODE 11189 c A notary public or other officer completing thiscertificateverifies onlythe identity of the individual who signed the document to,whicch this'certificate is attached,and not the truthfulness,.accuracy,orvalidity of that document State of California County of CIRANE F 05 16/-2023 I,DEJONOH,NOTAkYPUBLIC On Dole i before me. . Jt t O8 BREEDLOVE ({ ere insert Ngrrre prrcfXrtie ofthe E?lficer personally appeared ,Name(S):ofSigner(sl who proved to me on the basis of satisfactory evidence to be the person(s)whose,names)isfere subscribed to the within instrument and acknowledged to me that he/she/they executed the same in ttisitteritileir authorized capacity(ies),aiid that by his/faeriti signature(s)on the instrument the person(s),or the entity upon behalf of which the persan(s)acted,executed the instrument I certify under PENALTY OF PERJURY under the y 15 xotych i laws of the State of California that the foregoing ` ) � Notary iruhUc c2t so t3- x paragraph is true and correct.. x, rossmu5mn fi 4a" 31 r" u,,. ����� fx�ires�� la Z4t1 ,• WITNESS my hand aril official seal.Y is / Signature Place!votary Seal and/or Stomp Above „_ ignature of Notary Public OPTIONAL Completing this infarmotitkrf can deter alteration of the document or fra u.4i(erft reattachment ofthis form to an uniritended'document Description ofAttachd Document. Title or Type of Document: Document Dater, Number of Pages: Signer(s)Other Than Nerned Above: Capacity(ies)Claimed by Signer(s) Signer's Name Signer's Name' a Corporate Officer-Title(s): 0 Corporate,Officer-Title(s): o Partner: a.Limited q General CI Partner— CI Limited a General a Individual a Attorney in Fact t i Individual a Attorney in Fact o Trustee i a Guardian or Conservator o Trustee o Guardian or Conservator o•Other. a Other, Signer is Representing; Signer is Representing:: ©2018 National Notary Association - UTILITY AGREEMENT N HONORABLE MAYOR AND CITY COUNCIL CITY OF HTUNTINGTON.B.EACH,,CALIFORNIA Gentlemen: The undersigned hereby,promises and agrees that in the,performance of the work specified in the contract, known as the SAY"BROOK.LANE REI ILITATION.(IXwe)(it)will employ and utilize only qualified persons, as hereinafter defined,to work in proximity to anyelectrical secon or transmission facilities . Pi` tY ' The term"'Qualified Person"is defined in Title 8, California Administrative Code,Section 2700,as:folkows: "Qualified.Person: A person who, by reason of`experience or instructior4 is,u iliar with the operation to be performed and the hazards involved The undersigned also promised and agrees that ail such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal-OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may. be- retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. R.J.NOBLE.COMPANY Contractor By JACOBBREEDLOVE,SECRETARY Title Date. O5li612o23. • • DISQUALIFICATION QUESTIONNAIRE tif.aceordanee with Government+Code Sec"tion t4162,The Bidder:shall:ctttnplete; under penalty of perjury,. ttie'following..knestiontiaire. QUESTIONNAIRE' Has the..alder any ulcer of:the-Bidder or°any;employee of the Bidder wha has a proprietary itltexest;n the, Bidder ever been'disqualified;retnoved or otherwise prevented from bidding on or cothptetiitg a Federal, I ' Stag•or tocai gtoverninent project because of a violation►of law oraseety regulation? fl Yes tithe answer is yes,explain the cite iinstances in.the space provided, Note: This qucstionnatre constitutes a part,of the,'Proposal,and a signature portion of the Proposal;shall; constitute signature of this questionnaire cis COMPENSATION INSURANCE C ERTIFICATE y Pursuant to Section 1861 of the State Labor Code,each contractor to whom a public works contract has been I, awarded shall sign the following certificate. E J am aware of the.prs:iv sions 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 conWact:. l IL NOBLE COMPANY Contractor , By `ACOB BREEFLOVrt SECRETARY Title i 05/1612023 Date:: C-7 • I FORMATI` BIDDER,certifies that the.following information is:true and correct R.J.NOBLE CDIvIPANY Bidder Name • 15505 E. INCOLPI AVENUE,: Business Address • ORANGE, • CA 92865' City, • State Zip 714 ) 637-1550 jacobbreedloveerjhoblecompany:;earn: Telephone Number Email Address ,78290$CLASS A.&C.12 State Contractor's License No.and Class 0812000 Original Date Issued • 08131I2D24'. I Expiration Date The work site was inspected by111?ADEN PORTER,ESTINTAIWf our office on MAY 12 ,2O2 5 ., The"following are persons,firms,and corporations having a principal interest in this proposals R:J NOBLE'COMPA?Y A LIFO11NIA CORPORATION' AUSTINM CARVER.PRESII3E.*NT ICASONDRA.C;GONZALEZ,VICE,PTRESIDENT' is STEVEN L.MENDOZ.A,VICE PRESIDENT JACOB BREEDLOVE,SECRETARY JAMES N..DUCOTE,G.F.O. The undersigned is prepared to satisfy the Council of the City of Huntington.Beach of its ability,financially or otherwise,to'perfor.in-the contract for the•proposed work and improvements in.accordance with the plans and specifications set forth. R.J.NOBLE COMPANY Company Name Signature JACOB'BREEDLOVE,SECRETARY Printed or Typed Signature ie NOTARY CERI IFICATE ' Subscribed and sworn to before me this ,16Tclay of I AY ,-202a- . individual public or other officer completing this certificate verifies only the'identity of the L `td ual who. signed the document, to which this certificate is attached, and not the truthfulness,accuracy,or validity of that document State of cALIF,oi rtlA F County of ORANGE On 1s, ° before me, I. Insertiarrte and T Month,Day,and YearTitle of Notary personally appeared . ;JACOS BREEt7LOVE r Nariie(0 of Signer(a) who proved to me on the basis of satisfactory evidence to be the person(s)whose name(4)is/ar csubsoribed to the within instrument and acknowledged to me that heMy executed the saute in histr 3 authorized capgicity(kt9,,and that by IiisLhealtiti3ir signature,€)on the instrument the person®,or the entity upon behalf of which the person(4),acted,executed the mnstrutnent, I certify under PENALTY OF PERJURY under the laws of the State of.California that the foregoing paragraph is true and correct.' i AM& AIL%-MK 011)..,I11. A ft-Aft....e. an. ... GH i WITNESS my hand and official seal. : :: :r:a <k� rat Co ;ar - a s �zitt1� Cctnuston y 23U744t o,,ed, MY corrtr'i.Expe es Oct 23,.2023 t , Signature . Signature of Notary Public (PLACE NOTARY SEAL ABOVE) r. EIoxoh A C-s i r I: z 1 i I. :Bidder's PrOjeci:History i Far the: purposes of this project,. the bidder shall 'Provide.project.history of similar work,, specifically referencing the .construction of (Describe..specific-work rand `experience necessary for project. For :example,"Sanitary sewer line installation of at least of'1;000 of 8-inch and:greater in public right of-` 1 way: Sanitary sewer lift stations;of siirtilar.size;;proiect work Within streets,:an-area.containing;: :high.ground water and pineline:construction in:highYground water.reg ans with-trench depths of 8-feet: to the'invert."1; Bidders are encouraged to subm.it supplemental relevant project history':in addition to.die ;projects"liisted,hereim; i r Listed.below'are the'names, address and telephone numbers for three public-agencies for which the bidder: . has performed.similar work within thepast five years: 1 CITY-OF LAGUNA NIGL?EL 30I11.CROWNVALLEY ploAri.AGUNA.NIGUEL,CA., 2617 i R . 1 Namand e .AddressAgency of Public Age JO'HN PHA,M 949=362-4335 Name-and Telephone No.,Of Project Manager $$1,727,126.89 11IGUEL::ROAD PAVEMI;NTREHAintit.tON CC 20,10 05/2021 Contract Amount. Type"of Work Date Completed I 1 i Provide additional project description to show simiiar'work: ,A COI+ISTRUCTTON"SURVEY,TRAFI`IC CON�"RfiL;CONCRETE REM&,RE1'I.ACE;ADJUST U'i"IL1TiE5„TRAFFICLOOPS;SIGNAGE I*4-ERIPIN0.: 1 t 2:� CITY FT OEMECULA 41000 MAIN STREET=ramECULA,CA 9259Q Name and Address of Public Agency CHRIS WHITE 951 308 6388 Nance and.Telephone.No,of Project Mena et . GAVE MhNT R I IA DR&$ ROAD Et2UI 1Y DR,.- o-,. Si 0611 4•84 WIN.CHESTER RD PW.JB 01- Contract Ainoiint. Type,Of Work Date Completed. • Provide additional',project description:to show°similar:work CONSTRUCTION SURVEY,ELECTRICAL";CONCRETE,.TRAFFIC LOOPS SIGNAGE&S'RIPING " I 3;, CITY OR DOWNEY 11111 BRO<)KSFIIRE'AVE.DOWNLY CA 90241 Nate'and Address of Public Agency- . DI SI GUT IERRE"L?562+704-71'I0 1 Name and.Telephone No,of Project Manager; OLD RIVERSCHOOLROAD PAVEMENT 1 1, 52.'245`S43 0't0% REHABILITi4TION�CAPITAL IMPTS PROJ.16-20 07/2021 CotractAmount` Type of Work Date Completed Provide:,additional project"description tO show similar work: TRAFFIC CONTROL;:CONSTRUCTION"SURVEY;,EXCAVATION;COLD:MILL,ADJUST UTILITIES;-REM&CONSTRU.CT CONCRETE,STRIPING; TRAFFIC LOOPS;EI;EGTR gA.L.. - , €; 040 ir v 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 1 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. RYANOVERMAN 7 1, Name.of proposed Project Manager 714-632-1550 Telephone No.of proposed Project Manager: .. l Y:20 f4 STREET&SLURRY SEAL PROGRAM$1,512,1 0,4S ACISLUItIIX SEAL 0412029 Project Name Sc.Contract Amount Type.of Work Date Completed - RESIDENTIAL ROADWAY REHAB SI 97S 413 9g S'I`REET RCR#ABILITAION 101201% Project Name&Contract Amount Type of Work Date Completed r. a'FY OF NEWR0RT BEACH;SZ..4 MILLION PAVEMENT REHABIUTAION IC/2018 Project Name&Contract Amount Type of Work Date Completed 2.; CHUCK PIERS;CENE(ALSUPERINTENDEN1 Name of proposed Superintendent Telephone No:of proposed Sriper..interident, s�1550. CITY OF ONTARIO$6.1 MILLION" AC PAVING OF VARIOUS LOCATIONS OS/2019 Project Name&Contract Amount Type of Work Date Completed CITY OF TUSTIN $1.6 c1IILLUON PAVEMENT AVE REHABILITATION 10/2025 Project Name&Contract Amount Type of Work Date Completed 05/2019' I CITY OF SAN JUAN CAPIS'IRA15IO$2.1 MILLION STREETIIMIPTS " Project Name&Contract Amount Type of Work Date Compteted CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR)CERTIFICATE Pursuant to S0 854,(citing Labor Code Section 17711.1(a)),passed by the California State Senate oilJune 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.govir)LSE/PublicWorks/SB854FactSheet 6:30.14.pdf DIR's Contractor Registration Link—Call(844)522-6734 https/Defiling.dir.ca.gov/PWCR/ActionServlet?action=displayPWCRegistrationForm DIR's Contractor.Registration searchable database; https://efiling.dir.ca.gov/PWCR/Search.action I am aware and will comply with the provisions of Labor Code Section 1771,1(a)whicl 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 to this chapter, unless currently registered and qualified to perform public work pursuantto 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'201005 of the Public Contract Code,provided the contractor is registered to I perform public work pursuant to Section 1725.5 at the time the contract is awarded." I furthermore will comply by providing proof of registration with DIR.as the primary contractor,as well as for ALL subcontractors at the time of submitting the bid. R.J.NOBLE COMPANY Contractor x By jactibbree • noblecompany:coia: Email JACOB BREEDLOVE,SECRETARY Title Date. 05/1612023r PWC Registration.#;100000 s 1s C-12 1 STATE OF CALIFORNIA DEPARTMENT OF RESOURCES RECYCLING AND RECOVERY(CailRecycle) RELIABLE CONTRACTOR,r1ECLARATIO14f }, CalRecycle>168(Revised 7/13)' This"form must be completed and submitted to the Department of Resources Recycling and Recovery (CaiRecycle) prior to authorizing a contractor(s)to commence work. Failure to provide this documentation in a timely"manner may result in nonpayment of funds to the contra tor(s)„ This faint is intended to help the CaiRecycle's Grantees comply with the Unreliable List requirement of their Terms and Conditions The,Unreliable List provision requires the following: Prior to authorizing a contractor(s)to commence work under the Grant,the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractors)stating that within'the preceding three(3)years,none of the events listed in Section 17050 of Title 14,California Code of Regulations,Natural Resources,Division 7,has occurred with respect to the contractor(s). Please seethe reverse of this page,or refer to www.calrees.com If any of the events listed in Section 17050 have occurred,disclosure is required but will not necessarily result in CalRecycle ' refusing to approve the contractor. A signed statement eltplaining the facts and circumstances of the events must be attached to and submitted with this form, Contractor: Complete the form and send original to: the Grantee. Grantee Scan the form and upload it to the.grana t in CalRecycle's Grant Management System(GMS), For further instruction about logging into GMS and uploading this form, reference the Procedures and Requirements Retain the original form in your grant file. GRANTEE NAME: GRANT NUMBER:, , PRIMARY CONTACT NAME: s5 CONTRACTOR NAME: RI.NOBLE COMPANY AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: JACOB:BREEDLOVE,SECRETARY MAILING;ADDRESS: F:O.130X 40,ORANGE CA.92005 As the authorized representative of the above identified contractor,I declare under penalty of perjuty"under the hews of the i State of California that within the preceding three(3)"years,none of the events listed in Section 17050 of Title 14,.California i Code of Regulations,.Natural Resources,Division 7'has"occurred with respect to the above identified contractor, Alternatively,as the authorized representative of the above identified contractor,I declare under penalty of perjury under the laws of the State of California that within the preceding three(3)years, if any of the events listed in Section 17050 of Title 14,California Code of Repialions,Natural Resources Division 7,has occurred with respect to the above identified i 'contractor,I have disclosed all such occurrences in an attached'signed statement that explains the facts and circumstances of the listed events. Signature 't 4 Date osti Erzoas i JACOB:•. DLO O. RY STATE OF CALIFORNIA {DEPARTMENT OF RESOURCES RECYCLING AND RECOVERY(CalRecyrcle) RELIABLE CONTRACTOR DECLARATION C-13 t s CaiReate 1681Revised 7113) Title 14 CCR,Division:7,Chapter 1 Article S,Unreliable Contractors,Subcontractors,Borrowers and Grantees • Section 17050.Grounds for Placement on Unreliabl'List • • • The following**grounds fora finding that aoontractor,any subcontractor.thatprovides services for aCalReiycle agreement,greatcoat borrower • in unreliable and should be placed on the CalRecycle Unreliable Contractor,Subcontractor,,Grantee or Borrower List "Unreliable List"):The: • • presence ofone of these grounds.shall not automatically result in placement on the Unreliable List:A finding must be made;by the Executive Director in accordance with section 17054,'and there must be a final decision on any appeal;that maybe filed in accordance with section 17055 • et seq. (a) Disallowance of any and/or.all claim(s)to CalRecycle due to,fraudulent claims orreporting;:or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act,Government Code section 12650 et.seq; or. (c). Default on a CalRecycle loan,as evidenced by written notice from CalRecycle staff provided*the borrower of the default or • (d) Foreclosure upon real pmpertyloan collateral or repossession of personal property loan collateral by CalRecycle;or (e) Piling voluntary'or.involuntay bankruptcy,where there is a finding based'on substantial evidence,that the bankruptcy interfered with the CalRecycle.contract,subcontract,:grantorloan,or (I) Breach of the tents and conditionsof a previous CalRecycle contract,any subcontract for aCalRecycle agreement,grant,or loan, *Suiting in termination ofihe CalRecycle contract,subcontract,grant or.loanby the Ca1Recycle'or:prime contractor,or (g) Placement.on the CalRecycle'a chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solawaste facility;or (h) 'The person,or any+.partner,member,officer,director,responsible managing officer,or responsible managing employee of an entity has been:convicted by a court of competent jurisdiction of any charge of-fraud,bribery,collusion,conspiracy,or any act in violation, of any state or federal antitnutlawin connection with the bidding upon,award ot or performance under'anyCalRecycle contract, subcontract,•grant or loan;or (i) The person*entity is onthe list of unreliable,persons or entities,or similar list:of any other federal or California state agency;or (j) The person or entity has violated an Order issuedin accordance.with section 18304;or,: (k) Theperson or entity has directed or transported le,has or accepted waste tires at,a site where the.operator is required to have Out does not have awaste tire facility.permit or, (1) The person or entity has transported waste tires without a waste tire hauler registration;or, (m).The person or entity has bad solid waste facility or waste tire permit or a waste tire hauler registration:denied,suspended or revoked, or;. (n) The person or.enti y has abandoned ante or taken a similar action which resulted in corrective action or the expenditure.of funds by CalRecycle to remediate,clean,ar abate`a nuisance at the site;or (o) The following are additional grounds for a finding that,a person or entity described below should be:placed on the Unreliable List: (1) The person or entity owned 20%or more of an entity on the Unreliable.List at the time of the activity that resulted in its placement on Me Unreliable List; (2) The perien.held the position of officer director;manager,partner,trustee,or any other management position;with significant control'(Principal Manager):m an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3). The entity includes a Principal Manager who: • I. Was a Principal Manager.*an;entity entire Unreliable List at the:time of the activity that resulted in its placement on the UnreliableList;or, 2: :Owned 20%or more of an entity on the Unreliable List at the time of the activity that resulted in its,placement on theUnreliable List; (4) The entity has a person who owns 20%ormore of the entity,if that person:. I'. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that'resulted in its • placement on the Unreliable List;or, 2. Owned 20%or more of an entity on the Unreliable List it the time of the activity thatresulted in its placement on the Unreliable List (5) The entity has another entity which owns 20%or more of the entity,if that other entity: 1.. Is on the Unreliable List or, 2: Owned 20%or more of an entity on the Unreliable List at the time of.the activity that resulted:in its placement on the Unreliable List: • (6) Subsection(o)is not intended to apply to a person or entity that purchases or'otherwise obtains an entity on the Unreliable List:subsequent to its placement en the Unreliable List.. C 14 • k i r . i i '$1DDER S=cERTH..WA. hN'`` " HOUSING AND'URBAN DEVELO PMENT ACT OF'1968 AS AMfiMENDED 1N 19,92,SECTION 3 ' TITLE 24,Code-of Federal Regulations,Part,l3" * } :Economic Opportunities:for Low and Vert►-Low Income Persons i 'The.bidder,under enal" of ;er certifies-that except•as`noted.b• eiow,any person associated therewith . p tY" p J� .. • n-the;capacity of owner,part ier,director,,off icerr or manager(initial theapplicahle'selections) Will nsure that 10%of all new hues as a resul . ofthis project shall meet,all requirements of - Section 3 of CFR:Part I35 of the'HUD Aet:of a : 19.58 Of . . X Will:hire no new".employees in cornjunction:with i . ' this project;; - Will.award 10%of its.sub:contracts to Section"1 1 - businesses - -- _. - .. This certificatton.shal1rapply to the.pri me c_onrtractor's sub-contracts related.to this project,. l: . R.T.NOBLE COMPrANY . Cgnfractor: . . Contact'Persona" TACOB BRBEDL(OVh SEC AkY'. , ,... I �ontact`_Phone. zi •ssa Issa . Signed` ,...:: x , aslib!?a ° • * epartment of IH�usingg,and Urban Developtcment(24"GFR 1'35 tared Sub title A er •ci) and must lye submitted by the bidders and proposed sub-contractors only in connection with contracts and:subcontracts which acre subject to Section 3 of the 1968`Housing"and Urban,, Development.Act,as:amende in"1"992(HUD),. Previous non-compliance with Section 3 could result in drsgnahfication.- . i .. _ .. {;; ;G 1s: is i; „ . .. ., I • , . , . . . . 1 i .. . . . , . .. . . . . . . • . . .. . .• , . •• -- - - .. . ,,., . . 11 rovAttsp,LoymENTOPp.ORTUNITY,, CERTIFICATION: . , . • ' ' .I • ” , .. . , •-, . , . . . , -the,,hi.04er. p..roposed subcontractor . : ; • . „ - - . , heiebiiettifiesihateltai.:.„....... .;1.- . ,.,..,,,,....,,.....Ili t obtL,,...,...., participated.1h"...4:previous„. r ' contract----7-- orilitic subcontract t subject to ,ettt1fcipiitittiiility:.'4141•140$;,4 . 0R.,,4ii.edj:b,,31:1xeut.:i.izeOrd.,,,ts 109256-• , : .,...,...........:.,: .., required,tii14iOt;' '''-i11.40i,411.41b4iw4erg •-,he&itil:1!ti,:ththt J,itt"... Reporting Committee,the Director I I- of the Office n- tFederal tOntracitompiianee4•Vedet Federal O*.eittoeototiotr#OtjOii,ot'alt.Oittl§iiittg-Ogcoc.i.., , 1 ,::'.. , . •;. :- • — ..„.„ : ,.:, . .:. ,., ,..: -.....,......-.,..; . ,..tii. the- former President's cOlttnitie::,01. :f-,:qt*.t'74PtP.Ymt0 P.:000t4P4Y,,•40: eP9rtT,5:"11. •7447r .--t4..,e• app I able filling requirements..: . .. . . ., • .., ; , , ,, , , '- l ite'•''''T-. '-'.'..e'i'-::•-•ic•-w••-`-e—•;'r'-'certification.'' ' ..'T-.',-.''..'•,...,.t*..,-'r.-...,d-.-..-,-..l:-•-iY-:•'',the .^,.-,..t.,.-:•,..:,-4o,'..,.:7..a.-.2t Employment t...,-.i,.:p....p..-,..o,..,k-io,.,,.,,...,-,....it...y..;.,.-. R„..,..-„..;g,.....o..-.._40.,-ion.....,.o.:0.,:.(...-.,, the Secretary svc;,..;, of Labor (41 CFR 6 -1,7(1) (1 i and must be submitted by bidders and proposed subcontractors::pf)14iconnection Ivi contracts an9- niPniiiiiti-vhidt,are$4bject.tO,„e,equi4 opportunity clause. Contracts ao4:piIccmtra04. y1if.!F!,0 ,pt from the equal opportunity clans0-41Vg4 t forhin;41'cFR,614.5.-(detttAlly.onlyeoorgots,or:subcontractsotsi0,0 00„::,-;. . , F:: 'i• • • • , • •1 or outlet Aie;exiiiifit) . .: . .Currently, ... .Standardicitti100::(E (1... 4,))-1s::-th.e.:43piyrpOrt: 04)0!1iii.ythece0tiV0,9:"to*,Agit40Ar: r 1 implementing regulations.,, . - . . . .. . ... ... , , . . "9.•'.'P #:-•'.'.'''-''.i'•'''')iii'.'.'e contractors and subcontractors - y.t....1..0...-;14Y"..B:P0...01....0..!.,:.1..,.04t0..,410:4;;T.-,e.,q,,.,.°!4,,,,.,,...,•,:,.....9,-,P........,#...,4.;..;.,.P '.,6r subcontract subject to the Executive and have not Oje!, hefte4tit#,te,O.: , totl0;oote .: i41'ett:00-1,7(h)•(j4;?teseotiie'ayatfOiitraftsien4,je" ts:uless.!u":coacor submits a report covering he ielliittitlietioi3Ot such other pFp1o :speeified bytheFederal • Highway Administration or by the b44oior,"pticcict Federal Contract Compliance,-m ...i- , -, . •, • • • - - .. i. , Department of . ---:•-• -•,;-. .. •, i , ., ...,,, . . . , . . . , . . .r • . „ , - • - ,. „ , . . . , . L . . ,. .:... .. . .. . . .. '.c.10 , . . . . . • •I ,. i . . .. . !:, i . PUBLIC CONTRACT.COD1 ;. i PUBLIC.CONTRACT'CODESEG'TION 1'0285 1 STATEMENT i;; . In conformance with Public.Contract;Code Section 1,0285;l (Chapter 3'76, Stats::.1985),' the b,idder hereby declares: under penalty'orjury under the laws of the.State of California that the bidder 4. hasbeen., .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, oit any other act.:in violation of any state or Federal ar►titrust law-in ' r connection with the bidding.upon,award of, or performance of,any±public-works contract,.as deiined.in `Public Contract:Code'Section 1;101,with any public:entity,.as. defined in Public Contra,act Code"Section 1100,.including;the Regents of the University of'.California or th a Trustees;of;the California State.: v University; The.term a" dder";is understood;to include any partner,,member,afcer€director,responsible - managing officer or responsible:managing em lo. ee thereo P X f;as referred to:in Section.10285 t, 4 ;:Note:"'The:bidder must:place a checkmark;after"has"or''l as not" to one of the blank spaces.provided The above: Statement is parr oftlie Proposal: ;Signing duskroposal on:the.signature portion thereof shall also constitute ' • '.ai , of this.Statement:Bidders are caution d;tiiat making a false certi fication,may subject,the certifier to. , gnat. . 'criminal prose =. .r .., . ZACOB:B ligi)10YE,SBC ETARY`. DSI1(/2423 i PrintName, "Date PUBLIC CONTRACT ..ODE SEGTION10162 QUESTIONNAIRE 1 In conformance with:Public Contract Code Section 10162,the Bidder shall complete,;under-penalty of 4 penury,the following: questionnaire: a . Has the bidder;any officer of the bidder,of any ,e loyee of the bidder'who has a proprietary interest in, i the bidder,ever been disqualified,removed, or.otherwise prevented from bidding on or completing a federal,,state,:or local governmentprojeet because:t.,f a vioIation.of law;or„a safety regulation? yes No. .. lithansweris ys,explaitl e,cicnistaeesinthefollowing space<>i e ' C li 1 , L •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. JAC013 BREEDLOVE,SECRETARY 05/16/2023 e Print Name Date ii C-18 1 i i i , 3 i NoncolHusion.Adavit - - (Title 23 united States Code Section 112-` and Public Contract Code"Section 7146) . . To the CITY of Huntington Beach DEPARTMENT OF FUBLIC.Wo. KS. • F ;i• . " ._ ;In conformance.with Title.,23 United States Code Section 1 12 and Public Contract Code •7106.the bidder declares that ttie:bid.is'notr made in the nterest;of,.,or on behalf of an:.-. . undisclosed person,partnership eonpany1,association,organization,or.corporation,that _ the bid`is genuine and notwcoltusive.or sham,that:;the bidder has not directly or'indir�ectly ' :induced,or solicited any other bidder to put;in;a false or sf am bid;;,and,l as not directly or; uidrectly colluded;iconspired,connived,"or`agreed with.any I?iitiA. ,t..itotanyone else tv p it in a,sham bid,or that'anyone.shall'refrain from bidding,;that the bidder,h.as.not in-any , l manner,directly or:indirectly,sought by agreeme cainnuntcation;or'conference with 'anyne`oto fix the bid;price ofthe bidder or"any other biddr,oer to fix any'over head,profit,: -.. ;oncost element of the bid price,or of that of any:other bidder,or to secure any advantage against th e public body awarding,the. contract 'of anyone intere sted .iii.the;proposeii . ':contract,that all statements contained in the bid true;,and,further,that the bidder has notiectlyorairectlysubmittedso leeiprce orany beakdown thereof orhe, ,dr n r . - totit6htsihtit,o4,:ot divulged uiformation or data.relative thereto,:orpaid,,and..will not.pay, - "any, fee to any:corporatioti,:partnersl ip,company association,organization,bid:depository, . or to any member or agent thereof to effectuate a col lusive or sham bid: rr(ote The above I+ton.collusion Affidavit is part of the Proposal 'Signing this Proposal on the signature; ' pochon.thereof shall also constitute signature of this Dian collusion Affidavit, . Bidders are cautioned that making a false certification may subject the.certrter,:to crinunat:" , ptosecimon. 1 til ACOB BRFED,LOv.B,SECRETAt 7G 05 1612023. X X i a. Print.Name Date s. . 1: .1 . . :f49 is CALIFORNIA ACKNOWLEDGMENT 'CIVIL CODE§1189 A notarypubklc;orrother'officer cornplebctgthis certificateverifiiesonly the identityofthe individual who signedthe document to which this;cer<ificate;is attached,and notlhe trti hful�hessE`accuracy:.validity of that documei t. - , State of California ,County-of ORAN(E . 0511fJ2023 e 1 DEIONG NOTARY P[7BLtC i On bfore me: ' . Date JACOB BRFCCDLOY Here ln5eft Nome., rtiG'Ofthe(3(ftCel personalty appeared : . • Name(sl of Srgner(s) - - ' ' who proved to me on the•basis'Of satisfactory evidence to be the persons)whose name(s)Ware subscribed to the within nstrurnent and acknowledged to me that heisti Jt#ey executed the same•ih his/her/ttheir , authorized capacity(tes),and that by hisibe it signature(s)on the it sttumenttheperson(s),:or the entity- upon-behalf of which the persons)acted,executed the instrument: . i certi under PENAL.T OF PERJURY under the i fy,; Y `` laws of Ale.State of California that the foregoing a nio ct+ paragraph tnie and toned�`,�.- NotayP r= aisi?rai t - OrattgeCaunY I4 e,,iltisinoiY3G { 1 ITNESSny andaofia lseaf t 1423 . • ' '''.1 *, tAY C4mtz c*.Pg!s,a-' , Signetut Place'Notary Seal ondfbr Stomp Above Signature of Notary Public: OP710NAL; s letin this information can.deter alteration of the document''-or" Colr►P 9 ' fraudulent reattachment:of this:fami to on unintended"document Descnptiorl•ofAttached;Document . Titleof TeofDouent:, .m • Document . .-. ,NumberafPage�:- Signer(s)Ott er.Than Named,Above . Capacityt(1es)Claimed by Signers) ' Signer's Name Signer's Name - ❑Corporate,Officer: Titles) : - ❑Corporate officer Titl (s) . Partner- ❑ Limited ❑`General` © Partner Q Lrmited ❑ Oeneral ❑ Individual: !3 attorney~in Fact ❑ Individual, D Attorney;iin Fact: D Trustee ❑ Guardian or Conservator a Trustee. ❑ Guardian;or Conservator , ❑Other .- - D other , . Signer is Representing . . Signet is Representingt, . 02018;National Notary=A�ssociatota . DEBARMENT AND`SUSPENSLON CERTIFlCATIO TITLE49,CODE aP FEDERAL REGULATIONS,'PART/9 , The bidder under penalty of perjury certifits'Otati a cept as noted below,he/she or a any:other.:person associated therewith in the capacity of owners partner,director,> officer,manager: t • . is not currently under suspension,debarment;voluntary exclusion,or determination of ineligibility by any Federal agency; • has not been suspended,;debaried,voluntarily excludedor determined ineligible:by fany Federal;.agency within die past 3 years; • :-does nothave a,PrOPPsed debar rent n and • has not beets indicted,convicted,or had civil j rdgment rendered against it by-a court-of competent. 1 jurisdiction in:any matter involving fraud or official misconduct within the past 3 years: s. If thereeate any exceptions,to thus certification,.insert the-exceptions.iin the following space: ti y 4 .. 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 whont it`applies,initiating agency,:aind Oates of action: Notes Providing false information may.result in criminal prosecution or adminstrativesanctions a The above certification is part of the-Proposal Signing this Proposal;on the signature portion thereof shalt also constitute-signature of this Certifcattion: ACpB BREEULOV: SECRETARY O 1161 023. .Si Print Nallie ,Date C Z0 - NONLORBY NG CERTIFICATION.' .. FOR FEDERAL=AID CONTRACTS The prospective participant certif es,by signing and si bmhtu g this bid or proposal,to the best of lus or her knowledge and.belief,;t is (1)•.No.Federal:appropriated funds have been.paid or will be paid,by or on behalf of ttte undersigned, >to any`per•son;for influencing.or attempting.to in fluence an ofcer or"employee,of any:Federal i. " agency,a Member"of Congress,an.:officer"cir employee of Gongressz or an employee of a"1Vtember` €' 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 , r. . extension,continuation,renewal,amendment,or modificationofanyFederal contract;grant,loan, - Y 1. or cooperattve:agr - - la eer�nent. . - . : (2)"cif any fonds other than Federal appropriated funds have been paid.,or will be paid to anyperson far'influencing;or attempts g to influence.an officer ot.employee of any Federal agency,'a: t ;Member of Congre!Jo? s.;an officer:or employee of Congress,or.an employee of a Member"of' i Congress.in eonnect one with thus Federal cattpract grant, loan,-or cooperative"agreement;the is u•ndersigned shall complete and submit Standard Form LLL, ";Disclosure of Lobbying Activities,"Iln conform ance with its instructionsx This certification is a material representation of fact upon.which reliance was placed when this transaction .'i was:made"or entered into Submissionr;of this certification is,prerequisite far making or entering into thus 1 . transaction imposed by Section 1352,Title•31, 17.5 Code Any°person who:fails to file the required .. :certification shall be subject to a civil:'penalty of not less than$1.41,a40.and not more than$100;09"0 for eachsuch failure: The prospective participant also agrees:by sub hitting his or her bid or proposal that'he or she shall require -; that the language ofthis ce•rtifzcation:be included tn`all lowertier subcontracts,which:exceed•SI00,64:a. and that,all such•subrec ptents shalt "certify anddisclose accordingly, • ° X �* JACOB BREEDLOVE,SEEIEETARY OS,, ,.23 l fit, gent"Name Date is... • . i • c-2i 4 Local"Assistance,Procedures Manual Exhibit 15-G I F EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES 4 COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U S,C.1352' 1. Type of'Federal Acting: Z. Status.ofFederal Action; 3. Report Type ;Q a. contract El a. bid/offer/application ❑; ;a. initial b. grant b. initial award b. material change c. cooperative agreement c. post-award d. loan For Material Change Onl . e..loan guarantee year quarter f. loan insurance date of last inpo 4.: :Name and Address of Reporting Entity 5. If Reporting Entity in No 4 is Sub: •ardee, Enter Name and Address of Pri.r e. 0"Prime El Subawardee — Tier ,if known Congressional District,if known Congressional l)rs °.` if known 6. Federal Department/Agency:: 7. 'Federal Program •ame/Description: . 4. CFDA Num,;r,if applicable 1. 8 . Federal Action N mber,ifknowzr: 9.. Award ount,if known: 10. Name and Address of Lobby Entity in iduals Performing Services (If individual,last name..first name;MI) eluding address rf dill'e ent.fro from No.10) ' (last name,rust-name,.MT}� (attach Continuati - eet(s)if necessary) 12. Amount of Payment(check all that apply) 14. Type of Payment(check all that apply) i r S Q actual 0 planne• a. retainer q _ b one-time fee" ! 1 13. ForBm of Payment(check all`that apply" c: commission. '. a. cad _ d. contingent fee b. in kind,specify nature - e deferred. i. Value f other,specify 15. Brief Description of Servi- '.erformed or to he performed and Date(s)of Service,including •o cer(5),employee(s),or ember(s)contacted,for Payment Indicated'in Item 12: g' (attach Continuation Sheet(s)if necessary) 16. Continuation Sheet attached Yes (3a No Q 17 Information requested ough this form is authorized by Title. 31 U S.C.Section 13 ;This disclosure of lobbying reliance Sim X I' was placed by the 'r above when his transaction was made or entered:into •` disclosure is required pursuant to 31 JACCB-' aVE,: t; tf_S.C. l352. ''is information will be reported;to Congress PnotName:. w .._ j: semiannually ..will be available frit public inspection.Any person . ails to file the required disclosure,shall be subject Title: SECRETrtRI'` 1 to a civi ty of not;less.than$10,000 and`not,morethan 05/16/2023 SI00 t A for:eadi"such failure. Telephone No.: 714=637455° Date:.. Authorized for Local Reproduction I F., i era"use Onlyc Standard Form.-LLL 1: S . Form Lta:Rev:04-28-06 Distribution: frig-Local Agency Project Files IEXHIBIT10-Q DISCLOSURE OF LOBBYING ACTIVITIES INSTRUCTIONS FOR COMPLETING EXHIBIT 10-Q.DISCLOSURE OF LOBBYING ACTIVITIES' i 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 C-22 January 2019 j , i . , 1 • Lucal Assiltance Procedures Manual lthilit.154 . . 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.Conifre.ss.an officer or employee gt C-040eS'fOr:*:eMiiI0Y4*ta+ 0 Member Of Congress iti.:44atiection•i•Otli,a-•covered federal,aOtian.,Attach a continuation*beet for additional'1o4wrOaSrio if:4w**on the form is h144ecleste; Complete all items that apply for both the iiu:tiiiii::filing Anc.I material0aogo.repoTt...,Refer to tholinplemeneinggitidance published by the Office of Mimagementandlludget 3r 000924 inforOlarka I. Identify lbetype of coveredfedendaetion for*ticklobbOig aCtiirrtyla or has beenieetred to,iitiltithee,the outcome Of nenyetellitedirel action. ,. . . ..7, IdOMOY the qIatils.OttiM•OYged federal 44140n‘ . .... ... , 3 Identify the appropriate classification of this report. If this a follow-up report caused bY...a..tOetetial Oaalle to the information previously reported.enterthe year and quarter in whiehthe;change.occurred. Enter the date cift.thelast,.ptesinualy,stibnitted report by this reporting entity, .for thine:wired&data aition; • 4. Enter tim'f1,ilfttame,..addnati'eitY,,,stite;maziEeeileiefMe rellerti.4.'el*ItleinO:COngteietenaMistrici if known. Check*,apPropriate, • . . . , , . . . . .. , . . claistficationnftite:rePOrting,entity•thsittiesignstesiir it Is or expects to be a prime or stiliaward.reciptent Identify thetier Ofthesubawarrieci,e.g.,. the:fiat sufinvArdee.cif die.prime is the first tier.:Subawardsinelndebut lite norlithitedtat.•,'.eithetintreets;:sitbgriting,and contract awards'under S . granta. •• code. . .if the organization filing the report in Itina'fl.checks enter the frill notei.addiess,.eity,'State,and zip oldie prime federal 'realPierit,Inehide.Congreasinttai,PistrietilflutaWn.: .. .: • 6.., Enter the name of the:federal:agency.making theaward.erlontteonintinnent. Include at le0(one organization level below agency name,it known.FOr.0440010;PepaTa0OiOt T iii*iioiti#100,11iiittiittatot teen:Girard ... . . . .... . ••• 7 Enter the federal &sedition fOf,tha covered federal action(item 1).:If know;enter the fultatalegefEederdDemestie • . . .. , ...• ,. /lasi*itee.(gP4)*Mber for giants.;tooperativo'agreements,loans:and loan Co,mmitments • _, Si Enter the most aperopriamtedeMlidentifylogaember,rniailable fOtthezledgratactiomidentifiCation in item 1(e.g.,*guest for froPosid(0?) .•.. itninber,fiwitarion•for, Bid(IFB)mmiberi grant announcement number,the contract goo:*of Os*award number,the application/proposal control i number assigned by the.Tederal ageirey.). Inehrikprefdes,a4,,"ii#0.DE40401.". , ''f' • 9.• Fora covered‘federal action where there bas been an award or 440101.0*Oat bY00$4001a agency, the:federal:mount'Of the I, . .. .. award/loan commitments for the prime entity identified in item it:or 3. i 1.. 10, Enter tbifull;owe;address;city,state,.and fo..codt of the loahyintentity engaged by*reporting entity identifledinitem 4.to influence the ,. , ,•• covered reciorettiOtio* .• ,. . . ... . . . , . -.14 Enter tho' .,full—tethOsa.ibaladlitiktuakalPagfOrrOiOk$01*..**.aoitior4o40:11144401Ors. if different from 10(o):Enter LastNarne,,First Nam,and, Middle Initial(Ml). . . I t Ill.. Enter the'amount Of enniltei*Sen.*Or.t085 011atilY„capeOed to•be:paid by the tePettistestittOteln Ote:AfinbbYMII 0.4.00.114001.4' 1 I Indicate whether the payment has been made(actual)or will be made(planned). clieckalllio*that apply. If this is nitiaterial Change,report, 1 i• • , enter die•cimuilativeaMetintOf payMentMttde.Or planned tribe:made. 1 13, Check all boxes titat apply: If payment ia made through an in4indepritributing;specify 0**0'0.404 value of thelWkind;payment. I -1: 14. Checked boacs,thrii otioy.0,040;41014i pogo,. i .i• . . .,. Is. .P0,44)110040 and detailed description crthe.sendeei thelthe•babbYlit has performed or will be expected to*farm and the ditte(- a)of any . . 1 i services rendered. Include all preparatory and'relatedactitiity.:not just time spent in actual contact With federal OffiCials. Identify the federal I i •officer(s)or employee(s).contactedCritic ofbeer(S)einPlnYee(s):tirMember(s)-or totigreasthat.Were cantaeteri. 1 1 . .. 16. chnek•vdtelherarneincentir*don,abeet(S)•isattaChed. it The certifying official shall sign and date the form,and print:hialltet name title andtelephone nuniber„ Public reporting burden,for this collection of information is estimated to average 30-minutes per response,including time for reviewing instruction,searching existing dita s:Km:es.gathering and'anditta*g the datineeded,and completing and reviewing the collection of information. Send comments regarding the frlit,40.ostitiliat ot any other aspect ofthis collection of infonnatio*,ineltabiginggenitrisfer reducing this burden,olio Office of Management and Budget, 1 ESPerWeritRedeetienTinjeCt(934840dil.6);Wat*gtrin,,P.4 40503'.t#.4.1.14nstructioni• Rev;00,04 • ConitroodonCOntraciDBE,Commitaseit .1. .. • ' " . . .. . . „ • .. . JautinrY4019 • ,, Exhibit 12,11 Bidder's List of subcontractor tDBE end;NonDUE) ptart 1 As of March I,2015 Contractors(arid sub-contractors)wishing to hi ti on°public wotics tracts shall be registered'with the State Division of Industrial Relations.and certified to bid A on Public Works contracts.Please register at hops •ll�e lgng it t ctvlP V 'R/Actlon eM a ction=dtspia'P WC Reg1stratioil orr. In accordance with Title.44.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 toliowing; information is required forems,stab-contractor who wilt perform wi�rk amounting"to ore than'one halfofone p=rcent(0,5%)of the Total Base Bid or:$10;i0(whichever is greater): -Photo this form-for additional ' Fedetai Project Number: •Subeaatractorl4lan,e sad Line Item:&D�eriptiec Subcontract Pereeatagsof Cast RBE DBE C'eri , Annual Grams Roc ipts l.ocatioee . A,neuut Bit Item Sub lseesse 11trmber (17N Number . co*traded Dile Keg _ ,.. Number . Name: 5;41�? 41.million 1 ��' <S,5 Million _ City.State: - t 0 <S 10 Million :: $ly iniflinn � r '0 A ofFirnt:___,_yrs.. NamC:.NOBST INC Ufa,, � . �million 359 2 g Ixiillwt� City,stag; CE5T�ICRET,E' � � 1 �'rP�� - �=510�lltnn ::. $341,344 00' 100% N dA <$I5 million . GARDEN GROVE,CA1000011529 Y Age of Firm: ; :yes. Name:• 98686 , ' 4 <$5 millionVlIRIJ81E1t1 E) City;Stec: i r 1 <S10 million VARIOUS • .. $7;436,00, N +, 5 million C.RAGk SEAT 100 100000¢038 " ,rk � (wj - -;" LAKE FOREST,GA ,a, Age inn:. yes. Name: - - -.. �. S t v*n � � L. I - t million �� ' -&E.TREE 659506 .~ ix' S million V y ate: TREE SERVICE. 100 N 'r Nt .) lts million $?f,535,00 •< IS moor* ORANGE,• CA 1000001936 8,' M ,,, Age inu L y�rs. Name " {, J . t million CHRISi�00: : 37460a : f i S milluin flit. cilc. $10$t 50000 • I00'Y; (q�, IO nulliim . STRIPING N 1il c?t?;V[1t110 3 Ci192316' ,. - Ri Is million 100000506 w Y x , A of FFlnni`� yrs, A =N�nei • _ � °� I 1 ciiillion �� ( 1 ; <SS mi41on. •• N s illy,S»�� � i., <.t10 million 1-1 <$15 million .: Age of Finn: yrs Distribution; (ri ginal•Local Agency Pile, Z Copy-DLAF.cal:Award,Patagg C'28 • ' Exhibit l2-B Bidder's:List of sub ontractor.( BE and Non-DBE) Part 2 In accodatio0 with Title 49, action 26 of•the Cade cif.Federal Regulations,'the••Bidder shall.list all subcontractor who'pm+nvide a:quote or bid but were not selected to•participate as a subcontractor on litis.istojilcC Photocopy this forth for additional.linus. .•• Sntreostractor'Name aid Line Item it Description.. Ss heontrrct •Percentage e[ Contractor DBE ;I BE Care Aaauxt Cross Receipts .: Location Amount - BIdItemSub- ..LiresseNumber '(YIN) ;Number' • . . :, ' contracted ' IIIt• keg Number. Name; t . ° <S I million : GLOBAL ROAD'SFAUNG.. IB 7575$4" RAGI•SEAL IN minion City.Siwte• �, @,g �: �0 minion 1Q0?« GARDEN GR?VE,; A. 1000007715 ,•` , 0 : <$15 million • 1 = AgcofFimir'14•ym•:, 44 • • • E 4Si million lslsmt: I,CI STRIPING Si i8,i 5:QQ • 37Q76 `. ��"% 1 <SS million . City,State: • L00%: . S <$I0 million ' SO00813536 . - `a , .RI - >C1i1S million,:: :AZUSA;CA, l`t Abe ofFirm 30 yes R • • :: • $1 million .„ tame. 9 • •1144>. •. 1(� ivSr11t11�1A LANLISCA7?Et 4�28;G2 a � � i_ CCS xniflion -• " City,State: i Loo 4 .• ° , Q �t10.tniilion ,. • IaANDS AP GARDEN'GROVE t;1 • • -," , Q ; 15.'nillliao•. Ilia. . a4 Age of Firth. 45:-yrc . Name: •• ° , ❑ <$I mil! - CLIRISP CO 3745Q0> s #410$>75ti O S million City,Stitt :STRIPING 100 <$10 million'-: I�RFTsMpNT,FCA 10Q0006306, 1, <$13 m llion... •., , ,,¢ Agc•of Firm.4 4 yes :. • Name ° Li 431 million Ri�31LBPRi7SD CRACK Fill l ft 1.6. • • 998877 ° , ' '4$ iiillion 190.Ii 8 "G1►y;5taie: , : 4. °° '<Slit million 1'1:7I LERTQN,GA, ��.. S13�000 4u • • ny,q iS 1St,llian C'RA{"ISLAG Lt1I)QCIiQ7'�6 ° : , ° 'of Firm. yes Name �; 1::rn PAcrtitC►1R1IE2I 1019C75• ° • :E 0 <,SS inillian :Ci►y Slate 100% • kSi o si Milian. $60;150;93 1S million :. HtUETINGTON ItEAC1-r..t LANDSCAPE , .. 1t100804327 :g . ° Ages ofFirm: 7 yes. Distribution;1)Original-Local Agency File, 2)•Copy-DLAI 'w/Award'Package` . • .:. C49' Exhibit 12-8 B#diler'a List of`stul>►conttra+cttrr(DBE And Nog-DBE)- ` 'Part 2 In accordance with Title 49,Section 26 of the Code•of Federal"Regtilottons;the:Bidder shall bat all sttbcotstrector who provide:a quote'or bid but were'not selected.to participate as a subcontractor on this project'Photocopy this farttt'for additional fintts.• , SabeoetraeterNam•c slag • IAne Item&Eneeriptien Sabeoatract Percentage of Contractor •... -DEE DBE Cert" Annual Cerise Receipts Location Amount Ditlitem Sorb- License Number (YIN) Namber. contrasted• D1B.1teg, .. +istntbsr N ,1 ,'' ® . 4 1 million TREESII%IITH � * #7&;r8` 8027G5 �° 5•million City,State: rrREE $17 ISO 00 I)0 million° t0 ANA1Ili[M,:CA $E1tVIC0; i, ,,,, a El' �"IitS meiliion •• • E Of Fitrn: 7rs • -Name: 177686 ' •. 45 million BG'PRAi�FIC� City,State; $1211)222 00 10il�li i , 410tnititon• S`1'RIP[NG' + GARDEN GICOVE,.CA 1000407561 °3 �S15 m2lclion A$CsOfFirra: yrar Name:"NOBLST °' -'gl melit� • 359622 „ 6, 45 Million COtgeRE`1'E. City,State 1009o. - . I i �Sitt•millton (}=15 $391.344,00 [ • 4l5 tniiiiao C1ARIIEN GrRQVE,'CA 1000611529 a a1 • , . Age of Finn 45 Name: F ' 1 mdl 1 PAVEMENT REIlAB 1051374 ® - <$5 million City,5lale cOticTi•ETE 100%, .Y s 410 million $3CT,MQ`00 f '<SI"5 tnittion CORONA,CA *10-15' 11100064823 i _: ° A eofFittri: yta NHS _ � .. [3: $l-million, CONCRETE 72) 1& ;•:: . I 4S5million • Ltty,State: =1-o-1s� 100% ®" 410 midi ` $S7fi,22 (14 a i tS Million C;ORONr�,CA loo0o+�sz95" Aite-of Firm 20 r s ' ." .. .,._ Name: ❑ 41million. • V•&E. , 7.4 '654506. 1-"f .45million Cttyt Ststo i tI(19ii. r , IS <SlO,mitlion". C)RANC;E CA, $74•,535,00 ® �S15million ,< Age of trirm.40 yrs, -" Distribution: Origit l-1 ocOl Agency bile" 2)Copy.DLAE w!Award Package G29 . Ex bit 12-B Bidder's List iffsubcontractor(DBE and Non-DBE) Part.2' In accordance with*ilk Title 49,Section.26 ofthe Code cif Federal Regulations,the-Bidder shall list alt:subcontrai r who provide-1 quote:.or bid but were not selected to participate as subcontractor on this project.Photocopy this.form for addi ional firms,: Subeoninetor Nsme oast` Lige llem;&Deserdptlau Snbeo ret Percentage of- Contractor DBE DBE Cert Annual Gross Receipts Lacadroa. Amount' .,11kffttrrt:Eub xieanse Number .(YIN), Number contracted DIR lumber 1+Timie: • ; {Si rn_illlon SUPERIOR 77e306 •• � B � S million n -E � e CityState: $126,844.000 111 as ' , ' 0 . 41O.million CYP113 SS CA 10000ol 7 f l <Sl5 ruill�n 8-T. ,,2�T a -Age OfFiiera:'°23- rs. ,. Nam•e:Mt)R'(3i3BE111ZhD -City,State:: #18 $7.43&co' ; K ��SS,mitWm ;. loiu� �S1O million �' °, 41Smillion CRACK 1000006438. -y SEAL ' .Alie of F r y . ' LAKE Ff01�ST"CA. � 3fisnr , + _ <4S million :..' -tit'',State' 41t1 miiltoa 0 <41S rittrion • Age or Firm ..yrs,. Name .� <$1 minion- °° . <$5 mullion <$ , City'SWiet .� lO million . CIS million . .r v '° of Firm:»j„�.yrs. Names . ° 0 4fi1 million s 0 -SS million . i.ity,Stare '• . . 410 Million- g® 413.itudllon e ° Age of}left".- ...yrs. L..I � 4l-rn�ton: Name: <,,, 4S=million. . . la •• .a o million- yTStY E: 415-Million .vAie of Fil :. yrs. " m - Distribution:1)Original=Deal Agency File 2)Copy-DLAE WI Award Package • • C29.. Western Surety Company BID BOND (Percentage) Bond Number: N/A KNOW ALL PERSONS BY THESE PRESENTS,That we R. J. NOBLE COMPANY of Orange, California , hereinafter referred to as the Principal,and Western Surety Company as Surety, are held and firmly bound unto City of Huntington Beach hereinafter referred to as the Obligee, in the sum ofcrr.� t ( 10 %) percent of the greatest amount bid, for the payment of which we bind ourselves, our legal representatives, successors and assigns,jointly and severally,firmly by these presents. WHEREAS, Principal has submitted or is about to submit a proposal to Obligee on a contract for Saybrook Lane Rehabilitation Invitation#CC-1690 NOW, THEREFORE, if the said contract be awarded to Principal and Principal shall, within such time as may be specified, enter into the contract in writing and give such bond or bonds as may be specified in the bidding or contract documents with surety acceptable to Obligee; or if Principal shall fail to do so, pay to Obligee the damages which Obligee may suffer by reason of such failure not exceeding the penalty of this bond, then this obligation shall be void; otherwise to remain in full force and effect. SIGNED, SEALED AND DATED this 28th day of April 2023 R.J. NOBLE COMPANY (Pri al) X (Seal) By JACOB B , SECRETARY Western Sure om an urety) By (Seal) CO I Attorney-in-Fact Form F5876 • 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 ORANGF 05/03/2023 J.DEIONGH,NOTARY PUBLIC On before me, Date JACOB BREEDLOVE Here Insert Name and Title of the Officer personally appeared Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s)is/afe subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/fief/their authorized capacity(ies),and that by his/bap/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 J.DEIONGH laws of the State of California that the foregoing ;"F Notary Public-California paragraph is true and correct. W` Orange County i ' s Commission 230744i �'. My Comm.Expires Oc 2023 t 28, WITNESS my hand and official seal. C4LIG0,- Signatur Place Notary Seal and/or Stamp Above Signature of Notary 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: Signer's Name: ❑ Corporate Officer —Title(s): ❑ Corporate Officer—Title(s): ❑ Partner— 0 Limited 0 General 0 Partner— ❑ Limited 0 General ❑ Individual 0 Attorney in Fact ❑ Individual ❑ Attorney in Fact ❑ Trustee 0 Guardian or Conservator 0 Trustee 0 Guardian or Conservator ❑ Other: 0 Other: Signer is Representing: Signer is Representing: ©2018 National Notary Association 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 42tJ 2J 2023 before me, Tina Downey, Notary Public (Here insert name and title of the officer) personally appeared James Scott Salandi who proved to me on the basis of satisfactory evidence to be the person(s`)whose name(€ is/are subscribed to the within instrument and acknowledged to me that he/she/tbey executed the same in his/her/fir authorized capacity(Ee3` , and that by his/het/their signature(s`Yon the instrument the persons "or the entity upon behalf of which the person{s1 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. ‘.�- TINA DO`NNEY WITNESS my hand and official seal. a _ Notary P_blic California ,. I San 8ernareino County T. \ - 'J Commission;2383319 �/\- ..ii Oh° \�.=4%My Comm Expires Nev 21.2025 ublic Signature (Notary Public Seal) • ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM This form complies with current California statutes regarding notary wording and, DESCRIPTION OF THE ATTACHED DOCUMENT if needed,should be completed and attached to the document.Acknolwedgents from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary law. (Title or description of attached document) • State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s)personally appeared which (Title or description of attached document continued) must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her Number of Pages Document Date commission followed by a comma and then your title(notary public). • Print the name(s) 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/aee)or circling the correct forms.Failure to correctly indicate this ❑ Individual (s) information may lead to rejection of document recording. ❑ Corporate Officer • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges,re-seal if a (Title) sufficient area permits,otherwise complete a different acknowledgment form. ❑ Partner(s) • Signature of the notary public must match the signature on file with the office of Partner(s) the county clerk. I] Attorney-in-Fact Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. Other Indicate title or type of attached document,number of pages and date. ❑ Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). 2015 Version www.NotaryClasses.com 800-873-9865 • Securely attach this document to the signed document with a staple. • Western Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents,That WESTERN SURETY COMPANY,a South Dakota corporation,is a duly organized and existing corporation having its principal office in the City of Sioux Falls,and State of South Dakota,and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint James Scott Salandi,Leonard Ziminsky,David Jacobson,Individually of Irvine,CA,its true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign,seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature -In Unlimited Amounts- and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney,pursuant to the authority hereby given,are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By-Law printed on the reverse hereof;duly adopted,as indicated,by the shareholders of the corporation. In Witness Whereof,WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 24th day of June,2021. ? mac WESTERN SURETY COMPANY O Jqe? awl eE AN. _4‘2Lfr".g,fR aul T.Bruflat,Vice President State of South Dakota ss County of Minnehaha On this 24th day of June,2021,before me personally came Paul T.Bruflat,to me known,who,being by me duly sworn,did depose and say: that he resides in the City of Sioux Falls,State of South Dakota;that he is the Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument;that he knows the seal of said corporation;that the seal affixed to the said instrument is such corporate seal;that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority,and acknowledges same to be the act and deed of said corporation. My commission expires ` M.BENT Cg y�Dsou S°"7"11Y N uNIBLIoCa• March 2,2026 • M.Bent,Notary Public CERTIFICATE I,L.Nelson,Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force, and further certify that the By-Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this, day ord . 7t)Z3 WESTERN SURETY COMPANY ge =Wt ii L.Nelson,Assistant Secretary Form F4280-7-2012 Go to www.cnasuretv.com>Owner/Obligee Services>Validate Bond Coverage,if you want to verify bond authenticity. Authorizing By-Law ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY This Power of Attorney is made and executed pursuant to and by authority of the following By-Law duly adopted by the shareholders of the Company. Section 7. All bonds,policies,undertakings,Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President,Secretary,and Assistant Secretary,Treasurer,or any Vice President,or by such other officers as the Board of Directors may authorize. The President,any Vice President,Secretary,any Assistant Secretary,or the Treasurer may appoint Attorneys in Fact or agents who shall have authority to issue bonds,policies,or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds,policies,undertakings,Powers ofAttorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. i _ yf liy'Y • .aJay;uawnDop 6uiddiys•iasul ►I ,* �,,{ti. -- T , • S"k x F X"t&! per �I • 14e0 .�%" i� o T.1 "3 I . .,_,,,,,,, ,ataltks-,,,:%•0,,,,t,•,,, r':�C' �,`Qb26y1; I F -f xY f i `, �� t Fi-. ,- ,, l'>.RIGIN ID:FULA (714)637-1550 sY - JENNIFER DE IONGH SHIP DATE:04Mgy23 a Ui R J NOBLE COMPANY ACTWGT:0.50 LB r. I = ' 15505 E.LINCOLN AVE. CAD:255356447/INET4610 ORANGE CA 92865 U ITE STAT S g BILL SENDER To DOE FUENTES CITY OF HUNTINGTON BEACH 2000 MAIN STREET Q HUNTINGTON BEACH CA 92648 (714)536-5259 v IINV: . REF:BID BOND SAYBROOK LANE PO: m III IIIIIIIIIIIIIIIIIIIII II I I I III IIIIIII IIII III II I II II III DEPT 11111 } iiil 1111Q "111/111 Q. fti � iii v it 1I co NI 1 , a & co Lu TUE- 09 MAY 4:30P EgliTRK# 7720 4832 4020 • EXPRESS SAVER CZAPVA': 92648 CA.us S , 11111111111111111111111111111111 NA • LP • \�Q,J N Viri S" jt he Nff com Rxin N 0 R pany IWI 41 it , ENGINEERING CONTRACTORS 010 Pol 7,7 IQ R. CITY OF HUNTINGTON BEACH 2000 MAIN STREET HUNTINGTON BEACH, CA 92648 ECURITY-DONOTOPEN SAYBROC}K LANE REHABILITATION / ite:Tuesday, May 16at1O:0X]a.nn. �