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A2Z Construct Inc. - 2023-10-03 (2)
RECEIVED BY; CITY CLERK RECEIPT COPY �{ A C C f,t Return DUPLICATE to -}�C/►r City Clerk's Office (Name) after signing/dating 3I / 2 5 (Date) CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION „z7 TO: City Treasurer FROM: City Clerk DATE: :3/.�I /e)-5 SUBJECT: Bond Acceptance I have received the bonds for f 22 Cons rje€ it lC) . (Company Name) CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. Payment Bond (Labor and Materials) Bond No. Warranty or Maintenance Bond No. C S 2 14(P OCo IF 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 C011.911145111�-r Re: Tract No. Approved l'oM p r^ (Council Approval Date) CC No. Agenda Item No. 4, 9"fiD MSC No. City Clerk Vault No. (COO. SO Other No. SIRE System ID No. (Ct it c O)3 t-( g:/forms/bond transmittal to treasurer Recorded in Official Records;Orange County Hugh Nguyeq, Clerk-Reorder ...• _ - - 11111111101110111 11110111111 11114111111 'H Ill NO FEE . PLEASE.COMPLETE THIS INFORMATION ;Q 1 5 3 2 Ai 3. S. t 2025000008181:44 pm 01102125 REC'ORDINq REQUOTEO Sy't 371 NC-5•NI 2 1 • 0.00 0.00 0.00 0.000,00 0,40 0,000.000,00 0,0.0 • .INFIENSECORDEGNIAIL.TO! . are OF HUNTINGTON BEACH PUBUCANORKS DEPARTMENT 491164s,Griffin P:Ot litr;pt190-200Q.Iyilain Street Huntington Seack,OA 026.48. • THIS SPACE FOR RECORDER'S USE ONLY 'TITLE OFDOCUNIENT NOTICE OF COMPLETION • NOTICE IS HEREBY 00EN.bylfa,01tV.Pf Huntington*AO,Nino.in fear 200Q Mairt.Street,Huntington Beach,CA 91648i.that ft, contract A2Z:Canstructinc.,who wasihe cornpanytherelinlor difinallietbodwiog woekloksilt entrai Library Lower Lewd RestrnoreADA lentirOYenteitte,Project#-CC165.13 • Titatsaidienn( s .npIeted 08/09/202.4 by said company according to plans and specifications and tOthatatigentiOn Ohne City Engineer of the pity of Huntington Beach*10 that:010W0*Was.aPtaPted.by the Directorof Public Works on 0810912024,,per City Coundl.Resorution No..20.0340:adopted October 6o..2003. That upon said otttmot The DeSualty Surety Company.,waesuretylor the bond giverytty the said conipanyaS required by IOC • This document*solely fOr0i0,000,al business?of the 'Beach,as contemplated under Goeernment'qode*chdh 2 and should berecordedfree;of charge. . Director of Public Works or CitrEngin / Date City of Huntington Beach,California STATE OF CALIFORNIA), ' • County of Orange yes: City Of Huntington Beach: - • I,:the undersigned,say; am an Agent of the City'of Huntington'Beactii oWnerM fee.,in The foregoing NOTICE...OF COMPLETION:. I have toad said NOTICE OF COMPLETION and know the contents thereof;the same is truadfrnyitneyfiledge,. taddlare 000 pertaltyldtperjarythat the-foregoing is true and correct,midi?*Said NOTICE OF pqmPLETiott was duly and regularly ordered ter be„recordedin the OffiCe of the County Recorder of.OrangeCOunty.. This iissusienthrsoleirthe official business of ••• . • the Olfrof'Huntington Beach,as'CordompWed „ . . . Ondet•Govemment code section'27383 end' Di Pub f,orks.orCIty Engine" ate • of . - .. • • should'be recorded"five of charge, • City of 1-1011.00000 Beach,.California • - • . THIS PAGE1S ADDED TO PROVIDE.ADEGUATE SPACE RECORDING INFORMATION • (Additional recording fee apPiles). • PLEASE COMPLETE THIS INFORMATION RECORDING REQUESTED BY: WHEN RECORDED MAIL TO: CITY OF HUNTINGTON BEACH PUBLIC WORKS DEPARTMENT Attn:John S.Griffin 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 A2Z Construct Inc.,who was the company thereon for doing the following work to-wit: Central Library Lower Level Restroom ADA Improvements,Project#CC1658 That said work was completed 08/09/2024 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 08/09/2024,per City Council Resolution No.2003-70 adopted October 6,2003. That upon said contract The Casualty&Surety Company,was surety for the bond given by the said company as required by law. This document is solely for the official business of the City of Huntington Beach, as contemplated under Government Code Section 27383 and should be recorded free of charge. ;s Director of Public Works or City Engin r 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 Governmenti n and Director of Pub is orks or City Engine// f Date under code sect o 27383 should be recorded free of charge. City of Huntington Beach,California THIS PAGE IS ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION (Additional recording fee applies) i, ® CITY OF HUNTINGTON BEACH 1 le INTERDEPARTMENTAL COMMUNICATION DATE: 2/6/2025 TO: THOSE LISTED HEREON FROM: John Griffin, Contracts Administrator SUBJECT: Retention Release Payment- PO#30334 OJ Supplier#85211 Co.#239 Central Library Lower Level Restroom ADA Improvements, Project#CC1658 Contractor's Name: A2Z Construct Inc. Address: PO Box 80425 City, State and Zip Code: Rancho Santa Margarita, CA 92688 Phone Number: 949-283-5179 City Business License Number: A317570 Notice of Completion (Date by City Clerk): 1/2/2025 The conformed copy of the Notice of Completion for the above contract has been filed. The thirty-five (35) day waiting period has elapsed or will elapse before payment is made. Processing of the retention payment is recommended so long as no stop notices or outstanding invoices are on file with the City. I certify that no stop notices are on file. ate Chau Vu, Director of Public I certify that there are no outstanding invoices on file. 0/) a Date Joy cks, Deputy City Treasurer I certify that no stop notices are on file, and that a guaranty bond has been filed with the City Clerk's Office. Z Zv -Z VA:zisitsi uz-zr_ Date Lisa Lane Barnes, City Clerk of jo7 021' 7b Attachments U 1. Notice of Completion 2. Maintenance Bond 3. Certificate of Compliance with Prevailing Wage Laws 4. Contractor's Certificate 5. Certificate of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 6. Consent for Release letter from the Surety Company • Recorded in Official ReCords,Orange County Hugh NgUy.eili Clerk-RocOrdiet, 11111111111111111111111111 1111111. 111111111111 NO FEE • PLEASE'COMPLETE THIS INFORMATION 'S a. Q 1 5 3 2 .6 3: 9 1 S• 202500000818 1:44.pm 01/02125 RECORDING REQUESTED BYri 371 NC-5 N12 1 • 0..00°A0,0.00 0.00 0.00 0.00 0,000,000.00 kW WHEN,RECORDED:MAILTO: CITY OF HUNTINGTON BEACH PliBLIGWORKS DEPARTMENT Griffin • Boir190—2000 Main Street Huntington.Beach,.CA,4E48 • THIS SPACE FOR RECORDER'S USE ONLY 'TITLE OF DOCUMENT • NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN,by the-Ph Pf POO,evoret in fee;.2000 Main•Street,Huntington:Beach,CA 92648i.that the CentractheretOkr&awarded to•A21 Constructlitc.,who'was the compenythereon:fot doing'the following wodt10•Wib • •Central Ubraiy Lower Level RestrO0m:.ADA ImPtinieirrente,Project*CCU'S That said.woo(Was completed 08109/2024 by said company according to plans and specifications and tO.the tatiSfectieh'Otthe City Engineer of ther.City of Huntington Beach and that ealif Work Was.accepted by the Directorof Public Works on 0810912024,per City CoundiResoktion;No.2003.40 adopted October That upon Said colittatit The Casuelty Surety COmpany„wairsurety•for the bond given:by the said•coMpany'ss wired by law. • This document is.soli&y for the official business ofthe:City.orHuritington Beach,as contemplated under Government Code Section •27.1133'.and should be recorded'freeof charge. . . • /•• • . , . • . •• . • ' • 0110P101`Of Public Works at OltrEngin r • Coate, City of Huntington Beach,California • STATE OF CALIFORNIA), ' • County Of Orange )..as: City of Huntington Beach- , S. L•the undersigned,Sayil.am an Agent of the Cityvf-Hunbhgtoo Beech,owner*fee,in the foregoing NOTICE OF COMPLETION.. I have read said Nance OF COMPLETION and know the contents,thereof;the same is true•of mylearririedge. .14eCitire Under penally cfperjury that theforegaing Is true arid correct,and that said NOTICE OF CQIVIPLETION was,duty and k. regularly ordered to be,recordrad in the.0ifice.afthe County Recorder of Orange County. .• .„ • Th , Olr f PublL •.is docOnfent soleftthe official business of • . . . •• • . .tho CitSr ofilunfington Beach,as contomplefe.d • • . . .• • UnderGovernment code section 27383 and ect o tvIy Engine //t • ate shoulifbe recorded free of charge., • Of*of Huntington Beach.California /: • . THIS PAGE IS•ADDED TO PROVIDE ADEQUATE SPACEFOR RECORDING INFORMATION • , (Additional recording fee applies) • • EXECUTED IN DUPLICATE BOND NO. GS24600018 MAINTENANCE BOND KNOW ALL PERSONS BY THESE PRESENTS: That A2Z CONSTRUCT, INC. (contractor's name) P.O.BOX 80425,RANCHO SANTA MARGARITA,CA 92688 (contractor's street address,city and state and zip code) as Principal (hereinafter called Contractor),and: THE GRAY CASUALTY&SURETY COMPANY (surety's name) ATTN:SURETY CLAIMS,P.O.BOX 6202,METAIRIE,LA 70009-6202 • (surety's street address,city and state and zip code) a corporation organized and existing under the laws of the State of LOUISIANA with its principal office in the City of METAIRIE as Surety(hereinafter called Surety),are held firmly bound unto CITY OF ON HUNrMTHiR4 BEACH as Obligee (hereinafter called Owner), in the amount of SEVEN THOUSAND NINE HUNDRED NINETY FIVE AND 00/100 Dollars ($ 137,995.00 ), equivalent to the entire • contract amount including all orders, for the payment whereof Contractor and Surety bind themselves, their heirs, executors, administrators,successors,and assigns,jointly and severally,firmly by these presents, WHEREAS, Surety is a duly admitted surety insurer under the laws of the State of California;and Surety is certified and listed in the U.S. Department of the Treasury Circular 570, and able to provide proof of bonding limitation shown in said circular is sufficient to provide bonds in the amount required by said Contract;and Surety has provided financial strength ratings from reputable companies,such as from A.M. Best, Moody's, Standard &Poor s,to validate that Surety has positive ratings of being secure or stable;and Surety is registered and listed with the California Department of Insurance;and Contractor has by written agreement dated 20 ,entered into a contract with Owner for the CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS, CC-1658 in accordance with drawings and specifications prepared by DPW which contract is by reference made a part hereof(hereinafter referred to as the Contract);and • The Contract provides that the principal will guarantee, for a period of one year, the work performed as part of the Contract from and against all defects in materials and workmanship;and • The Contract also provides that the Contractor shall secure Contractor's obligations during the one-year period with a bond executed by a surety duty admitted in the state of California;and The Contract has been completed, and the Owner, Contractor and Surety agree that the commencement date for this Guarantee and Bond shall be SEPTEMBER 10 ,2024, NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that if Contractor shall, for a period of one year from and after the date of completion and acceptance of the Contract by Owner, repair and/or replace any and all defects arising in the Work, whether resulting from defective materials or defective workmanship, then this obligation shall be null and void; otherwise it will remain in full force and effect. The Surety hereby waives notice of any alteration or extension of time made by the Owner. Whenever Contractor shall be, and declared by Owner to be in default under the Contract, the Surety shall, within thirty (30) days following Owner's written notice of default, either: (a) remedy the default, or (b) shall promptly complete the Contract in accordance with its terms and conditions, Surety shall save the Owner harmless from any claims,judgments, liens or losses arising from the Surety's failure to either remedy the default or to complete the Contract in accordance with its terms and conditions in a timely manner. 1 -4584/J1813E 1 Whenever the Principal shall be, and declared by the Owner to be in default under the Contract, which shall include without limitation, any breach or default of the Contract, then, after written notice from the Owner to the Surety, as provided for below,the Surety shall either: (a)remedy the default or breach by the Principal;or(b)shall promptly and faithfully take charge of the Work and complete the Work in accordance with the requirements of the Contract with a contractor other than the Principal,at its own expense, and make available as work progresses sufficient funds to pay the cost of completion less the unpaid balance of the Contract including other costs and damages for which the surety may be liable hereunder, provided, however, that the procedure by which the Surety undertakes to discharge • its obligations under this Bond shall be subject to the advance written approval of the Owner. Within thirty (30) clays after Surety's receipt of a written notice from Owner of the failure of performance of the Contract by the Principal, it shall be the duty of the Surety to give to the Owner a notice, in writing, of the Surety's election to (a)remedy the default(s)of the Principal promptly,or(b)arrange for performance of the Contract promptly by a contractor other than the Principal, time being of essence to this Bond. In said Notice of Election, the Surety shall state the date of commencement of its cure or remedy of the Principal's default(s) or its performance of the Contract. The Surety's obligations for cure or remedy, include but are not limited to: correction of detective work and completion of the Contract, additional legal, design professional and delay costs arising from Surety's actions or failure to act: and liquidated damages (or if no liquidated damages are specified in the Contract; actual damages caused by delayed performance or non-performance by the Principal). The Surety shall give prompt written notice to the Owner upon completion of the cure or remedy of the Principal's default(s)of its performance of the Contract, It the Surety does issue its Notice of Election and does not proceed to cure or remedy the Principal's default(s) of its performance of the Work within thirty(30) days after receipt of a written notice from Owner, Surety shall be deemed to be in default on this bond,and the Owner shall be entitled to enforce any remedy available to Owner. No right of action shall accrue on this bond to or for the use of any person or corporation other than the owner named herein or the successors of Owner. Signed and sealed this 10TH day of SEPTEMBER , 20 24 Principal Raised Corporate Seal A2Z CONSTRUCT,INC. (MUST BE AFFIXED) (Contractor Name) • By: dI (Seal) SEE CAUFORNIA NOTARY,ATTACHED -7 Principal Raised Corporate Seal [MUST ErEAFFIXEDJ (Title) THE GRAY CASUALTY&SURETY COMPANY (Surety Name) By: / �ry I lit, ll• r r •-;Seal) MARK D.IATAROLA,ATTORNEY-IN-FACT • APPROVED AS.:TO FORM,.. NOTES: ..Michael E. Gates, City Attorney 1. • Acknowledgments must be completed and returned •as parr of the bond. }. 2. Raised Corporate Seals are mandatory. 3. Please attach Power of Attorney. .54 584/118138 2 • I CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California 1 County of SAN DIEGO J} On 9/10/2024 before me, SANDRA FIGUEROA, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared MARK D. IATAROLA Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the persons)whose name(s)is/afesubscribed to the within instrument and acknowledged to me that he/3he/they executed the same in his/`cr/thcir authorized capacity(iee), and that by his/herftheir signature(a)on the instrument the person(s),or the entity upon behalf of which the person(a)acted, executed the instrument. I certify under PENALTY OF PERJURY under the SANDRA FIGUEROA 1 laws of the State of California that the foregoing COMM. 2334108 paragraph is true and correct. • �► ; SAN DIEGO COUNTY ' � NOTARY PUBLIC-CALIFORNIAZ �y1k�,,f � WITNESS my hand and official seal. MY COMMISSION EXPIRES SEPTEMBER 22,2024 Signature Place Notary Seal and/or Stamp Above Signature of Not 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: MARK D. IATAROLA Signer's Name: 0 Corporate Officer—Title(s): 0 Corporate Officer—Title(s): ❑ Partner— 0 Limited 0 General 0 Partner— ❑ Limited 0 General ❑ Individual lg.Attorney in Fact 0 Individual 0 Attorney in Fact ❑ Trustee 0 Guardian of Conservator 0 Trustee 0 Guardian of Conservator ❑ Other. 0 Other: Signer is Representing: Signer is Representing: ©2017 National Notary Association Helen Maloney&Associates Insurance Servi( 09/10/2024 11:20 1121760047083 THE GRAY INSURANCE COMPANY THE GRAY CASUALTY&SURETY COMPANY GENERAL POWER OF ATTORNEY Bond Number:GS24600018 Principal:A2Z CONSTRUCT,INC. Project: CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS,CC-1658 KNOW ALL BY THESE PRESENTS,THAT The Gray Insurance Company and The Gray Casualty&Surety Company,corporations duly .organized and existing under the laws of Louisiana,and having their principal offices in Metairie,Louisiana,do hereby make,constitute,and -appoint:John G.Maloney,Helen Maloney,Sandra Figueroa,Tracy Lynn Rodriguez,and Mark D.Iatarola of Escondido,California jointly and severally on behalf of each of the Companies named above its true and lawful Attorneys)-in-Fact,to make,execute,seal and deliver, for and on its behalf and as its deed,bonds,or other writings obligatory in the nature of a bond,as surety,contracts of suretyship as are or may be required or permitted by law,regulation,contract or otherwise,provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed the amount of $25,000,000.00. This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both The Gray Insurance Company and The Gray Casualty& Surety Company at meetings duly called and held on the 26'h day of June,2003. "RESOLVED,that the President,Executive Vice President,any Vice President,or the Secretary be and each or any of them hereby is authorized to execute a power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings,and all contracts of surety,and that each or any of them is-hereby authorized to attest to the execution of such Power of Attorney,and to attach the seal of the Company;and it is FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be binding upon the Company now and in the future when so affixed with regard to any bond,undertaking or contract of surety to which it is attached. IN WITNESS WHEREOF,The Gray Insurance Company and The Gray Casualty&Surety Company have caused their official seals to be hereinto affixed,and these presents to be signed by their authorized officers this 4'h day of November,2022. „fti, aSU R•A.,y tiq 7������ JP�j YOB U;P `j`: ;.3 By: Michael T.Gray Cullen S.Piske SEAL ' 1; SEAL _ ;,, President President y''fir•• 2r The Gray Insurance Company The Gray Casualty&SuretyCompany `�yr•..• �`� State of Louisiana ss: Parish of Jefferson On this 4'h day of November,2022,before me,a Notary Public,personally appeared Michael T.Gray,President of The Gray Insurance Company,and Cullen S.Piske,President of The Gray Casualty&Surety Company,personally known to me,being duly sworn,acknowledged that they signed the above Power of Attorney and affixed the seals of the companies as officers of,and acknowledged said instrument to be the voluntary act and deed,of their companies. pt ' � , �-. ��l� A 1, 4M�! kl" Ir'L „:..;; p Leigh Anne Hcnicrn 0 "n: y r v Notary Public Anne Henican Notary ID No,92653 Leigh �•�' Orleans Parish,Louisiana Notary Public,Parish of Orleans State of Louisiana My Commission is for Life I,Mark S.Manguno,Secretary of The Gray Insurance Company,do hereby certify that the above and forgoing is a true and correct copy of a Power of Attorney given by the companies,which is still in full force and effect.IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Company this 10TH day of SEPTEMBER , 2024 044.4 40,1•04~4 1,Leigh Anne Henican,Secretary of The Gray Casualty&Surety Company,do hereby certify that the above and forgoing is a true and correct copy of a Power of Attorney given by the companies,which is still in full force and effect.IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Company this 10TH day of SEPTEMBER ,2024 } 1 aSURAHc,� JPNTY O wol SEAL SEAL ..........••• e3" 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 9/11/2024 before me, Tejal Munsif, Notary Public (insert name and title of the officer) personally appeared Matthew Jafari w • proved to me on the basis of satisfactory evidence to be the ers whose na • - '.) is/:re cubs'ribed to the within instrument and ackno a to me tha he/s e/they executed th- ame in his/ -r/their authorized capacity(iis), and that b his/h r/their sig re(s) on the instrument the - son(s), or the entity upon behalf of which the on(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. TEJALMUNSIF Notary Public-California sr:�y Orange County .7 Commission#2335015 My Comm.Expires Oct 17,2024 Signature (Seal) 1-10JAA4eVaLIXCI2_ 01-Aa Certification of Compliance with Prevailing Wage Laws To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach,CA 92648 Re: Certification of Compliance with Prevailing Wage Laws Contract: CC-1658 Project: Central Library Lower Level Restroom ADA Improvements The undersigned contractor on the above-referenced project("Project")hereby certifies that all laborers, mechanics,apprentices,trainees, watchmen and guards employed by him or by any subcontractor performing work under the contract for the Project have been paid pursuant to the minimum wage and bona fide fringe benefit requirements specified for each particular classification of work, as set forth in the wage-rate determinations of the State of California, Department of Industrial Relations, and/or the United States Department of Labor. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this 10th day of September , 2024 , at Rancho Santa, California. Margarita M u 4--44-ie w: rI ontractor Name) I APPROVED TO FO BG M' ael E. Gates ty Attorney 1 CONTRACTOR'S CERTIFICATE I, Matthew Jafari , state and certify that: (Name of Declarant) I A2Z Construct Inc is the general contractor to the City of Huntington Beach ("City")on Contract No. CC-1658 (the"Contract") for the construction of the public work of improvement entitled: Central Library Lower Level Restroom ADA Improvements (the"Project"). 2. All work to be performed pursuant to the Contract has been completed in accordance with the Contract Documents(as such term is defined in the Contract). 3. Except for the claims listed below and the disputed claims listed in paragraph five(5), all persons supplying labor, services, materials and equipment to the Project, including all claims against the contractor arising from the performance of the Contract, have been paid and satisfied(list unpaid debts and claims; if none, write "NONE"): None 4. Attached hereto are the lien waivers required by the Contract Documents, which lien waivers have been executed by all persons who performed work on or supplied labor, services, materials,and/or equipment for use at the Project. 5. Set forth below is a list of disputed claims or claims that are the subject of a Notice to Withhold filed pursuant to the Civil Code of the State of California(list all disputed claims;if none, write"NONE"). None I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at Rancho Santa Margarita on this 10th day of September ,2024 . ,Signature o Declarant) APPROVED A RM Michael E. Gates City,Attorney 1 Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 To: City of Huntington Beach Department of Public Works 2000 Main Street/P'.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 Contract: CC-1658 Project: Central Library Lower Level Restroom ADA Improvements The undersigned contractor on the above-referenced project("Project")hereby certifies that it has complied with title VII of the Civil Rights Act, the Equal Opportunity Act of 1972 and Executive Order 11246,and has not discriminated against any employee or applicant for employment because of race,color,religion,sex,sexual orientation, gender identity,national origin, age or disability. The undersigned contractor also certifies that it has not maintained any segregated facilities at its establishments on the basis of race,color, religion, sex, sexual orientation, gender identity, national origin, age or disability(with the exception of access for the disabled). I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this 10th day of September , 20 24 at Rancho Santa California. M rgarita (C tra t a APPROVED AS T6 FORM By: Mic iel E. Gates Cit' Attorney 1 EXECUTED IN DUPLICATE BOND NO. GS24600018 OWNER ❑ CONSENT OF SURETY ARCHITECT ❑ TO FINAL PAYMENT CONTRACTOR ❑ Conforms with the American Institute of SURETY Architects, AIA Document G707 OmR ❑ TO OWNER: CITY OF HUNTINGTON BEACH ARCHITECT'S PROJECT NO.: (Name and address) 2000 MAIN STREET HUNTINGTON BEACH, CA 92648 CONTRACT FOR: PROJECT: CENTRAL LIBRARY LOWER LEVEL CONTRACT DATED: (Name and address)RESTROOM ADA IMPROVEMENTS CC-1658 . In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the (Insert name and address of Surety) THE GRAY CASUALTY&SURETY COMPANY ATTN: SURETY CLAIMS P.O. BOX 6202 METAIRIE, LA 70009-6202 ,SURETY, on bond of (Insert name and address of Contractor) A2Z CONSTRUCT, INC. P.O. BOX 80425 RANCHO SANTA MARGARITA, CA 92688 ,CONTRACTOR, hereby approves of the final payment to the Contractor,and agrees that final payment to the Contractor shall not relieve the Surety of any of its obligations to (Insert name and address of Owner) CITY OF HUNTINGTON BEACH 2000 MAIN STREET HUNTINGTON BEACH, CA 92648 ,OWNER, as set forth in said Surety's bond. IN WITNESS WHEREOF,the Surety has hereunto set its hand on this date: SEPTEMBER 18,2024 (Insert in writing the month followed by the numeric date and year.) THE GRAY CASUALTY&SURETY COMPANY (Surety) BY: � � (Signature of authorized representative) Attest: (Seal): MARK D. IATAROLA,ATTORNEY-IN-FACT (Printed name and title) S-2134/GEEF 10/01 FRP p C CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of SAN DIEGO Jr On 9/18/2024 before me, SANDRA FIGUEROA, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared MARK D. IATAROLA Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s)is/afesubscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/`c„C-nit„ authorized capacity(ies), and that by his/weir signature(e)on the instrument the person(6), or the entity upon behalf of which the person(s)acted, executed the instrument. ..r. SANDRA FIGUEROA I certify under PENALTY OF PERJURY under the ;; '= COMM.#2334108 laws of the State of California that the foregoing Zr•p SAN DIEGO COUNTY > paragraph is true and correct. z i. +s NOTARY PUBLIC-CALIFORNIAZ ' "'^_•,"' MY COMMISSION EXPIRES '' SEPTEMBER 22,2024 WITNESS my hand and official seal. Signature Place Notary Seal and/or Stamp Above Signature of 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: MARK D. IATAROLA Signer's Name: ❑Corporate Officer—Title(s): 0 Corporate Officer—Title(s): ❑ Partner— 0 Limited 0 General 0 Partner— ❑ Limited 0 General ❑ Individual E7 Attorney in Fact ❑ Individual 0 Attorney in Fact ❑ Trustee 0 Guardian of Conservator 0 Trustee 0 Guardian of Conservator ❑ Other: 0 Other: Signer is Representing: Signer is Representing: ©2017 National Notary Association ~ Helen Maloney&Associates Insurance Servic 09/18/2024 14:28 844272036552 THE GRAY INSURANCE COMPANY THE GRAY CASUALTY&SURETY COMPANY GENERAL POWER OF ATTORNEY Bond Number:GS24600018 Principal:A2Z CONSTRUCT,INC. Project: CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS,CC-1658 KNOW ALL BY THESE PRESENTS,THAT The Gray Insurance Company and The Gray Casualty&Surety Company,corporations duly organized and existing under the laws of Louisiana,and having their principal offices in Metairie,Louisiana,do hereby make,constitute,and appoint:John G.Maloney,Helen Maloney,Sandra Figueroa,Tracy Lynn Rodriguez,and Mark D.Iatarola of Escondido,California jointly and severally on behalf of each of the Companies named above its true and lawful Attorney(s)-in-Fact,to make,execute,seal and deliver, for and on its behalf and as its deed,bonds,or other writings obligatory in the nature of a bond,as surety,contracts of suretyship as are or may be required or permitted by law,regulation,contract or otherwise,provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed the amount of $25,000,000.00. This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both The Gray Insurance Company and The Gray Casualty& Surety Company at meetings duly called and held on the 26'h day of June,2003. "RESOLVED,that the President,Executive Vice President,any Vice President,or the Secretary be and each or any of them hereby is authorized to execute a power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings,and all contracts of surety,and that each or any of them is hereby authorized to attest to the execution of such Power of Attorney,and to attach the seal of the Company;and it is FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be , binding upon the Company now and in the future when so affixed with regard to any bond,undertaking or contract of surety to which it is attached. IN WITNESS WHEREOF,The Gray Insurance Company and The Gray Casualty&Surety Company have caused their official seals to be hereinto affixed,and these presents to be signed by their authorized officers this 4th day of November,2022. i0 .41111401.' 07.4019 (; a e; SEAL `3 6 BY: Michael T.Gray Cullen S.Piske a` SEAL 1.0 F President President ,1•.. *, The Gray Insurance Company The Gray Casualty&SuretyCompany y: 1.. �� .•�� State of Louisiana ss: Parish of Jefferson On this 4'h day of November,2022,before me,a Notary Public,personally appeared Michael T.Gray,President of The Gray Insurance Company,and Cullen S.Piske,President of The Gray Casualty&Surety Company,personally known to me,being duly sworn,acknowledged that they signed the above Power of Attorney and affixed the seals of the companies as officers of,and acknowledged said instrument to be the voluntary act and deed,of their companies. 1�,Ip, Ay._.)' j Alrvv'+ -C,M Ca"'— .,(;; Leigh Anne Henican U' p Notary Public Leigh Anne Henican "f "' Notary ID No.92653. F� Notary Public,Parish of Orleans State of Louisiana Orleans Parish,Louisiana My Commission is for Life I,Mark S.Manguno,Secretary of The Gray Insurance Company,do hereby certify that the above and forgoing is a true and correct copy of a Power of Attorney given by the companies,which is still in full force and effect.IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Company this 18TH day of SEPTEMBER , 2024 044.4 4appropyrooll, I,Leigh Anne Henican,Secretary of The Gray Casualty&Surety Company,do hereby certify that the above and forgoing is a true and correct copy of a Power of Attorney given by the companies,which is still in full force and effect.IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Company this 18TH day of SEPTEMBER ,2024 I t } i m^ :t••U RAIN c.. _.JPIT .8.............0 6,titlyr--) .,1 V v`Q �/V'V 1 Ear ': +� 17,1 SEAL ;. `,1: SEAL i° RECEIVED BY: CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office (Name) after signing/dating (Date) %, CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: City Treasurer FROM: City Clerk DATE: c�'/�'! /c3 SUBJECT: Bond Acceptance I have received the bonds for pc2? Onsly-vc Ine)• (Company Name) CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. Payment Bond (Labor and Materials) Bond No. Warranty or Maintenance Bond No. G S21-I le 000 I g 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 10/3/2023 (Council Approval Date) CC No. ((.PS'S Agcndaa It No. 0-3' 0 MSC No. City Clerk Vault No. (QOD. 5O Other No. SIRE System ID No. (OI IL l0139 g:/forms/bond transmittal to treasurer 1 RECEIVED BY: CITY CLERK RECEIPT COPY + l , /V`0C-a Return DUPLICATE to J C�/ City Clerk's Office (Name) after signing/dating 12, I + 3 (Date) CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: City Treasurer FROM: City Clerk DATE: /.2//2J23 SUBJECT: Bond Acceptance I have received the bonds for A2; CGh'1 C+I I{1 . . (Company Name) CAPITAL PROJECTS (Includes CC's and MSC's) p� Performance Bond No. 2l 4 Qo�UI D Payment Bond (Labor and Materials) Bond No. G52040 0001 g 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 I 13 I 2-3 (Council Approval bate) r, CC No. I tP Agenda Item No. 2,3- qi"D MSC No. City Clerk Vault No. (POD.W Other No. SIRE System ID No. VI-ILD 0)3L/ g:/forms/bond transmittal to treasurer CDBG FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND A2Z Construct Inc. FOR. CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS 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 A2Z Construct Inc. , a California corporation , hereinafter referred to as "CONTRACTOR." WHEREAS, the Federal Department of Housing and Urban Development is providing partial funding for this Contract to CITY through a Community Development Block Grant; WHEREAS, CITY has solicited bids for a public works project, hereinafter referred to as "PROJECT," more fully described as Central Library Lower Level Restroom ADA Improvements, CC-1658 in the City of Huntington Beach; and CONTRACTOR has been selected to perform said services, NOW, THEREFORE, in consideration of the promises and agreements hereinafter made and exchanged,the parties covenant and agree as follows: 1. STATEMENT OF WORK; ACCEPTANCE OF RISK CONTRACTOR shall complete and construct the PROJECT pursuant to this Agreement and the Contract Documents (as hereinafter defined) and furnish, at its own cost and expense, all labor, plans, tools, equipment, supplies, transportation, utilities and all other items, services and facilities necessary to complete and construct the PROJECT in a good and workmanlike manner. SF:16-5215-142605.doc/rev 12/2016 1 CONTRACTOR agrees to fully assume the risk of all loss or damage arising out of the nature of the PROJECT, during its progress or prior to acceptance by CITY, from the action of the elements, from any unforeseen difficulties which may arise or be encountered in the prosecution of work, and for all other risks of any description.in connection with the work, including, but not limited to, all expenses incurred by or in consequence of the suspension or discontinuance of work, except such as are herein expressly stipulated to be borne by CITY, and for well and faithfully completing the work within the stipulated time and in the manner shown and described in this Agreement, and in accordance with the requirements of CITY for the compensation set forth in the accepted bid proposal. 2. ACCEPTANCE OF CONDITIONS OF WORK; PLANS AND SPECIFICATIONS CONTRACTOR acknowledges that it is fully familiar with all the terms, conditions and obligations of this Agreement and the Contract Documents (as defined below in this Section), the location of the job site, and the conditions under which the work is to be performed, and that it enters into this Agreement based upon its thorough investigation of all such matters and is relying in no way upon any opinions or representations of CITY. It is agreed that the Contract Documents are incorporated into this Agreement by this reference, with the same force and effect as if the same were set forth at length herein, and that CON TRACTOR and its subcontractors, if any, shall be bound by the Contract Documents insofar as they relate in part or in any way, directly or indirectly, to the work covered by this Agreement. "Contract Documents" as defined herein mean and include: A. This Agreement; SF:16-5215-142605.doc/rev 12/2016 2 B. Bonds covering the work herein agreed upon; C. The CITY's standard Plans and Specifications and special contractual provisions, including those on file in the office of the Director of Public Works of CITY and adopted by the City Council, and any revisions, amendments or addenda thereto; D. The edition of Standard Specifications for Public 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. All bid documents, including the Notice Inviting Bids, the Special Instructions to Bidders, CONTRACTOR's proposal, (attached as Exhibit "A"), "Form HUD-4010," the Federal Labor Standards Provision of the United States (attached as Exhibit "B"), and "Standard Federal Equal Employment Opportunity Construction Contract Specifications," as established by Federal Executive Order 11246 (attached as Exhibit"C"). F. The particular Plans, Specifications, Special Provisions and Addenda applicable to the PROJECT. Anything mentioned in the Specifications and not indicated in the Plans or indicated in the Plans and not mentioned in the Specifications, shall be of like effect as if indicated and mentioned SF:16-5215-142605.doc/rev 12/2016 3 in both. In case of a discrepancy between any Plans, Specifications, Special provisions, or Addenda,the matter shall be immediately submitted by CONTRACTOR to the Department of Public Works of CITY (hereinafter referred to as "DPW"), and CONTRACTOR shall not attempt to resolve or adjust the discrepancy without the decision of DPW, save only at its own risk and expense. Should there be any conflict between the terms of this Agreement and the bid or proposal of CONTRACTOR, then this Agreement shall control and nothing herein shall be considered as an acceptance of the terms of the bid or proposal which is in conflict herewith. 3. COMPENSATION CITY agrees to pay and CONTRACTOR agrees to accept as full compensation for the faithful performance of this Agreement, subject to any additions or deductions made under the provisions of this Agreement or the Contract Documents, a sum not to exceed one hundred seventeen thousand six hundred Dollars ($ 117,600.00 ), as set forth in the Contract Documents, to be paid as provided in this Agreement. 4. COMMENCEMENT OF PROJECT CONTRACTOR agrees to commence the PROJECT within ten(10)working days after the Notice To Proceed is issued and diligently prosecute the PROJECT to completion within sixty ( 60 ) consecutive working days from the day the Notice to Proceed is issued by DPW, excluding delays provided for in this Agreement. 5. TIME OF THE ESSENCE SF:16-5215-142605.doc/rev 12/2016 4 The parties hereto recognize and agree that time is of the essence in the performance of this Agreement and each and every provision of the Contract Documents. CONTRACTOR shall prepare and obtain approval as required by the Contract Documents for all shop drawings, details and samples, and do all other things necessary and incidental to the prosecution of its work in conformance with the progress schedule set forth in the Contract Documents. CONTRACTOR shall coordinate its work with the work of all other contractors, subcontractors, and CITY forces working on the PROJECT in a manner that will facilitate the efficient completion of the PROJECT and in accordance with the terms and provisions of this Agreement. CITY shall have complete control of the premises on which the work is to be performed and shall have the right to decide the time and order in which the various portions of the work shall be performed and the priority of the work of other contractors, subcontractors and CITY forces and, in general, all matters concerning the timely and orderly conduct of the work of CONTRACTOR on the premises. 6. CHANGES CONTRACTOR shall adhere strictly to the plans and specifications set forth in the Contract Documents unless a change therefrom is authorized in writing by DPW. CONTRACTOR agrees to make 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, CON TRACTOR shall submit immediately to DPW a written cost proposal reflecting the effect of the change. Should DPW not agree to such SF:16-5215-142605.doc/rev 12/2016 5 cost proposal, the work shall be performed according to the changes ordered in writing by DPW and the proper cost thereof shall be negotiated by the parties upon cost and pricing data submitted by CONTRACTOR; thereupon, CITY will promptly issue an adjusted change order to CONTRACTOR and the Agreement price will be adjusted upward or downward accordingly. 7. 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: 1. A bond in the amount of one hundred percent (100%) of the Agreement price to guarantee CONTRACTOR's faithful performance of the work; and 2. A bond in the amount of one hundred percent of the Agreement price to guarantee payment of all claims for labor and materials furnished. In addition, CONTRACTOR shall submit to CITY a bond in the amount of one hundred percent (100%) of the final Agreement price, including all change orders, to warrant such performance for a period of one (1) year after CITY's acceptance thereof within ten (10) days of filing of the Notice of Completion. SF:16-5215-142605.doc/rev 12/2016 6 9. WARRANTIES CONTRACTOR unconditionally guarantees all work done under this Agreement including, but not limited to, any workmanship, installation, fabrication, material or structural facilities constructed. CONTRACTOR, within ten (10) days after notice by CITY of any defect in the work, shall have the option to make'appropriate repairs or replace the defective item or items. Upon expiration of such ten- (10) day period, CITY may then make appropriate repair or replacement at CONTRACTOR's risk and own cost and expense. 10. INDEPENDENT CONTRACTOR It is understood and agreed that CONTRACTOR is, and shall be, acting at all times hereunder as an independent contractor and not an employee of CITY. CONTRACTOR shall secure at its own cost and expense, and be responsible for any and all payment of all taxes, social security, state disability insurance compensation, unemployment compensation and other payroll deductions for CONTRACTOR and its officers, agents and employees and all business licenses, if any, in connection with the PROJECT and/or the services performed hereunder. • 11. LIQUIDATED DAMAGES/DELAYS It is agreed by the parties hereto that in case the total work called for hereunder is not in all parts and requirements finished or completed within the number of calendar days as set forth herein, damage will be sustained by CITY; and that it is, and would be, impractical and extremely difficult to ascertain and determine the actual damage which CITY would sustain in the event of and by reason of such delay. It is,therefore, agreed that CONTRACTOR will pay to CITY, as liquidated damages and not as a penalty, the sum of one thousand Dollars ($ 1,000 ) per each calendar day's delay in completing the work in excess of the number of working/calendar days SF:16-5215-142605.doc/rev 12/2016 7 set forth herein, which represents a reasonable endeavor by the parties hereto to estimate a fair compensation for the foreseeable damages CITY would sustain in the event of and by reason of such delay; and CONTRACTOR agrees to pay these damages herein provided, and further agrees that CITY may deduct the amount thereof from any monies due or that may become due to CONTRACTOR hereunder. For projects on the National Highway System (NHS), the local formula for liquidated damages will be provided. CONTRACTOR will be granted an extension of time and will not be assessed damages for any portion of the delay in the completion of the work due to unforeseeable causes beyond the control and without the fault or negligence of CONTRACTOR, including, but not limited to, acts of God or of the public enemy, fire, floods, epidemics, quarantine restrictions, strikes,unsuitable weather, or delays of subcontractors due to such causes. CONTRACTOR shall, within fifteen (15) days from the beginning of any such delay (unless DPW shall grant a further period of time), notify DPW in writing of the cause of the delay and CITY shall extend the time for completing the work if, in its judgment, the findings of fact thereon justify the delay; and the decision of DPW shall be conclusive on the parties hereto. Should CONTRACTOR be delayed in the prosecution or completion of the work by the act, neglect or default of CITY, or should CONTRACTOR be delayed by waiting for materials required by this Agreement to be furnished by CITY, or by damage caused by fire or other casualty at the job site for which CONTRACTOR is not responsible, or by the combined action of the workers, in no way caused by or resulting from default or collusion on the part of CONTRACTOR, or in the event of a lockout by CITY, then the time herein fixed for the SF:16-5215-142605.doc/rev 12/2016 8 completion of the work shall be extended by the number of days CONTRACTOR has thus been delayed,but no allowance or extension shall be made unless a claim therefor is presented in writing to CITY within fifteen(15) days of the commencement of such delay. No claims for additional compensation or damages for delays, irrespective of the cause thereof, and including without limitation the furnishing of materials by CITY or delays by other contractors or subcontractors,will be allowed and an extension of time for completion shall be the sole remedy of CONTRACTOR. 12. DEMANDS FOR ADDITIONAL TIME OR MONEY A. Definitions. (1) "Change Order" means a document signed by CONTRACTOR and CITY which authorizes an addition, deletion or revision in the work, or an adjustment in the Compensation under Section 3, or the Completion Time specified at Section 4. (2) "Demand"means a written demand for a Change Order by CONTRACTOR for any of the following: (a) A time extension; (b) Payment of money or damages arising from work done by, or on behalf of, CONTRACTOR pursuant to this Agreement and payment of which is not expressly permitted pursuant to Section 3 of this Agreement; (c) Payment of 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 SF:16-5215-142605.doc/rev 12/2016 9 differing materially from those indicated in this Agreement or the Contract Documents, or unknown physical conditions at the job site, of an unusual nature, differing materially from those ordinarily encountered and generally recognized as inherent to work of the PROJECT; or (f) A request for a time extension or additional payment based upon acts of neglect by CITY or due to fires, floods, labor disputes, epidemics, abnormal weather conditions or acts of God. B. A Demand for a time extension or payment of money or damages may only be granted by a Change Order. C. No Change Order may be granted except where CONTRACTOR has submitted a Demand to the DPW (or his or her written designee). All Demands shall be submitted promptly, but in no event later than thirty (30) days after the occurrence of the event giving rise to the Demand. The Demand shall be in writing and include all documents necessary to substantiate the Demand. The DPW shall act on the Demand within fifteen (15) days after receipt, including by requesting additional information from CONTRACTOR to determine whether to approve the Change Order the Demand seeks. The DPW shall act on the Demand within fifteen (15) days after receipt of the additional information or within a period of time no greater than the time CONTRACTOR took to produce the additional information requested, whichever is greater. D. Notwithstanding the thirty (30) days to submit a Demand under Subparagraph C, in the case of differing or unknown site conditions, immediately upon encountering the conditions, CONTRACTOR shall notify the DPW in writing of the conditions, so that the CITY may promptly investigate the conditions. SF:16-5215-142605.doc/rev 12/2016 10 E. If CONTRACTOR disputes the DPW's written response on the Demand, or the CITY fails to respond within the time prescribed, CONTRACTOR may so notify the City Engineer, in writing, either within fifteen (15) days of receipt of the City Engineer's response or within fifteen (15) days of the DPW's failure to respond within the time prescribed, respectively, and request an informal conference to meet and confer for settlement of the Demand. Upon CONTRACTOR's request, the DPW shall schedule a meet and confer conference within thirty (30) days to seek to resolve. F. CITY and CONTRACTOR shall execute appropriate Change Orders covering changes to the time or price by executing the Change Order by mutual agreement. If the CITY and CONTRACTOR are unable to reach a mutual agreement, then the City Engineer shall issue a written decision on the claim within a reasonable time. G. Following the meet and confer conference, if the Demand remains in dispute, CONTRACTOR may file a claim with the City as provided in Chapter 1 (commencing with Section 900) and Chapter 2 (commencing with Section 910) of Part 3 of Division 3.6 of Title 1 of the Government Code. For purposes of those provisions, the running of the period of time within which a claim must be filed shall be tolled from the time the time CONTRACTOR submits his or her Demand until the Demand is denied as a result of the meet and confer process, including any period of time utilized by the meet and confer process. 13. VARIATIONS IN ESTIMATED QUANTITIES The quantities listed in the bid schedule will not 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 SF:16-5215-142605.doc/rev 12/2016 11 quantities listed in the bid schedule, the bid price shall prevail subject to the provisions of this Section. DPW may, at its sole discretion, when warranted by the facts and circumstances, order an equitable adjustment, upwards or downwards, in payment to CONTRACTOR where the actual quantities used in construction of the PROJECT are in variation to the quantities listed in the bid schedule. No claim by CONTRACTOR for an equitable adjustment in price or time for completion shall be allowed if asserted after final payment under this Agreement. If the quantity variation is such as to cause an increase in the time necessary for completion, DPW shall ascertain the facts and circumstances and make such adjustment for extending the completion date as in its sole judgment the findings warrant. 14. PROGRESS PAYMENTS Each month DPW will make an estimate in writing of the work performed by CONTRACTOR and the value thereof. From each progress estimate, five percent (5%) will be deducted and retained by CITY and the remainder of the progress estimate, less the amount of all previous payments since commencement of the work,will be paid to CONTRACTOR. When CONTRACTOR has, in the judgment of DPW, faithfully executed fifty percent(50%)or more of the value of the work as determined from the bid schedule, and if DPW finds that satisfactory progress has been and is being made, CONTRACTOR may be paid such sum as will bring the payments of each month up to one hundred percent(100%) of the value of the work completed since the commencement of the PROJECT, as determined in its sole discretion by DPW, less all previous payments and less all previous retained amounts. CITY's final payment to CONTRACTOR, if unencumbered, or any part thereof unencumbered, shall be made thirty (30) days after the acceptance of the work and the filing of a Notice of Completion by CITY. Provided,however,that in the event of a dispute between CITY SF:16-5215-142605.doc/rev 12/2016 12 and CONTRACTOR, CITY may withhold from the final payment an amount not to exceed 150 percent of the value of any disputed amount of work. Payments shall be made on demands drawn in the manner required by law, each payment to be accompanied by a certificate signed by DPW, affirming that the work for which payment is demanded has been performed in accordance with the terms of the Agreement and that the amount stated in the certificate is due under the terms of the Agreement. Partial payments on the contract price shall not be considered as an acceptance of any part of the work. 15. WITHHELD CONTRACT FUNDS, SUBSTITUTION OF SECURITIES At the request and at the sole cost and expense of CONTRACTOR, who shall retain beneficial ownership and receive interest, if any thereon, CITY shall permit the substitution and deposit therewith of securities equivalent to the amount of any monies withheld by CITY to ensure performance under the terms of this Agreement. 16. AFFIDAVITS OF SATISFACTION OF CLAIMS After the completion of the work contemplated by this Agreement, CONTRACTOR shall file with DPW its affidavit stating that all workers and persons employed, all firms supplying materials and all subcontractors working upon the PROJECT have been paid in full and that there are no claims outstanding against the PROJECT for either labor or material, except certain items, if any, to be set forth in CONTRACTOR's affidavit covering disputed claims, or items in connection with Notices to Withhold, which have been filed under the provisions of the statutes of the State of California. SF:16-5215-142605.doc/rev 12/2016 13 17. WAIVER OF CLAIMS The acceptance by CON TRACTOR 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 CONTRACTOR hereby agrees to protect, defend, indemnify and hold harmless CITY, its officers, elected or appointed officials, employees, agents, and volunteers from and against any and all claims, damages, losses, expenses,judgments, demands, defense costs, and consequential damage or liability of any kind or nature, however caused, including those resulting from death or injury to CONTRACTOR's employees and damage to CONTRACTOR's property, arising directly or indirectly out of the obligations or operations herein undertaken by CONTRACTOR, caused in whole or in part by any negligent Pact or omission of CONTRACTOR, any subcontractors, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, including but not limited to concurrent active or passive negligence, except 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 SF:16-5215-142605.doc/rev 12/2016 14 against liability for workers' compensation; CONTRACTOR covenants that it will comply with such provisions prior to commencing performance of the work hereunder. CONTRACTOR shall maintain workers' compensation and employer's liability insurance in an amount of not less than the State statutory limits. CONTRACTOR shall require all subcontractors to provide such workers' compensation and employer's liability insurance for all of the subcontractors' employees. CONTRACTOR shall furnish to CITY a certificate of waiver of subrogation under the terms of the workers' compensation and employer's liability insurance and CONTRACTOR shall similarly require all subcontractors to waive subrogation. 20. INSURANCE In addition to the workers' compensation and employer's liability insurance and CONTRACTOR's covenant to defend, hold harmless and indemnify 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 SF:16-5215-142605.doc/rev 12/2016 15 applicable to the PROJECT shall be deemed excess coverage and that CONTRACTOR'S insurance shall be primary and non-contributory with any other valid and collectible insurance or self-insurance available to the Additionally Insured Parties. Any available insurance proceeds in excess of the minimum coverage amount specified herein shall be available to the Additionally Insured Parties. All coverage available to CONTRACTOR shall also be available to the Additionally Insured Parties. Under no circumstances shall said above-mentioned insurance contain a self-insured retention without the express written consent of CITY; however, an insurance policy "deductible"of$5,000.00 is permitted. CONTRACTOR shall be responsible for causing all Subcontractors to maintain the same types and limits of insurance coverage as that required of CONTRACTOR by this Agreement. 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. SF:16-5215-142605.doc/rev 12/2016 16 The requirement for carrying the foregoing insurance coverages shall not derogate from the provisions for indemnification of CITY by CONTRACTOR under the Agreement. CITY or its representative shall at all times have the right to demand the original or a copy of all the policies of insurance. CONTRACTOR shall pay, in a prompt and timely manner, the premiums on all insurance hereinabove required. CONTRACTOR shall provide a separate copy 'of the additional insured endorsement to each of CONTRACTOR'S insurance policies, naming CITY, its officers, elected and appointed officials, employees, agents and volunteers as Additional Insureds, to the City Attorney for approval prior to any payment hereunder. 22. PAYROLL RECORDS CONTRACTOR agrees to keep accurate payroll record showing the name, address, social security number, work classification, straight time and overtime hours worked each day and week, and the actual per diem wages paid to each journeyman, apprentice or worker employed by it in connection with the PROJECT and agrees to require each of its subcontractors to do the same. CONTRACTOR further agrees that its payroll records and those of its subcontractors, if any, shall be available at all reasonable times to the CITY, and the • employee or his representative, and the Division of Labor Standards Enforcement and. the Division of Apprenticeship Standards, and to comply with all of the provisions of California Labor Code Section 1776, in general. 23. CALIFORNIA PREVAILING WAGE LAW AND FEDERAL DAVIS- BACON ACT. A. The CITY has ascertained from the Director of Industrial Relations of the State of California the general prevailing rate of per diem wages and the general prevailing rate SF:16-5215-142605.doc/rev 12/2016 17 for legal holiday and overtime work in the locality in which the work is to be performed for each craft or type of work needed to execute this Agreement, and the same has been set forth by resolution on file in the office of the City Clerk of CITY. CONTRACTOR and any subcontractor under it shall pay not less than said prevailing wage rates to all workers employed on this public works Agreement, as required by California Labor Code Sections 1771 and 1774. In accordance with the provisions of Section 3700 of the California Labor Code, CONTRACTOR agrees to secure payment of compensation to every employee. B. Pursuant to this Agreement and in accordance with Section 1774 and 1775 of the California Labor Code, CONTRACTOR shall, as penalty to CITY, forfeit twenty-five dollars ($25) for each calendar day or portion thereof for each worker paid (either by CONTRACTOR or any of its subcontractors) less than the prevailing wage rate established for that particular craft or type of work. C. This Agreement also is subject to the Federal Davis-Bacon Act. The minimum rate of wages for each craft or type of worker needed to execute the PROJECT shall be those as determined by the United States Secretary of Labor. If there is a difference between the minimum wage rates predetermined by the Secretary of Labor and the general prevailing wage rates determined by the Director of the California Department of Industrial Relations for similar classifications of labor, CONTRACTOR and subcontractors shall pay not less than the higher wage rate. 24. CALIFORNIA EIGHT-HOUR LAW A. California Labor Code, Sections 1810 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 SF:16-5215-142605.doc/rev 12/2016 18 require more than eight (8) hours of labor per day or forty (40) hours per week from any one person employed by it hereunder, except as stipulated in California Labor 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 CON TRACTOR or any subcontractor for each calendar day during which such worker is required or permitted to work more than eight (8) hours in any one (1) calendar day or forty(40) hours in any one(1) calendar week in violation of California Labor Code Section 1815. 25. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE Section 1773.8 of the California Labor Code, regarding the payment of travel and subsistence allowance is applicable to this PROJECT. 26. EMPLOYMENT OF APPRENTICES Section 1777.5 of the California Labor Code, regarding the employment of apprentices is applicable to this PROJECT. 27. EQUAL EMPLOYMENT OPPORTUNITY During the performance of this Agreement, CONTRACTOR agrees as follows: A. CONTRACTOR will not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, or national origin. CONTRACTOR will take affirmative action to ensure that applicants are SF:16-5215-142605.doc/rev 12/2016 19 employed, and that employees are treated during employment,without regard to their race, color, religion, sex, sexual orientation, gender identity, or national origin. Such action shall include, but not be limited to the following: Employment, upgrading, demotion, or transfer, recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. CONTRACTOR agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided by the contracting officer setting forth the provisions of this nondiscrimination clause. B. CONTRACTOR will, in all solicitations or advertisements for employees placed by or on behalf of CONTRACTOR, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin. C. CONTRACTOR will not discharge or in any other manner discriminate against any employee or applicant for employment because such employee or applicant has inquired about, discussed, or disclosed the compensation of the employee or applicant or another employee or applicant. This provision shall not apply to instances in which an employee who has access to the compensation information of other employees or applicants as a part of such employee's essential job functions discloses the compensation of such other employees or applicants to individuals who do not otherwise have access to such information, unless such disclosure is in response to a formal complaint or charge, in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or is consistent with CONTRACTOR's legal duty to furnish information. SF:16-5215-142605.doc/rev 12/2016 20 D. CONTRACTOR will send to each labor union or representative of workers with which it has a collective bargaining agreement or other contract or understanding, a notice to be provided by the agency contracting officer, advising the labor union or workers' representative of CONTRACTOR's commitments under Section 202 of Executive Order 11246 of September 24, 1965, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. E. CONTRACTOR will comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the United States Secretary of Labor. A copy of Executive Order 11246, as amended, is attached as Exhibit C. F. CONTRACTOR will furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by the rules,,regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books, records, and accounts by the contracting agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders. G. In the event of CONTRACTOR's non-compliance with the nondiscrimination clauses of this contract or with any of such rules, regulations, or orders, this contract may be canceled, terminated or suspended in whole or in part and CONTRACTOR may be declared ineligible for further Government contracts in accordance with procedures authorized in Executive Order 1124'6 of September 24, 1965, and such other sanctions may be • imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law. SF:16-5215-142605.doc/rev 12/2016 21 H. CONTRACTOR will include the provisions of sub-paragraphs A through G in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each sub-contractor or vendor. CONTRACTOR will take such action with respect to any subcontract or purchase order as may be directed by the Secretary of Labor as a means of enforcing such provisions including sanctions for noncompliance: Provided, however, that in the event CONTRACTOR becomes involved in, or is threatened with, litigation with a sub-contractor or vendor as a result of such direction, CONTRACTOR may request the United States to enter into such litigation to protect the interests of the United States. 28. RECORD RETENTION Financial records, supporting documents, statistical records, and all other CONTRACTOR records pertinent shall be retained for a period of three years from the date of the City filing the Notice of Completion of the PROJECT. The only exceptions are the following: A. If any litigation, claim, or audit is started before the expiration of the 3- year period, the records must be retained until all litigation, claims, or audit findings involving the records have been resolved and final action taken. B. When the non-Federal entity is notified in writing by the Federal awarding agency, cognizant agency for audit, oversight agency for audit, cognizant agency for indirect costs, or pass-through entity to extend the retention period. C. Records for real property and equipment acquired with Federal funds must be retained for 3 years after final disposition. SF:16-5215-142605.doc/rev 12/2016 22 D. When records are transferred to or maintained by the Federal awarding agency or pass-through entity, the 3-year retention requirement is not applicable to the non- Federal entity. E. Records for program income transactions after the period of performance. In some cases recipients must report program income after the period of performance. Where there is such a requirement, the retention period for the records pertaining to the earning of the program income starts from the end of the non-Federal entity's fiscal year in which the program income is earned. F. Indirect cost rate proposals and cost allocations plans. This paragraph applies to the following types of documents and their supporting records: indirect cost rate computations or proposals, cost allocation plans, and any similar accounting computations of the rate at which a particular group of costs is chargeable (such as computer usage chargeback rates or composite fringe benefit rates). (1) If submitted for negotiation. If the proposal, plan, or other computation is required to be submitted to the Federal government (or to the pass- through entity) to form the basis for negotiation of the rate, then the 3-year retention period for its supporting records starts from the date of such submission. (2) If not submitted for negotiation. If the proposal, plan, or other computation is not required to be submitted to the Federal government (or to the pass- through entity) for negotiation purposes, then the 3-year retention period for the proposal, plan, or computation and its supporting records starts from the end of the fiscal year (or other accounting period) covered by the proposal,plan, or other computation. SF:16-5215-142605.doc/rev 12/2016 23 29. NOTICE OF THIRD-PARTY CLAIM Pursuant to Public Contracts Code Section 9202, CITY shall provide notice to CONTRACTOR of receipt of any claim filed with CITY or a court of competent jurisdiction which arises out of performance of this agreement within ten (10) days of receipt of such claim or claims. 30. DEFAULT AND TERMINATION If CONTRACTOR fails or refuses to prosecute the work hereunder with diligence, or fails to complete the work within the time specified, or is adjudged bankrupt or makes an assignment for the benefit of creditors or becomes insolvent, or violates any provision of this Agreement or the Contract Documents, CITY may give CONTRACTOR notice in writing of its intention to terminate this Agreement. Unless the violation is 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 default by CONTRACTOR, CITY may elect not to terminate this Agreement; in such event CITY may make good the deficiency in which the default consists and deduct the resulting costs from the progress payments then or to become due to CONTRACTOR. If it is subsequently determined by a court of competent jurisdiction that CITY's termination of this Agreement under this Section was wrongful, such termination shall be converted to a termination for convenience under Section 29 and any damages shall be assessed as set forth in Section 29. 31. 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 • SF:16-5215-142605.doc/rev 12/2016 24 notice to CONTRACTOR. In the event of termination, under this Section CITY shall pay CONTRACTOR for value of work in place on the PROJECT through the termination period less all such payments already made. In case of such termination for convenience, CONTRACTOR shall be entitled to receive payment for work executed, and costs incurred by reason of such termination. In no event shall CONTRACTOR be entitled to recover overhead, profit or CONTRACTOR's fee on work not performed. Such payment by CITY shall be CONTRACTOR's sole and exclusive remedy for termination by CITY for its convenience and CITY shall have no further obligation to CONTRACTOR. • 32. DISPOSITION OF PLANS,ESTIMATES AND OTHER DOCUMENTS CONTRACTOR agrees that upon completion of the work to be performed hereunder, or upon expiration or earlier termination of this Agreement, all original plans, specifications, drawings, reports, calculations, maps and other documents pertaining to this Agreement shall be delivered to CITY and become its sole property at no further cost. 33. NONASSIGNABILITY CONTRACTOR shall not sell, assign, transfer, convey or encumber this Agreement, or any part hereof, or any right or duty created herein, without the prior written consent of CITY and the surety. 34. CITY EMPLOYEES AND OFFICIALS CONTRACTOR shall employ no CITY official nor any regular CITY employee in the work performed pursuant to this Agreement. No officer or employee of CITY shall have any financial interest in this Agreement in violation of the California Government Code. SF:16-5215-142605.doc/rev 12/2016 25 35. STOP NOTICES;RECOVERY OF ADMINISTRATIVE COSTS CITY shall be entitled to all reasonable administrative 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. 36. NOTICES Any notices, certificates, or other communications hereunder shall be given either by personal delivery to CONTRACTOR's agent (as designated in Section 1 hereinabove) or to CITY as the situation shall warrant, or by enclosing the same in a sealed envelope, postage prepaid, and depositing the same in the United States Postal Service, to the addresses specified below; provided that CITY and CONTRACTOR, by notice given hereunder, may designate different addresses to which subsequent notices, certificates or other communications will be sent: TO CITY: TO CONTRACTOR: City of Huntington Beach A2Z Construct Inc. ATTN: John Martin ,Public Works ATTN: 2000 Main Street (13 \(ia.- aeciiIID Huntington Beach, CA 92648 Hahn yt ' s1 fl+ J C/v SF:16-5215-142605.doc/rev 12/2016 26 37. SECTION HEADINGS The titles, captions, section, paragraph, and subject headings, and descriptive phrases at the beginning of the various sections in this Agreement are merely descriptive and are included solely for convenience of reference only and are not representative of maters included or excluded from such provisions, and do not interpret, define, limit or describe, or construe the intent of the parties or affect the construction or interpretation of any provision of this Agreement. 38. 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. 39. LEGAL SERVICES SUBCONTRACTING PROHIBITED CONTRACTOR and CITY agree that CITY is not liable for payment of any subcontractor work involving legal services, and that such legal services are expressly outside the scope of services contemplated hereunder. CONTRACTOR understands that pursuant to Huntington Beach City Charter Section 309, the City Attorney is the exclusive legal counsel for CITY; and CITY shall not be liable for payment of any legal services expenses incurred by CONTRACTOR. 40. ATTORNEY'S FEES In the event suit is brought by either party to construe, interpret and/or enforce the terms and/or provisions of this Agreement or to secure the performance hereof, each party shall SF:16-5215-142605.doc/rev 12/2016 27 bear its own attorney's fees and the prevailing party shall not be entitled to recover its attorney's fees from the nonprevailing party. 41. INTERPRETATION OF THIS AGREEMENT The language of all parts of this Agreement shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any of the parties. If any 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. 42. GOVERNING LAW This Agreement shall be governed and construed in accordance with the laws of the State of California. 43. DUPLICATE ORIGINAL The original of this Agreement and one or more copies hereto have been prepared and signed in counterparts as duplicate originals, each of which so executed shall, irrespective of SF:16-5215-142605.doc/rev 12/2016 28 the date of its execution and delivery, be deemed an original. Each duplicate original shall be deemed an original instrument as against any party who has signed it. 44. CONSENT Where CITY's consent/approval is required under this Agreement, its consent/approval for one transaction or event shall not be deemed to be consent/approval to any subsequent occurrence of the same or any other transaction or event. 45. SIGNATORIES Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify CITY fully for any injuries or damages to CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. 46. ENTIRETY The foregoing, and Exhibits "A" and "B" attached hereto, set forth the entire Agreement between the parties. No waiver or modification of this Agreement shall be valid • unless in writing duly executed by both parties. The parties acknowledge and agree that they are entering into this Agreement freely and voluntarily following extensive arm's length negotiations, and that each has had the opportunity to consult with legal counsel prior to executing this Agreement. The parties also acknowledge and agree that no representations, inducements, promises, agreements or warranties, oral or otherwise, have been made by that party or anyone acting on that parry's behalf, which are not embodied in this Agreement, and that that party has not executed this Agreement in reliance on any representation, inducement, promise, agreement, warranty, fact or circumstance not expressly set forth in this Agreement. SF:16-5215-142605.doc/rev 12/2016 29 IN WITNESS WHEREOF,the parties hereto have caused this Agreement to be executed by and through their authorized officers on 0011 3rit' ,2023 CONTRACTOR: CITY OF HUNTINGTON BEACH,a municipal oration St f California By: ,r-N - /I 4'7 --� 4 V Mayo (print name) 2,6714iii41.444) ITS: Chairman/ es' /Vice-President City Clerk /Z//Z " (circle one) INITIATED AND APP V D: AND Director of Public Works (print name) REV A 1 PRO -D: ITS: S to / Chief Financial Officer / Asst. Secre /Treasurer (circle one) City Manager APPROVED ORM: ? City Attorney (1( SF:16-5215-142605.doc/rev 12/2016 30 EXHIBIT A (Contractor's Proposal) • • SF:16-5215-142605.doc/rev 12/2016 31 SECTION C PROPOSAL for the construction of CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS CC No. 1658 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 60 working days,starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications,Instructions to Bidders and all other contract documents.If this proposal is accepted for award,BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes,royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded,the AGENCY will reject all bids and will 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 Tf,awarded theOnti aef4 the enders gnedagrees.that in the eve�t of the I3TDDER'S default iii executing the required contract'and file g the=necessary bonds and insurance certificates within 10 working daysufter;the.date of the AGENCY'S'notice of award of the BIDDER the proceeds of the,security accompany ig this bid:shall become the property of the AGENCY,and NS bid and the acceptance hereof may at the AGENCY'S option, be eoi sidered hull.and void. Accompanyingthisiproposal of bid find iilife 51 16 Y 1p�.in the.amount of I.t,-iio. 'o winch said amount is not less than 10%b of the aggregate of the total bid price,as required by.the Notice hiviting-Sealed OR ELECTgONTC Bids,.payable tO the AGENCY. (Pease,insertthe words."Cash","Certified Cheek' or''Bidder'sBond for_% (% as the case mayt'be),Aoy staxidard suretY Bid Bond Pori is acceptable, Bidder shall signify receipt of all Addenda here,If any Addend No:. ate Received _Al' . `s Srgnatt,e r r s i , il 1 i , F ...CITY OF HU.NTINGTON'0,EACti. CENTRAL:'14 EtilARY LOWER tEvot:10$10.0:0m.A1):A IMPROVEMENT sitk4cHEbt.1.11 -. .• Item•,it 1).0 :otiptiott OfWit.t.k Quantity ,. Unit Unit lrOni-Totdt .., ... ... 1 ..Mobilization 1 '14 $Si ppo,:/•;?0*5:•#•.00o,'c),o 2 . or'.,4ft:0-0:1.ori,Wtit,6,Mdtiooemprij '1, -'..$ $2, faCa 20 V.-:,,:000,:0..c: .' •.•:. , • . - :••‘3', 00$00.02,. 1 LS :•$•:',, ,',OW-,•(V 1','-3,1OO.2'..0(5. ,• • :, .. 4 0.0ttiOlitiori 1. LS $ M,0,-,-OP'01.2xmoo . . 5 Abatement 1., LS $ $ 0,6,0• i . ,„, :•• • :• 4, Concrete 011-01RoinfotepM01.11 t 1..$ .(04',CYCO',PP$(0 t.'.: f...Pc7. :•• :•• .., ,,,_. 7 cdbworKt:courifOrtop : ,1,, IS $t (40,a>., $ 676().,...;fe .:0-• :!,•• 8'. Blanket Insulation 1: t$i ! $tiomor>, 0:..... '. 1 „. i 9 Joint Sealants 1. L.'S $ 0..m.,',2-se>: '`.e.,c70. c'.Pt: . ICY _ AIU.hinympgpOiipt,m05' 11 .LS SZiccAao .$2;04,10,04. ,- ,.,:,... . . . 1 1 , Wood Oppg2. • 1 L$; :•S'A!:0Me2,20 ii $,3-,. ).0.:0.b'..: .-:- - la Access Door .F.i0010..,$.1 .t 1-$', $ 64000H$ ::0&)•tt.->. : . . ,.. _.. ....: . . , Ili Door Hardware-:: ' 1: LS . *2,,-00.7›•06?: .*:.ZCr4... ..0' ,.,- , . .,. ,. , 14 Glazing/Mirror ' 1 ' 1,3! $ ti:0-0P..,:0-0 ':7.$ '4_•••-e40:'-: -•t, '•,.;','Ii..: lS: ' Gypsum Board : 1 , Is ,'„$,2„,.c.bo,t -,0 ••2,:000...•or, • • .. . $ Ii6, Metal Stud Framing , 1 P '.1i.:3::.0...60::.00: $'.3.ica?.;:.01:7:' 17.. rorc..Ofslin TO Floor Piii.s.tino 1 ., LS.: : $ . . 10! Porcelain Tile WO Finishing '- 1 • 1$•••• $k64.6,,b0,i0.0 :$ i000.E:or) . . . ... 1... • rdihfieiq . . 1 ; (S''' I'$1:DOV.:Ob ':$27()to,00: . ' ' 20. Sib,,P000. 1 LS... .S 50:0: 00•:: 601,co • .... 21 itii.101-:ApepogS0t104, ). LS VF:4.6000. :: ::,2:1,5:0,'M • 2.,2', .PlornOing, 1 LS ' $12!•ee20, '$410,00. . . . 23 l.Mechanical I ' LS $-. $''tY)O‘CO--$., $,,0t).,00, . . . 24 -- - ' ' : Electrical : . 1 PE: :1X5,,,t:7,r0.- -.PS.,OEV.',0.2). 1700,fili.,,O•urritYor $ ;HI 600 t — ' • - j1 ..: iD c2,1 Total ln.Words': !wjirt ' }C4 ::rt, (CD. NQTEi?. The estimated:quantities listed in the Bid Sheets are approximate and are to be used onlyas comparison.of bids.Payment for quantities will be made.from:field measurements If.the.actual quantitiesrshow either an;increase or decrease:from the quantities given•`in the Proposal Bid4Sheet,the_Contract Unit,Prices will prevail:Full.cotnpensation will be paid•at the contract price':for the actual:work completed,and,no additional Compensation-will be allowed therefor.Payment will riot be made'for inaterials"wasted or=disposed of in a; manner not called for under the:Contracts.ths includes rejected material:not unloadedfrom vehicles and material rejected after ithas been placed;:. compensatiQn will be alloweLl for disposing;of rejected.or excess material,The city reserves the right,'to reject all,bids and:to increase o'rdecrease the amount of any quantity shown on the Proposal H'[d:Sheets. In case cif a'variation between the:unit price and'the tota:ls:shown by.the bidder,the-unit price will be considered to be the bid. Compensation for items of work;,not specifically identified in these bid items shall include all labor,,materials,tools,equipment,,safety measures,and supervision:required to,complete the worleto,grades end dimensions shown inn the Plans or staked in the`field,There shall be no compensation except for the bid;items•specified in the Proposal The cast of all work shown in the Plans and Specifications but not specifically identified as a bid item or'c escribed within a bid item shall be;ircluded:in related biditeriis :and:no additional compensation>slall become due the Contractor'.by.nature of;compliancewith the'Plans:and Speifications: C=2.2 LIST OF SUBCONTRACTORS Tr:acoordanc"e with G ovennhnent.Code"Section 21.1611 .the:Bidder shall set forth the name and business address;of 0."Oliz suboontractor who will perform work o Tender service to the bidder on said contract in an.,amount its excess,of tte.half,of one percent of the total bid Or $10,000, whichever is..greater, and the portion of.the. 'work.,to. be done by such subcontractor 8xd .Name and Address of Slate Mass DIR PWC Dallas' %of Items}. ,Subcaatri,iefOr License Registration# Amount Contract. 1Vuniber; ifl By snbrri ssioz .of this proposal,the iiidder certifies:; 1; That;he is.able to:and will perform the balance:-of all work which is not covered In the above subcontractors listing:: 2, Thatthe AGENCY will be furnished copies of:all subcontracts-entered into and bonds fixrntshed.by,siibcontractoi for:this project. „C-3: • NONCOMUSION AFFIDAVIT' TORE EXECIITMBY:ItIODtlt:.AND SIMMUTED.WITI1 BID I dettatt under PehaitY.Ofpeijhry'litidettba law' :of the'.,tato?of calif0 44iat-thot Tiho foTegoitt$is true.andeprNot:444thOtttli$:declaration iS.0:Xe.a4011-,ohli 10 ki,atil&t417t2c.k1.4*Wyk* C A- r , Date .C1Or. State ,. ..1Aa-1-4-6-iri ,being first duly sworn,deposes and says:tha0.e' .r: , .sheds,--rre.Siekefrpf-: dr 'itl,,),, ,-6.6P-S-i:iii4+-1),-.6- Iho partyrnal.<ihgthe, . ., „ foregoing bid.that the bid it:pot:P4de(pike interest dtot on the behalf of;any undisclosed partnership, OnV4-PY, association, organization, corporation, that' ther bid is genuine and not . . , 0.6110.**ox.s.bggthatthe bidtktha5 60:di-tee:ay or hit:Wetly induced cr.Slicited-any other bidder _ .. to put 4:A.:161.$ 6f-$'11,001bicii and has not directly or :-.conspired, OpitiiiVed, or agreed with any)51iticter!or anyone a,8hambia,orthatahyohe:**grofswrpm.hmtng;: that the himOhasnott any matu-46t,:4trotly.nt indireetiy,. oughthy,:agreetnent,.corpopnicatip43, •1,':. or conference with,anyone,to fix the bid price, or that.of any other bid4er4 or to secure any advantage against the public body awarding the contract of anyone iPtOtOSIed, in the,proposed. contract, that all.a4t6hints. contained in the:bid are true, and, *hot:1)14'0:1e:bidder has: not, directly or indirectly, submitted.his :At her bid price or any breakdown thereof, or the contents thereof, or divulged'information or.data,relative thereto, or:paid, 411.j.,.will not p4y,fee to any corporation,parMorsbi*OMpanY.asoaatior4:0-tgaiii4tiogi bid depository, or' to any ulejoi3or'br :agent thereof tr.).effeetoteia,00llusive;ot,001blel 1, , :.iA:.' .. ., Name of Bid* MA4+ .0-4, . ;.: i i,',- . , . ill Signs. e : . . ittar' 1: .1F....a.Ktko.S0+,4141 :::riirt...i .,., .. ,. . . Adar6stof.B0.f ' .:. ,,. Fi 7(ITILTTYAGMMSNT: noS.QOAKV IVIAWOR,00[0ty:Ott..Nett4: amp gV801NotoNuAcitRALWORNIA. Q000.*4; The undersigned hereby pxotoi$os and agrees that in performance of the work specified ii1:010 contract known::as the CENTRAL tritRov LOWER LEVEL,ADA: IMPROVEMENTS, 0.(0)00 will employ and utilize only qualified mom;f.as-hereinafter defined,,.to work: in proximity to any electrical secondary or transmission facilities The'.tl*term, "Qualified Person" :ik deAtigOri Title 8,Califbittid iV(itilitijat400 C0.00,Section 27100,gAii.oWs. "Qualified Person.. Aposol,,Witoi by teoso 4 fOpokijo.o,ioilioi,u00014,isfatiti.Zum with the . • ..,.• -. , ,„.. pAeratfork ti4 be peOki001::and*het,t4e4S:ffiWANOitil ThO,'4440r$40441WPW-fikajOn4 40t. that all such work,§hgl.'1*.performed in accordance , with,all applicable electrical olity'o:oiiipoii.y;o requirements),Thilitiei,utility,Commission 04-00:. otia StO.W btedilibitia.CatPSKA:YKOrq0104 „ .„:.... - 1110‘utiOpoigott further promises.A.tid:41-ee&Ahat ili.c.N.7.P*1011$herein shall:10tid are binding upon any subcontractor or subcontractors that may be retained or employed by ill6ttidemigoo4 and that the undersigned shall take steps as are necessary to assure compliance by:0y, said; $00.0ritraototo wboottottotsvitli the requirements contained hotoft4 • A.).1 tek5tylk6t7-:- i ke...... Colitractor,.„ . . . , .. ..„.,,. .,.. ,- • • -......- .• . .-..:,.". • •, .,/ :: . " . ... Title . . ... •• batet42P'1.i,Z3? ,E • „:, il ... ,., ,'•• .. 7 . :DISQUALIFICATION'' QUESTIONNAIRE ill accordance with Governiiient Code SectiOn.19162,the Bidder shall cotr plete,.under penalty of penury,'the fellti ing,questionnaire.; QUESTIONNAIRE Has the Bidder„ any officer of the Bidder or my.employee Of the Bidder who has a proprietary interest,iii 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 regplatiok El Yes:: Na if the answer is yes,;explain the eiroumstanees iti,the',space provided. ) .. r f f: [.I Note: This.questionnaire-constitutes a part ofthe Proposal,and a signature portion of th e j Proposal shall constitute signature.of this questionnaire., C':6 COMPENSATION INSIIRANCE.CERTIFICATE. Pinsuantia,Sectiort 180.1' Hie Slate:Lab.Or Cocleeachconfractorto wbor0,,a public WOrkAtbigradt has.been.awarck4 shall sigh the follo*iPgcerObato. I am aware the provisions of Section 3700 or the t.alvr Code 1,4 -require every employer t!;3.:,be*tired.against 1iabi1ity for WoAex' !cOrilixetsAtioii. or to undertake Of-' insurance in accordance with the provisions of that code, and I wili comply with such prpyisigns-bei4e0.0.0.114 010h .00.01: .'Otti5filiaiioe of the work of This poUtrapt; ‘?' tbleV5171nitt+ 4-A Contractor 1et, w AY Ttle --PvcSij-e" Date: ii C;7` MI:MEWS INFORMATION BIOPER certifies that:the folloWing inforination'istnie and correet Bidder Name -Pe). T,Px S4342,6 Business Address KaictcjCya NI' 12:4 City„ State Zip 0'111' i 11, u2ir't5-Fi4tc-f-ikAcj_P 461.e.64.1 Telephone Number. Email Addre• ss State COntractor''s,LieenseNo.and Class erat Original Date Issued 31 I I 25 Expiration bate , The work site was inspected by ka-F--kkekgjAtit 'of our office onAil' Tbil -1,7S 2013 The folloWitigare persons,fmnS,and,corporations having"a principal interest m this proposal 4-4-ke SA-T-Air i The undersigned-is,prepared to satisfy the Council Of the City of Auntington Beach of its 41,1 1 ity, financially or otherwise, to perform the contract for the proposed-Wait and improvements,in accordance withtliaplans and specifications set 60p-Asity-wit, Company Name See Meet)CA Notary Sjgtiatpre of Bidder jL,IA 4-47 ke v,,N1 hinted orlyped,Signature C;:8' ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only mojcjOrgiitytt the individual whO'SiOneclifte document to which this t6etificatd,is attached,and not the truthfulness,:accuracy, Or validity of that document• State of California . County of Orange On August 21st, 2023 before me Lisa Carole Baggerly, Notary Public (insert nanteand title of offjper).. personally appeared. Matthew jafori who PrOved.to me on the basis of satisfactory eVidOnpe to be the person(s)whose narne(S)tstare Subscribed to the within instrument and.acknowledged to me that ha/she/they executed the same in his/her/their polhodied:capacity(ieS),:ahathat by".hit/heritheit signature(s),on theinstrurriprittg 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$tate,of California that the foogdifig,. paragraph is true and oprreof, •WITNESS hand and official sealijsA 10 LE BAweitty. Mange 4101ty. ,-,c,T„g; t.pm,T4s5.1,06,0439#1,„ , Catii:m..Expires Art 0.;2027 siohat& „ , ; ,(Seal) 441.7712-;•0#0,,T44. V/ii Ck6:64th • •,, • NOTARY— C-Ig RTIFICATE •••• Subgeribedi:andWOrn't0 liefOrerne thiSal*f.day of Nkatm.- ,2023 • , : . . .•• . .,: ,... A.:notary public or other officer ..cothplethig;this oertifio4te,:.verifies 'ohty tho identity of the inditsi40,41 *ho: signed the, document, i.,to ,whioh, this certificate is attached, and not the . ... frpthfi40•00i,igootom orsi4lidity,of that tl000thelit, c. ... : State ofUa.14,1tv..- „ ) ; •Coupfy.olovarliit_:, ) • ; . .. -.-... „. . . eivi ''" t '' .'12:tdk - , oii - -44i-gi t 141,::.3:i ipArt —tiloot.4,-1)4Y;,-,ahci Yekt before me,4.s..44.,:. '. :. t ' .'',.31. N.07:4AA , ,Ie.,;:e :Ii*rt:N4,. :';41-id•Titte:o •':ooty, personally Ovveared. Ma4 N.10 „1-0ihIttri ----- — '.'' -' - NaA*0 of:$iper(4 ..,..-.• • ......._. . . : .. . . who proved.0;1.:tue?.on the asis,of satisfactory'd-Videnee to be the person(0 whose 44x,p.:9(0 iglatg sohootihed.;10 01:e. vdthj4fpgr1.1010.04 and acknowledged to -tho•hAhettliey executed the':saule in hiatet/thit aotbotiied:oapadityOe0,and that by •si:grow.re(0,on the in ataiiiot the . .. •. , .,,. ... , •„..,,, ,• pe.rsotot orlhoefitity upt/h,heh4tfOtWhieh.th0Vet$01.0)4404,.:00d1:40cit,4e4nst ti4110.t, 1, I cettify under PENALTY OF P,P.O.JuRY oder'tlie..laws:of the State of California that the' z, • .:: . , . _, foregolftva,r4graphis.Tro:and co/rect, • 'WITNESSmy hand and.official seal':: ... .:-': 7 tot, ,..41, 4 /. ,,, : ::•: .$4,.c4 ,,4,,7.,pbuLEBAGrrni, .1 .. 4. ,, ..crimmissIpp#29#369: U., _loattir'.., .:- .,... • : :'-. :. .. .' ::. .,, 4 .. „ ., , ,: , .. ..„. ...m.,....,..r .,.....,., • SignattireOf 011' 040 (KAM..'N.OTARY SEAL Atipw) rj • ,1 e:_k .„ Bidder's Project nistorY For the purposes of this project the contractor and subcontractor:Must have4 in the last five,years,. tonstrUeted et least five ($),Projects.of similar work specifically referencing:the construction of foescribo...opetifi0 wort(and experience necessary for Pr-Mee('for example"Reconstruction or rehabilitation of existing public use )3idclers',are encouraged to submit supplemental t"elevatttPro.iecthistOt'Ylti addition to.thaPtal,Oet.s.II$Ited,herein. The following list ofprofectS:meet the Tptaiii:enletag':et above: City of NOWPOrti$each, 100 Civic Center Drive, Newport Beach, CA 92660 Address,ofRefetertoe , Name and Telephone No of PrOlettiMan4W 'TOM'Sand efur, 94.9644-33.21 $100.,000.00 perno.flooring, install (N)tiles 1212021 Contract Anlouni Type of Work Date Completed Provide additional project description to.show similarworlt Toilet partitions, plumbing fixtures; copper awning, paint 2. City of Mission Viejo, 200 CiviO.Center,Mission Viejo,,'CA 909.1 'Nark-411ci Address ere . Nerneand TelephOtie No. ofTitleOlOnaer _ Jerry Flit '949-470-&1$5. , . $.161,555.90, Concrete Walkway August 2020 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: patio and concrete Slab, sewer lit*,and.metal column . . City of Santa.Ana, 20 Civic Center Plaza Santa Ana, CA 92702, Name ati•a*18tes5lifileferetice, Narne,arkt;tel4bote:NO..ofth..(iiectvioliver: RobertAguirro714-647=5051 $06;113,71.00 Interior,renovation 0/2021 . Co.:44:44444,6vot Type ofWork Pat -CoTti.:Igete41- yrovide,additional.project description:toshow sirnilnrWo& Ceiling,-dabinets, wall covering, flooring,..and seating:uptitilatery C.-16 • 4 C t of' lar ) 4'b1 E-,.- Cl 7t e. o(Ckr-#-t.ct ( 't 1. `�2` �D t Name and Address 0f Refereric Name and Telephone No of Owner: K.6/41 Kt Gt trA 1 is 4t ct2t •1 u 0 i t f ? Cz?. Al* S l rQvit (wtpJtr "" l' ICc ContractAmou t Type of Work ;Date Completed.; Provide additional projectdescription to'sligw sirnilarwork 5. (oa S- .r 1 .wr14_t +r -;./ (t21tle Di C- -.,- Qr(v\ c 6 f Co I(e. d. --- l tr Name and Address.6f Referent.° "7 v t 'vc1' gd,} -Fec fv1-e:s4 Cil, V Name and Telephone No of.'Qwner.`: <• PArrO .1 D'1 D ', "1^1 = 7Dt`(DPP_CP. Eleeti-ice c rJc 1rt..t Coner-e+. IAA-. ..2.oZ Contract Amount Type of Woxk Date Completed Provide additional project,deseription to diet-sfn larworlc 11 i L. 1. G 11 Bidder's Cr'Ilea Staff LiStedbolOw are the na,nieS,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 staffhas performed similar wOrkWithin die last five years: These projects do not have to be under the employment ofthe bidder of thisproject.,,,13iddeare encouraged submit supplemental relevantprojectliotory 4:addition to:theprojects listed littein, M.44±i'veN4 1-444 rir Name of proposed Project Manager ZDS•S -II Telephone No:of proposed Project Mgagot eS ro-6- Ptoject Name:84;Contract Amount Type of Work Date Completed , PrOda Nan*.4.e.Contraot Arriourit Type of Work PaW.COMPleted. projd'a Name 4 contract Arriekint Type of Work Date Completed: :J784vrt. Nanie of proposed Superintendent 444 4,lit3 •'S TelephoneNcr.,of proposed Superintendent Reff AD. -pak .. •t — PtPjPg-t,Nati*&ContraaAnieunt. Type of Work Date completed: ProjectName&Contract Arnount Typeof Work Date COMplete0. , PrOjett`Naine.84 Contract Amount Type-of Work Date COMpleted • 'ON.t. RACTORREGISTRATION:WITH:CALIFORNIA DEPARTMENT .0•.V 0013STRIALRELATIONSE(Ii IR)attTIP1CA1T ... . Pursuant to 813 SS'gi.,(eitih$,Labor Code S'oft.0-0 i7711:0)) „1.**0.4 by tho,.cohforui4,$1-4te,50410,te, .„. .:., . .. • . .. -.......-- on jin*:::20,;2944i e•04b110e&Ahewpolgiovotkl Contractor gegistragOil;PitOgroth,,Vhieh requires all contractors and:subcontractors hiddihg and, performing work on 'ipdblie Works Projects to ...„. .., ... _. . . regioer,tip.,01t'OriNg '1**..(each July1 through June 30 state fiscal year) with the California P0OtthiOittof Industrial Relations(D0)„.eii:rt4hdytho4iihtiatiioh-tafih-id4hlo registration fee for Contractors is S300 Each tontractor:tc;(;;;Whorh A public works been awarded shall sign the rOlOWitl$:OPtttiOOM; Dilt.PA&SHEET.oh,SR g54 • ,• ••littp.,:Mww;dttioR4gov,-/M$EilhbliOW.oriWS1054F4OtSbeet ;0,30.A4.:;pctf .•• • pigN dvtrotot:11400-400 Link-Call,(844),,522• 6734 htti$,W.0.044.4*ea,:goVilVeRilietiOdSememotiopFdisplpyr$Ogegt,404ttobV,Orti) ... DIR.70-Cotiftattot,RegigtOtiott.$,otai4bk,'-d4tatwe :::http,Vi.eghtig,ditetkov/E*C,Meoett,4otiott 1 4410WarP 404 will comply with piOV.WObtliftabor Code Section 177 t!,I(,4) wtijOti.states "Aootttr4ptc.ror subcontractor shall not bet,titiAlMed.to,]-V4 on be listed in.ra':bid proposal, §ithjet46,-the requirements of Section 004 of the Public Contract Code, Of.oggo,iii the performance of any contract for public work,,4.,$,.,40t),:44:4 this chapter, unless currently registered and,04-lifio14 perform public work pitspArit,to Section! 1.71255, It is not a.,. violation of section for an qorOgi$10tOd:O0.000fot.f.0 submit k bid that is authorized by. Section 17070J,of the Business*I Professions Ow or by Seotioh.'1,010.4,or'201014.:of, tho., Public::05,hteot Code, provided the contractor is registered to perform public work poimitotto.Section 17153&thetithothe cohtPctl$:,.#wolod..,;:i. ' I furthermore will comply by proofolreotradoh,with DIR asthOl5flifiati[OOnfract. .... .. .. 4, 'Wel as at theAbho 9.4tibitiit0hgft•bid, .... ' 0.....*V.-kl. :Str..14:4•47--j: 14,-„, Contractor .. Kv r'1, ),•.il -.3.7, 147.• ,' ' ,•:....' ..':;..,,:,,, ..„,/ „ ., . .. AY N A' ,.(:0•:0.1.5.1•Y'..K4+f P,,,te.,Xpi:,,.-gt6,1.:,i t4 04 .•. , .gOvit: • 1.1 7,F.-v ..5•14.0k1,-Y . .. • Title Date: OW,.1 il! • fl PWC gogistotio t,loact,17 • • • .... ...... - il C4J ill • EXHIBIT A . DISADVANTAGEO.BUSINESS ENTERPRISE-(IDlJE), Thigi:Proioot ft$14400 to..P4t..t;2091Z.1,:Titld.1,-Code of Federal kegtil*cos 0.01104040.400174; With: Small and Minority,Businesses, WOrderes11313.gri :Eilterfiri...§-04i and Labor Surplus. ii Area, . . .. Pirtle The Regulations illtbekerAirety,pre incorporated berelo,by thi§.W.feteriee„ , . ... .. .„.„,. .: ._ , ,• It,.* the policy of the .-City that. disadvantaged.business enterprises (DBEs), as 0010.04, in •,•• .,'11''''''''F':•••••••'•''••'••'.''..' Part 200 321, Tiiite 2 CFR,..shall be epouraged to'participate in the performance:.of Contracts financed in$0,10or*)4.rtwitil fed0r4I:farirlsilhe:Colititoiot§hou0.0.koreh#0./3,V$4 as defined it) Pgt.100,4114,,:Titt.0:Z0:1 have the opportunity to participate to the porfoo440! of this COofooti:04, hollt40:411:rig004ty:04.,10000,W:gto.Ni 44Y, otfOrt-higftit 200324.,Title 2 ati . ... • assurance $11044040-toiA:to:basof"t400y color gatio*I origin, .,. :. or sex littbeA.Wora40.4:000040#0.0:Ofi0(ibcoara44.Faitaite'fii carry out the requirements.0,f 0',i,4 shall ,a,boaok:or:(0:tittaot and may result in totrottotioivofthit:Cb.ritract or otliart.a4y"tilt.City 0*y:deem approp44* ...n_id„de...rs shall be., fully i„t..,.for..,,e,d respecting,.,.,.' e....requirements ofthe ... ,. .Regulations.., and are,urged .to obtain DBEparticiptmigtp , .O; 0 : 110ro 0oogal foDIEparticipqm, • .;.:;::'!.....s:...1.: • ..,, ..: il 111 ill 044: • EXITIBIT B DBE INFORMATION—GOOD FAITH EFFORTS Federal-aid Project No.,. 1.1 .55 Bid Opening Date 5112-pa . The City of Huntington Beach established a bisadvatitaged Business Enterprise(DBE)goal of, . fer this Project. The information provided herein shows that a good faith effort was made. , Lowest,second ldwestand third lowest bidders submit the following information-to document adequate good faith efforts. Bidders should submit the foilbwinxinfermation,even if the "Local Agency Bidder DBE that the bidder has triet::the'DBE goal. This,will protect the bidder's eligibility for award of the contract if the administering agency determines that .- the bidder failed to meet the goal for various reasons e.,..g a DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency lilidderA5lIE Conimittneal form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made.. The following items are listed in the Section emitted "Submission of DBE Commitment" of the , Special.Provisions: t.( A. The names and dates of each publication in Which a2Tecitie:St for DBE partieiPatlenfor',,this project was placed,by the,bidder (please attach copies of advertisements or proofs,of publication): Publications Dates Of Advertisement , . ( Md k isitk: pis . '6,0,ta i B. The names and dates of written notices sent to certified DBEs soliciting bids for this Project and the dates-.and methods used for following up initial solicitations:to determine with certainty whether the DBEs were tereSted(please attach copies of solicitations;telephonef records, fax confirmations.Ptd-).. " ,Br c /IQ '' DV ' Nathes,of DBEs Solicited Date of Initial Follow Up-Methods , ,. Solicitation and Dates k i li I Nip- cLis „.,:i'l:•,'.. C. Tli# .i;0•010.:,,:or work which the bidder tn491.o available to:-.DBE firms -'inoluding.:whom ,,, . , ,:- , „. appropriate,any breaking down the contract work ftom.5(including those itonwnorm-41,jy performed by the'1),-..04,or its forces) into economically feAsible•Attif$•lto faoilitito. DBE participation. ft is the bidder's responsibility to,.demonstrate that sufficient work t facilitateDBE participation was made available to:.00.0:!btm$, Items of work, tiiddoii'Notiiiallsi :'.13reakdown of Amount Percentage Performs Item Items 'FM:!, of . • (WN:), :contruot . : : , :.., . . ..,:,. . , -: . , ...,,,,:..,i,. , ” Et: 6attQ' 15 O''/' ( . ,.. . „,,.,,, ----,:•:•.' ' -r .. :..„ . ... ... .. ! •.. ....:.„.: . ••••: •••• • •,.., .„ „. ..... ... . .. „.. .. „ . i.....: ..„ . . . .. . ,..... .. . .7,--- ,.1 D. The names.saddressess, and. Pt19.4.P:•-•413111.1Pg0 .P. rejected DBEi.MS:,.''.the:'r0,4kati.§. for',the, :.. .,. ,..,„ , .. - - . hiticlot .•;rojtotiOn of the -DBE§,,,the:firms,selected:for thati work(please attach• oop.ia of , „ , v. . .,.. quotes '''...flointho Atits.involved), and price difference for each ORE.ift*.soloOtod:fitai, ,f1 .,!.: .i ,,11.0t a DBE:.: Names,:.,addresses arid phone numbers of rejected :)))3F4:;014 the reasons for the bidder's ' - . 47-hti) E• -itolootiono...t,.-,...B s,.. :.,,,,..: :if., .'•.•:....t„ .7e.d,)i',:$ '..:.(:)y..•.:..., . . .„._ . ..,..... . ...:....:... ..;.......... . . ., . ,,. N/4.. -• „ . . . ,... .„.. .s.• -- .., ,. . . ....... .. ..... ., .: ... . .. . s. : . .., , . .. .. . Not.no$;...40:1-to.000.iuto phOtti*toott Oftitiaggelected for the work Above; .'..6.14k.... . . . , .. . ...,.. • •-•::. . • • • „,„.., :,-••••• . • • • 11 „„„ :.....•- II ....„. E. , ffOr,t$.,1'.t14,de-stO. assist interested DBE. .iii..d.tatAitihag bonding,lirtesi of;credit.,or insurance, il and any technical •Ap.slotmtee,or i'MfOrmatioo related to '-thoe ptuiig,, specifications and re4uiremerif ,„,for:the,work.whielvwas:provided to DBEs: lil VW.. Ao--4:1! '1 ,,.. D..'?..i:,,'•:. .., ,..: .. 'Nth' — . ' • • ' ,: . , cl 0.-16-, :,...,.., pl F. 'Efforts ;made:: to assist":interestod DBEs in obtaining net+•$ ary equipment; ;supplies, materials or related assistance or services, excluding supplies arid equipment'the DBE • subcontractor.purchase or Leases from theTprime contractor or its affiliate; • ri G. The names of agencies, organizations or groups:"contacted to provide:.asslstance in c ntacting; recruiting and using:DBE.:firms:{please attach"copies of requests to agencies a a -respoes•received,,:x i e.,l ndny ns sts,Internet page download,etc)h' Name of Agency/Organi tioir iblethocl/Date of Cox%tact; results, (' H. Any°additional data to support a dexx�onstration of gbocl• tlT.:;efforts:lose"a ditional,sheets if inecesary) =--. NO : USE ADDITIONAL SHEETS OF p.APER,IF'NECESSARY.. I. ti ii I ii c -1'7 l• IF'...0011.0VINER,ORS:CiLE CONTRACTORSIGN HERE: (11 Name nndat,V:fiia business''i. conducted. , . (2),Signature(given and surname) Orp.NplietO4 (3);Plaet 6f,,11.11$ina."0:: (S.Itte,t and Number) . ,:::-•.' City and State ,. .1aphoneNo, (5) &gad., . „ IF A PART.IstgitglItt%,:gt614} REt (1)::Namaunderlybieh business ig:,colitluore'd ,. )41-tr. (2) Signature (given and';gt.gniagte.,and character•of partner) (Npfct ,.g4I-o.tt.tt.o must be made by a gongT41.•pattot) . „ ... .(3);P14c. :.ofBusittess . : , • ... ..: :-, ;. ,-"-----*-- 414.M3,01 . ,.. city and State „ . ... (4)2.i•o...Ctitie:'.. ....':::.':' :. . . Telephone No. ,,...' (5):E,Miil. . .. . '. ii ,.: . 6.1.k. .. • IF A C.OR.PORATioN,SIGN'HEREt 0),N,dme:under which businesg is tonOuctedq Po--- -- COVIS-1-16 C.+ ,, • - / . •, , (2) ' ' • '' '/ ) (3.1gratur . . (Title) , Impre.ss,COVpatp Seal'heir- (3) Incorporated under the laws.of the State of (24 (4) Placo.of Business L 14 Itt) , (Street and Mitillidi) City and State, efAYit,h0 .<-5111'1±7z;-= miLie-f-D4,1, alic II (51 zip Cod0 q.)-6,55- -Telephone No. qttit-2-:, 4 C 119, (6) E-Mail kola-CO*64-(w c..÷-i'vve.i,/-ffett,I.ev 1--1 ..AWAL,AitOTOWLEDMENT OF EXECUTION BY ALL$IGNATOTIIE$ WO SE ATTACHED List beict•WharneS-ofOresidont,vice pr04944 secretary god assistant•sec,r04Y:, if'4,OcoQtotoir,if gsportt.i.or.ship, list riglAeis of wi,genetglij--artnand tnanaging partners: Me44-11-e_y3- 17A-1-Avl. Tiresftterit'- , - . , e Ateph CA f ; 1 1 C-19 , A:DKN( WLEDGMENT • 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,iaccuracyi or validity of that document State of California County of Qt409i3 August:21st 2023 Lisa"Carote=Ba erl Nota .Public �n before me 99 '✓, ry insert name and•title of the officer) personally appeared. Matthew.safari_ :; . . £ a: who proved to me on`the basis of satisfactory evidence to.bethe person(s)whose'name(s) isare subscribed to tie 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 signatures)on the instrument the personfs), or the entity upon behalf of which the persons)acted, executed the instrument„ I certify under PENALTY OF PERJURY under tte laws of the:State of California that the foregoing paragraph is true and correct. i. WITNESS my hand and,official seal;. i ¢oaf USAGAROLS BAGGERL,Y i , � Nola gecoua ficrnf8 01/z ` ^P►' S4n,mISSiCIA 11t 3436b i 1j ' . ., :„ :, yliti kktlft-I.T • Loco.,..A.:0ENty..oroDER nitr,ciaNtigiTMENT(coN$110T.O.TONcoNTRACT* . ..„ . . . • . , . . ttF,AstittVot OTilimittvElt$0slogov THIS PORIV tpicALAGENCYt,.. , PROJECT r .••. • TOTAL CONTRACTAMOUNT4, • •• • .:•01)) . . . T3TO.DEgOKAmtt, .07i$TRACT‘Tigg;00i81; „ . tb-NtiACT iTtM OP%At&AND DESCRIPTION OgEttkir•NtL NMSIE0.-t 0E1)040 Arkix).t.NT ITEM NO OR SERVICES TO SF4S111,4>01. (.0.41jg4pr.044.po*,6.,..dkte4lit4 DOE:, KrociploiKppp Ot MATERIALS address ftiho and phone " " " • • • • • . ,. . "• • - •• . For Local Agency to,;000v1,0-w totat itoqtdbttsctNtuiib-e: . • Feile•41.,4id IsFpjCt Npniber, teileralliarev „. . t:ciiititet.A*Otd Daft. 1 Lca1 Agency certtfe&that1 DBE catinsiiare been verified and Siidd • . . orc,4::0;040:Tel.3Nitt„ Date. • Lotai...pioposi.,Rof6§dittitisid:; PFF.s..,pa.47.A9A00 S•Ate..f.•:0546)TPhoniter 4.0.41..A.g .74100)5.04,0,iiyiliiron!tep**thii,,060-40.0) • PLEASE NOTE This inf'ormat on,may`be submitted with your;bid .If it is not,and;you arc the apparent.low bidder or the econd o r third low bidder,it must be:submitted and,received as':specified in the�Special`P'roviskms. Failure:to submit;the required:DBE commitment will be grounds for f nding.the:bid nonresponsiv 'The form requires specific information ;regarding the construction contract: Local,:Agency, .Location, Project Description, Total Contract Amount, Bid Date..Bidder'�s'Name; and:Contract: DBE Goal: The form has a;column for the Contract:Item Number and; Item of Work.,and Description or Services to be Subcontracted or.Materials to be provided"by DBEs,,Prune contractors shall:indicate; all'work to he performed"by DBEs:including,`if.the.prime i .a DBE,. work:performed by its.over: forces, if a DBE The DBE;shall provide a ceitif cation number to the Contractor and expiration: F, date Fritter the,DBE prime,'s::and..subcontractors':certification,numhers.The,fotui,has a column fa- t e Names of DBBE contractors to perform:the work.(Who must be:certified on the date bids:are: opened a nd include the D,BIE address arid plione;number) .• IMP©RTANn Identify all )BE.firms•participating;in the project regardless oftier Names of:tl e First Tier DBE Subcontractors,and their:respective:ite (s) of work listed.should he consistent, where applicable,with the names and items:of workin the=''List:of Subcontr...actors"°;submitted with your..bid, Tyre is .a column for the DBE:participation dollar'amount Enter the Total' Claimed DBE; Participation.dollars and percentage amount ofitems of LwTork submitted with°.your bid pursuant:toy; the Special Provisions, Of 1.00%of:iteni is;not to be performed or furnished;by the DBE describe exact portion of trme.:to be'performed or furnished by the DBE.) S:ee Section "Disadvantaged. Business Ehterpriise.(DBE),'of the pecial.Provisions (construction contracts),to:detour ine hew; to count the participation Of DBE firms.. Exhibit 1 G must be signed and dated by the person bidding. Also list-a phone number in.the-; f space.provided.>:and,print the narrie of the person to contact. Local agen sho uld complete th cal e;Lo ,Agericy,:Contract Award,Federal=aid Project.Number, Federal Share Contract,Award Date fields'and verify ti a�t all;in formation is complete and accurate before signing and filinig F •C-21. EXHIBIT D • EQUAL.EMFLOYMENT OPPORTUNITY<CtOrtr e.ATIQN: • The bidder - ` :C vt c-t t C± I. [proposel subcontractor (.011.0 ,]hereby certifies thathelshe/)ha.s: ,has not ✓;participated m a.;previous eentract or subcontract subject to the Equal Oppor."toity.clauses,,as required by Executive Orders 10925, 11114,or 1.1246,:and that,where required,he/she/rt l as filed with the;Joint•Reporting Committee,the: Director of the of Federal:Contract compliance,:: a Federal Government;contracting or adrntnistermg agency;-or the:former President`s Committeeon;Equa1`EmploymentOpportunity, all reports-dues under the appl icable:• filling xequirernents:. Note. The above certification.is required-by°th Equal EmploymentOpportunityRegulatiots;df the Secretary of Labor(41 CFR 60-17(b) (1)), and must be submitted by:bidders and:proposed subcont•ractors only in c• onnection with contracts:and subcontracts which are subject to;the equal opportux ty clause Contracts and subcontracts; which are exempt'from, the equal opportunity clause are het Earth in 41 °CFR 60`= S (Generally only.contracts or subcontracts of$10,000;or under areexempt) Currently,Standard Form.100:(EEO-i)is.theonly eportrequiredbytbeExecutiveOrdersortl�.eir: implerne444g xegulatio4. 0000 g0y10 rployersteeo 1 survoylind ex e fm) P`r.+opose :.prime,coritract00 and subcontractors who have participated fn a previous, contractor ,subcontract subject to.thdExecutiveOrders and have not filed the required reports should note.that 41 CFR 60 1;7(b) (1) prevents the award of`contra is andV subcontracts str ess such• contractor • submits a report couenng the delinquent period,or such other period specified by the Federal: Thighway Adiruus[ratiot •or by the 'Director, Office of Federal: Contract Compliance, Departmentof Labor: $: nature • Date SI w J 7: Print Nauie.< l`�(a+-- r. r t'' • Title: TireSf• ei�l• C-GG XXIIMITt 1; . ,. NO1V—C.CALIISION AFFIDAVIT . ,. .: .. . . (Title United States Code Section 412,4-nd „., . . ::. Public Contract(00*d.004 cm6) i [NAME OF CONTRACT] .6 ,,,w ): —- . - -.• . ' . '1, ' -Qs1 'h•.•:_.A. \..101.'Koveto"..e.44-Hts' aj-c) LiAorectrix LL.',•,r.L:es-ihrt>,, . . . . . .. To the City )=.140.04e04 p0a0.11. ,-; In _.:;.confOx,o a: *ifTidta:3'0-01i0. .:&tates Code Section 112 and 04100ni4'P. uii0Continct Code 740044e•I010,40100$.0*the bid is otEoaao;ii :hojritoto0.of; or oh behalf ofaitiywidi$016$00: • person,va.r.(40;sliip,othpgyi.m06atiori,,organization,or that the is..gn.i.ii,40'-aoct; .,., , not collusive orislIntgJ4.0 the bidder 44n0p40004.0t.itorootly ww04,cot,$.6ti.ditod.oty:other :. bidder to put iA4f000::01t.sli*V-4andhat'.nOi direedYtitiiidirOOdY,00:110404 conspired,connived,-!- .. of agreed with• .fiy.liid'clondr r,art.:ydrie..eig to pain 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 a,nyone'fq fix the bid price of the bidder Wool other bidder, Or to fix any overhead,profit, or cost element of the bid?:p.00,or of tat of other bidd01;:ory ii secure any advantage against the public body Awarding the„contract,,of anyone interested in the: ,• proposed contract, h4-k-.411:'atatprognts contained in the bid otot(00,,0,4Af-oboti:.0).4010.bjd40711..4:: 0.0t ,dito0y,0 indirectly,submitted*si::0T::kor bidpnce or any breakdown thereof,or the contents f, 111004 or 4i**104.:ipfonjo.tiokot,440.relative thereto, or paid, and will not pay., any fee 4,,any , 004)&41Q.4,,pattii0t$1114 :0001pany 4sociAttei) otgo.ti*iwitif4 depository or to any Tijorubo or ,Agontinoot•to.:•0170,00t:*acollusive or:stio.t1)bid, ,., Note..7 'The:above lN1049911400.0 Affidavit is of the Bidder's Propooat By siOtog4v, . Tippo-s01th6Biddek ha <alki:!,§ikned,thisNoncollusion Affidavit „,, ,Oiddm,go 0400n:ed.t11.4;414140.g4.4.1$0,co#01040.04,014yvillligooltoliiddor,,to,:ottititta proson4004: -.. .:-.: :. ., . . . , . , . . . , : •e- : • Signature , - : , ,• - . i .: . ,IP . . . , : 121) . --..(-! -. .bato:.. 6 121 . . /..... ,, Pill:A:Mitt& Mix•-14-k66) dikktitiff' Tit:W., 1! •! c-la . . . . MIIMIT.V. DEMRIVIMEAINtr$VSTENgiON CERTIMATION TiTt:F..4 ,q0.00 OF FEDERAL REGOIATIONS PART .. , The liickl:01;under RetiAlty!.0f,PerjittY, certifies that;::,except#s noted.Mow;..Wojip,pr,g,Ily 0thpr, person associated in the capacity of owner,partner, director, officer,manager; - is not eurretttl*undeTsusgensiOn,debginent,,voimitOy.eXelnikion,or. determination of ineligibility byAnyfederAI agency, • has nabeenstispendek deNrred,,,VOlunturily excluded or 4001-Tiiii)44 koligilgo. by anyTederg 4gency Witinte..1)443.years; • does tiot'havei:aroposed4fetvrment,pending 440 .: ,.. i b.a$:gptIvoilliwiote.ct,oottviaed?or had civil judgment rendered against him/her --, .. ._ „.. .. by a colgtof.0:44pOtoit jiiii$.4idibity in any Matter:involving fraud or official misconduct i! withinithe pait,34ears;: il If'themw:talt exceptions to this certification,iiiSeitthe exceptions in the following space.: _ . .: tkeeptiOnS'ivill'not necessarily resta iiit doitol x)f,4WAN't bntWilt'':b*cOnSideted Jri determining. . . , _... ... „ . bidderrespert$i6114.,To4r:*IY.occoptio*togd olios7 indicate below te,:..'0401 kapplies *0144g . . , .:.,•• , : .,% 'a.gency,and:dates cfnction, . .„ Note Providing false itfetihatiet.'itio result in criminal prosecution or administrative sanctions: The above certification;is part of the Proposal. :.•Signifig this Proposal on the, . , .•,signature portion thereof shall also constitute sigoAtIvP,•0*Ig Certification, t.1 " ) . . . SigOature.7. . ;,-:.- ... :: Date,(. . ':' :,.:-;'r ' , . . , .,J'a P:tiritanie.,, mwoN tiort Tidet 7:ifeSif.: :f*,,i-i77 . i! 11 1, • . ,., .044, • •: ,:. EXHIBIT G • NONLOBBYING,CEItTIV.WATtON FOR CONTRACT'S . , . - The prospective participant certi tics, by signing, ti41.Siibtnitting,-this'hid or proposalhis or ,to the best of her knowledge and 134ef::,:.that: I) No Federal appropriated funds have been paid or will be paidt by or On behalf of the.. Under§ikned to any person for influencing :or .attempting to influence, an officer or employee any Federal agency, a Member employee of Congress, or an;000*e of a Member of Congress in connection with the. awarding of any Federal contract,the making of any Vederal grant,:the:,ffiaking ofaTly,Fedetql loan, the entering into of any cooperative agreement, and the ..'000,41* continuation. renewal, 004d-tuoi4 orAmodification of any Federal contract,grant, loan,or cooperative agreement.:, 2). If any fo4tothalli-ki Federal appropriated funds have been paid or will be paid to any :person.for influencing or atterititing,to influence an'Officer:or employee:of any Federal agenoy.;:,•414pmlor or.'Cloogra§1;alt:Offibor or,,employee of Congress. or an employee f of Member of Congress this Federal contract, grant,Joao,or cooperative the.undersigned shall complete and :Standard, "Disclosure of tObhlyirtgAetNifies;'iixtdoto.:0400iwith its This .•• certification is a.:;1040441.170P:t,0$014fiOn,:Or frApt upon which Was;Placed.when.this ,•• •• transaction was made or entered into. Submission of this certification is!!:aprereggigite1:0.1"-th4kiiig. ,•• or entering -this transaction imposertitiT Section 1152. Code.Any person who fails to filo•te:,.toqdre&eertifiatiotihaltbe.,,'sul)jotto-;a civil penalty of not less than$11000.and not more than$1.9:02.04'91::cooh..:otta failure. The Propettive:PatitiCipantalso agrees by submitting his titthdetild or proposal-that he or she shall require ,!haft TAO language of this certification be included 01..all lower tier- subcontracts, which ,exceed.1;IQQ..()0.0 and that 4.112.s so. - pientS shall certifY'anct4iSolose accordingly. Signanm . . . . Date:f t):12"0: , . . r, , Title: . . '1. EX1103ITH . .„•:.: .„,•„.••...",.. . •. ., .. : • ..„ .. . .DISCLOSURE DISCL OFLOBBVING TI ACTIVIES . ;COMPLETE Tar.gTORM-TOI)1$10:141',0) .YING...-..4QTWITIPS']pUlmANT'170-•$,A„,:=u!,54,1'.351. .... .: : 1 Type of Federal Actio • rt: Status Arg4orat ACttpitr • 3 Report Type • :,,..„ • , .,.:.. .. :,. •'4•contract .„...... :!i,':14..4114frOriappliCatiOD:. -1-1...„.itiai ... IY,'. 1itif '1):A1-i61 a*Sfd lvp,i4taliaLe"."-ge'i c 0§vggiyqLni"„gc4IP..11t.- ,:d.,w40,0,4 4).0.4p. For Mat.'":.al Change Only e : .• ,,:.. ...::.:.• ,..., - ....1104tigiOiabrm r quarter LIpat giti4affee,'; •.:,'t.tatal'Aply.0411, . .. • . •. ..,..:••• •• , •- .t. NA.tp#A44.A400'it.zot140.60tigpttiry If 40:01.10t.goi.i..•,,iiii.Nt,i4-1c6.-oii**.o..iloi.*Pt.#:.IV:060.,4' !,:Atfrit.05-.Of Piiii* Li.,.. .. .:. 0 pii;0 ,$!iiia*445-tp::.,-... .,-- . . . '-qet, „fa fki voti., ;-. • . Oiwro,sooniouputtitt.-,,if kilizkt Co!.:::,..•fi01:600.I.1).Wtit.45itkiitVOI Federal Deprtment/Agency 'i ....,Cdtrat Program Nktii0t1)00tIptita,;,- ,.::•' efl)Aftfottetift'appik„ahte. : •• . S; fOera'.1,Actiotti.NionbotiikknotOik; .:...'": .40: .8,W#174 Amount,it il:reAtie .,•10 ,*Volor40444tkeo..4 40hy„:„sittio„ :x '14,10.i.404 R*0070#00*.jos„,.0404,4iog .(4048iiitiaLitiimrioi:titi:t.,,..0,#*,m1) .:- 444*:;04itroitetitfrAili.Nc.3:04. ] 044ii*.4.ilit*fi4*--# 10:'. ..,. 1 coft:4 ---,,polii0040.004gAto:jf:,-11*$$.40, .,-. . , TL, ,Approntok4oipiittciickg0#,:4Fiti ) :1'. .', iyotgrayatontlejokalfthoiati.pl$,.):, , $ El Actual ,. I. P101itied , it,firainev • . • ..-,„..,,..,„. ..••', V:hti,..... .....,.. , II. Fig*of PAytteiitlehi4:#110 ;.*00.(y); c:,;.coininiksicio: :*.:0.ih v ' 4.ppOrtiggpi-Ae, ';',,.54:1.:.i.4.;.,p,c4:6 - 4:i.gr.c., . deferred ...„, •::,--•.•- ..Valte, : f',.,t1t/tetvV'e.difSii ,. .,..-,. ,.. ,.• 14. '8tiet(00$`01.0tihtt:Pf,.:-i..0,0sle.etfOtlitiect*I0 kieii)oft,004444.I):04,0):tif*OICkjit.ohiCIiiw , facer(s)c:OhtiloyOje..);:ei::iiI0001:(0)contacted,Ot P,OntOatindicarig in Item it !•CatiO.40t.itIhtiatipri•EIShOt.(s)if necessary f.i .. . I . c1;0"00010."!:$400g0.i4tt.004`.c4 Y04, .0. .S0 la 16.,.'.InfoiiiiAtio•' equested t4i7Oti1,I!:thi"..-;;:fpt:pyi*•,:pthpri.*015kTriti . 31 tbsq:' ?:404.1),-;4,::17,64.41j$4950rA:V*i00>yip:g reliance Signature .-. •was pie -:d 1:,y.!Itliiip.r,01402.g when his tintikdiicti7i;viirniaderkif OW'. ttith,./II4tligeloWieig'feittifitif"04-04041-I.4.1-.s-p, R#41,:ggpqt.:, 1352 ,,nii ..',..!filforniatiaii will tiO: 0041'4 to ;'cong.rm; to'"itifiiall$rs:#4 will .y4potc:,for public inspection '4,0-y Title: on who fail tt,fil;;Jhe required disclosure shall kit subject t a 944 penalty.91-•*(,:1!*tli*S1A.900>A0.4?;110t,Itakt:that 171dfilitiii6Nt:::: . ... .. '....0ate.;.. I.M .; f090,:for,q.ackaacii.f.aiIarp Ant40001'.:1Tor;40.01,110t*iinoon, .:F..-4000:0.4:.0.11 .iE S4h4rd FOOn.:1:4],: .„ StariclOrcl'f4tri;t4KO;;.q9,7:1;Z497,' !y! Ca6". .,...., • I1 ISTR>`TCTIONS:FOR COMPLETION OF`EXHIBIT HI.. DISCLOSURE OF LOBBYING ACTIVI'1IES This disclosureform:shall be completed by the porting entity,whether subawwrdCe or prune Federal "recipient, at ttie initiation or;receipt of covered Federal action or a.material.change to previous fling • pursuant to. title iseprim I35 The filing of a form is required for such:payment or agreement to make payment to lobbying;entity for influencing or attempting:to influence:an officer o> employee of any;agency, a Member of Congress'; an. officer or employee of Congress or an employee of alYko,mbor of Congress in connection with a covered Federal action. ,Attach a continuation sheet.for additional information if the space on.the form is inade •quate: Complete.all items that apply for both the initial filing and 1material change,report Refer to the irriplerxmenting gtidah1ce published bythe O ffice if Manageixieht and:Budget for adeliuonal:ixifornation; 1 Iden•tif•y the type of covered Federal •action for which lobl ymg activity is.and/or has• been secured:to ziifluence 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 prev ously reported,.triter the year and quarter in Whic`l the change occurred„Enter the date of the last:previo isly submitted report by this reporting; :entity for this,covered Federal actions 4)` Enter the ful• l name, address•, city, state and •z•ip .code of the :reporting entity Include+ Congressional`Distz ct'if known..Check the appropriate-classification of`Che reporting entity that designates:if it is or expects to be a;prime or subaxvar. recipient Identify the tier oI tY e sut�awairdee, e,g,the.:':first subawardee of:theprime.is the:first tier Subawards mclude t ut are. not limited to subcontracts,subs and contract awards under If grants. 5) 'the organization.fling the report,in:Item 4 check•s "Subawardee' :then enter.the full name,: address,:city,state°and zip code of tlieprin%e Federal recipient>Include Congresslgnal District, • if known. F) Enter the name;of the Federal agency-making tie award or toad commitirre it. Include at teast one organization level below .agency :name,. i-f known. For example, Department Pf Transportation,United States Coast Guard. 7). Enter the Federal ptograri? name or.des ription for the covered Federal.;act•ion (stern I , If known; • otor the full;Catalog of Federal Domestic Assistance 4-CODA) number for:grants,; cooperative>agreements, loans and:loan commitments: g) Enter•the most appropriate; Federal identifying; number available: for the; Federal actto identification i i item 1 (e.g;; It equest fOt Proposal (RFP)nuniber Invitation for Bid(IFB4 • numbm grant: announcement number, the contract' grant: oar :loins award number, appIication/proposal;control railtber assi ned"by thefFederal agency) Include prefixes, e g „RFP-DE-90=001'h 9) Fora coveted'Federal action where there has been,: award or-loan commitment by the Federal agency,enter the Federal amount of the cornrtirtments for the prime entity identified its item 4.or'5, 10)(a)Enter the.full name,-address,city,state and zip code of the:lobbying entity engaged by_ the, reporting entity iri iteiii,4• to infl tencecl the coveredz Federal action;: C2' (b) inter rho full names ofthe.individt al(s)perfarniing services;and include fi 11 address if. different from• .16 (a):. Enter Last•I••iamex°First•.N• ame ai d Mxdclle Initial(MI) 11.),Bnter the amount of`c•ompensati•on paid or•re• aso•nably expected to be paid by the�reporting •entity(item 4)to the lobbying entity(item 10). Indicate whet• her-t e payment• has been made (actual) or"mi4 be made (planned) Check aXl"loxes, that apply If"this is a material.change report,enter the cumulative;amount of;payment made or"planned robe made 12)Check the appropriate box(es).,Checkaall`boxes that apply If payment is nad through an in kind contribution,specify the nature and value.of the in kind payii eht 13),Check"the appropriate boxes) Check alll boxes that apply If other;specify nature:. 14):Prrov"ide a spee f'ic and detailed description oftl e services that the lobbyist has performed or will be expected to perform and the dato(s) of any services rendei ed. Include all.preparatory acid related activity not,just time.agent ih actual contact with ked'eral,officials.;Identify tli.e Federal officers) or`employee(s) cotitacted""or the offfeer(s) employees) or.Member:.`(s)of Congress that°were contacted 15)Check whether or`not a continuation sheets)is attached:, 16)the certifying;official shall sign and date the form,print his%her lame title>and telephone number Public reporting burden for this'collection of information is:estimated to average 30;minutes per response; including titre for reviewing instruction,searching existing data sources,gathering and; maintaining the;data needed,,;and completing and reviewing;the collection:of:,iiiformation"Send, comments regarding the burden estimate:or any other aspect of this collection.:of information, including suggestions: for reducing this burd0i;0 to the :Office o Max agement anti: Budget; Paperwork Reduction Project(0348-0046),Washingto i. I)C. 2050 By my signature on`this proposal I certify under penalty of perjury under the lavt aftState<of California,, that the .foregoing: questionnaire and-statements of Public Conitra:0 Code Sections 101.601 10232 :and. 102851 are tr.,ue 404 correct.and that the bidder has complied, with the requirements of Section 8:103 of the Fair Bmployment and,Housing Cammission. Regulations (Chapter S,Title 2,of:the California;Administrative Code):, 11 { C 2$:. L JallArt:I.. FEDERAL LOBBYING RESTRICTIONS` Section.:1352x Title 31, United Statea Code recipient prohibits Federal funtts`from being expended by the or ay r lower tisr: subrecipient: of a, Federal aid 'contract to pay for any person,for influencing; or attem• pting to influence; a Federal agency. or Congress in connection:.with the awarding of any�Federal aid-contract,the`making of ally Federal granter loan,or the entering,.into o f any cooperative.agreement, If anyftm4ptoritwo Federal funds havebeenpaid for the same purposes_in connection with this: Federal.;aid contract,the recipient shall submit.an e•xecuted certification'and,ifrequired, s•ubmit a completed disclosure form as part of the`bid dacurnenis; A certification for Federal aid.contracts xegardingpayli ent of funds to lobby Congress or!i Federal:: agency is included in:'the Proposal Staiiddard:lyorm -"L.LL, `,Disclosure of Lobbying Activities,' . withwithiii§tinctiot4 for completion,of the Standard Fonn.is also iiiojudait the Proposal, Signing Proposal shall.-constitute signature of the Certification; Thab e ove referenced,certification and disclosure of lobbying activities shall be included in each. scontract and any dower-tier contracts exceeding $100,000 All disclosure forms,,but not' • certifications,shall.be forwarded from tier to tier until received by tic Engineer:; • • The Con tracctor su•bcontractors and any lower'ti.:er contractors shall:file a.;disclosure form at the mend of each calendar`quaff er in which there occurs arty event that requires disclosure or that materially affects the accuracy of the inferrriation contained in.any disclosure form previously filed+ by the•Contractor subcontractors and any lowet'tier contractors *4 event tat materially affects` the,accuracy of the.-informatio inclu n reported des'; 1) A cumulative increase if$25,000 or more izt,the amount paid oz expected to be paid fo" influencing Gr attempting to influ :aence covered Federal actinic o.r` 2) A change iii the persori(s).or ii.1.404.0101;i0fNoloingot attempting to influenceka;covered Federal n;actio tsr 3 3) A change in the>officer(s), einployees(s) or.Meinber(s).contacted:to influence Of attempt to ItOtence.i.a covered Federal Action.. • lq 1111 mi . C229 • EXHIBIT'B (Form HUD-4010,the Federal Labor Standards Provision of the United States) Federal Labor Standards Provisions U.S.Department of Housing and Urban Development . Office of Labor Relations Applicability (1) The work to• be performed by the classification, The Project or Program to which the corstruc;ion wail: reques.,.. „,,:, , performed t... classification in the wage:: havered•bj this contract pertains es..being assisted by the, deteririinatian,find United States of America:and the fulluwirig..F ederal i_abot (2) The classification is:,utilized. in the ;area by the. S tandards Provisions are' included in ,this Contract constreetion�industry:and' pursuant: to :the- provisions applicable t•o such Federal: (3) i he proposed; wage rate, including any.'.bona fade a:ssiutance fringe benefits bears a reasonable `relationship to the A.: t. (I) Mini num Wages. Alt laborers.and rnechaniea wage"rates contain .d in the wage determination: employed or working upon the site of he work wrtl he paid (b)' ff the cc niractoi�and ttiic laborers end mechanics`to:ha unconditionally",and not.lass often;than"once a Wee!(;:and employed to tha elassiticatton. (if, known),: or their` without subsequent deduction or rebate on any account representatives, and' HUD er its designee agree on the; (except such payroll. deductions; as are: permitted try classification and: wage Fate {includ•ing the amount regulations issued by the 5ecrikary'of Labor under the designated torfri;:'-benefits where-appropriate} ,a •report: Copeland Act (25:CFR:Part 3), he fait amount of Wages of the eation:talcen'•st alI be sent by,Htl;I or its.d•esignee;to and'bona fide fringe bene:fits�(or cash equivalents thereof) the Administrator. of the Wage and Hour Division. Ave at time of payment computed at rates:not less than employment Slandards Administration;U S.p:epariment`:of those contained in the. wage -deterirrin'a,tion of the, Labor, Ydashngfon, DC ":2021D: The Administrator or.an Secretary;of Labor which is attached hereto and thane a" authorized:' represe•ntative, twill approve, •modify, 'or purl hereof regarofess of any contractual :relationship:,{ship; • diisapprove every-additional::classification actiorr.within 30 which may.:be alleged to,exiist between the contractor and' days of receipt and s'o advise HU!D Or its designee or wilt such tooprers and meeha.nics Contributions made or notify HUA or its designee.within tile 30 day.:period:"{fiat; costs reasonably anticipated far bona•fide !tinge benefits- additional time is necessary,:{Approved by the Office::•of: under Section i(b)(2) of the>Davis-bacon i4ct on behalf of. Management anti Budget under•:0Mb control number 12115:-: laborers or mechanics are considered wages paid 10 such O'14.0.) iabgrers or mechanics subject to the;provisions of 28'CFft (c) fn the.e:vent tire;contra tor,the laborers ar mechanics 5 5(e)(1)(iv) also regular contributions Made or casts t"v 'be "employed . in the classification:: or their incurred for more then a weekiy period (but not less often representatives and HUD ar its designee do net aarae:on than quar€erly) under ptanst funds; o'r programs, .which the proposed alessificalian`.arid wage rate.(including'%the cover- the particular weekly':period:,-,::are deemed: to ,be: constructively made or Incurred durinn"su ch weekiy period: amount designated for frinll-•benefits,;where apprapriafeg'; Hi1Gl ar Its designee-shall refer the°questions including Such laborers andlinechanics shall"he.pa• id tf a appropriate the;iriews of all interested parties.and the recommendation wage rate and fringe beneltts on the wage deterrninatiori ef. -:Hun er its: designee; to the, Administrator .:for for the classification:of work actually performed, without, deter, ination The Adm •nistrator,. or an: authorized regard to :Skill except as providt it in 28-CFt2 5 5(a)(4),. representative will':issue a determination within 30:days:of Laborers or mechanics performing::w.tirk In more than-.once receipt•and so advise HU.D or its, designee or will notify classificat on rnay'1 a compensated attha ratespeaifiod for HUD or its designee within the -30-day period that= e ach•ClasSitiCation•.•ter the,time actuallyworked therein: additional time is necessary,:.(Approved by'the Office;r.f Provided,.That the employers payroll records accurately: Manogement and Budoet: under OMB Control Nu• mber. sat forth;the time-;::spent 1rt each classification in which 121:5 0140.}. work is performed The wage determination(including any- ai<titrpnaisslftcatlan and gage rati?s Conformed tinder (d) The tvago rate (tnoiuding' fringe benefits vJt ei.s 29 Ci P. ,5.5 a 1 ti anti' the t3avf; bacon,poster WH appii)(b) tti), determined, pursuant to subparagraphs ( }( ){ ) { (1}(ri (b ,or {a} of this arc ra h, sh'a1t' he aid to; ail: 1;321)shall ha posted at all.Inner,by'fhe caritrectoraad>its ) ) P.i g• p'- P • • workers-perfermrng ►work In;the:classification under this: Subcontractors at-the site:of the work in a prominent;and` contract from the first day=on:which work:is perfarmetl;In aetot0ible, place: whore it°can be easily ••:seen by-the the:classification. workers. (ii) (a) Airy ctass;of laborers or•mechanics which is not: (iiij; Whenever the minimum wage rate.prescribed in"the- es listed in:'the wage determination' arid which ie. to be' contract•for c oach-;.bf Laborers-Or as a aiii u t rate,the e mployed under` the contract shall he classified it fringe ctor it;which to not:expressed as an hotrriy rate,:the: conformance.with:,the wage. determination:: HUD shalt wuocdontr dot 'shalt:either pay-:the: b'e'nofit•as stated 'In:the :approve an addrtic.'nal classification and ?wage rate and wage determination'•or shad pay atiather bone.f oe frir9ge: • .triage benefits:therefor.only When the following criteria: bentlfit of an`haurly;cash equivalent thereof I a.Ve;heen met; (Iv).If the contractor:does not make payments'•:to a trustee; ..:..... .:.. .. or other;hied person,,t, .contractor {nay consider_ a,pail; .. form HUD-4010(0012009) Preiriaus editions are:ntisoictn: Pag&.1:of5' ref.Handbook 13441: SF:16-5215-142605.doc/rev 12/2016 32 f:the wages of any laborer or mechanic the:amount of.any communicated; in writing to the laborers or Mechanics; costs reasonably anticipated'in providing bona fide,fringe:: affected, and records which show the costs anticipated,or ,benefits under a:plan or program; Provided That:the. , the actual cast incurred tit providing such benefits• . Secretary,of Labor has found, upon;the written request of` Contractors employing apprentices or lrsinces under: the.contractor,;that the:.applicable.:standards:of the..Davis .. approved.programs shalt maintain written evidence of the Bacon Act have bean mef; The Secretary of Leber•may registration of apprenticeship programs and certification of :require,:the contractor to.set aside in a separate acco iiit: trainee programs the;'r`egistration of the;apprentices and; :•assets for the meeting of obligations under the plantar. trainees, and the reties and wage rates•:,prescribed in the: • n applicable ra rams A rbved b . prograrel..tApprovod by th;e Office,of Mara,,, and p s ;, { Pl?, y:; t'a Office of 73udgetunder OMB-Control Number'121540140 j-. Management and Budget,under OMB ;Control Numbers .• 12150f40 and•1215 t3017.) 2. UYithhoicfingc. HUD':or..its-designee•shad upon its.own - ; 'action ar upon written rer}nest of an authoried; (it) (a) 'The:contractor shall submit weekly for each week; represenratrve eCthe, Department: of Labor withhold er:` in which any."contract rk wo is; performod a: pony of..all: cause to be Withheld from the; contractor under: this; payrolls to HIjD or its-designee.if the agency is a party to •contract•or any other Federal contract with;the same prime the "Contract,,but if the agency is not such a""party, the: contractor, Or: any, ether• Federally-assisted contract: contractor ;will• submit. the payrolls to the; appiicant. subject :to Davis'-Bacon prevailing; wage requirements.,; sponsor,or owner aS.:the cese'may be,for lransm ssian to: Which is:field.by rho some:prim contractor so much of the:; Ht1O or i•ts designee. The payrolls:stihmitt•ed shall set alit :accrued payments or advances: Cr. may. be considered` accurately:and completely all of the::information required: necessary to pay laborers and' :mechanics including, to be rnaintaiaed•under 29 CFR:S 5(a)(3)(r)eXCept,thet full apprenitces:: trainees. ;and helpers, employed. :by: the sacaai security numbers anti home addresses shall not he: • cantratter or any-:subcontractor thsc,"fllll amount or:wagges< included on weekly"transmittals.. Instead-:thu.,payralls shall, required.hy the contract,In the eve it of failure to,pay:'any only need to°include an individually.idenfitying number for taborer or mechanic,1nGliiding any .apprentice,,trainee;or each employee (e g,%thelastifour digitsssof the,employee.'s • .helper..empioyedor working on the site othhe work "all or social sec•urity nu•mber) The required weekly payroll pert of`the wages_requited by th;e ecrttract, HOD,or its information `may be::_submittted. tit any' forts: .desired; designee;_may, after written notice to the contractor♦; Optional •Fora- WN 347 is avaitabte;for<this purpose•from; sponsor,.,appli5art, or owner take such:action,as triay be the Wage; and Hour Division Web " site at necessary to cause .the: suspension Off,. any :further btfnfr//a'w;t dot,pee/esa wbdlforrrr';'wh2"a7instr;htm. or• its paym ceent, advan or::guarantee of funds until such•_ successor site The prima contractoris responsible for: violations.have ceased : ;:HUD or its designee may.;after: the aubrnissivll•of copies of•payrolls by"all subcontractors. written notice to the contractor, ,disburse •such amounts' Contractors .and 'subcontractors shall maintain :the,: full withheld: for and en account of the contractor or: inept security number and current address:.of each subcontractor to the respective•employees to whore they covered worker and:shalt previda them upon request:to are due., The :Gomptrcller General shall. make; such; HLUD;or its-designee :if the agency is ,.k.:.:prtV.',::,t.to. the disbursements in the Case of direct Davis Pawn l+ct .contract but if the agency .is not such a; party the contracts .contractor will.• :submit the payrolls: to the. applicant 3.. (I) Payrolls:;and basic:records. Payrolls.:and basic sponsor or Owner as the icase:.may tie,for trartanilssionto records :;retahitg: thereto shall be rnaintaihed try. the:: HIJD`or its designee,;the•contractor.or the Wage;and tour- contractor during the course of the, work preserved tar':a Division at tale Department of`Labor for purposes of art petiod of three years thereafter for all laborers; and° investigation or audit;of compliance with prevailing wage mechanics working at the slte of the"work, Such,•records; requirements; It is not.a violation of thisrsubparagraph for shalt contain the name,; address; ,and social security a prime contractor to require a subcontractor to provide number of each such'Worker,: his or,. her correct addresses and social security numbers to the prime classif+cation hourly rates of wages"paid (including:rates. contractor,for its own::records, without:vleckly submission Of coniritiuiions trr costs: anticipated for bona fide,-..fringe: to IUD Cr its designee_ (Approved .by. the. Office "of benefits or cash equieater�is•iherepf of♦fie types desariti+eit: Management and Budget under QMB' Central Numbor in. Section l(b)(2)(B)• of.the Davis-bacon Act) daily:and 1215,-D148.J weekly"number,of hours :worked, deductions made and- (b) Each payroll submitted shall be accompanied by,a actual wages paid. Whenever the.Secretary;of Labor has °Statement,of Cnmplt'ance. signed,by=:the contractor"or found under 29:CFR 5 5: {a){1)(iv}that the weges;of any subcontrmctar•or his or her agent whit pays or supervises laborer Or mechanic include the amount:of any .costs thepaymeet of the persons employed under.the'contra t reasonably anticipated rn ;iroviding:henefits,:under a;plan; and:stiall;cerlffy tort tolicwing: or ro ram described in':Sectiott;.l.b 2 t3 of the Davis.: . P g { )( ){„) , (1) Thai the payroll:for the payroit'period contains the Bacon Act, the. contractor shall maintain records r Neil information required to be provided rtndet 25`CFR 5 5 show that the commitment to provide• such benefits is (a),(3)(i1) the appropriate Information is being maintai►ied enforceable„ that the plan or program is financially;: under" 28 Gl ft 5.5(a)(3)(i). and that such information is responsible, ands that: the,plan or •program Iles ::bean correct and complete; : rreviouseditions are.obsoiete toim HUDalo10'(06120p9) i'a9p 2 of:5 to #�andbi ok 1344.1 SF:16-5215-142605.doc/rev 12/2016 33 {2} That each:la.. ... br meehanic;;(inaluding each t4:elper, i not registered 4r:oth Mae employed as staled above:,; apprentice, and'.trainee}::empioyed:;on:the:::coritract during: ,shall be paid not less:than•the applicable wage rate ort tthe the payroll period has been paid':the Nil:weekly,wages •wage determination:for the classification of Work actually earned;;without`'rebate,.;either directly or indirectly; ;and performed In addition anyapprentice performang.work;on that no: 'deductions have: been -mane either directly oir. the:lnb site?in exc ss of the ratio:permitted;under the: indirectly from the tutt wages: earned; other than; registered :program shall :be paict.•:not loss than the permissible deductions as set forth in 29 C,FR Part 8;:. applicable wage rate_ on'the wage determination for the (8} That each laborer or mechanic has been•paid not less Work agivaliy performed Where a contractor is<performing than th's;`appiicabie wage rates..and'fringe benefits or cash: construction on a protect in.ia locality Omer•than that in equivalents..:for the classification of work performed,:as Which its program.is,registere7 the ratios and wage rate:: ;specified in the applicable; w• age detenrl:ination {expressed •in• percentages :of the journeym s.en hourly incor:p'orated intosthe contract rate) specified in the r's, contracto or subcontractor s registered program•shall be,;observed: Every apprentice (c) The weekly submission of a properly executed muss be:paid at not tees.than the rate specified in the certification set forth an the reverse side of:Optionel:Porm registered program,:for the apprentice'a level of progr`ess;; H 34'#',:shall sa isfy the.requirement for submission;of the expressed as a percenfagir-'of ffie journeymen'houity rate "Statement of Compliance required by:: subparagraph specified In the: applicable wage d£'terr1)01,pn,. A.3(ii){by Apprentices; shall tie; paid fringe bOitefits iii aeeor'danci d `The;falsification,t5f any of the above certiticat€ails may; t t with the provisions,1 the apprenticeship program If fife subject the contractor or subcontractor to civil or.criminal apprenticeshi program does?not sppcify fringe benefits; prosecution under Section tOOl of, Title 18 and,Section apprentices<must•be paid:the full amount of`fringe'benefits 231 of Title 31 of the United States Code,, listed' on 'the Wegp determination :for the applicable. (oil) The: contractor. or ,subcontractor shall make:::the classification If ttie Administrator determines that:: a "records required:Under subparagraph A;3.(i) available for different` practice prevails for the applicable apprentice. • inspection, copying of transcription by authnrizefi classification fringes shall be;.paid•in accordance with trait. representatives of HUD or its'designee or the Department determination. In the event-the Office of Apprenticeship. of Labor and: -shalt permit such representatives to; Training Employer; and tabor Services of a State interview employees during.working hours on the job. if •Apprenticeship Agency recognized by the Office,, the contractor oir'subcontr`actor tails to:subinit the reeuir0d withdraws :approval of an :apprenticeship ,ri grem, the records;or to make:them• available; HUD or its:designee contractor -will no longer be permitted to. .utilize may after written notice to the contractor sponsor; apprentiices`at less than the applicable predetermined_rate applicant or owner take such action as maymniiv,..iiit 1ii6,0iiiii for the w ork perfoeutilaaceptble grogram ism `to cause' he suspenslen ofany further payment advance •approved. 'or•guarantee of funds Furthermore faiure to submit the •(il}` Trainees --inept as. provided 5n 29':GpR 5 6 required recardsupon request or to.make: such.records trainees will; not be permitted to work at less: than the: available;may be;grounds for debarment action pursuant;to: predetermined rate:fer the work.performed unless they:are 2P CJ~R'_P"i2 :On ployed pursuant •',ta and individually registered in;:a' 4. Apprentices and Yrtei`nees. program which has received prior approval, evidenced.by` . . t formal certification •:by the 11 S Department:of Labor•, (Iy Apprentices: Apprentices flint he permitted to:work at less than the predetermined rate for rite work They Employment and •Training Administration The •ratio of trainees to journeymen on the:job-siteshall not':be greater performed when•' they are emptayed pursuant to and: than permitted under the' plea •approved by the :Individually: registered in a bona fide apprenftLabor, Employment and Treinin' Administration Every trainee program:registered Witn the U S; papartinent of L:abar: .. • Employment and Training Administration, Office of must be paid at not less than the rate spaciftod in: the •Apprenticeship Training,f mpioyer'and Gabor Services, o.r approved program for the trainee a level of pregrpss. with `a State Apprenttci strip Agency. recognized by trig, expressed as a percentage of the Journeyman hourly rate Office., or if a arson is c.em to ed In his; or•her first 9,0 specified in,the applicable wage determination, Trainees p' i shall be paid fringe. benefits• in accordance with. the days of probationary employment:a:an'apprentica ih:Stich an apprenticeship program; who is' not individually; pip risions of the trainee program lfthe trainee program registered in the°:'program;•but•who has'been certified by does not mention fi*inge•benefits :tralndes shalt he path the Office of'Appronticeatiip Training, Employer and Labor. the full;amount of fringe benefits listed on;:the Wage Services or a_ State ."A renticeshl A' enc where determination unless;the Administrator of the_Wage;and pp p *genet ,t: Hour Division determines that.there is an apprenticed ip "a ipropriatey to Ere eligible for probetionary;`amptoyment,as an aipprenkce The allowable ratio of apprentic.t s to program associated: wilh the correspon ding,journeyman journeymen an`the job site in any'craft`clasification shalt wage.rate on the wage.determination:which.provides.for! not be greater than the ratio permitted to the contractor-as less than full fringe bene.fits for `=apprentices Any • employee;listed on the payroll at a trainee rate;whn is Got Ito the entire worklerce under the registered„program: Arty; registered and participating in a training plan approved by. .:worker listed on a payrait,at an apprentice vage.rafe,who . Previous editions are obsolete;, ' ' fod HUD:4010(062009)�Page3of 5 refW : ,k13M1 . - ,SF:16-5215-142605.doc/rev 12/2016 34 • -the Employment and firairtirtg Adntlnistreti n shalt tw polo awarded, HUD contracts• or participate in HtJt3 progranis: not less;, than the applicable wage rate on° the.:wane pursuant io.2A.CFR.Pert,24. determination for the work;actually performed in addition; 0.1f 'So part: if this contract- hall be.subcontracted tariy . :any trainee performing work on.the Job sit"e in•excess of" person or farm ineligible for award ;of a Governiiiierft the ratio;permitted under the registered program shalt be contract by virtue of;5ection 3{a) of the Pavia-6acon,-Act paid not.loss than fha gpphcabte.wage rate an the:wage. r or2l'I CFR 5:12(a)(1) or to.'be awarded Htrt3 contracts or determination fir the ivorir actually performed . In the event the Employment-> .and Training•. Adm•inistration participate in HtiD prper8ms pursuant la 24 IrFR Part 2#. (iii) The penalty for malting false statements Is preseribep; *00:taws approval of a training-program, the CQntracto In fha t4-5: Criminal Code 18 LIS.G: INIT.::: Additionally,, will•no longer be-permitted.to utilize train ees at teas(hen. the eppi pa0e predetermined rate:far the'tiorJt performed t1 S, Crim inal Code, Section 7 01 0 Title le t)S+c4. Federal ifousing Adiritntsttatton transactions -provides it :4tIttt an acceptable program is approved. pert- Whoever for the purpose et.,;.::,;....,. influencing in any ;(ill) Equa•l employment opportunity The utilia;ation or` wayrthe action of such Administration.< makes; utte•rs•ar apprentices trainees end Journeym.ern under;29•GFiR.Part o, publishes any statement knoiiring the same.to be false:.. shalt be in conformity; with the equal employment;: shaft be fined trot more than; 5 O tt'or imprisoned. not opportunity requiromcnts::of •Executive;Order 11245, as meoe•th`an two yedrs;.'erbath:a i3mendoo, and 29CFR•Part 30 11, Complaints, Proceedings, or Testimony by. 5 Compliance:with Copeland Act,requirements: The: Employees:. No laborer or mechanic to whom'the wage,•. contractor shall comply with the requirements of 29:C.FR. salary or other labor,standards,provisions;.of.this Contract Part 3 which ar:;•iti rporated by reference in this contract are:applicatsie shall b discharged or in"arty-ether ioniser 6 Subcontracts The; contractor or Subcontractor will disorrminated against by the Contractor, or any, insert: in any: subcontracts. the= clauses contained :in subcontractor :.because such employee :ties tiled „any subpareggraphs:.-I through 11 in this paragraph A acid Opt. complaint or instituted or caused to: be Instituted any other clauses aS HUD or:it•s designee tray:by.appropriate proceeding or has testified ;or is about tit,testify,• in-:arty instructions require and a copy of the appl•icable proceeding under or relating to the labor `.standards ''prevailin eg wag :ffacistan :"and also:a clause requiring tOo app iccabte under this;Contract;fo his"employer.;: Subcontract• ors to inctude-:these .clauses'in any lower.,fier. 8. Contract;Worts Hours and:Safety Standards, Act. 'rile subcontracts The prime"contractor &hall be responsible. provisions of.thors paragraph E are applicabtewtiorn•the amount of tare far the compliance by any subrantractiir':or tower tier prime contract;:exceeds $i100000 As i,$ed in this•paragraph•the subcontractor with all the contract. Clauses in this terms'laborsrs and"mechanics°Irclude.watchmen•and guards. paragraph (1) -Overtime requirements; Na coni actor or:subcontracter :7 Cgntrriet•termination,•debarment. A:breach of the,• contracting Itir any part.•of the rxmtract work;whi h may•require of contract clauses;: in 9: CFR 5.5`' may e round b gs for'' iev ye,the etiployrndnt,;of iaboters;or mechanics shall require or termination of the:contract.and for:.deberment as., a *Milt any such laborer or me hariic in any wrkw oee&in whirr the: contractor and?... subcontractor: as provided in 29 CFR Individual le.employett,on:such work to workitt:excess ofd0.hours n 5.12; , such workweek unless; such laborer or mechanic receives 6 Compliance with Davis-Bacon and Related Act Requirersrents.:.. comp•ansation at a rate not teas than one and on•e-halftimes the basic Alt rulings. ans."interpretations of the, bavis-Bacon and rate of`pay for art hour• s worked,"in excess of 40 hours in such Related`Acts contained in 29:CFR':Parts'1, 3 and 5 ar;e. workweek., herein incorporated by reference in this contract (2), Violation, liability for unpaid wages,: liquidated 9: Disputes concerning labor: standards, Disputes damages..• Ili the::event.ef only violation of•the clause set arising out of the labor standards provisions 6f this• forth in subparagraph(t)of this paragraph the contractor . contract shall not be. ,subject to the general :•disputes and'any"subcontractor responsible t'herefet-•, hall be liable clause•of this:contract: .Such disputes shall be resolveti.:in for the unpaid wages. in addition, such contractor and; accordance with;:the procedures :of the :D0partment of. subcontrac•tor shalt be iiable',to the Untied States (in tile. Labor set forth `In 29,CFR Parts;;5, 6, and 7 Disputes case of work done:.'ender con•tract::for the.: District of :within the meaning of thro';t4ose include disputes between•• Columbia or a territory,, to such District or to such the contractor (or any of its,subcontradtors} "and HUD.sir tarnitory}, for liquidated damages Su'•ch•..�liquidated Its designee,: the U Sa Department of Labor, or the damages shalt be computed with respect to each individual ;employees or,their representatives>; laborer or :mechanic`, including watchmen an•d Oh-:a:•ri,e,: 10 (f) Certification of Eligibility By entering into this employed In vtolati_en of :the clause seta forth In: contract the contractor certtfres that neither it (nor he or subparagraph('f) of this paragraph,in the sum of;$10 foreach she) nor.arty tefeon yr.firm who lira an interest in "the. calendar day:on which=such indhilduat was required a•t permitted to • :•contractor`s. firm is, a .`person or firm: ineligible:'to be work,in excess of the standard workweek of46;hours without payment 'awarded Government contracts:by virtt rr of'Section 3(a)of of ft a o+ieifime wagesFrequired by the clause set forth:litAub. the Davis-Bacon AG( or' 29. CF:R 5.1,2;(a)(1). ar ;to fee:- paragraph(1)of•this paragraph Previous;editions are:obsolete ten;HUD-4at0(t>192O04 Pattie;A of5. ref.tiandbook1344. SF:16-5215-142605.doc/rev 12/2016 35 (3), Wtthholdtng•for: unpaid:wages and liquidated damages tiUD or its designee.shall upon its own action or upon written;:request of an,authorised representative of the Department-Of Labor withhold or cause;to•be•.withheld from any moneys payable on ae ount of Work performed by the contractor or subcontractor under any;such contract:or any other Federal centred with the seine>:Prin'e contract,; or any-other.rederaliy-assisted !contract subinct."to the Contract 'f.ork: Hours_°and Safety;Standards Act which is. held by the same prime contractor such sums as may be; d•etermined to:>be necessary to satisfy any liablllties of such,contractor or subcontractor for:unpaid_wag•es ans liquidated damages.as provided ih the.ctause.set.forth in. subparagraph(2) of this:paragraph. (4) ,Subcontracts. The;contractor or subcontractor shall: insert 1n any subcontracts the ciauses set: forth 7tt: subparttgraph;(1)through (a)of:this paragraph end also a clause requiring the ,subcontractors to; include those clauses in ally', leWet tier subcontracts The prime contractor• shall: be responsible for "compliance. by any; subcontractor;or lower rpgr subcontractor:with the clauses set •forth in ;subparegraptis: (1)' 'through.. (4) of this paragraph: C, Health and,:Safety. Tree proisiuns of this•prrragraph.C..are appliCaldeVriteradte.Ometeitiefthal prime contract ekeeeds S1Ofti 00.. (1) No taborer or mechanic'•shall be required to work.in. surroundings_or under working Conditions which are unsan taary, hecardotis, ;or dangerous to ilia health and safety'as determined under construction safety end health standards promulgated'by the: Secretary .of` Labor by regulation. (2) The Contractor; shalt comply with all regulations issued by the Secretery'of Leber pursuant to•Title 20 Pert; 1926',and failure to t omply may result in impos lion of sanctions pursuant to foe Contract Work Hours and Safety_ Standards Act;(Public,:Law 91-54, 83 Stet 0.6). 40 USG- 370 2-ef3�'sq (3} The contractor aboil include•.the provisions;of this paragraph in ery ev subcontract so;that surds provisions will, be binding on.each ;subcontractor.. The contractor shall take'such action with respect•taany"subcontractor as tale Secretary :of Housing; and titian rievetnpment ,or the Secretary of Labor shalt,direct es a means of:enforcing. such prOvisronSi Previous"editions:'ire obsolM form•HUD.4010(0812149) Page5"of 5 rat Handbcale i$44.1 SF:16-5215-142605.doc/rev 12/2016 36 • EXHIBIT C United States Department of Labor Office of Federal Contract Compliance Programs . . . Office(4 Federal Contract Complianc Programs(OFC. Executive Order 11:24.6i,AS Amended orscLATmER.- Orecutilie:Order'4:1446.--Equal Employment Opportunity . . provisions Order 11..2409fSpk.::24,106S.,appearat30 FR 12319,12935,3:.CFR,..10E4.- 196$toraP,,P,330,..oritSg:00jer*e..pOted, , Under and by virtue of the authority vested.10.mp.as?reskiant of the Witted Eteh!aPrthecOnshtutipp.and statutes of the United States,it is ordered as Part I Nondiscrimination in.Government Employment: , [Part.I. uperaedett hy:E0.1403 pfAug.4,1000;34 1.90,208,3 CFR,1006A9701.Comp,, • Part Nondiscrimination in Employment by Government Contratto. rS and 5400.1.4t.4.0000• Subpart A Duties of the.seteetailt of Labor SEC.201 : . . . The Secretary of 4009r,$11011.43.017.PPPoosi!*:f9r the administration and.'enforcement*Part0::11Pri4.01 of this Order.The Secretary,004 adopt such rules and regulations and issue such orders aparecipelped pecessaryapc1eppropriatetp• .actilayathe.piirPa*.pfOeitg14.111'.Pfthj. 000. [see.2.01.ortlenoect*:..4.0 12.080..rif Subpart.B .COntractoreAgreeMentS SEC 202: Except in contracts exempted inacrprOance with kr:intv. ,(i4:.cir this Order,all*yemrpaht..cpritrectjpgegeprjes shall. indude in every 0iverrirpapt contract hereafter epterep:iptaithefplIPwipg p*iaipti4; During the 0.04fPrOat10PftWO2htractiiheitorktractOr agrePs:4-folloi•ls;: • 1,The contractor will discriminateagaiPat any employee apPlicant.,fpr.amplpymept.becaue:Pf race,.color, religion,sax,eexUalprieptahop,...gepperjdePtityi er:pationa1orjg .:Thepeptractpro41talca.affirmatiya action to eriUre that applicants.plieritplaYrec4.00-that:6001pr*.eretieatel during employment,without regard to: their rateitelor,ierigton; e4kinialPtientatiPrii*Pder identity,ornational oriqin.Suth action shall include, but pet be limited to the following•••employment,upgrading,demotion,or transfer;recruitment or recruitment adyert1ting.;loye.ot.terminatiott rates of pay or other forms of entno,notionl.and selection for trairlirigi including appreptiPaahip,.Thp.contractor'ogrgici post in conspicuous pjacasiavailahlet.o.,o:monyo4:,ona applicaptaferempipmepti noticestp.ha...prpyfled..hylthecoptractipTpfficer.act0pg.forththe:protisiphs.ofthja: nondiscrimination clause . SF:16-5215-142605.doc/rev 12/2016 37 *w�w w"inif tj _—_'---__�� � ~,the:cc)ntrading%agency and the,secretar� purposesof `..=== ~~_-_~_~_-~�~_~~~_._~. __- ~�_-__~~_~_~_~ ,remedies invoked as,Provided in., r.4 r, 0_11240,of ber 2%1 rd g upon:each. SEG SF:16'5215-142605.doc6nv12/2016 38 . . that:event:to,su Mit,:on behalf Ofthemselvesand'their proposed:subcontractors,..CO.mpliance Reports priorto: Ores an iOitiat 04,6fthektikfol'.'nei/Ptiation ofeCorivaa. t.Whenever the CoritratOr"OrsUbCOntractOri.haS 0.0pilective bargaining agreernentbr-other'contractor- , underS6nding,Vith.a labor union or an agency referring workers or providing or supervising apprenticeship or training for such workers,the Compliance.keportshaliinclude such information'as td:such 1aborunions:br agency's Prattk*.S::and'POliCieSaffetting.Odriuillante;as the Secretary of Labor mayprescribel,..OroVided,Ahattd tho-exteptSq4kinformatiOpJsWitliinthe:*CIUsiye possession of a labor union or an agency refernn6.workerSAt providing or supervisingapprenticeShloor training and such labor union or egenty-,ShagrefUSetefprolSh such infOrmatIOn.to.thecontractor,,thecoritraCtor shags°.certify to thet ecretaryottaboraspartof its Compliance RepOrtandthaji.SetfdrthWhateffOrts,heheSrnatietdebtainsu.Ch information. • d,The seertary...Of Labor may direttthet..any bidder or or subcontractor shall submit,as part of his tompliance:Reportio.,.statement iv.vjttng,signect byapauthorized officer or agent on behalf of any labor union or any agency referring workers orproViding:or superVising,apprenticeship•orother-training,with which the bidder or prOspectiVecOntratter deals,With:supportingi'infenriation,taitheeffectthat thesignees practices and policies do obbAlS4nrOinateorvthel:gropn40 of race,ColoGreligiOn;SeX,SeXUal'OrientatiOn,,.g ender identity,,m-national origin,and that the signer either will affirmatively0000*e in theiMPlementation of the policy and provisions of this...Orderor that it consents and agrees that teeruitrnent,.8voloyment,enO the terms and.ConditionS of eniployment.underthepr000sedContract shall:be inaccordance Withltiepurposesand provisions ofthe order ri.:;;:theeyentthettnetinion,..or the agency shall refuse to execute such a statement,the Compliance Report shall so 4004fvencli. etforth...*fiefeffsfirtS'have been.macietri SetiireSOCI .a.staternent and sucir.additional factual material.as:theSecretary of Labor rnayreqme ec..203 amended by EQ11375,0 1967,..-.32.ER 14303,3i.CER,1966•-i97.0 p.:•168.4,,,..Eiti 1.2086•ofOct., 5:,:107.0,43.FR46501,--1,CFK 1970 COMP'4..0.230,E0 13672 ofIuly21,.21:04,:79.'F"..k.45711: SEC.204: Tnesecreory..::Of Labor may,When the sedetaq,00erns'thatsUecialitlitumstan4eS in the national interest so; require,exempt a contracting agency from the requirement Ofinckidiriganyor,aWof.dieprovisionSOf Section 202 of this.order in anyspetificcontratt,.subcontrectforptirchase order, 'b.-..TheSecretary,of Labor may,.by rule or regulation,exempt certain classes of contracts,subcontracts,or purchase order0...(1)WherieVer work is tO'be'or.haS".-been performed outside the United States and no recruitment of workers within 11010.0fthlJnited$tateSls.,10VOlved:r(2)for standard commercial supplies or raw materials;(3iinvolVing less than spedfiedamount.S..Of money or specified pumpers.of workers,or(4):itdtne extent that they inyolVestibcoritrads.below a specified tier C.SeCtiOn202-OfthiS:ONef$11011.06t:apply tdarlOV-.erninent.co ntractor:or subcontractor:that is a religious. corporation,association,educatiOnal..institutiok.Or society,Mth reStie4kbOthe.eril0Ovrnerit of incli*idual.S Ole particular religion to perform work connected with dieorrying.opoysothcorporations;:associalleri,educational institUt(on,.or society of Such and,subcontractors are not exempted or excused from, Compl-y.lhg.with the otherreguirem.ents contained inthis order: d.The,Secretary may alo.provIce,,,ltiy.rOiej reijolapOh,:o,Orkr,..fOr the*ervp,tion:of fatititles'ref contrattorthatAro.in all reSpectl-Separateend distinct:frOM activities of the contractor related to the performance:6f thecentractprovided,::thk'suchan!eXemptiorivoill=not.intettre wittforimpOtio-theieffectotleu ofbhe:pirposesofbbis..0rder:and provided further,that inthe absence such an'exemption all facilities shall be-COVered bYtho provisions of thiS,01400.., 1$04,204.0Mended by EC)1279E.Of130.C,,1.6,2002,...§7.fR 774.41,3j:FR,20.0Z.:041P,:o.-0:7714.1.-77144] • . .• Subpart C,-...Powers and Duties.Pu0e4,of th0%.r.0tY of 1.41/0. rarvd the•ContractOig Agencies. SF:16-5215-142605.doc/rev 12/2016 39 SE ..205. The Secretary of Laborshalite responsiblefor securing compliance by ali,Gevemmeritcontradors and subcontractors. With this Order and any implementing rules or regulations.All contracting agencies shall comply with the terms of this order and any implementing rules,regulations,or orders of the Secretary of Labor Contracting agendesShalltOoperate With the Secrtary Oft.abOr'and shall furnish such kite:010bn and aSsistainceetthe Setretaryjny ISet,2.0S aniendertby 01-)42.0.86,of Oct.5;-197'8,15 FR 46501,j tFrt,'1.97 coropq . a The Sacretary of Labor may investigate the employment practices Of any:cevontnent:OintrOttof or subcontractor to determine whether or not the contractual provisions specified in Section 202 of this Order have beenNialated.,Such'inveStigation shall be conducted in accordance with The proceduresfestatilished by the :SeCre::tarYor Labor. • hi!:TheSetretarYOftatiee may receiVeand inVeStigeteCOmPlaints by erñp!oyèesbrprospeCtivg grn ploVgeOfa. Government contractor or subcontractor which allege discriMination contrary to the cOritrattual:provisions specified inSection 202 of this Order. 206l amended EQ 12085*Oct 5.,:197.8,-43.F.R 465,01,3.:CFR,i197.8 Conip4 P.;23,01 SEC;.207 The Secretary Of Labor shall use hisiher best efforts,directly,and through Interested Federal,State,.and local agencies, contractors,and all other available instrumentalities to:cause any labor union engaged work under Government contracts or arrsiagehey•referritig workers or providing'or supervising apprenticeship or training for Or in the course Of . such work to cooperate in the implementation of the purposes cirden'The-SeCretanrof Labor shall,inappropriate. cases,notify theEqualCfimployment OpportunityCommission,the Department ofJustirm,or other appropriate federal agencies whenever it has reason to believe that the;practices of any such labor organization or agency violate Title VI or Title VII of the Civil Right Ad Cif 1964 or other proViSitiet Offederal . .[Sec,20.7ainend0 btaci42085 Of Oct:5;:1978,43 FR,46504 3 CFRI 19.7E3 cpnig,ip,2361 SEC.',ZOO e Secretary of Labor,or any agency,officer,or employee in the executive branch:Of:the Government designated by rule,regulation,or order Of theSeCretary,may hold such heaeings,public:prpriyatei as the Secretarymay:deemadvisablefar compliance,enforcement,or educational purposes. b.The Secretary of Labor may hold,or cause to:be beld,'hearingsin..accordance with Subsection of this Section prior to jrnPOSing,.ordering,or recommending the.inipositkip of penalties and under this Order No :Order for debarment any contractor from further Government contracts under Section 209(6)shall be made without affording the contractor an opportunity for a heating:, • SObpart,P—:.Snctionp:and Pena!tiés In SE4.49 accordance.witnsy.....rh regulations,or orders ea, ho. egptary of Labor may issue or adopt,the Secretary may:: 1:..kbrIsh,:or cause:to be published,f the names:Of:contractors:or:unions which it haS condudecf have complied or have failed to comply with the provisions of this Order or of the rules,regulations,and-Orders:of the Secretary :of LabOr, 2.RedoMmend..tothepepartrnentef•Josticethat,in cases inwhich the,re is substantial.or materialAtiolption,Or the threat of sUbStantlal or.•material violation of the contractual provisions setforth in:SeCtion 202.:ofthisbrileri appropriate:proceedingSbe brought to:enforce:those proviSions„Including the enjoining,within the limitations SF:16-5215-142605.doc/rev 12/2016 40 !of fapolicpwolov,!,„Qtorp*.o.000,...irOividgmt,.:07.groups Who pteVent directly or indirectly,OrSeeic:tO prevent directly or Indirectiw.compliancewith.the proVisions of this.Order. 3.Recommend tp.t.t00 plotjyrolotpopipt4:0.4.CoMMisSiOnor the Doftirient .3100i.t11 ::Otitifp.tifi*e proceedings.be instituted under Title CivilllightsACt ofi§64, 4,Ro. tirloodto oiopopoirttriot:of10ce.that itirnioat proceedings 00bitoglitfOr falSe infOrrnotiont0 any'Cootractingagencyor.t-oltheSecretaiy.Of.LOOr.as'theOsoney .5.After:consultihg with thecontracting agencyidireathe contracting agencyto.cance1,-;terrninate,suspend,or cause te be cancelled,terminated,or suspended,any contract,or portion or portions'thereof,for foNee:of the:contraCtoror subcontractor to.comply Wititequaiemploymentopportunityprovilions of the contract. Contracts,maybe cancelled,terminated,:or suspended absolutely or continuanceof contracts may be col-403.W:blicm.a:PiP91:011 fOr the Secretary. 6.Pipiidp:.,thot any contracting agency.shall rp.fraiil from entering Into further contracts,or extensions or other- modifications of existing contracts,with any 06itotioyieici.sntl'Aqojii;.otito such eooti*.to has satisfied the: Seitetattcif Labor diatsuch contractor has ettahlished and.Wiltoarry out persdrinel.and emplOyenent policies lii. 'compliance with:the provisions of this Order. ( ).PurgOrlt 0.:(0100.010 r0:90:141040 prescribed ilit110:04Pti..Sr:PT.Whorl tJW siaceePriA01mak004Sono010 qfOrt4i- within.a reasonable time Iiinitationito secure compliance with the contract provisionsof this Order by methods of cOnferenCe„.itiodook*,:mediatiOn,and persuasion before proceedings shall be instituted under sUbseCtiOrila)(?).Orthis Section,Or,pefOrda diritraCt shalt,be:cant:61[0d or teririinated iowhole Of:in:part under subsection(a)(5)i:of vlis section, [Sec 209 amended"by.Ei3:12686:,,otocL 5,1978,43:F1i465011 3.CR,1978 Comp.,p.230] SEC.::210 Whenever the Secretaryof Labor makes adetermination underettion100,the Secretaryshalipromptly notify the appropriate agen The agency shall take the action directed by the Secretary and shalt report the results of the action it has taken to the Secretary of Labor within such time as the Secretary shall speClfY.if the contracting agency fails to: take the action diieutèd within thirty days,the:-Secretary.i-nay take the;:actiowdirectly, [Sec.21:0 aiiendedby v?:12666,tif Cd.5,:197.8,43 FR:46501, 1978:coop:, S,M If the Secretary shall so,direct,contracting.egencices:.thall notenter into contracts with any bidder or prospective contraciorunless the bidder or prospective has:satisfadorily.compiled with the:provisions ofthis.Order or StibrnitS a'prograrn for the:SectetarY Of a[ [Sec.211 amended by 042086OfOct. 1978,43 Fil..46501,3CFR,1978 Comp:,p230] SEC. 212 When contract has been cancelled or terminated under SeCtior(20.9(aX5),,or a contractor has been deberred,frorn • further Government contracts under sectiowm(e)(8)ofto Order,because of nOnCOMplianCeWittf:theContract provisions specified-la:Section 20.2.of this Order,:theT,9eaetary.of Labor shall promptly notify the Comptroller deneraf:of the Uriitect States; [Sec.212 amended by EO12086.Of Oct,5,4978,43.FR 46501,3.CFR,1978 Comp, StilipaitE—Cértificatés of.Piletirt SEC. 213 • • SF:16-5215-142605.doc/rev 12/2016 41 • T ie Seaetary.of:Labor.may provide for issuance.ofa United.States,Government Certificated Merit to employers or labor :unions,;or otheragenpes which are or may hereafter be engaged;.in,work under Government contracts,if the Secretary: isotisroothetfthePerSonriel and employment practices of the employer,or that the personnel,training,epprenticeshiip, membership,grievance..and representation,upgrading,and other practicespraCdcteSand polices ofthe labor.union or.other agencyrnnform'to the purposes:and provisions:ofthlsOrder. SEC..214 Any Certificate:of Merit'may atanytimebe suspended or revoked by the Secretary;of Labor if the holder thereof,in the. judgment.of the.Secr:eta y,hes;failed to,comply with the provisions•of this Order. SEC.215 • The Secretary of Labor.may provide for the exemption:of any employer,labor union,or other:agency from any reporting requirementsimposed under or`pursuantto this,Order if such employer,.laborunion,::or:otheragency has been:.awarded a Certificate ofMent which has not been suspended or revoked. Part III--Nondiscrrmrnation Provisions in Federally Assisteed Cons#ruct>oir Contracts~ SEC.$01, Each executive d'epartment,and agency,Which administers a program involving Federal tlnarroal`assistanee shall require as a condition for the approval of any grant,contract,loan,insurance,or guarantee thereunder,which may involve construction contract,:that the applicant forfecieral assistance undertakeand:agree.to incorporete,;or cause to be incorporated,,irito all construction contracts paid,for in whole or,in:part with-.funds obta►ned from the Federal Government or borrowed on,the credit of the Federal Government:pursuant to,such grant„contract;loan,insurance,or• guarantee,orundertaken pursuant to.any Federal,'program involving such;grant,ccntract,,loan,insurance,,or guarantee;the provisions prescribed for:Government contracts by Section 202 of this Order or such modification thereof,preserving in substance;the contractors<obligations therreunder,,:es may:be:approved by the:Secretary of Labor,: together with Sufi additional provisions the Secretary deems appropriate to establish and;'protect the interest of:tle United:States in the enforcement`.of those obligations Each such applicant shall also undertake•and agree( ')to assist and cooperate,act velywith the Secretary'of Laborin obtaining the compliance ofcontractors and subcontractors.witi those ceht(ett provisions and with.the rules,reg.ulations:and relevant orders oftheSecretary,(2)to obtain and to furnish to the Secretary of Labor such.infOrinatiOk as the Secretary may require for;the supervision of such coinpliar ce, to ca out (.) ny sanctionsand penalties foc violation ofsuel obligations imposed upon contractors and subaintractors by the:Secretary of Labor pursuant to.Part U,,:Subpart D,;of this Order,and.f 4)to refrain from entering into any coritratt subjectto this:Order,.orextension or other modification of.sudi:a::contract with acontractor debarred from Government contracts underPart II;Subpart D,of this:Order:: [Sec.301 amended by'EO-12086 ofOct.:5,1978 43 FR'46501,.3 CFR,1978•Comp:,p 2301 SEC 302 a.'Construction contract as used`in this Order means any contract for the construction rehabilitation,alteration, conversion,extension,or repairrepaircf buildings,highways,or.other improvements:to real.property:. b:The provisions;of Part II of this Order sfia apply:to such construction contracts,and for purposes of such application the.:administering department or agency shall be considered the;contracting agency referred to: therein. c The term neppliicant"as;used in this Order means an applicant for Federal assistance.or,as determined:by .:agency regulation,other'progiam participent,,wiith respect to:WhoM:a0 application for any grant,contract,loan, `insurance,orguarantee•is not finally acted upon prior to the date of this Fart,and it indudessuch en applicant after he/she:becomes a recipient such Federal assistance.: SEC.303 • SF:16-5215-142605.doc/rev 12/2016 42 • a The Secretary:of Labor shall he responsible for obtaining the CO mpliance:ofsuch.applicants with their undertakings under this Order.FOr.11:4drrithishOr104dotiartuioht and o 6rifcyjs dir*ted'tO cooperate Wit4 the seattetv-iif Labor and to furnish the.SedretarySOCh information assistance as the Secretary may reitVire:in the.perfO rmance the.Secretary'S'fimetions under Order. 10 the event ou:oppilaut fails and rell:*sloi cool*with:tho'ApplOrg.'5.:.uudertoidrigs'E.ours000.to this Or ër tho,. .ecretary.ot.1.abor may,after consulting with the administering department or agency;takeanyor.04'of the following actions (1)direct any administering department Or agency to cancel,terminate,Or. 6*3000,in whole or in parttheagreerrienticontreCt•OrOtnet.***0*it with such applicant With,4;...eS000:Yj which the failure or refusal'occurred;, 2j direct any administering:department Or agency to:refrain:from:extending any further assistance to thezpOlicant under the,program with respect owhich thefaiture or Tefusatbcairred satisfaCtOry`assurance of future ocONiar*ho been receNedbYtne-secretary of Labor from such.applicant; and 0 'referthe:•CaSeto theDepartrneritc;ifJuSticeor the Equal OtiplOyrnent Opportunity Commission for appropriate law enfOrcernent.Or:other proceed-111gs. c.10 casesball 40iOtitie;takeh;:yyith:re$00# "Nr.0,cietittd.0000(1)or(2)OfSiihSection(h.) Without notice andoppo rturiity for hearing, [Sec::303 0 4040 of.Pct.•5,1,974,.43:FR 400,014 074;Ornu.,]P.:230] SEC.104 Anytkecuthie'dePottrlieot or agency which imposes by rule],regulation or orderteAuirenients of nondiscrimination in employment,:other thamrequirements'imposed pursuant to this Order may•delegateta.the.Secretaryof tabor.by agreement such reSpOnsibilitleSWith.reSpect to compliance standards,repertS„.:andprOceduresasi would tend td...bring' the administration of such requirements iuto.opriforrri4with,the'qdrhirlistropoo:uf requirements imposed under this Order:ProYitied,..lhat actions-to effectcompliance by:recipients of Federal finandaIassistance with requirements: imposed pursuant to Title VT of the Civil Rights Art of 1964-shal1be taken in conformity with the procedures andE limitations prescribed in Section, thereof aridtheregtilationS:Of the adrn in istering department Or agency issued thereunder. Part IV—Miscellaneous sEc,,401,. The Secretary oftatiOr.:May delegate to any officer,agerg;er employee the Executive 4rariti-rof the Government, — • • . any funCtiOn or duty:of the Secretary under Parts:Iland ofthis Order. 401.aMend4by-Kl:1:2086.OfOCt.S, F13 46501,3çFR,1„978,.0004:P.230] •SEC,i,:$92 The Secretary of Labor-shall provide administrativesupport forthe execution of the program known asthe'Plansfor Progress.° SEC.403 a.Executive Orders Nos,10.590(January 19,1:9$51..,10722,(August 5.4957),10925'(ilarCh 6„.1561.),1.1.114 (JUnel'.a2e,t9,q),and 14162(July 28,1:9104);are:.tierehysuperseded and the Presidents Committee oh Equal Empluymentopourtunity.establitheoy Erecuthe6Order.Na.16925 is herebyabolisheci,All records and property:in die custody of the•Committee shaltbetransferred:tothe Office of Personnel llanagement and the :,$00-eterif Oftetitir,,:as,a0ratiriete . . „ . b. Nothing.in thiSOrder shall be'deemed to relievezny person of any obligation assumed or imposed under or: pursuant to any Executive Order superseded'by.this'order.All rules,rogulatiorts,•orr)ers;.instructioris, d000hatiOnS4and other directives issuoc1.by thOpresidOrit's400mittooun Equal Employment Opportunity and those itsUed bythe:heads of WriouS.departnients.br agendeS,Urider or pUrsuatit Watiy of the EXOttitiveorders superseded:1w thiSOrder,:shall;tpAheextent:tha-they'are:not friconSist.eut.with this Order,remain in:NlifOrce • SF:16-5215-142605.doc/rev 12/2016 43 • and effect Unlessand until revoked or superseded by,appropriate authority.References in such.directivesto provisions of the superseded orders shell be deemed to be references to the comparable provisions of this Order. [Sec.403 amended by E012107 61Dec.28,1979,44 FR 1055,3'CFR,1978 Comp.,p,264] SEC 404 The General Services shall take appropriate action to revise the standard Government contract forms tO accord with the provisions of this.Order and of the rules and regulations cif the Secretary of Labor. SEC.405 This Order shall become:effective thirty days after the date of thisbrder. SF:16-5215-142605.doc/rev 12/2016 44 • EXECUTED IN DUPLICATE BOND NO. GS24600018 . PREMIUM: $2,352.00 PERFORMANCE 0046 PREMIUM IS FOR CONTRACT TERM AND IS SUBJECT TO ADJUSTMENT BASED ON FINAL CONTRACT PRICE OCONALLOWitlatief 3YllilE490.14RESE07.4%;:. WHEREAS,Pk.fiflitspitiOrg444,X***4!ifttErecPkrtgtoitiVAOstirivriii*:VNemetittratiliti • . A2Z CONSTRUCT,INC: . . P.O.BOX 80425,RANCHO SANTA MARGARITA,CA 92688 .. „: . ' . • . . . . . . . . . . . tfaillePandaddisaSgavotta404 Mtiviriattittt..tafarradlip 440:perforiaaa*,..0914.400454eaci(bgdias kiikwgt CENTRAL LIBRARY LOWER LEVEL.RESTROOM ADA IMPROVEMENTS,CC-1658. . . . • (Rrject Title). WHEREAS, Said . . . . 0004#01.•....000.all documents 00fritetti011jetel6 tbafe$041tat 0E0000 Zis.tftb;i1..:are. ptittli*Of:asitiotigh.-ittforth herein irUfull:and tici4P0444.0:,: gultadollaritla.:10070.af:.ttig:0*gaalt1410#00aitilt*aiteata§460,0.004 riOttir0 potiaManca,01404 it4itintaik by 14.4* admitted sum*sinsurer under the laws:Of the State.of •-04rfOiliiitgiorefOtiftertefertSkt."*'!$OtiliatiOd, PM .001140, and' ,1161OO'ilir,the titS,.ZapagiaatitOta.:Tfeaa.tay-Oiroular and talk p**0.prpof !•-•.g.Ticjellt.:14PrAdiogi litnitalioris as;119.Wn in said lo:provicie bonds itt the V000pt...t.0,41 :d.by said %01414.11110. "..f,;.4101.301aPTSERidedlihant40:43trioORik.::00,04itla,Faputaiik.campaafealaar* Standard tt.P6c4:140,6001.014.t Burety4,1400.01.0**.00.040F1*****007 ttfikklikid Supity..is.registered And hated with 01.0.0.01.100110434PadtPeni41004MOg,. NOW,THERWORE00,:ihigur*rsigOottiortilvtpat and THE GRAY CASUALTY&SURETY COMPANY • 1225 WEST CAUSEWAY APPROACH,MANDEVILLE,LA 70471 • . . . . • 110,10-*kiiitgTOMIOS . • iti*BUttliej IgOihiococykno:o!toro top;att ihA#ai:Mirial:atincif—ONE,HUNDRED.SEVENTEEN • • THOUSAND SIX HUNDRED AND 00/100 • • ' . . . . . • .06.1104 rs...1 17,600.00 this'arroiOrki*OgnOtiew.lhanf.DOOihOntifell vaiverit,prtio0P0-?settlifrIn the Contract,In**NI inOkiy'effltie.iittObtk'Stato*;ifit sum,well and truly we bind Olif*leti.0..caaataac***Igkatiliff firitt****404,W...010WOranAtiaM.these; WOO*, , . VitObititlibtf-r5#7141kist30.00ag tlikrif**Piiiiiit**Olt#0041404.*,onittifititz* 00#00#40041..4.0tt#1#ihR..00006.3.04.101.040400*010.IttiNg10 be done and 0.40ralaitt by the Et.1000:01'10:. ittibt,a0o0n;14roo.vithibo,tarrwOfiho'044rOMotrfo**10.;..w41464..marPaOlteM3200MOrtaedOr modified h7Pm V.P*101000arid Wtheiniticgal...01t4It 0.11$01.0.0aktiaPhiOr-tati****1§104'16,0,701400:f044**4.011040k411.00.404.0 c4.4inti.:),24Tieritik)stoPTict069003.*:**440:tfr00041#611i***.le,FoeiLV0**JP:V;141% **11.0W1.iititioOtilittAttl*OfkloodittegisoMofibotalloro4griltfatittpottty.0.10.0vmfafintipolialbo, pottotro**o.osif..40 Othoteinworthe..,ciblVario40.4f*O•POOPOOt,104414.011 tettord0.60i..***i00 :460'1041*onoffitTiigiik*ri 'artioarairitioa..*:*Paratit***Ore0::thafaaiitliik.thea.;thlt,tutia0ak 040;00 voici;.,0thogrodge.i It otitilitevidi it*ternaitii0 filitiorg.e.nuftiffect• •St*.k.'4001.4tkikPflPt.P.00.,.**Ioe,re:ciewattAtvot no 440410atif of the or prIce In the Contract a.0.11y! altPreecTS.ghOriPas.401Edioniiitdditiary or other 10;fhoPpntrigk.ta‘lhe.4**tiii4*ki*O0, ther00000,,0611TO anyway•affect,itnit;7eo4jiOtsitrogIvorrekoeitteObikAlOtOrtile**yooiiertiiii• tOtItt, %TekyirOtottriOlite;Of'frO0Iyitrtliftt of contract or contract Or*and arlypitlatattartaOkaagai,... isEkdon,aiotiamorztbersnowtotormottiotiott*t-artfieViditt'bkperformOdlhOptOor,aprlAtit.04 • gotsgitarttn. .. . , . GS24600018 lb Auto/pig:R*1y,Odgittilip.tieosivoofitiliclimIdio*Oviai:Aktetertergoi 01..ter#1,0rt%OrarOas„. eftileiOnsi 0001:14,43CtithritticKifIciatippS., Nret 110***0.0,006100t071 cgternattiMid*Ohj .. 0040frittIpf***4,0011****PIti carteWbaSs Soti**b-ii***.ltifi . . .OrtAniiki.18404.1:r400-$::04.40:01,04%. lliii,0414001**Iiiit.:0014.011..***Ihtittliqitth*:.10#11000.****40.41.060041#::OS:10, all'Orig0-000,00101.714kg.4.04,.Prit*EillOilOh*Otivir*.i.cmolsfovOlp: INVITO-r4WHEREP:FkAadir 004.1001*40..ahOist0410*.attiotistoitiveittr*:400.tioy Nktr4044"P.OIiiii0..Ruidisorot on ti*dat*.ofoiiiii*Gw.,044*.norno of 0,0*.0,06204:Or* •.0000****040is;iiiphoort0.000:01901 imo*.arolhilahe.itiditik**4003:(WitIstoritit. the OrItIefiTlf411007;0000; Surety,0:,60604000 this bt:INI WalV410*.til#AMM*Ifich=4-0T8t,141$14rtle.Ir.t*Velzi,rf**6011:or.any f011.4te,rif the, Pr10001:****01000,ptirit.**40,00:004... - - Delia NOVEMBER 2,2023 - .41.r.rEST. A2Z CONSTRUCT,INC. , .. .. .. (coeP9reite-$*/.. • . ”...' . 1)41:** _ .. _ • . . SEE CALIFORNIA NoTARY,ATTACHED .*Onip: . TPt. ..criAt rf • - tft*fifv.5-1411-11. . . . • : ., .. 'THE GRAYCASUALTY&SURETY COMPANY 10000ite$01) • IA (4i.finViliii$1:i ,1111111 .5, O. rvir/Prvb- , . riiiiiim..MARK D.IATAROLA,ATTORNEY-IN-FACT ' . ' Ofiri04044fM4OW46,016t#S4ftity) #0140kilfW0-ractOtl..111#0# Z4 21Ft-nS.15 -• - • •.:• • • **,*)ciii4Ail.ekOVItelOtri**11r..40itijy): . . OPiticive.b.*6:40:0000,w., '-e, • 4: • - • ,", . . . . , :: ,:',000; -7.: ... •-- iak. ' :....-'.•. • ..*, ..• ..._,..„_,.." ' - ... --e ' 1.•:' ':.:..*:•thittifk.WFT-ofnwx:. . 1.._42r. ...,. .. • • Nort;:.Ifits.ivariAmkottig•oxfoutioOdoPf.0414001.04#1,406.***0.40,4100*,.-oetotitkitoiett*. iithodikrif.tirlY,P0008,3iiriv't*.at000)40,..00#44.014:4 .F.Eit#.0.***1*i3Optti. raii0..pia 045tatino* CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of SAN DIEGO J} On 11/2/2023 before me, TRACY LYNN RODRIGUEZ, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared MARK D. IATAROLA Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s)whose names)is/we-subscribed to the within instrument and acknowledged to me that he/3hc/they executed the same in his/herftheir authorized capacity(ies), and that by his/licr/their signature(s) on the instrument the person(s),or the entity upon behalf of which the persons acted,executed the instrument. I certify under PENALTY OF PERJURY under the .....,;. TRACY LYNN RODRIGUEZ1 laws of the State of California that the foregoing r ;alli ':. COMM.#2318838 D paragraph is true and correct. Z`" y' - SAN DIEGO COUNTY > NOTARY PUBLIC-CALIFORNIAZ WITNESS my hand and official seal. MY COMMISSION EXPIRES JANUARY 1 1,2024 Signature I Jl+ •�� Place Notary Seal and/or Stamp Above Si.t•ture • .. 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: MARK D. IATAROLA Signer's Name: ❑Corporate Officer—Title(s): 0 Corporate Officer—Title(s): ❑ Partner— 0 Limited 0 General 0 Partner— 0 Limited ❑ General ❑ Individual Si Attorney in Fact ❑ Individual 0 Attorney in Fact ❑ Trustee 0 Guardian of Conservator 0 Trustee 0 Guardian of Conservator ❑ Other: ❑ Other: Signer is Representing: Signer is Representing: ©2017 National Notary Association Helen Maloney&Associates Insurance Servi, 11/02/2023 09:19 1300356065753 THE GRAY INSURANCE COMPANY THE GRAY CASUALTY&SURETY COMPANY GENERAL POWER OF ATTORNEY Bond Number:GS24600018 Principal:A2Z CONSTRUCT,INC. Project: CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS,CC-1658 KNOW ALL BY THESE PRESENTS,THAT The Gray Insurance Company and The Gray Casualty&Surety Company,corporations duly organized and existing under the laws of Louisiana,and having their principal offices in Metairie,Louisiana,do hereby make,constitute,and appoint John G.Maloney,Helen Maloney,and Mark D.latarola of Escondido,California jointly and severally on behalf of each of the Companies named above its true and lawful Attomey(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its deed,bonds,or other writings obligatory in the nature of a bond,as surety,contracts of suretyship as are or may be required or permitted by law,regulation, contract or otherwise,provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed the amount of $25,000,000.00. This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both The Gray Insurance Company and The Gray Casualty&Surety Company at meetings duly called and held on the 26's day of June,2003. . "RESOLVED,that the President,Executive Vice President,any Vice President,or the Secretary be and each or any of them hereby is authorized to execute a power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings,and all contracts of surety,and that each or any of them is hereby authorized to attest to the execution of such Power of Attorney,and to attach the seal of the Company;and it is FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be binding upon the Company now and in the future when so affixed with regard to any bond,undertaking or contract of surety to which it is attached. IN WITNESS WHEREOF,The Gray Insurance Company and The Gray Casualty&Surety Company have caused their official seals to be hereinto affixed,and these presents to be signed by their authorized officers this 4a'day of November,2022. ua,i4,. *(4.01.- 74W• (-17() ,,:TY & a cif l n SEAL t BY Michael T.Gray Cullen S.Piske �1 SEAL sg �,t _ y President President o1 ti. y .,,,w,,, The Gray Insurance Company The Gray Casualty&Surety Company y .�, ,."- State of Louisiana ss: . Parish of Jefferson On this 4th day of November,2022,before me,a Notary Public,personally appeared Michael T.Gray,President of The Gray Insurance Company,and Cullen S.Piske,President of The Gray Casualty&Surety Company,personally known to me,being duly sworn,acknowledged that they signed the above Power of Attorney and affixed the seals of the companies as officers of,and acknowledged said instrument to be the voluntary act and deed,of their companies. • � cam— . e L'ei9li Anne'Her�iba,i e+" .�.�I Nbt2ry Public~ iv." -,,,,,; Leigh Anne Henican Notary ID No,:.9.2E53 Notary Public,Parish of Orleans State of Louisiana 7 Orleans Parish,Laulsia.na My Commission is for Life I,Mark S.Manguno,Secretary of The Gray Insurance Company,do hereby certify that the above and forgoing is a true and correct copy of a . Power of Attorney given by the companies,which is still in full force and effect.IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Company this 2ND day of NOVEMBER ,2023 0/44/440•1/044°‘ I,Leigh Anne Henican,Secretary of The Gray Casualty&Surety Company,do hereby certify that the above and forgoing is a true and correct copy of a Power of Attorney given by the companies,which is still in full force and effect.IN WITNESS WHEREOF,I have set my hand. and affixed the seals of the Company this 2ND day of NOVEMBER ,2023 . `�+'.c�L 'Li' ,• .Vf in, 6,t.),yV,_,) _ of SEAL s 117 ofc SEAL i i&. o _ 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 November 3rd 2023 before me, Tejal Munsif, Notary Public (insert name and title of the officer) personally appeared Matthew Jafari who proved to me on the basis of satisfactory evidence to be the •- op(whose nam= )e-re su cribed to the within instrument and ackno g d to me tha 4D e/they executed the same in his/ er/their authorized capacity(ies), and that b hi her/their sign- re(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 an official seal. sf, . TEJALMUNSIF Notary public-California • Z -r Orange County Commission M 2335015 ` "'�My Comm,Expires Oct 17,2024 Signature _ (Seal) aktrcjj\D__r3Q- — F \ (L)/\II/\/\a A kCQ (-e)" . 0Skye) DOO EXECUTED IN DUPLICATE BOND NO. GS2460001 8 PREMIUM INCLUDED IN PERFORMANCE BOND PAYMENT•BOND` .. w.:.''A ...PERSONS:BY T# ESE'PREStrigs;',,: Witiktxt tlitof Wul rs ters r referred to As"CIty"'y 4as:awllardeid i`,p-. . . A2Z CONSTRUCT,INC. . .P.O.BOX.80425.RANCHO SANTA MARGARITA;CA''92688 .tt0.6.e and• .pf'Contractor). (hereinafter;re.**d.laas.'Principatt:a'I a e':C:Contracf)for ie:woifc'ddesst ,folk as:,. CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS,CC-1658 . • WHEREAS, Pririrapei'le:"q urted under#(fie terms of ttte C c t'egd 14*..0;i..Iifornia.Civil:'0ode 1 fil ish-a ,,bid to secure he payni of claims of lat rs,mec har�r,3iiatenalmen,and other•persons asgrovictedb La wt by a•doty**mot surety insurer under the laws o!f^the ..of Ca uca daereinaffer rtflitred':to•as. ''Surf};aced:• • is'Oettftadand:listed i trite U.S • c re Tr> ury Ctrrular 70,and has ovided proof ref bonding.Iicr oris•cis shown•:in;saki !far tp provide bands in the ar;bunt required by said: CDntnadi;:attid *tic hats prisuided firtanaai engtlt*Ogg from a putable impenies, hi Best;A ctioe40 pr' sOIBBatxt.to.Plaors,10 t.,Surety'has positi*.ratings Of being:,seclare:or.s le;an Surety is tegl d and J fi•Noltfi't a tit :%'> erb'netit:a#1044 NOW 7.00..i.OSIR .:.s*, he::unde sItno.d***at ci ti , ..;..... . . • ' THE GRAY•CASUALTY&SURETY COMPANY. 1225 WEST CAUSEWAY APPROACH MANDEVILLE,LA 70471 . 0400.!0**1' :of Suurety) t s:Surett,areheld and m ly bofund'tat+ +y+,in the penalsum ONE HUNDRED SEVENTEEN THOUSAND.SIX HUNDRED AND 00/100• t ($117,600.00 1,this amountbeing not tessthan one hundred•petceht;.( Q%%} total price set f id' ,in•lawful tr ay of the United States oY America,ft '. 040•O,scum,well , lQ j E Et we bind:.our*Sitii•and Bath Af'o ur h stirs,, ei utora;..sdminimtrators,: .and'ass :ne,:: .ri !'and selraiadi ;'firmly by'these pr THE CONDITEO OF7tiIS OB IGATION IS SUC.CH.Tt AT,ii:the Pamc+pat, .her,orits elt#Olo itdra, i rim rs or ,yr ailbcordraators shall tR pay . ttie Pis namerd in,.Section 3.11il of•the Caltforpia Civil C laltile. s"t for aIl`°labor,mate ritsis 4).r Agp,40igt.u0xt ar reasonablyrequired for ootinp ►mti10 oftlte dent abed In the 6a ,#ar Arty amounts due i nderth a Urtemployi tt. Ern tnce•Cnde ill( ,,e i 40'w4+ri!,e or taib irperformed b?:any 5u01 Claimant orprevafir wragesdua:•and proiegt.inerrn ed.porwari'ta•8e,c rs 1774,1 18l or 1815 s 'the Lei.Doda,as ani►amen required io be dsdt ,:wtttitoim:a d paid**,buii•ie Development t +�'f�+the l of er yleee:nfttie PrL'it t aria[Su ntr 'pt at'tt"t Sectiion 1 of. tlnemnpl ometnt insurancew4*-1especttothe work'or lborpoiformed underthe ontract, etyl ll pay for same; hi:fin amou t naf; ngdtiepe'naI sum.spesafied"in this'ond; r+wise:,his obli ton atiall be.nulland ' T bona ehaii Inure'fctffie tienefrttof ttly'alliMpampta.44thimerl i i Se<ztlon.3181 of"thie>Catiforrria Civil_Code •so as to•ghee:.e right of ionho 00t.careens orfheirassigns. In case Snyactionis:broitgtlt;t pun this bond, Surety isirther+ es-tQ pay..all:curt sand a e:ttttortrey''s.fl a in an amaupttio*,by the opurt, 1?.4t4501`HC 1? .Pa a'4 b!'1t e • Surety i4440.1.5.and agrees,for value received,itipts.no,*0100,,extension,of time.alteration, iddifitiet-oemodthcatiort.toffie for*of the Contra ,fit*ix:sooektr#ot.documentor any workto be 01101#601000000:4;****.:,;***fitiroc **.it,*tiokitisgoryrax46act impair Of MOO* 11**0110404,4.1t eioett onotoikulot,Ookliitrox waives ntica oF any such change, 040400 of lime;011erAilono.klifftkEti,*aciiikftitilhoetot al the Contract.ti*goiitrAO: 4000OiOnto.to7 thOi000,14.1.00.0tOki.*OW,000 waives the provtsirn .of c#1.4M. *Q114Pocie;i§i • • ltiVitt4Et010101E0t...00.,0.04.05MAROSaitt*Or04110100341#40V00040VbeettdOlit exeitOto tOals.,04004ii:0014.0: bctrit4Aiiiidsheolifirix.ouoil.porfEs jndividuals figi0,..b‘eit:34.0uthtpiii0.p4to:00144140;006t404.11F*. .pOw..A.growl#*.giftSart:iit ..,06460L-Wak****.:44****-gtir44,:,'hiiia*****-W tgaii*:.of any failure ri*******prprmoilt extguke.04,004, 031ted.,!NOVEMBER 2,2023 ATMV:f. A2Z CONSTRUCT,INC. • • • • " • • (.000**01), tiggilOt • . . 14Itit‘Al a '15. cid egir I see CALIFORNIA NcirmY.muctIED _.. „ Title-t-rei Slag n ,.THEGRAY:CA$UALTY&SURETY COMPANY . tot. •• *-1---- • • • Name: MARK'D.IATAROLA,.ATTORNEY.-IN-FACT t$J00.0iii:1:AttOrneieltWeiglerrairn.T. • 600!tiOlci70111,c00qc%.0,4. M.218-0,535 . . • . 44.4:060,&Tokii064:10Mti.gehir.Sulkif .APPANttIM: • may " ' •• • • • ...;.14,4014S.i!. . tie" I'401.7#'r wok og000timmtop.:0046.sojsistigralto• 46tostogvziator*:00t000took oonontwatft*. 4woorityo*********Kompsoutpoppototip -rAksislettONO poge.t.t;t1 .1.140603g • I CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§1189 - - - - - - - ®- - A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of SAN DIEGO On 11/2/2023 before me, TRACY LYNN RODRIGUEZ, NOTARY PUBLIC , Date Here Insert Name and Title of the Officer personally appeared MARK D. IATAROLA • Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person($whose name($is/afesubscribed to the within instrument and acknowledged to me that he/eliefthey executed the same in hisAfer/tlieif authorized capacity(ies),and that by his/herftheif signature(e) 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 ^^TRACY LYNN RODRIGUEz� laws of the State of California that the foregoing COMM.#2318838 paragraph is true and correct SAN DIEGO COUNTY D K"4I NOTARY PUBLIC-CALIFORNIAZ WITNESS my hand and official seal. MY COMMISSION EXPIRES JANUARY 11,2024 v v vvv Signature 1 at Place Notary Seal and/or Stamp Above tu f ary Public OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document Description of Attached Document Title or Type of Document Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: MARK D. IATAROLA Signer's Name: ❑Corporate Officer—Title(s): 0 Corporate Officer—Title(s): ❑ Partner— ❑ Limited 0 General 0 Partner— 0 Limited 0 General ❑ Individual ICI Attorney in Fact 0 Individual 0 Attorney in Fact ❑ Trustee 0 Guardian of Conservator 0 Trustee ❑ Guardian of Conservator ❑ Other: 0 Other. Signer is Representing: Signer is Representing: ©2017 National Notary Association ,. Helen Maloney&Associates Insurance Servic 11/02/2023 09:18 1301832065827 THE GRAY INSURANCE COMPANY THE GRAY CASUALTY&SURETY COMPANY r GENERAL POWER OF ATTORNEY Bond Number:GS24600018 Principal:A2Z CONSTRUCT,INC. Project CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS,CC-1658 KNOW ALL BY THESE PRESENTS,THAT The Gray Insurance Company and The Gray Casualty&Surety Company,corporations duly organized and existing under the laws of Louisiana,and having their principal offices in Metairie,Louisiana,do hereby make,constitute,and appoint John G.Maloney,Helen Maloney,and Mark D.Iatarola of Escondido,California jointly and severally on behalf of each of the Companies named above its true and lawful Attorney(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its deed,bonds,or other writings obligatory in the nature of a bond,as surety,contracts of suretyship as are or may be required or permitted by law,regulation, contract or otherwise,provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed the amount of $25,000,000.00. This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both The Gray Insurance Company and The Gray Casualty&Surety Company at meetings duly called and held on the 26th day of June,2003. "RESOLVED,that the President,Executive Vice President,any Vice President,or the Secretary be and each or any of them hereby is authorized to execute a power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings,and all contracts of surety,and that each or any of them is hereby authorized to attest to the execution of such Power of Attorney,and to attach the seal of the Company,and it is FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be binding upon the Company now and in the future when so affixed with regard to any bond,undertaking or contract of surety to which it is attached. IN WITNESS WHEREOF,The Gray Insurance Company and The Gray Casualty&Surety Company have caused their official seals to be hereinto affixed,and these presents to be signed by their authorized officers this 4a'day of November,2022. .4,,..ii.J344v.c, , .1.1#4,1 74er SEAL si: BY Michael T.Gray Cullen S.Piske �i SEAL ;; President President o � 7',, '- The Gray Insurance Company The Gray Casualty&Surety Company '�.�•� ,,,. . * State of Louisiana ss: Parish of Jefferson On this 4'h day of November,2022,before me,a Notary Public,personally appeared Michael T.Gray,President of The Gray Insurance Company,and Cullen S.Piske,President of The Gray Casualty&Surety Company,personally known to me,being duly sworn,acknowledged that they signed the above Power of Attorney and affixed the seals of the companies as officers of and acknowledged said instrument to be the voluntary act and deed,of their companies. Lei9h:Anne:Henicari dvf,),44.-) 81. ,,, v: :Alotary Pukilic Leigh Anne Henican 'III" -I v"' Notary ID No.92653 Notary Public,Parish of Orleans State of Louisiana Orleans Par&h;.Lptilslatna My Commission is for Life I,Mark S.Manguno,Secretary of The Gray Insurance Company,do hereby certify that the above and forgoing is a true and correct copy of a Power of Attorney given by the companies,which is still in full force and effect.IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Company this 2ND day of NOVEMBER , 2023 - 0124,440proorpodilb , I,Leigh Anne Henican,Secretary of The Gray Casualty&Surety Company,do hereby certify that the above and forgoing is a true and correct copy of a Power of Attorney given by the companies,which is still in full force and effect.IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Compan\PLAMAA y pt�hiis�2ND day of NOVEMBER ,2023 tt,4,14....). o SEAL ' o SEAL le' * 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 November 3rd 2023 before me, Tejal Munsif, Notary Public (insert name and title of the officer) personally appeared Matthew Jafari who proved to me on the basis of satisfactory evidence to be the •- song)whose name( sre 'scribed to the within instrument and acknowl-=.=• to me tha 6•he/they executed the same in - er/their authorized capacity(ies), and that by his!'er/their sig - ure(s) on the instrument the ■-rson(s), or the entity upon behalf of which the p-rson(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. „,L TEJAL MUNSIF WITNESS my hand and official seal. L=' - Notary Orang e County California • Commission#2335015 `4L,0,-"' My Comm.Expires Oct 17,2024 Signature (Seal) CuactclArLdi palmev.,1_ (sevci No . acRz - 60000/$ 11/21/23,2:31 PM Company Profile �lllx ON 1 , Ana P „ k pwRirvEl,f711,,FAVAJAM° COMPANY PROFILE Company Profile Company Search Company Information Company Search Results GRAY CASUALTY&SURETY COMPANY(THE) Company P.O. BOX 6202 Information METAIRIE, LA 70009-6202 Old Company Names Old Company Names Effective Date Agent for Service Reference Information Agent For Service NAIC Group List AMANDA GARCIA Lines of Business 330 N Brand Blvd Ste 700 Workers' Glendale CA 91203 Compensation • Complaint and Reference Information Request for Action/Appeals Contact Information NAIC #: 10671 Financial Statements PDF's California Company ID #: 5739-8 Annual Statements Date Authorized in California: 03/14/2012 Quarterly Statements License Status: UNLIMITED-NORMAL Company Complaint Company Company Type: Property &Casualty Performance& State of Domicile: LOUISIANA Comparison Data Company Enforcement Action back to top Composite Complaints Studies Additional Info NAIC Group List Find A Company Representative In NAIC Group #: 1208 GRAY INS GRP Your Area View Financial Lines Of Business Disclaimer The company is authorized to transact business within these lines of insurance. For an explanation of any of these terms, please refer to the glossary. SURETY back to top © 2008 California Department of Insurance https://interactive.web.insurance.ca.gov/companyprofile/companyprofile?event=companyprofile&doFunction=getCompanyProfile&eid=108885 1/1 11/21/23,2:32 PM Surety Bonds-List of Certified Companies GRAY CASUALTY & SURETY COMPANY (THE) (NAIC #10671) BUSINESS ADDRESS: P.O. Box 6202, Metairie, LA 70009 - 6202. PHONE: (504) 888-7790. UNDERWRITING LIMITATION b/: $10,823,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, GA, HI, ID, IL, IN, IA, KS, KY, LA, MD, MI, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OK, PA, RI, SC, SD, TN, TX, UT, VT, VA, WV, WI, WY. INCORPORATED IN: Louisiana. GRAY INSURANCE COMPANY (THE) (NAIC #36307) BUSINESS ADDRESS: P.O. BOX 6202, METAIRIE, LA 70009 - 6202. PHONE: (504) 888-7790. UNDERWRITING LIMITATION b/: $18,396,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY. INCORPORATED IN: Louisiana. Great American Alliance Insurance Company (NAIC #26832) BUSINESS ADDRESS: 301 E. Fourth Street, Cincinnati, OH 45202. PHONE: (513) 369-5000. UNDERWRITING LIMITATION b/: $2,997,000. SURETY LICENSES c,f/: AL, AK, AS, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY. IAlrnnnnnATCn IAI. https://www.fiscal.treasury.gov/surety-bonds/list-certified-companies.html 41/102 AM Best Rating Services The Gray Casualty & Surety Company BestLink i1 AMB#:011955 NAIC#:10671 FEIN#:721326720 Mailing Address P.O.Box 6202 Metairie,Louisiana 70009-6202 United States Web:www.GraySurety.com 'Phone:504-888-7790 Fax:504-454-6122 View Additional Address Information Assigned to insurance companies that have,in our opinion,an excellent ability to meet their ongoing insurance obligations. BESTEXCELLENT a(AM etal Euength R View additional news,reports and products for this company. Based on AM Best's analysis,045016-BCP Surety Group SPV, LLC is the AMB Ultimate Parent and identifies the topmost entity of the corporate structure.View a list of operating insurance entities in this structure. Best's Credit Ratings 1/4 Financial Strength View Definition Best's Credit Rating Analyst Rating(Rating Category): A-(Excellent) Rating Office:A.M.Best Rating Services,Inc. Outlook(or Implication): Stable Financial Analyst:Christine DePalma Action: Affirmed Associate Director:Raymond Thomson,CPCU,ARe,ARM Effective Date: June 23,2023 Note:See the Disclosure information Form or Press Release below for Initial Rating Date: June 16,1997 the office and analyst at the time of the rating event. Long-Term Issuer Credit View Definition Disclosure Information Disclosure Information Form Rating(Rating Category): a-(Excellent) View AM Best's Rating Disclosure Form Outlook(or Implication): Stable Action: Affirmed Effective Date: June 23,2023 Initial Rating Date: June 19,2007 Financial Size Category View Definition Financial Size Category: VIII(USD 100 Million to Less than 250 Million) u Denotes Under Review Best's Rating Rating History AM Best has provided ratings&analysis on this company since 1997. Financial Strength Rating Long-Term Issuer Credit Rating Effective Date Rating Effective Date Rating June 23,2023 A- June 23,2023 a- June 15,2022 A- June 15,2022 a- I June 10,2021 A- June 10,2021 a- March 19,2021 A-u March 19,2021 a-u January 28,2021 A- January 28,2021 a- December 19,2019 A- December 19,2019 a- November 30,2018 A- November 30,2018 a- I Best's Credit&Financial Reports 1111 Best's Credit Report-financial data included in Best's Credit Report reflects the data used in determining the current credit rating(s). 2/4 Best's Credit Report-Archive-reports which were released prior to the current Best's Credit Report. MUM Best's Financial Report-financial data included in Best's Financial Report reflects the most current data available to AM Best, including updated financial exhibits and additional company information,and is available to subscribers of Best's Insurance Reports. el l Best's Financial Report-Archive-reports which were released prior to the current Best's Financial Report. View additional news,reports and products for this company. Press Releases a e ;Title Jun 10,2021 AM Best Removes From Under Review With Developing Implications and Affirms Credit Ratings of The Gray Casualty& Sure y Company. Mar 19,2021 AM Best Places Credit Ratings of The Gray Casualty&Surety Company Under Review With Developing Implications Jan 28,2021 AM Best Assigns Credit Ratings to The Gray Indemnity Company;Affirms Credit Ratings of The Gray Insurance Company, and Affiliate Nov 04,2011 A.M.Best Revises Outlook to Stable for The Gray Insurance Group and Its Members Oct 01,2009 A.M.Best Revises Rating Outlook to Negative for Gray Insurance Group and Its Member 1 ( , i C European Union Disclosures A.M.Best(EU)Rating Services B.V.(AMB-EU),a subsidiary of A.M.Best Rating Services,Inc.,is an External Credit Assessment Institution(ECAI)in the EU.Therefore, credit ratings issued and endorsed by AMB-EU may be used for regulatory purposes in the EU as per Directive 2013/36/EU. United Kingdom Disclosures A.M.Best—Europe Rating Services Limited(AMBERS),a subsidiary of A.M:Best Rating Services,Inc.,is an External Credit Assessment Institution(ECAI)in the United Kingdom(UK).Therefore,Credit Ratings issued and endorsed by AMBERS may be used for regulatory purposes in the United Kingdom as per the Credit Rating Agencies(Amendment,etc.)(EU Exit)Regulations 2019. Australian Disclosures A.M.Best Asia-Pacific(Singapore)Pte.Ltd.(AMBAPS),Australian Registered Body Number(ARBN No.35486928345),is a private limited company incorporated and domiciled In Singapore.AMBAPS is a wholesale Australian Financial Services(AFS)Licence holder(AFS No.540265)under the Corporations Act 2001.Credit ratings emanating from AMBAPS are not intended for and must not be distributed to any person in Australia other than a wholesale client as defined in Chapter 7 of the Corporations Act.AMBAPS does not authorize its Credit Ratings to be disseminated by a third-party in a manner that could reasonably be regarded as being intended to influence a retail client in making a decision in relation to a particular product or class of financial product.AMBAPS Credit Ratings are intended for wholesale clients only, as defined. Credit Ratings determined and disseminated by AMBAPS are the opinion of AMBAPS only and not any specific credit analyst.AMBAPS Credit Ratings are statements of opinion and not statements of fact.They are not recommendations to buy,hold or sell any securities or any other form of financial product,including insurance policies and are not a recommendation to be used to make investment/purchasing decisions. Important Notice:AM Best's Credit Ratings are independent and objective opinions,not statements of fact.AM Best is not an Investment Advisor,does not offer investment advice of any kind,nor does the company or its Ratings Analysts offer any form of structuring or financial advice.AM Best's credit opinions are not recommendations to buy,sell or hold securities,or to make any other investment decisions.For additional information regarding the use and limitations of credit rating opinions,as well as the rating process,information requirements and other rating related terms and definitions,please view Guide to Best's Credit Ratings. 3/4 About Us I Careers I Cont I Events I Media Relations I Mobile App I Offices I Press Releases I Social Media Cookie Notice I Legal&Licensing, Privacy Notice I Regulatory Information I Site Map I Terms of Use Copyright©2023 A.M.Best Company,Inc.and/or its affiliates ALL RIGHTS RESERVED. 4/4 • ., , ^ ...IT ® DATE(MM/DDNYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE L .� 11/10/2023 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 NAME CT Shannon Balo ' Number) Insurance Marketing Services PHONE FAX 17111 Beach Blvd Ste 103 INC.No.ExO: (714)848-4400 we.Not:(714)848-3500 Huntington Beach,CA 92647 E-MAIL Shannon@numberlins.com License#: 0C17917 INSURER(S)AFFORDING COVERAGE NAIC 0 INSURERA: Continental Casualty Company INSURED INSURERB: United Financial Casualty Company 11770 A 2 Z CONSTRUCT INC INSURER C: Nautilus Insurance Company 63 VIA GATILLO INSURER D: National Liability&Fire Insurance Company RANCHO SANTA MA, CA 92688 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 00004613-1855909 REVISION NUMBER: 5 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADM SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MMIDDIYYYY1 (MMiDDNYYYi A X COMMERCIAL GENERAL LIABILITY Y C6981502082 11/09/2023 11/0912024 EACH OCCURRENCE S 1,000,000 DAMAGE TO CLAIMS-MADE X OCCUR PREMISES(EaENTED occurrence) $ 100,000 MED EXP(Anyone person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIESPER: GENERAL AGGREGATE $ 2,000,000 X POLICY[1 JECT n LOC PRODUCTS-COMP1OPAGO $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY Y 08445692-7 08/1512023 02/15/2024a sB�IINdEeDSINGLE LIMIT $ 2,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY X AUTOS HIRED NON•OWNED PROPERTY DAMAGE $ _ AUTOS ONLY _ AUTOS ONLY (Per accident) $ C X UMBRELLA LIAR X OCCUR AN1296287 11/09/2023 11/09/2024 EACH OCCURRENCE S 2,000,000 l EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 DED RETENTION$ $ D WORKERS COMPENSATION A9WC377373 12/26/2022 12/26/2023 X S ATUTE OTH- ER AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y( 1 N rA E.L.EACH ACCIDENT $ 1,000,000 • OFFICERIMEMBER EXCLUDED? I (Mandatory In NH) E.L,DISEASE-EA EMPLOYEE $ 1,000,000 • U yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) RE:CC 1658 Central Library Lower Level Restroom ADA improvements ' City Of Huntington Beach,its Officers,elected or appointed Officials,employees,agents and are rim*.:..i 18 appreds as respects general and auto liability,and this insurance is primary and noncontributory with aft r I a drflindd onal insured as required by written contract,per attached endorsement(S). ././( PY: MICHAEL E.GATES CERTIFICATE HOLDER CANCELLATION Cif/MICANBY Girt OF HUNTINGTON BEACH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Huntington Beach ACCORDANCE WITH THE POLICY PROVISIONS. 2000 Main St. HUNTINGTON BEACH, CA 92648 AUTH BZEDREPRESE TATIV I (SSB) ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by SSB on 11/10/2023 at 04:27PM BEST CHOICE CONTRACTOR PROGRAMBlanket Additional Insured - Owners, Lessees or Contractors This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Policy Number: C6081502082 ' Endorsement Effective: 11/10/2023 at 12:01 a.m. Named Insured:A 2 Z CONSTRUCT INC Authorized Representative: SCHEDULE Name of Additional Insured Person(s) or Organization(s): (Blanket) (Specific) Any person or organization that the Named Insured is City of Huntington°Beach, its offices, elected or obligated by virtue of a written contract or written appointed officials, employees, agents and agreement to make an additional insured on this volunteers Coverage Part,provided such contract or agreement: • Is currently in effect or becomes effective during 2000 MAIN STREET the policy period;and HUNTINGTON BEACH,CA 92648 • Was executed prior to: a. the"bodily Injury," or"property damage"; or b. the offense that caused the"personal and advertising injury"; for which the additional insured seeks coverage. Location(s)of Covered Operations: Any location In the "coverage territory" that is subject 2000 MAIN STREET to the contract or agreement specified above. HUNTINGTON BEACH,CA 92648 A. Section II—Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule,but only to the extent that the person or organization shown in the Schedule is held liable for your acts or omissions arising out of your ongoing operations performed for that Insured. B. With respect to the insurance afforded to these additional insureds,the following additional exclusions apply: This insurance does not apply to"bodily injury"or"property damage"occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work,on the project (other than service, maintenance or repairs)to be performed by or on behalf of the additional insured(s)at the location of the covered operations has been completed;or 2. That portion of"your work"out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project. C. With respect to the insurance afforded to these additional insureds,this insurance also does not apply to "bodily Injury","property damage"or"personal and advertising Injury"arising out of the rendering of,or the failure to render,any professional architectural,engineering or surveying services, including: 1. The preparing,approving,or failing to prepare or approve, maps,shop drawings, opinions,reports, surveys,field orders,change orders or drawings and specifications;or 2. Supervisory, inspection,architectural or engineering activities. D. Primary and.Noncontributory Insurance If so required by a written contract or written agreement,this insurance will be primary to, and will not seek contribution from,other insurance under which the additional insured is a named insured. But in all other instances,and notwithstanding anything to the contrary in the condition entitled Other Insurance,this insurance will be excess of any other insurance available to the additional insured. CNA97587XX(4-2020) Policy No: C6981502082 • Page 1 of 2 Endorsement No: Effective Date: 11/10/2023 Insured Name: Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.used with permission. BEST CHOICE CONTRACTOR PROGRAM CNA Blanket Additional Insured - Owners, Lessees or Contractors This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Policy Number: C6981502082 Endorsement Effective: 11/10/2023 at 12:01 a.m. Named Insured:A 2 Z CONSTRUCT INC Authorized Representative: SCHEDULE Name of Additional Insured Person(s) or Organization(s): (Blanket) (Specific) Any person or organization that the Named Insured is City of Huntington Beach, its offices, elected or obligated by virtue of a written contract or written appointed officials, employees, agents and agreement to make an additional insured on this volunteers Coverage Part,provided such contract or agreement: • Is currently in effect or becomes effective during 2000 MAIN STREET the policy period;and HUNTINGTON BEACH,CA 92648 • Was executed prior to: a. the"bodily injury,"or"property damage";or b. the offense that caused the"personal and advertising injury"; for which the additional insured seeks coverage. Location(s)of Covered Operations: Any location in the "coverage territory" that is subject 2000 MAIN STREET to the contract or agreement specified above. HUNTINGTON BEACH,CA 92648 A. Section II—Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only to the extent that the person or organization shown in the Schedule is held liable for your acts or omissions arising out of your ongoing operations performed for that Insured. B. With respect to the insurance afforded to these additional insureds,the following additional exclusions apply: This insurance does not apply to"bodily injury" or"property damage"occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work,on the project (other than service, maintenance or repairs)to be performed by or on behalf of the additional insured(s)at the location of the covered operations has been completed;or 2. That portion of"your work"out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project. C. With respect to the insurance afforded to these additional insureds,this insurance also does not apply to "bodily injury","property damage"or"personal and advertising Injury"arising out of the rendering of, or the failure to render,any professional architectural,engineering or surveying services, including: 1. The preparing,approving,or failing to prepare or approve, maps,shop drawings,opinions, reports, surveys,field orders,change orders or drawings and specifications;or 2. Supervisory,inspection,architectural or engineering activities. D. Primary and Noncontributory Insurance If so required by a written contract or written agreement,this insurance will be primary to,and will not seek contribution from,other insurance under which the additional insured is a named insured. But in all other instances, and notwithstanding anything to the contrary in the condition entitled Other Insurance,this insurance will be excess of any other insurance available to the additional insured. CNA97587XX(4-2020) Policy No: C6981502082 Page 1 of 2 Endorsement No: Effective Date: 11/10/2023 insured Name: Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.used with permission. PROGRESS/YE NUMBER 1 INSURANCE COMMERCIAL 17111 BEACH BLVD 103 HUNTINGTON BEACH,CA 92647 1-714-848-4400 Policy number: 08445692-7 Underwritten by: UNITED FINANCIAL CAS CO November 1,2023 Page 1 of 2 Certificate of Insurance Certificate Holder CITY OF HUNTINGTON BEACH 2000 MAIN ST. HUNTINGTON BEACH,CA 92648 Insured Agent/Surplus Lines Broker A 2 Z CONSTRUCT INC NUMBER 1 INSURANCE 63 VIA GATILLO 17111 BEACH BLVD 103 RANCHO SANTA MA,CA 92688 HUNTINGTON BEACH,CA 92647 This document certifies that insurance policies identified below have been issued by the designated insurer to the insured named above for the period(s)indicated. This Certificate is issued for information purposes only. It confers no rights upon the certificate holder and does not change,alter, modify,or extend the coverages afforded by the policies listed below. The coverages afforded by the policies listed below are subject to all the terms, exclusions,limitations,endorsements,and conditions of these policies. Policy Effective Date: Aug 15,2023 Policy Expiration Date: Feb 15,2024 Insurance coverage(s) Limits BODILY INJURY/PROPERTY DAMAGE $2,000,000 COMBINED SINGLE LIMIT UNINSURED/UNDERINSURED MOTORIST $2,000,000 COMBINED SINGLE LIMIT ANY AUTO BODILY INJURY/PROPERTY DAMAGE $2,000,000 COMBINED SINGLE LIMIT Description of LocationNehicles/Special Items Scheduled autos only 2014 TOYT TUNDRA DOUBLE C 5TFUM5F11 EX057101 Stated Amount $31,000 MEDICAL PAYMENTS $5,000 COMPREHENSIVE $1,000 DED COLLISION $1,000 DED RENTAL REIMBURSEMENT $50 PER DAY($1500 MAX) ROADSIDE ASSISTANCE SELECTED Continued Policy number: 08445692-7 Page 2 of 2 Certificate number 30523NET692 Please be advised that the certificate holder will not be notified in the event of a mid-term cancellation. Form 5241(10/02) Form 2366(02/11) BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided by the Commercial Auto Policy,Motor Truck Cargo Legal Liability Coverage Endorsement,and/or Commercial General Li- ability Coverage Endorsement,as appears on the declarations page.AU terms and conditions of the policy apply unless modified by this endorsement If you pay the fee for this Blanket Additional Insured Endorsement,we agree with you that any person or organtion with whom you have executed a written agreement prior to any loss is added as an additional Insured with respect to such liability cover- age as is afforded by the policy,but this insurance applies io such additional Insured only as a person or organization liable for your operations and then only to the extent of that liability.This endorsement does not apply to acts,omissions,products,work,or operations of the additional Insured. Regardless of the provisions of paragraph a.and b.of the"Other Insurance'dause of this policy,if the person or organization with whom you have executed a written agree- ment has other insurance under which it is the first named Insured and that insurance also applies, then this insurance is primary to and non-contributory with that other insurance when the written contract or agreement between you and that person or organization,signed and executed by you before the bodily Injury or property dam- age occurs and in effect during the policy period,requires this insurance to be primary and non-contributory. In no way does this endorsement waive the"Other Insurance"dause of the policy,nor make this policy primary to third parties hired by the Insured to perform work for the Insured or on the Insured's behalf. ALL OTHER TERMS, LIMITS, AND PROVISIONS OF THE POLICY REMAIN UNCHANGED., Form 2367(06/10) BLANKET WAIVER OF SUBROGATION ENDORSEMENT This endorsement modifies insurance provided by the Commercial Auto Policy,Motor Truck Cargo Legal Liability Coverage Endorsement,and/or Commercial General Li- ability Coverage Endorsement,as appears on the declarations page.All terms and conditions of the policy apply unless modified by this endorsement 34 BEST CHOICE CONTRACTOR PROGRAM Blanket Additional Insured - Owners, Lessees or fr � Contractors This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Policy Number: C6981502082 Endorsement Effective: 11/9/2023 at 12:01 a. m. Named Insured: Authorized Representative: A 2 Z CONSTRUCT INC, DBA:A 2 Z CONSTRUCT INC SCHEDULE Name of Additional Insured Person(s) or Organization(s): (Blanket) (Specific) Any person or organization that the Named Insured is obligated by virtue of a written contract or written agreement to make an additional insured on this Coverage Part, provided such contract or agreement: • Is currently in effect or becomes effective during the policy period; and • Was executed prior to: a. the "bodily injury," or"property damage"; or b. the offense that caused the "personal and advertising injury"; for which the additional insured seeks coverage. Location(s) of Covered Operations: Any location in the "coverage territory" that is subject to the contract or agreement specified above. A. Section II—Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only to the extent that the person or organization shown in the Schedule is held liable for your acts or omissions arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to"bodily injury" or"property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work,on the project (other than service, maintenance or repairs)to be performed by or on behalf of the additional insured(s)at the location of the covered operations has been completed; or 2. That portion of"your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project. C. With respect to the insurance afforded to these additional insureds, this insurance also does not apply to "bodily injury", "property damage"or"personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: 1. The preparing, approving, or failing to prepare or approve, maps,shop drawings, opinions, reports, surveys,field orders, change orders or drawings and specifications; or 2. Supervisory, inspection, architectural or engineering activities. D. Primary and Noncontributory Insurance If so required by a written contract or written agreement, this insurance will be primary to, and will not seek contribution from, other insurance under which the additional insured is a named insured. But in all other CNA97587XX(4-2020) Policy No: C6981502082 Page 1 of 2 Effective Date: 11/9/2023 Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.used with permission. BEST CHOICE CONTRACTOR PROGRAM A Blanket Additional Insured - Owners, Lessees or Contractors instances, and notwithstanding anything to the contrary in the condition entitled Other Insurance, this insurance will be excess of any other insurance available to the additional insured. E. Solely with respect to the insurance granted by this endorsement,the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to add the following to the condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit: Any additional insured pursuant to this Coverage Part will, as soon as possible: 1. Give us written notice of any claim,or of any`occurrence"or offense that may result in a claim; 2. Send us copies of all legal papers received and otherwise cooperate with us in the investigation, defense or settlement of the claim; and 3. Make available any other insurance and tender the defense and indemnity of any claim to any other insurer or self-insurer whose policy or program applies to a loss that we cover under this Coverage Part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 3.does not apply to insurance on which the additional insured is a named insured. F. Solely with respect to the insurance granted by this endorsement: 1. The words"you" and "your" refer to the Named Insured shown in the Declarations. 2. "Your work" means work or operations performed by you or on your behalf, and materials parts or equipment furnished in connection with such work or operations. G. Blanket Waiver of Subrogation We waive any right of recovery we may have against an entity that is an additional insured under the terms of this endorsement with respect to payments we make for injury or damage arising out of"your work"done under a written contract or written agreement with that person or organization, provided such contract or agreement: 1. Requires such a waiver of our rights; 2. Is currently in effect or becomes effective during the policy period;and 3. Was executed prior the"bodily injury", "property damage" or"personal and advertising injury"that gave rise to the claim. All other terms and conditions of the Policy remain unchanged. This endorsement,which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA97587XX(4-2020) Policy No: C6981502082 Page 2 of 2 Effective Date: 11/9/2023 Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.used with permission. BEST CHOICE CONTRACTOR PROGRAM Blanket Additional Insured - Owners, Lessees or Contractors This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART • Policy Number: C6981502082 Endorsement Effective: 11/10/2023 at 12:01 a.m. Named Insured:A 2 Z CONSTRUCT INC Authorized Representative: SCHEDULE it Name of Additional Insured Person(s) or Organization(s): (Blanket) (Specific) Any person or organization that the Named Insured is City of Huntington Beach, its offices, elected or obligated by virtue of a written contract or written appointed officials, employees, agents and agreement to make an additional insured on this volunteers Coverage Part, provided such contract or agreement: • Is currently in effect or becomes effective during 2000 MAIN STREET the policy period; and HUNTINGTON BEACH,CA 92648 • Was executed prior to: a. the"bodily injury," or"property damage"; or • b. the offense that caused the"personal and advertising injury"; for which the additional insured seeks coverage. Location(s)of Covered Operations: Any location in the "coverage territory" that is subject 2000 MAIN STREET to the contract or agreement specified above. HUNTINGTON BEACH,CA 92648 A. Section II—Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only to the extent that the person or organization shown in the Schedule is held liable for your acts or omissions arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to"bodily injury" or"property damage"occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs)to be performed by or on behalf of the additional insured(s)at the location of the covered operations has been completed; or 2. That portion of"your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project. C. With respect to the insurance afforded to these additional insureds,this insurance also does not apply to "bodily injury", "property damage" or"personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: 1. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys,field orders, change orders or drawings and specifications; or 2. Supervisory, inspection, architectural or engineering activities. D. Primary and Noncontributory Insurance If so required by a written contract or written agreement,this insurance will be primary to, and will not seek contribution from,other insurance under which the additional insured is a named insured. But in all other instances, and notwithstanding anything to the contrary in the condition entitled Other Insurance,this insurance will be excess of any other insurance available to the additional insured. CNA97587XX(4-2020) Policy No: C6981502082 Page 1 of 2 Endorsement No: Effective Date: 11/10/2023 Insured Name: Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.used with permission. BEST CHOICE CONTRACTOR PROGRAM Blanket Additional Insured - Owners, Lessees or Contractors E. Solely with respect to the insurance granted by this endorsement,the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to add the following to the condition entitled Duties In The Event of Occurrence, Offense,Claim or Suit: Any additional insured pursuant to this Coverage Part will, as soon as possible: 1. Give us written notice of any claim, or of any"occurrence" or offense that may result in a claim; 2. Send us copies of all legal papers received and otherwise cooperate with us in the investigation, defense or settlement of the claim; and 3. Make available any other insurance and tender the defense and indemnity of any claim to any other insurer or self-insurer whose policy or program applies to a loss that we cover under this Coverage Part. However, if the written contract requires this insurance to be primary and non-contributory,this paragraph 3. does not apply to insurance on which the additional insured is a named insured. F. Solely with respect to the insurance granted by this endorsement: 1. The words"you"and "your" refer to the Named Insured shown in the Declarations. 2. "Your work" means work or operations performed by you or on your behalf, and materials parts or equipment furnished in connection with such work or operations. G. Blanket Waiver of Subrogation We waive any right of recovery we may have against an entity that is an additional insured under the terms of this endorsement with respect to payments.we make for injury or damage arising out of"your work"done under a written contract or written agreement with that person or organization, provided such contract or agreement: 1. Requires such a waiver of our rights; 2. Is currently in effect or becomes effective during the policy period; and 3. Was executed prior the "bodily injury", "property damage" or"personal and advertising injury" that gave rise to the claim. All other terms and conditions of the Policy remain unchanged. This endorsement,which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA97587XX(4-2020) Policy No: C6981502082 Page 2 of 2 Endorsement No: Effective Date: 11/10/2023 Insured Name: Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.used with permission. POLICY NUMBER: C6981502082 COMMERCIAL GENERAL LIABILITY CG 20 37 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations City of Huntington Beach, its offices, elected or appointed CC 1658 Central Library Lower Level Restroom ADA officials,employees,agents and volunteers improvements 2000 MAIN STREET 2000 MAIN STREET HUNTINGTON BEACH,CA 92648 HUNTINGTON BEACH,CA 92648 • Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage" caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the"products-completed operations hazard". 1. Required by the contractor agreement;or However: 2. Available under the applicable limits of 1. The insurance afforded to such additional insurance; insured only applies to the extent permitted by whichever is less. law; and This endorsement shall not increase the 2. If coverage provided to the additional insured is applicable limits of insurance. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 12 19 ©Insurance Services Office, Inc., 2018 Page 1 of 1 .„ . . . BID BOND coiformsith. eAi,00,r1Ogojo$.f.it.o*of. Atefilte.Ofs,.../04-0000111Orit NO..4410: l• .:A240ONSTAUCT,INO,,. and the THE,GRAY CASUALTY:&SURETY COMPANY: , , ,n 6itorotion-dtgrorgani7Ad unclor. ...,!4:80tay„,',:nerottiottet?.nalidttibe.$itte .are-beld:'.andy;:bldond tuit4 • . • CITY:OF HUNTINGTON BEACH . , hereinafter cohOdtho:Ohligoe, in sum.of TEN PERCENT OF GREATER AMOUNT . " . 16%, ,fo hichum welind Iyio,be niade,the saidPiincipatandthesaitt at*asp,bind ourselves, .'i•cactiti:trki;:a.datinbtrafors,:succcssors and assigns jointly atutseverally,,futily, by;these presents WHEREAS the Principal has submitted a bid for . . CENTRAL LIBRARY LOWER LEVEL.RESTROOMS ADA IMPROVEMENTS , . NOW . : , . , , •, . „ . THEREFORE,if theObliAft.shall:AceEpt-t46:bhl otbe p.43.-00.4144tho-.PxrincIp4.,1 shall enter into a.Centract-*ittithe:Chtigee in:400W40'60 WIth,.t4p,t411:4 of such bid, and give such bond ot bonds as may be spocifiedinthosiiidditg•Or,Co4tiaot:DOctini.ent4*.itb goodrantLonfficient surety.forthe-faitliftil performance of such Contract and forthe prompt payment of)01**g44...ftg.grj40#0itiod.,:in; the prosecution thereof,- tO...-ant6f sich Ciiiittapt and give such bond or bonds, if the Principal shall pay to the Obhgee tud. ‘difference titittil-rxceed the penalty hereof between Ihe'itunoutli specified fli said tit&and such laxgeramount.;for winch the Obligee may in good faith.00ntinoi:with.,OnOth.et party to perform the Work covered bSr said bid,then this obligation shall be null and voldintitetwiooto remam in full force and effect Signed ondsettle;0140.-, AUGUST , 2023 . . (Seal) A2Z CONSTRUCT, INC., . . Orig. .. . •-• BY.; . Witness • • • SOS THEGRAYCASUALTY&suReEr COMPANY1: , , . . . „ Wjüiess { BY. . - MARK D IATAR014A,:A4ornePqnTAc't . _ . , , . , . , •S-0054/GEEP 12/00. " " . , f!IP, ... .. licien,11/24aInnayeezUs-ociate:ilntnrOkOefiiii, 11V.,PPOI3 ti,.:-.11 .0.0$ 2.04./$..65'.. 'OW GRAY INSURANCR:03* ,. ,. Ilig GRAY'CASVATOYA'SPORTY CO.MrANY Okn'....R41- 0-.WAR:bk'.ATTOORY )3hhil.N.dhiliet?.-,-,,,-,., ... • - -, ,,•'-:••, - . :•• -- . P4-00044A4.:P;t3SIOTAMIli,Y1140, 00...00.•(.T.N.I'ML J410.M.:kno8,:Ia t:.f.;_i-8•vEL.R0:1-Vo4p.:4 t.m Ti.goviviiim ...: . . . . . . :NN9W4444-, :Tiv.s:g pFgsp..mys,;.THAT Thinsurance o,Gtay Company and the,GrayeatifaityleSigetkantiffink;•:antiotatinfikdnlY• , - •- ,:- • ..". , ‘--- ., •• : , • . .. ,• ..y , :,.., . . , : ,:- „ ,: .,..,..-•..- .., .....- .. organized and•existinKunder the laW,a;.0130.000;044:114yklfrif principal offices.,ioAirsli$.iauk,Aolieteby,taak6.,,,t0tittittit ;:aiid 4000.-Tobn'0.Maloney,Helen Matoncy4 and Mai kikiatarda.oltkondidni C4hfOrldajnYttlY404 several on behalf of etigi-C....-fthe Cninpatitegita*d l!,30:.*04-‘t00'004.)0R:f0 Athmiey,(0]i•in-F4et tpm4e,vceettt,stitata‘ckli*,parmiti.bifitSileholl.04 0-::):t •ci.04,..1-?6:iiicik.:Or, other wiitinp,ObligOolyiwitie.noiiiteotittuid;as:kt.ietVeoptf4CO of',,Oto#,Oii„4A0-0.ioy'jv,rggpftapppp:Tioitoci„.15yfffa)wregol.aiibn;; 0).ift#(.70k 00i4is:0;0*404:itii4(1)01),Q04:9r undertaking or contiattasurefsithig, ted1400 ,01-;4;iitiotity,:44ittx:0,0ed the amount or 12506,0aba, •-This Nyeral'Afining :-4 gtaitaaid is 4giod',iy . ..: . 0. ,N,4iithot.ity of ptfo. ,hwkgR.,etpihti.,.oh$ acloigtf tqf 410 130441.1 of , •7 ,,`' ,, ' '',,,, . 70ii*Otait',,bf both The Gtaylijorwg.-Company and The Gray Casualty 4.:,giitetytoliiiimiiy attintiifg dutji.,,called and oh of 44* .00, RESOLVED;.'dial thg wet**.EZ. aiiti .,Vide.„Pi6sident:iiity Vice President)0t theSeOte tat•yU•andeadh or ator..ipithantlirby.is andanized:to "aeente•a:tral*nfAft.otioyciolitjligAtp-thm*ythhhoci,in•:.ti*g:i340h!ghwor:,pf.Attottity...to 4a04e„onbehatf.0-1,d*Ohthp*.y.:tkinck *doltkitsktod:hjl.ohitatt. hiohmo,,:aholli*.:44Abt#,Y.,00ienjato*Wangotizolciattnattn:0140xcolitio ofanch Yo*at'Of:AttOMM and:: tO:Ott4....eh the,P041•01hAP04:00Y;otait'i$. rEtiftitiEkT;0$0:Vit);'th4:the signature'Of:4/..40h:Of*eti4iialligAeOnt the Company may he affixed to any--sueh...ka!wei.):4Mortiopotttrliny: zadifiefittsnIatingfbmin;Ity.Aesirn k and.,thy;Sneti.NiVet,,iit Attorney or certticate bearing such fidioilk:06004*iie facsimile seal shall be 140.4V.01,P*P000.1*49*-.04 in the wbe.w.so tirixo*i't.h.reprdln any bond;litidatakiiig eirOtitract,ON#V,V4ipyrij#04,00,4, INVIINtgS NVEMRtO.P,A. b.tay....iiistitatied Company and f.rl*GiV(Cilgiialti&Snre*CiaprianY',.havecan5gaibeiT official sezdstff:.'lle..lotiittci „ .,: , ,. ... . _.,..,...,...:..... ...: ,,...„ .„ ... .. .. .,„ „.. , .„ atrixect-and:,thescvresents lOin,.:8*etYtf.11*..ix:044140.....1*ciffit4*(,45:0**tsfii,,Tovoinbot..g972. ., . .......: •. - ,..... .: . . „ ., . . ,•:;',: ii;t"it •;.''''., „ „ . . . , . , . , , . , • ' . , 1-:.- :• ' ,...8.'SE :i7,0,...,.:it:NLY.....&..9--%,:u.•_,,:„..,. ,.C,-i,Ali 'li By Miella61*,: ,.: Gray0*trg.:P.itkd ,in,•SEAL ... „ . ., . . Pt0idelit . President .. , 'i 0V ... T:& ..,,.,...e.,.,. ..1.-,,-.- Gray Insurance Company 'iliePt0C400tk ‘.'.0t0tk024„a4Y Stateattaufsiana Patia04•Jetretann, Pif.biO.4'h',44Y,!fif 19.0.011140,;;;OZZW*,1pqaNcitary:Pub11c,:pmolviltYvpoarea:laihaer T. (tray President Gray Inantatice., oinpany.,,.anattilleii S...riskeiThsident Of,TheGray..coaaltylEn*ty'qoiiiw:*46no:,10.,...4u100.40#1:0,;07v::*00:acknowledged,, 1, that they$igoott*415.0gRoot.p.fAttooloy,40.arfincPiL0 seals of tho;:eonimiiies,a .p*pers.„.6: 01.1,4 acrcnn4ndggd*441004.n0104TP:411i0' izeluntatraot aid:de4,6Men,:paitipania$:.' ..'. . ' , 16141fAti*:-H ''' .; ::, ,, NbtA*yiblid, . .,.. _ , .. ...„ , „. .. Leigh Anne,Ilt.01005 Notary Public, Parish OdeanaState.of Louisiana Myc . ' , "'''1.'Ot(a'arj.4: dat'fitiantatait' :. ' ' ' . for Life..': ',..:,.-. • ' ,••- ,,•-,.,,, -,4 imunisxonii, •:, ,.: t MA1:1(;$::R.410110i'SO*1#00*,P44±1***,coopoimpiftgow.:*#157##010:40ckfoocog,4.4A4d:corrgc,topy4f‘a:,. t lifpwgrpfAi'torTigygiveii-,byil*goin which ia.atitlt companies adiforce and effect JA•liAccil4E§S AVIIERE(*it have set•my hand and :. - . : aMtett'die.aealliftlia Companytilio;2.m. ,44y.of;moot 2021 .• .: ..... ...., (.; I The Csi*Ity:84,siots(:400146,dnifi3OteWeeil4y.ipattlOfr. thqf1#010g.:1*t.140.0)4014.00,, ,. copy of a::Za.:0..t of Attorney gwen by the companies thithisk-t4tio full force and IN WITNESS have set Andairdalhe,atala of A 6.eninpanydna at&T .day nif:NJOng ,,,,,iv,i7:',;;:.,:, .;--.4t.;,..„...,,-..„*.z, 46,-,, 041.44 .,; ,. s : ,,., .. :. .<.: . ' ?", . ' •.•:-:,;- IA ,: •'.,: ,41.1, - ttiock. , :OW . 4 , , . :.,,,,,,,,,,,..A. . ,,-. -1 . ,...,e,y. .,, •t, ,t.a. ,../, . .•.. •:;USEAL' . IN., g.e .,i .:, ..,- 4,., -,-, :.„, r:..„,...,..... , . CALIFORNIA ALL-PURPOSE 40KNOW40p0MENT. OVII'-,COOE ki1.8.P". .-.:-..1:-.4,-.71Ei-....i.:;,:,..:.,,i.::4,1,:u1,,::::,:;:ii,4-..:il.:: :::::,.7.,:z.i .:::;4:::....".:::.:3.=.7.1.4-*;0..pir.: :...i.4: -.. .:::,,,:,..:!:•f.f4.4,t.. ....1=4:...!*...,-5:1-4.,i;?...,..!.:..i*.::: :::4,4,...1::,.. ..,:.::::::i..-.:,.,-4,j.;4;.i .z .,is.,i,„0:.:;- : ' AnbtarypOli0 orOtijorOff*toro010,..tifigthicOitiOteVettnP4011,44e:•icietititY-Ofthe individual who signed tile document to which this certificate is 4tiOheci3Olid..nottlielruttifiliness,accuracy,or validity of that document: .., : . State of California: ... :,..,...., :County of .. ._ :SA.,:NI.DIEGO ... On 8/21.11203] , before Me, TRACY LYNN RODRIGUEZ,NOT-AqY 1.70641a Dote Here Insert Noio.and TitioP?'the Officer personally..appeared MARK illATfiROLA: '.NOme(s).Ot Signers)whp.Rrqv.edt.te,...rilopri..ttip.basis of satisfactory eocie..6.C.0 to be thePer§On .Whose imme4isier-esubscribed tatiie!viitiiin,Ahstrument.znd acknowledged to toe'Ai'14t:0010f10f...tltrOXgaitedlhe same in IiiVileiltlitOW authorized capooltAfoo),and that by his/her/their.:signature )on:the'intrumenvffigersonk or the entity upon behalf of which the acted,executed the instrument.; ii ;.i I toify:IlridOr'pFNAt,rrOF-PRRjURY.u0Oer:,the-, .„..,.,,_,........, :— .,..,-- ..„..._..... 1,..._ - laws of to4Stitolot California that: :the foregoing,f,w,,i),(.14'144 13.:b)FIGUEt. 0.0661006.is true and COtrget• ; . ..1 ...-44-iiioTAM,;.0kitkie,clie.tfotiv,,-2.: WITNESS ''",''':-.'.7' MY COMMISSION EXPIRES 7 ‘my 640000d official seal. L - iAtittliAl .it.2ti74 .1. ) . , Signature I b1 r -: '..., - - Place NOt06,0, 01.1-07dkiit$tc00:AbOve. SiA.:i; oie. . No Public, .. P OPTIONAL [ Completing this information can il. tPr:i41tOrattOp of the gotpmopt or fraudulent r eattOkhatept otilii4,f0n410'..orr'tnyinipnOpctoocument. [. . „ .. DesotiptioTtOf.114tpt!le4Vqognont: Title or Type of 0000nioem. ... . . ..-. ... :: . ... , ...,.. .:. . -:.. : . . ..:.: , . , Document Date: . : .:,... - , . .. , NUrnber of Pages:,.. Signer(s)Other Iliattmot-0*.t Aboye:., ,• ; .. C...pipacity(ies)..Ciaitned by tigner(4). W .,, r Signer's Nattie.t.'.MARKD. 1ATAROLA, . .. :....., . Signer's Name:: .. . , :0 Corporate Officer-Title(s): --,-,.. - ..-, . trCorporate Officer,,L;titte(s):-:: tti Partner-:0:Limited-0.General i 0'Partner- 0:timited 1:1 General .ti:individual Attorney in o Individual: ':0 Atteiiney,in Fact: ., 0 TrU§tee, :0.•Guardian of Conservator 0,Trnstee, '0 Guardian of conservator . I' . . $ tl l Other: - . - - . , . 0s. O'Qt1101; , ,,...,.. Signor is Representing: - := . :-,..,-.,:0:. - - :: :Signer is Representing: , 02011 National NOtary,..MkoClaticirt r. t f , . ACKNOWLEDGMENT A notary-publietie-tither officer completing this ' 1 idertitieate,verifies only the ideritity.ofthe individual t who signed the document to which this,certificatels attached,and ritit the truthfulness, accuracy,,,-or validity or that document , state 9.1 California ,,,- Orange, County of ) . . On August,21.st 2023 befbr6 iii6• Lisa.CaroiaBaggOtlyt Notary.Publit ,., (insert hanie and title of the officer) personally appeared', Matthew 3af8ti.'' . 0 who proved to rn0 an the basis of satisfactory evidence to be the person(s)whose name(s)it/are tubseribedlotthe within instrument and acknowledged to me that he/she/they executed the same in his/her/their atith0r14-0 cl:P.PPaOity(ieS),.anettfit'by-,ht$Itiotifh6irsighature(t)on the instrument the person(s),Or the.entity Upon,behalf Of which the Person(S)acted,executed the. nstrorrient., I certify under* PENALTY OF PERJURY'Oder the laws of the State of California that the foregoing . . ., , . , . . . paragraph:is true arid correct. WITNESS myhand and:official sea4 . . LISACAROLERAGGERLY •J or,, . Notarypublic Catffi,rnia • ' - , 1 -4-44,'',..Ctiumb'slah C2434340` '1 ' ' - , it , 1 ied signature ' , . . ,14,.. (Seal) 1_,;4:::; ; ..2.0. .. ... ? ,e . . . . ....„ ,., — , --316 eiod - ee., Ner,i9.- ,' ' .? - ;'.. ' , = ' , c i i • ••• ,• • , Beach Public Works Department 2000.:MOlfv:StiviOt TeL (114):5.86464.' t Fax(714)a7:44:157$ ADDENDUM '.NUMBER.ONE ,• CENTRAL LIBRARY LOWER LevEL. RESTROOM ADA, IMPROVEMENTS ,• A000t404:::.201a .•• Noit6,044-mtsitittots,:,„ .•• . • . Please note 'oorifiagotii:.t4tft01 Project Pki%, Specifications,and Special • 1) DV tl.P0MOCI WOO(iWitilitiOtibil dated has been attached herein. This]r00:00.ft*. W000,00tOrtriki4tibtifaihd in Appendix of tflprojpet specifications Trills,,to,,•.00koomotwwt000pt:000 tot:low:0f*whom Number One,dated August 15,2023 (i4 'Pt 44k -T ,44tr . . , : :I - 7 C70610.4iiSi Name By • t1,232.. 12 . . . , • P0* Oft of:A0.00.1100iii•No.j. RECEIVED BY: CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office (Name) after signing/dating (Date) , in CITY OF HUNTINGTON BEACH ,_., INTERDEPARTMENTAL COMMUNICATION TO: City Treasurer FROM: City Clerk DATE: /2//Z/2, SUBJECT: Bond Acceptance I have received the bonds for A2�Conz-iyuCt I 1 VLG . (Company Name) CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. 6G2u I9 ODUI Payment Bond(Labor and Materials) Bond No. csov000lg 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 10 /3 I23 T 1�.PJ (Council Approval bate) CC No. No. MSC No. City Clerk Vault No. (POD.a) Other No. SIRE System ID No. (P4U7 0)34 g:/forms/bond transmittal to treasurer INGi0�� City of Huntington Beach �) ) ° `� - �` �9 � 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov o°,e•Ktir Ada Q . . Office of the City Clerk �FCoj7 Tl C)7\\ 2' Robin Estanislau, City Clerk • December 29, 2023 A2Z Construct, Inc. 63 Via Gatillo Rancho Santa Margarita, CA 92688 Re: Central.Library Lower Level Restroom ADA Improvements—CC No. 1658 The City Council awarded the bid to your company for the above referenced project. Enclosed is a copy of the executed contract with the City of Huntington Beach. A Certification of Compliance with Title VII of the Civil Rights Act, Certification of Compliance with Prevailing Wage Laws and Contractor's Certificate form must be returned to this office after the project is completed but prior to the release of retention funds. • In addition, the following item must also be on file, with this office before the City can release any retention funds: A warranty bond guaranteeing the final amount of work and materials for one year. If your performance bond does not include specific wording for a one-year warranty, then a rider or separate bond must • be submitted. Should you have any questions or concerns regarding the enclosures or items that must be on file in this office prior to release of retention funds, please call the Public Works Department at 536-5517. Sincerel , SRA, gAiletn14,1444) Robin Estanislau, CMC City Clerk RE:ds Enclosures: Copy of Contract including Proposal Copies of insurance/bonds Sister City: Anjo, Japan �NTifVG 2000 Main Street, Huntington Beach,CA 92648 �_• at City of Huntington Beach Q r APPROVED 7-0 File #: 23-770 MEETING DATE: 10/3/2023 REQUEST FOR CITY COUNCIL ACTION SUBMITTED TO: Honorable Mayor and City Council Members SUBMITTED BY: Al Zelinka, City Manager VIA: Chau Vu, Director of Public Works PREPARED BY: John Martin, Capital Projects Administrator Subject: Accept the lowest responsive and responsible bid and authorize execution of a construction contract with A2Z Construct Inc. in the amount of$117,600.00 for the Central Library Lower Level Restroom ADA Improvements, CC-1658 Statement of Issue: On August 22, 2023 bids were opened for the Central Library Lower Level Restroom ADA Improvements, CC-1658. City Council action is requested to award the construction contract to A2Z Construct, Inc., the lowest responsive and responsible bidder. Financial Impact: The total cost of the project, including contingency and supplemental, is $179,122. Funds are available in the Community Development Block Grant (CDBG) account 23980357.82800. Recommended Action: A) Accept the lowest responsive and responsible bid submitted by A2Z Construct Inc. in the amount of$117,600; and B) Authorize the Director of Public Works to execute change orders not to exceed 20% of the contract costs, or$23,520. C) Authorize the Mayor and City Clerk to execute a construction contract in a form approved by the City Attorney. Alternative Action(s): Do not accept the recommended action and direct staff accordingly. Analysis: The existing men's and women's restrooms in the lower level of the Central Library are original to the 1975 construction of the building, and are in need of updating. The restroom tile, finishes, lavatories, City of Huntington Beach Page 1 of 3 Printed on 9/27/2023 powered by LegistarT"^ File #: 23-770 MEETING DATE: 10/3/2023 • mirrors, glazing, plumbing fixtures, and ceiling tiles are at end of life and need to be replaced. Additionally, both facilities will be converted to family restrooms to comply with accessibility standards. Tile finishes, along with modern plumbing fixtures, glazing, and lavatories will be installed. A new hard lid ceiling system will replace the existing acoustic ceiling tile, and lighting and mechanical modifications will be included as well. These systems and finishes were designed to match or resemble the upper level restrooms, which were renovated in 2019 to meet accessibility standards. The engineer's estimate for this project was $200,000. Bids for the project were opened on August 22, 2023 and are listed in ascending order below: Bidder Submitted Bid 1 A2Z Construct Inc. $117,600.00 2 R&R B Inc $130,866.00 3 3m Construction Corporation $135,730.00 4 Global Builders Inc $149,888.00 5 Corral Construction Development $164,709.00 6 Camp Constructors Inc $177,000.00 7 Rhome Profile Construction $194,654.00 8 MLC Constructors $284,219.00 9 Builtall $294,000.00 10 Kazoni Inc $354,710.00 11 MBC Enterprises Inc. $384,720.00 City staff has conducted a reference check on A2Z Construct Inc. and has received satisfactory reviews of their past performance on similar scale restroom renovation and tenant improvement building projects. Therefore, staff recommends awarding a contract to A2Z Construct Inc. in the amount of$117,600. The total project cost is $179,122 as outlined below: Bid submitted by A2Z Construct, Inc. $117,600 20% Contingency $23,520 Supplementals (inspection, construction administration, etc.) $38,002 TOTAL CONSTRUCTION COST $179,122 Staff is requesting that the Director of Public Works be given authorization to approve change orders on this project up to 20 percent of the construction bid rather than the standard 10 percent. This request is based upon the fact that there may be unforeseen issues given the age of the facility and the contract is relatively small compared with a typical construction contract. Environmental Status: This project is categorically exempt pursuant to the California Environmental Quality Act, Section 15303.c City of Huntington Beach Page 2 of 3 Printed on 9/27/2023 powered by LegistarTM File #: 23-770 MEETING DATE: 10/3/2023 Strategic Plan Goal: Infrastructure & Parks Attachment(s): 1. Vicinity/ Location Map 2. Project Overview Presentation City of Huntington Beach Page 3 of 3 Printed on 9/27/2023 powered by LegistarTM CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS— PROJECT LOCATION MAP 43 — L_ %%O t" 9OLSA AVE j roil Sri 6 Me A v� DDEN AVE. _ I 0EDINGER kft AVE. \ • \ z g 0HEILE a W AVE.m °� W.`NER 8 AVE \ a tit SLATER < AVE. CP w T.4LBERT AV PACIFIC y 'b4-1P, EWS AVE. 410. GAR FIELD AVE, �, YORKTOWN AVE. 4 * w A I AVE. PROJECT �NDIA LIS AVE. Q '.h. I � J C am" SITE ATLANTA 5 9 r AVE z m NAM LTON AVE. } BANNING OCEAN 'I" N Ali -Ai, . ----. e nLibrary ra SIN7.0 -. .. Leve ,.•'�,CpRP oRgT4''' \ ADA __ _ _ Restrooms ,ii,r. yam` "` �. __ ___ rll„i /rr(, !„ 4,,, \ � i Improvements - ____ __ _ �_-!: _� — Project Overview ,.�- -,„ 'i., ,,, ems, �- �'�- October 3, 2023 * ----.'-7: --,,---.-.-',"--:-. 7-7----,--- •' __ dk8416, $ 1) 190 , ' 1/4.••• 4c,c'Cl 0 k."\ k 0 Cou NT ill'o►•'to►i►/'1 B A C K G R 0 U N D ,. . . . . %Q. ,..,_._......,,, , _ . . . IIOISn C° .„ , , 1 _ • .. ,. N to N ,� "' q MC Af7I} `�l� . EIDNGER . , mom _ _ F�' "'" •.:z.:.....a.+r '• tee.. •;.�.,:....�. . x NE1Lv ■ .AYE.9 I_►,� . ,. y_.....•.-_._...,��., • WARNER p AYE. N .. F,7. T • milin g Ave IIIIMI CZ, so ER W JS.tiERT . � T•"q„w+.,, r PACIFIC i'"" 9 _ I 7 to '� .r.. i . .' I! \ . �"► etas �� st imm 4 j !!!� low GARE ELD � AVE :.[ , l 'i.4c',+. . ; ,: t * . .,, Yb'KTOiNN W IV y ' -11' 4111 n_ miimil S ^arm. ��' PROJECT,, :4k41 SITE .�A v HA TbN 1�•111 {xt {r( e� n ° +� 4 s a� c 4 4 YY i i. .�•* rrryN[INGT °�"" � • Huntington Beach Central Library - originally constructed in 1975 �`` 'y9RPoearf°"� • Project scope involves renovation of (1) Men's and (1) Women's r '. restrooms located in lower level 'v+•••••�8(),9959�t•'•0Q ff • Upper level restrooms were renovated with ADA improvements in 2019. The lower level restroom finishes will match the upper level finishes NEED/WHY/ B . EN FITS r�= `T . Restroom facilities have not been updated � ` ,� �•., ` �: since original construction in 1975 * ',w ten,. ,, ` t A • Improvements will comply with modern ADA ' k accessibility standards x R ',•.n�•y A lZ ! r ; '��+ (ky+, S Wed '�'G�+ �� "^�-...d.: �, w'ii., e. tat I • Liao r .J� • ii .iie. S.V S f 4 F,. � ' ¢ Vice..-'=..-a7;t7a,r-^ s. j y £ ` :.sec- :r_•.$�sk i�hs," .,,".} , ggyyg�yjj 1 +L /.-i e • a f„,. w...a. R'" '� - 4. "� a d= � s _'t '2t.S.Z,C. a'y �; _ a ..®... .._.i,..=.1.. 2".. m....w.. a.,w7w.w.w...r.o-_ � - Y.. v4 5 Fa�N.'v1y:Ta'.9rt. .4L °V • New restrooms will be first set of "Family ;" .' �, wilt �i - u Restrooms" at Central Library. This style is 4 ¢' °' -- more spacious and includes amenities such as i + eft: baby changing stations - `" ! - ,_ ___. D ETA I LS T $ T T I I 1 (1o3z 2Wz) 0901 o 910 1002 ' 1093 T'. 0002 „_ I 9002 TYP. 1018 1019 '••<6'/. /,.., 7/ ( 4tl/7 • /1 //imnv,a�a racr+x w an���xn/Hm s g�' / •I f -� `'L_ E_ AM a -d,� ,1�__ lr 1i \\ I I/f Niy ill 1o21 lozs �1 I I I I L 4 k �`_� d *q" �-91 �. / 11 I R01 I i I+-� gIr I I RD2 I I! lozo b g t+� 4a I FAMILY I •p l S��I ILC I / FAMILY (E}MEWS • J L y �_��, (E}1ti0h7EN'S 1RESTROOtvt I I I RESTR00M 2 RESTROOM -} f -i RESTROOM — L _�u--� _=-J J` I I 9ooa rrP 191a el, ,-J (( 1o1z TYP 0093 / `� llI - I !' ,e, co - - 4...e — �i 1 1IIl IjI I • 0907 d ---131 1 -- I 9097 (16i8 T •0009 / - SIP 999! (1047> - O -I OI— (t997> ..: I C I 1 (1049) Ono) n DEMOLITION FLOOR PLAN IMPROVEMENT FLOOR PLAN ,,,'' " ,0 TIN rp i N G '0 Off( \U69RPORATE,•.,�F \ CdUNTY C;dl DETAILS • Shown below is the upper level restroom, which was renovated in 2019. These finishes are exemplary of the style that will be installed in the lower level restroom. ..„......., . Y .r F C. .1 ��s ;:if: .:•.:::',.:_. GI � ', \ , k" }.y.a . } Al;; Qt �L d .S�"`' _ ,_ , Yi, _`.1,.... �} a" \ a \\ t COMMUNITY OUTREACH • Central Library patron feedback has shown a desire for family restrooms in the library • City maintenance groups have been consulted on design to ensure consistency in components and parts between new upper and lower restrooms ,,/ N-TiNCT AOF O` �_ t0Y7ORA1' .," =677NTy t;r�i FUNDING/SCHEDULE FUNDING: SCHEDULE: • Engineer's Estimate: • August 2023 — Bid project $200,000.00 • August 2023 — Open bids • October 2023 — Award contract • CDBG Fund account: • November 2023 — Begin construction 23980357.82800 • January 2024 — Complete construction `� , NTINGT t- U ` .•\NCO ATFO•••• \ Q,_. • fir :111,-;11: : '1 ,.," _ —1 4:.'''.,'«,:'':,.k44'-'''.i6t•,'';-..w,.,.,,':.-,:..:"f;,,414-:,*1.'-..*,_'2-.,.:1-;.;s.-...c--....;...-'.!',,1.,-:7.',,-„.1X,-,A•.,.:..! ues ions . ---'-lt...P4-,ii, i:".'.`',' .'','..','.''.-,.i,;''-'.'';.:'.;';:,'-',,.:'..4',:.'P,,,' „,,Vi,.:1'':$*,::,.('i''i*'A,,„,:*,...;lr...,;.,,`4':,,,',4 1;.....',,'.•'',,,':, .;,. 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' '* i Err_( : 7/1q/tea �w 7/9 7.aoa= SECTION A gi3/aoa3 g/1oP' _ NOTICE INVITING ELECTRONIC BIDS for the construction of CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS CC No. 16.58 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 2:00 PM on Tuesday,August 22, 2023, on the City's Planet Bids 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 Planet Bids System Vendor Portal website at: https://www.planetbids.com/portal/portal.cfm?CompanyID=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 Planet Bids system to view and download the Contract Documents,to be added to the prospective bidders list, and to receive addendum notifications when issued. Note that a pre-bid job walk (not required but highly recommended). will be held on Tuesday August 8, 2023 at 9 AM. Meeting point will be the entrance to the Central Library at 7111 Talbert Ave. Huntington Beach CA 92648. Please call John Martin at 714-375-5011 if an alternate appointment is needed. 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 Ait-b 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: CENTRAL LIBRARY LL RESTROOM ADA IMPROVEMENTS CC#: 1658 Bid Opening Date: August 22,2023 at 2 pm. 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 B, at the time of award. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. All extension of unit prices will be subject to verification by the AGENCY. In case of a variation between the unit price and the extension,the unit price will govern. Project Description: Rehabilitation of the existing lower level men's and women's restroom at the Huntington Beach Central Library. Each room will be converted to an ADA compliant family restroom. Wall finishes,plumbing, and HVAC will be replaced as well. The contract shall allow the Contractor SIXTY(]_working days to complete the contract. The Project Disadvantage Business Enterprises (DBE) goal is 0%. All questions related to this bid solicitation must be submitted through the City's Planet Bids 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 Planet Bids 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 60 days. BY ORDER of the CITY COUNCIL of the CITY OF HUNTINGTON BEACH, CALIFORNIA, the 29th day of June 2121,by Resolution No. 2020-39. Attest: /s/Robin Estanislau CITY CLERK OF THE CITY OF HUNTINGTON BEACH Column OFFICIAL AD PROOF This is the proof of your ad scheduled to run in Huntington Beach Wave on the dates indicated below. If changes are needed, please contact us prior to deadline at (714) 796-2209. Notice ID: gyZ53E44W05Wjr0667w1 I Proof Updated: Jul.20,2023 at 10:50am PDT Notice Name: CC-1658 Central Library LL Restrooms(5196687) ( Publisher ID:0011614944 FILER FILING FOR See Proof on Next Page Tania Moore Huntington Beach Wave tania.moore@surfcity-hb.org (714)536-5209 Columns Wide: 5 Ad Class: Legals 07/27/2023: City Notices 804.53 08/03/2023: City Notices 804.53 08/10/2023: City Notices 804.56 Subtotal $2413.62 Tax% 0 Total $2413.62 CC-1658 Central Library LL Restrooms(5196687) - Page 1 of 3 SECTION A NOTICE INVITING ELECTRONIC BIDS for the construction of CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS CC No.1658 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 protect and will receive such bids prior to 2:00 PM on Tuesday August 22,2023,on the City's Planet Bids 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 Planet Bids System Vendor Portal website at: https://www.planetbids.cam/portal/portal.cfm?Company I D=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?Companyl D=15340.Bidders must first register as a vendor on the City of Huntington Beach Planet Bids system to view and download the Contract Documents,to be added to the prospective bidders list,and to receive addendum notifications when issued. Note tbat a.preebid lob walk_(notreyuired.but highly_recommended),will be helu_on Tuesday August 8.2023 at 9 AM. Meeting point will be the entrance to the Central Library at 7111 Talbert Aye. Huntington IWO CA._92648.P_lease call John Martin at71k375-5011ifan_alternate appointment is needed. Any contract entered into pursuant to this notice will incorporate the provisions of the State,Labor Code.Pursuantto the provisions of the Labor Code of the State of Cal ifornia, 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. Tile 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 bidders 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 cis follows: OFFICIAL BID SECURITY-DO NOT OPEN Project Name:CENTRAL LIBRARY LL RESTROOM ADA IMPROVEMENTS CC#:1658 Bid Opening Date:August 22,2023 at 2 pm. The successful bidder shall be licensed in accordance with provisions of the Business and Professions Code and shall possess a State Contractors License Class B, at the time of award. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY.All extension of unit prices will be sublect to verification by the AGENCY. In case of a variation between the unit price and the extension,the unit price will govern. Project Description: Rehabilitation of the existing lower level men's and women's restrootn at the Huntington Beach Central Library. Each room will be converted to an ADA compliant family restroom. Wall finishes,plumbing,and HVAC will be replaced as well. The contract shall allow the Contractor SIXTY (60) working days to complete the contract. The Protect Disadvantage Business Enterprises (DBE)goal is 0%. All questions related to this bid solicitation must be submitted through the City's Planet Bids System Vendor Portal per the information provided in the Instructions to CC-1658 Central Library LL Restrooms(5196687) - Page 2 of 3 Bidders.Any other contact to City staff regarding this bid solicitation will be referred back to the Planet Bids system. The AGENCY reserves the right to relect any or all bids,to waive any irregularity and to take all bids under advisement for a maximum period of 60 days. BY ORDER of the CITY COUNCIL of the CITY OF HUNTINGTON BEACH, CALI FORN IA, the 29th day of June 2020,by Resolution No.2020-39. Attest: /s/Robin Estanislau CITY CLERK OF THE CITY OF HUNTINGTON BEACH Huntington Beach Wave Published:7/27,8/3,8/10/23 CC-1658 Central Library LL Restrooms(5196687) - Page 3 of 3 rIFOUNNCLUDESTAIN THE Avi VALLEY VIEW 1920 Main St. Suite 225, Irvine Irvine, California 92614 (714) 796-2209 legals@inlandnewspapers.com City of Huntington Beach 2000 Main Street Huntington Beach, California 92648 Account Number: 5196687 Ad Order Number: 0011614944 Customer's Reference/PO Number: Publication: Huntington Beach Wave Publication Dates: 07/27/2023, 08/03/2023 and 08/10/2023 Total Amount: $2413.62 Payment Amount: $0.00 Amount Due: $2413.62 Notice ID: gyZ53E44WO5WIr0667w1 Invoice Text: SECTION A NOTICE INVITING ELECTRONIC BIDS for the construction of CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS CC No. 1658 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 2:00 PM on Tuesday,August 22, 2023, on the City's Planet Bids 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 Planet Bids System Vendor Portal website at: https://www.planetbids.com/portal/portal.cfm?CompanylD=15340 [https://www.planetbids.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[https://www.planetbids.com/portal/portal.cfm? CompanylD=15340]. Bidders must first register as a vendor on the City of Huntington Beach Planet Bids system to view and download the Contract Documents, to be added to the prospective bidders list, and to receive addendum notifications when issued. Note that a pre-bid job walk(not required but highly recommended),will be held on Tuesday August 8, 2023 at 9 AM. Meeting point will be the entrance to the Central Library at 7111 Talbert Ave, Huntington Beach CA 92648. Please call John Martin at 714-375-5011 if an alternate appointment is needed. Any contract entered into pursuant to this notice will incorporate the provisions of the State Labor Code. CC-1658 Central Library LL Restrooms(5196687) - Page 1 of 3 See Proof on Next Page INCU/OES THE FALNTAIN / j VALLEY VIEW �-'" Huntington Beach Wave 1920 Main St.Suite 225,Irvine Irvine,California 92614 714)796-2209 2000 Main Street, Attn: Human Resources Huntington Beach, California 92648 AFFIDAVIT OF PUBLICATION STATE OF CALIFORNIA County of Orange County 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 County, State of California, on July 1, 1998, Case No. A-185906 in and for the City of Irvine, County of Orange County, 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: 07/2712023,08/03/2023,08/10/2023 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:Aug 10, 2023. CJGo Signature CC-1658 Central Library LL Restrooms(5196687) - Page 1 of 3 SECTION A NOTICE INVITING ELECTRONIC BIDS for the construction of CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS CC No.1658 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 protect and will receive such bids prior to 2:00 PM on Tuesday,August 22,2023,on the City's Planet Bids 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 protect via the City's Planet Bids System Vendor Portal website at: https://www.planetbids.com/portal/portal.cfm?Company I D=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?CompanyI D=15340.Bidders must first register as a vendor on the City of Huntington Beach Planet Bids system to view and download the Contract Documents,to be added to the prospective bidders list,and to receive addendum notifications when issued. Note that cLpre_kictlob walktnotTe_auire_d but ilighly recommeaided),will_be_held on Tuesday_August 8,2023 at 9 AM. Meeting point will be the entrance to the Central Library at 7111 Talbert Ave, Hulitingtga Be tch CA 926448_Please call John Martin at 714-37575U1_1.if an giternate appointment is_needed. Any contract entered into pursuant to this notice will incorporate the provisions of the State Labor Code.Pursuanttothe 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 bidders 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:CENTRAL LIBRARY LL RESTROOM ADA IMPROVEMENTS CC#:1658 Bid Opening Date:August 22,2023 at 2 pin. The successful bidder shall be licensed in accordance with provisions of the Business and Professions Code and shall possess a State Contractors License Class B, at the time of award. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY.All extension of unit prices will be sublect to verification by tile AGENCY. In case of a variation between the unit price and the extension,the unit price will govern. Project Description: Rehabilitation of the existing lower level men's and women's restroom at the Huntington Beach Central Library. Each room will be converted to an ADA compliant family restroom. Wall finishes,plumbing,and HVAC will be replaced as well. The contract shall allow the Contractor SIXTY (60) working days to complete the contract. The Protect Disadvantage Business Enterprises(DBE)goal is 0%. Ali questions related to this bid solicitation must be submitted through the City's Planet Bids System Vendor Portal per the information provided in the Instructions to CC-1658 Central Library LL Restrooms(5196687) - Page 2 of 3 Bidders.Any other contact to City staff regarding this bid solicitation will be referred back to the Planet Bids system. The AGENCY reserves the right to relect any or all bids,to waive any irregularity and to take all bids under advisement for a maximum period of 60 days. BY ORDER of the CITY COUNCIL of the CITY OF HUNTINGTON BEACH, CALIFORNIA, the 21th day of June 2020,by Resolution No.2020-34. Attest: /s/Robin Estanlslau CITY CLERK OF THE CITY OF HUNTINGTON BEACH Huntington Beach Wave Published:7/27,8/3,8/10/23 CC-1658 Central Library LL Restrooms(5196687) - Page 3 of 3 UNSUCCESSFUL BIDS CC No. 1658 Central Library Lower Level Restroom ADA Improvements e00,,,„NT INGTp City of Huntington Beach c:c)� 2000 Main Street ♦ Huntington Beach, CA 92648 --_ _ (714) 536-5227 ♦ www.huntingtonbeachca.gov 1�� Office of the City Clerk C°UNr{ CPS 0°� Robin Estanislau, City Clerk December 29, 2023 Builtall 4712 E 2nd Sttreet, Suite 520 Long Beach, CA 90803 RE: Central Library Lower Level Restroom ADA Improvements—CC No. 1658 Enclosed please find your original bid bond for CC No. 1658. Sincerely, Robin Estanislau, CMC City Clerk RE:ds Enclosure Sister City: Anjo, Japan 111,e:de: SECTION C PROPOSAL for the construction,of CENTRAL LIBRARY,LOWER LEVEL RESTROOM ADA LMPROVE1 ENTS CC No.1658 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE, MAYOR AND MEMBERS OF !t'HE 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 ihe.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 completethe work"within.4ti 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 underthe 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,takes,royalties,. fees,.etc., and will be guaranteed,foraperiod of s�" �'.days from the bid opening date,If at such. time the contract is not awarded,the AGENCY will reject all bids and:will readvertise the project. In the,case of discrepancies in the amounts bid,.unit prices shall govern over extended amounts, and words shall govern over figures. C-;1 If awarded the Contract,the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds'and insurance certificates. within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER,the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option,be considered,null and;void, Accompanying this proposal ofbid,find G( in the amount of which said amount is not less than 10%of the aggregate of the total bid price,as required by the Notice Inviting Sealed OR.ELECTRONIC Bids,payable to the AGENCY, (Please insert the words"Cash", "Certified Check",or"Bidder'sBond for %o",as the ease in,ay be)Any stRndArd Surety Bid Bond form is acceptable. Bidder shall signify receipt of all Addenda here,if any; Addent a No, Date,Received ` Batter's Signature _. 15'0o 2 CITY OF HUNTINGTON BEACH CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA. IMPROVEMENT BID SCHEDULE Item# Description of Work Quantity Unit Unit Price Item Total 1 Mobilization 1 LS $ il gee $ Ifs*Of iv 2 Construction Waste Management '1 LS $ 3g6t? ""- $ 3 Closeout li i LS $ 1/70 a" $ gal 4 Demolition, - 1 LS $ihffi-•"'" $1109 g% • 5 Abatement 1 LS $g 0-9,5 0 sie515"2?" 6 Concrete and Reinforcement 1 LS $ loge $49if 1 _d. v 7 Casework/Countertop 1 IS $ 5-ilt, $,4,/k '0 / 0 8 Blanket Insulation 1 LS $ /719--Ow $ ?7 ' i ,T „,, 9 joint Sealants 1 LS $g75,`1"' $075/9 v 10 Aluminum Door Frames I LS $;IV 11 Wood Doors : 1 LS $ rree€1 SOW f op i ow, 12 Access Doors and Frames 1 LS $ 13 Door Hardware 01 0 e, 1 LS $qgg ,$10 14 Glazing/Mirror 1 LS $ ge4P $g V 6-41 15 Gypsum Board 1 LS $ qv," •-• $ filo, 16 Metal Stud Framing 1 LS $ 7 5A9 17 Porcelain The Floor Finishing 1 IS $ ik,‘,OP v $/4 oil o' is Porcelain Tile Wall Finishing 1 LS $al 60'Y $49.75-#8 of P I 19 Painting 1 LS $ siv 0 $ctre ...e 20 Signage e , 1 LS $ /spo $to pp 0 21 Toilet Accessories Ile AV: 1 LS $/5115-'f' $155 / 0- 22 Plumbing 1 IS$ $b41/1/7 $/441/7ef 23 Mechanical 1 LS $ (30-eve-/ -$5c/P-4.4,1, 24 Electrical 1 IS $ 1 Ve7/et $ 9:7avt -1/- *-- ....X Total in q Numbers C-2,1 Total in Words: 4/1141711 zOre NOTES: The estimated quantities listed,in the Proposal Bid Sheets are approximate and are to be ,used°illy as comparison of bids.Payment for quantities will be made from;field measurements..If the actual quantities show either an increase ordecrease from the quantities given in the Proposal Bid Sheet,the Contract Unit Prices will prevail.Full compensation will be: paid at the contract price for the actual completed,and no additional compensation will be allowed therefor.Payment will not be made for materials wasted or disposed of in a manner not called for under the contrac4this includes rejected material not unloaded from vehicles and Material rejected after it has been placed. No corn pensationwilil be allowedfor disposing of rejected or excess material,TheCity reserves the right to reject all bids and to Increase ordecrease the amount of any quantity shown on the Proposal Bid Sheets.Incase of a variation between the unit price and the totals shown by the bidder,the unit price will be considered to be the bid. Compensation for items of work not specifically identified in these bid items Shall include all labOr,materiels,thals,equipment,:safety meatikesi and superVition reciiiired to complete the work to grades end dimensions shown on the Plans or staked in the field..There shall,be no. compensation'except forthebid items specified in the Proposal.The cost of all workshown in the Plans and Specifications but not specifically identified as a bid item or described within a bid item shall be inclUded in related bid items,and no additiOnal compensation'Shall become due the Contractor by nature of compliance with the Plans and Specifications. C-2.2 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 $1,0,000, whichever is greater, and the portion of the work to be done by such subcontractor. Bid Name and Address of State class DIR"I'WC Dollar t)(3,of Item(s) Subcontractor License Itegiqtr4 IR%it Amount Contract Number teak 505C-44 odelaYin h flog 100'5' ,04461,4C123#jW 0-0 -801. b :961171 itirdck gOirr .ivit 31 0 Q03 , 1070 !Meg ,ipii,v0440141 Ofg •VO4. tC2Iatoto oet ,4,t-ratee4leitivt A04 ‘1 5,01fite gqbe D4 .4;f4r'''M 00fr iitedo‘ bow ep_00 jefik4 gA 4 foog ow krMir--)C4` lq woroXit-e4 119416 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 NONCQLLt.SIO►N AFFroAVIT TO BE EXECUTED'BY BIDDER.AND SUBMITTED WITH BID I declare under penalty nf penury under the laws of th State.of California that the foregoing is true and correct and that this declaration is executed on4N .at GITT �, Date Liar State ,P ‘k /t ,being fire dilly sworn,deposes and says that he or - " she isiN of Le 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 ha-5 not directly or indirectly induced or solicited any other bidder to put in a false or Sham bid,And has.not directly or indirectly collluded„'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,comma cat on, 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 i the bid are true, and, further, that the bidder has not, directly or indirectly, submitted his or.bet bid puce 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 agentthereof to effectuate a collusive or sham bid. Mine o Bidder Signature:of Bidder .11 .. ' 049 5 Address of Bidder UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF IfUNTINGTONBEACH,CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the CENTRAL LIBRARY LOWER LEVEL ADA IMPROVEMENTS, (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't is defined in Title if„California Administrative Code, Section 2700.,as follows: "Qualified Permit. A person who, by reason ofexperience orinstraction,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 arty 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. *' Contractor ri(ekf arlionoti By r Title Date: C-5 DISQUALIFICATION QUESTIONNAIRE In accordance:with Government Code.Section 10162,the Bidder shall complete,under penalty of perjury,the following questionnaire.. QUESTIONNAIRE: Has the.Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been.disqualified,removed or otherwise prevented fombidding on or completing.a Federal,,State or local government project'because of violation of law or a safety regulation? CI Yes No If the answer is yes,explain the circumstances in the spacexprovided.. Note: This questionnaire constitutes apart of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C=6 COMPENSATION INSURANCE CERTIFICATE Pursuant ttft•Section.1861 ofthe State Labor Code,eachcontractorro whom apublic works contract has been awarded shall sign the following celtifiCate• I am aware of the provisions of Section POO of the Labor Code which require every employer to be insured against liability for worker's compensation of to undertake self- insurance in accordance with the provisions of7 that cad; awl I will'comply with such prONTiSiOilS before commencing The perfohnance of the work of this contact flAd'IAL Contractor Pr-it-10 ALEYorof By Title Date', r. C-7 BIDDER'S INFORIVIATION BIDDER certifies that the following information is true and correct: fWMIL6, BidclerName L 171— rPtir7 5.1 Butiness Address LAO 'WO 9g-gY3 City, - State Zip (50) 67-76• ,0,1 goo'Ya9.90e4 Telephone Number', Address 7g52 75" e-)7z State Contractor's License No.and Class q-cf7ego Original Date Issued g'aq Expiration Date , g The work site was inspected byga lityX.~4 of our office on - 20g3 The following are persons,firms,and corporations having a principal interest in this proposal:, OWW14-4 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its:ability, financially or otherwise, to perform the contract for the proposed work and improvements in • accordance with the plans and specifications set forth. gke_<oitt e, Company ame Signature of Bidder itiPilErVe Printed or Typed SignatUre NOTARY CERTIFICATE Subscribed andaworn.ta bid=me this day of 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 truthfillness,acctiraq.,or validity of that document. State-of, '61* 8 Ltis a/ les; county of e ), On vg- 9.7, 7ion before me , A — , - onth,Days 4114 Year Tn.-ert Name and Title of I otary personally appeared -.Peke Da.tir d trielt erson Name(S)0 Signer(S) ....... who proved to me on the basis of satisfactory evidence to be the person(s) whose.name(s),:isiare subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/theirauthorized capacity(ieS),and that by his/her/their signature(s)on the instrument the person(s)i or the entity upon behalf of which the person(s)acted,executed theinstrument. 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. e dks .s4„atur / , e i 6 y i•_ - Si tas ,f I e of:1%1.0'41y RiNic (PLACE NOTARY SEALABOVE) i -.. ..- AA ,ffl, -•••• ...ea—ai ..... ek—esa.:as f x 1 JENNY CLOUD ,. Notary Public California , 4 fp., .. Los finales County. .77... Commission*2320142 ''' my Comm,Expires Feb/5,2024 0.9 Bidder's Project History For the purposes of this project the contractor and•subcontractor must have, i± the last five years, constructed at least five (5) projects of similar work specifically referencing the construction of {Describe specific work and experience necessary for project,for example"Reconstruction or rehabilitation of existing public use facilities". Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein.. The following list of projects,meet the requirements of above:. 1, 5Y 011110 NA 19141 "- 1.-r, Name and Address of Reference Name and Telephone No. of Owner: Cere 44/0.‘4Cc441 Woo oe-mr-Y57-7 ffr COON &owe- 41-0.2,42•5 Contract Amomat Type of Work Date Completed Provide additional project description to show similarworlc eple‘ e 51#11.1- &.5422A467 494 lifIZAVO. 2 frilur -7 -1-0`40.4rit4 0.6*.friletOW nVirk-t- ; 1t72 ro'4,amei2/ oleo goo' Name and Address of Reference Name and Telephone No. of awner:"Nal akWagatt 111/11( 3693--5-051-50r 13(170) f&gwe Contract Amount Typeof Work bate Completed Provide additional project description to show simila.rwork: an)tig --r r- -4700129/4 17 * -re 3. qP40 ethiC iSr Pu4/. 111(.41,, 14, frAirA0341 Name and Address of Reference Name and Telephone NO. of Owner: 5s1" -691-5321V/49 giC e ‘WP 910 tite.17 /17'e-ggg0 Contract Amount Type of Work Date Completed Provide additional project description to sh_owsinailarwork: g;OPM riegiX It) R eim704, 01,11-e rfr 4 PIP, et.e1.55 ig"gl91 G-10 4. N ite16,5 "": iV *-VP a 44, Name and Address ofReference Name and Telephone No.of Owner L-4C/0 rie-A405749 ig5 D‘f ,,koppri:w grow-4v,-, F-dPif contract Athoimt Type&Work Date-Compieted Provide additional project description.to show similarwork: MK" Aett.,2 10,K91-AWN Tt2WE 5- gg, 711 e4yr 5t< &-0.0: a Name and Address ofReference Name and Telephone No.of Owner - 4trokiiN4a gis M . Tfr /RV Contract Amount Type of Work Date Completed Provide additional,project description to showsiimiarvv9r15: x5isi.,4-r<41A f...3<xitPro e4%.407 feA,6,c4 k-Auf ve,tkeimiceol c_il Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager,and Superintendent.For each of these critical positions,please list at least three projects for which the critical staff has performed similar work within the last five years. These projects do not have to be under the employment of the bidder of this project.Bidders are encouraged submit supplemental relevant project history in addition to the projects listed herein. I_ ?Xerox ivrikie Jog Name of proposed Project Manager Telephone No. of proposed Project Manager ''/ 1-25;144 Project.Name&Contract Amount Type of Work Date Completed 111-&0 (v, ferowooraaz -0-62eZni'5. ProjectName&Contract Antmmt Type of Work Date Completed tke50 4f0 ACOrir 0Wri&r-° c54 Project Name&Contract Amount Type of Work Date Completed 2. 04 ditXrMt-- Name of proposed Superintendent ti14 V-4/-7d Telephone No,of proposed Superintendent A-014 PigpiN 1111014tfar- I641 Project Name&Contract Amount Type of Work Date Completed. PI-A/ 11111.4.5f gf)Pd Project Name&Contract Amount Type of Work Date Completed t-allAkr 51°40/ .4149,5 //4 tiiik7~441 .710-/tV Project.Name 8c Contract Amount Type of Work Date Completed 042 CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS.(DIR)CERI1FICATE Pursuant to SI3 854(cifing Labor COde Section I771.1(a)),passed by the California State.Senate on June 20,2014,established a new public works ContrattorRegistration Prograta,Which reqinies all contractors and subcontractors bidding and performing work on Public Works Projects to register on. an annual.basis (each July 1 through jute '30 state fiscal year) with the California Department of Industrial Relations(DIR) Currently the annual non-refundable registration fee for Contractors is$300`Eaeh contractor to whom a public works contract has been awarded shall sign the following DM FACT SHEET on SE.854http://wWw.dir.ca.gov/DLSE/PublicWorks/SB854FactSheet 6.30.14.pdf DIR's Contractor Registration Link—Call(844)522-6734 https:/ ling.dir.cagov/PWCR/ActionServlet?action=displaYPWCRegitrationFonn DIR's Contractor Registration searchable database: https://efiling.dir.ca.gov/PWCR/Search.action: I am aware and will comply With the of Labor Code.Section 1711.1(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 palified to perform pubhc 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 291015 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 tinid of sainitting the bid. a WO--114 Contractor By -*ri'4ft4 Email Title. Date: 8-ig,ifg 3 AA a .01 2. PWC Registration ik ttrit/PU C-ia EXHIBIT A DISADVANTAGED BUSINESS ENTERPRISE(DBE) This Project is subject to Part20032.1,Title 2,Code of Federal Regulations entitled"Contracting with Small and Minority Businesses, Women's Business Enterprises,and Labor Surplus Area Firms." The Regulations in their entirety are incorporated herein by this reference.. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in Part 200.321,E Title 2 CFR, shall be encouraged to participate in,the performance of Contracts financed in whole or in part with federal funds.The Contractor should ensure that DBEs,as defined in Part 200 321., Title 2 CFR, have the opportunity to participate in the performance of this Contract and,shall take all necessary and reasonable le steps,asset forth in Part 200.321,Title 2 CFR for this assurance.The Contractor shall not discriminate on thebasis ofrace,color,national origin, or sex in the award and performance of subcontracts.Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project,although there,is no specific goal for DBE participation. C-14. • EXHIBIT B DBE INFORMATION—GOOD FAITH EFFORTS Federal-aid Project No. Bid Opening Date ift-afel72,6/ 5 - - . The City of Huntington Beach established a Disadvantaged Business Enterprise(DBE)goal of 0% for this Project.The information provided herein shows that a good faith effort was made. Lowest,second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the"Local Agency Bidder DBE Comniitanent”form indicates that the;bidder has Met the DBE goal.This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening,,or the bidder made a mathematical error. Submittal of only The"Local Agency Diddet.Dilb Cortimirrnent"britm may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled"Submission of DBE Commitment" of Special Provisions: A. The names and dates of each publication in which.a request for DBE participation for this project was Plated by the bidder (please.attach copies of advertisements or proofs of publication): Publications Dates of Advertisement ft/ B. The names and dates of written notices sent to certified DBEs soliciting bids for this Project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested(please attach copies of solicitations,telephone records;fax confirmations,etc.): Names of DBEs Solicited Date of Initial Follow Up Methods Solicitation and Dates , . C-15 C. The items of work which the bidder made available to DBE firms including, where appropriate,any breaking down of the contract work items(including those items normally performed by the bidder with its own forces)into economically feasible units to facilitate, DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items ($) of (Y/N) Contract a 9, D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs,the firms selected for that work (please attach copies of -- quotes from the firms involved),and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: Names,addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested DBEs in obtaining bonding,lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: C-I6 F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affliate: G. The names of agencies, organizations or groups contacted to provide assistance in contacting,recruiting and using DBE firms (please attach copies of requests to agencies and any responses received,i.e.,lists,Internet page download,etc.): Name of Agency/Organization Method/Date of Contact Results H. Any additional data to support a demonstration of good faith efforts(use additional sheets if necessary): NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. C-17 AiIF A SOLE OWNER ER-OR SOLE CONTRACTOR SIGN THERE: (1)Name under*blob business is conducted (2) Signature(gib and surname)of proprietor (3) Place of Busines (Street and Number) City and State (4)Zip Code° Telephone No: (5) E-IVTai1, IE A.PARTNERSHIP,SIGN HERE: (1)Name under which business is conducted (2) Signature(given and surname and character of partner)(Note: Signature must:be made,by a general partner (3) Place of Business (Street and Number) City and State (4)Zip Code Telephane.No; (5) E-Mail C-18 IF A CORPORATION,srei HERE: (1)Name under which business is conducted (.2) (Signature) .g41 (Title) Impress Corporate Seal here (3) Incorporated under the laws of the State of eA,...‘peire /f (4)Place of Business 1/7a aiW61- 5--.12e(j1 (Street and Number) City and State 1-49/614 004, (5) Zip Code 904Kifi Telephone No. 3/A - (6)E-Mail Pygin NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED List below names of president,vice president,secretary and assistant secretary,if a corporation;if apartnership,list names of all general partners and managing partners: Pe-rox EIEVW0dod 171 ,5ipoitiL.r Po-wo rforox irloYAr-tioti irkge7vroz C-19 EXHIRIT C LOCAL AGENCY BIDDER DBE:COAIMIWENT(CONSTRUCTION CONTRACTS). NOTE:114EASE"-RERF411 TO INSTRUCTIONS ON IkU REVERSE SIDE OF FORM • LOCALAGEIXY; LOCATIbit .PROJECT DESPRIETIQNt TOM bbtITEACTAMbiNT: 111DDA.TE: • VDDEle2S.SAME; CONTRACT DBE GOAL:. CONTRACT ITEM OF WORK AND DEscR7DoNDBE•CHUM). •;IAMB OF EACH DBEDOLLAR AMOUNT ITEM NO SERVICES TO 3E011),attqltAt1casr. ifideitifit4 OnAlin.rfate'MOSE: SUBCONTRACTED OR MATERIALS DATE are opened-include DBE address TO BE.PEQVID)313'(ot tontracted,'.ittlie and iihone-number), •bidantia a DBE) For Local Agency to Complete: Total eraitiddDBE : 7.4301:Agency b.OnttaefAinther rrOjnet:I'iliitabeit Fedirtallhate , COntlantA*ard Date • Lanai Agehonettiteittiiatalt DBE:ceitIficationslave been v.exiliedand • informs *con:00W'and,annotate- Sign of Etidder 94. Date (AreitodeMer,No, Print Name :Signature Date, 1::704104 "Attgver_e-Ariv „Pertoirtcueontkcit. —,(Kease Typ.o nirrint): CArea bodeyTeterificineNintaberi. . AmtnntRidderDBECommitment(cOorinwOon4oinagto) glev 6126109), . . C-20 PLEASE NOTE; This information may.be submitted with your bid..Ifit,is not,and you ate the apparent Tow bidder or the second or third low bidder,it must be submitted and received as Specified in,the'Special Provisions.failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency;. Location, Project Description, Total"Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs.Prim contractors shall indicate all work to be performed by DBEs including,if.the prune is.a DM,work performed by;its own. forces,if a DBE. The DBE shall provide a certification number to the Contractor and expiration_ date.Enter the DBE prime'S and subcontractors'certification numbers-The form:has a.column for the Names of DBE contractors to perform the work(who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all`DBE firms participating in the project regardless of tier.Names of the First-Tier DBE Subcontractors and their respective item(s)of work listed should,be consistent,. where applicable,with the names and items,of work in the"List of Subcontractors"submittedatibminedwith. your bid. There is a column for the DBE participation dollar amount. Enter the Total. Claimed. DBE Participation dollars-and percentage amount of items'of work submitted with your bid pursuant to the Special Provisions. (If 100%of item is not to be performed or furnished by the DBE,describe -exact portion of time to be performed or furnished by the DBE.);See.Section 'Disadvantaged Business.Enterprise(DBE),"of the Special Provisions(construction contracts),to determine taw to count the participation of DBE firms. Exhibit.x G must'be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the,person to contact. Local agencies should complete the Local Agency Contract Award,Federal-aid Project Number,. Federal,Share,Contract Award;Date.fields and verify that all information is complete and accurate before signing and filing. C-21 EXHIBBIT"D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The.bidder if , [proposed subcontractor ]:hereby certifies that helshelt has. ,has not ,participated in aprevious contract or subcontract subject to the Equal Opportunity Clauses,as required by Executive Orders 10925., 11114,or 1.1246,and that,where required,he/she/it has filed with the.joint Reporting:Committee,the Director Of the Office of Federal Contract;Compliance,a Federal Government contracting or administering agency,or the former President's.Committee on Equal Employment Opportunity,. ail reports due under`the applicable filling requirements. Note: The above certification is required by the Equal.Employment Opportnnity,Regulations.of the Secretary of Labor (41 CFR 6.0 17(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$10,00 or under are exempt.). Currently,Standard:Form 100(EEO 1)is the only report required by the;Executive Orders or their iinplementingregulations. (eeoc.gov/employersleeolsurveylindex.cfn) Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject lathe 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 ofLabor. Signature:r: Date: Print Name: P 41 ' Title: C-22 EXHIBIT E NONCOLLTISION AFFIDAVIT (Title 23 United States Code Section.112 and Public Contract Code Section 7106) [NAME OF CONTRACT] eeeli To the City of Huntington Beach In conformance with Title 23 United States Code Section 112 and California Public Contract Code 71.06 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 41ST1T;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 colluded,conspired,connived, or agreed with any bidder or anyone else to put in a Shalt 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 for 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 contact 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,.organi7ation„bid depository,or to arty member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. By signing the Proposal,the Bidder has also signed this Noncollusion Affida.vit. Bidders are cautioned that making a false Certif.' cation May subject the Bidder to criminal prosecution. 'Signature: Date: R-0-2ag 3 Print Name: , Title C-23 • EXHIBIT F DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS,PART 29 The Bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated with Bidder in capacity downer,partner,director,adder,manager: • is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any Federal agency; • has not been suspended,debarred,voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending;and • has not been indicted,convicted,or had a.civil judgment rendered against him/her by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to.this certification,insert the exceptions in the Miming space: Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility.For any exception noted above,indicate below to whom it applies,initiating agency,and dates of action. Note: Providing false information may result in criminal prosecution or administrative Sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Signature: Date: - - ;7 Print Name: /1/10Yried Title: c_24 EXHIBIT°G ,NONLOBBYNG'CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies,by signing and submitting this bid or proposal,to the"best of his or her k owledge 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 inflfluence an officer or employee of any. Federal agency, a Member of Congrress 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 anyFederal 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 I,T'I., "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 rnacl a or entered into. Submission of this certification;is a prerequisite for making or entering into this transaction imposed by Section 1352,Title 31.,U.S.Code..Any person'who fails to file the required certification shall be subject to a civil penalty-of not less than$10,000 and not more than$100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower, tier subcontracts, which exceed$100,000.and that all such subrecipients shall certify and disclose accordingly. Signature: Date: , Pg'% 3, Print Name: P l Titter. C-2$ man-Brr ft DISCLOSUit OFLOBBYING ACTIVITIES COMPLE,Tb THIS.FORM TO DISCLOSE LOBBYING ACTIVITIES PLITCSUANT TOr 31 IT.&C.1352 . , 1. "Typaef Federal Action 2 'Status Of Federal Action:: '1.. •Reportlype; 0&coat:met Dui bWofreriapplidatien 0 a.undid 17,::grata. "it,initial'.award *.material change , C.Mitiperative,agreement t404).tattl 4100 FOrMktg/00:11411g4Only:. &loan:guarantee year'guider • ' .1`.;loan inSuratice A*414417ePe.r.t. '. 4. NaMe:arritAildreSS of Reporting Entity ,5. IllteporOngEntkrin NO:4 Is SohaWardite,klik. Enter Name and Address Offirime; • •. El Ptirrie 0 Subawardee Tier ,ifintown ,.ckagresslogal,Platrist,Almown Cangreatikinal Dittrict,ifknown 5. Federal Deparratertf/Agency; 7., 'Federal Pregram.NsiinefDescription; CHIA Nimiber;irapplicable 1•,. federal:4400n Nomber,Iflon 9. Astard.Amount.liknown: ' • 10; a.Name and Address of Lobby Ratify li:, .ludIviduals Performing Services (Mauling (TtindividiagyfainiCutikfirat name;MI) •edtbess•if different from No:100 gag•niniei.first name;1141) • (attach Continuation Sheet(s)if:necessary) 11:. „Amount ofPaynient(clieekallthat apply) 13 Type OfInyMenr(idiecksitIther apply) $. . 0.Actual. lOplanned a,retainer 17. b;kne-titatiet , . 124 Penn of Payment(check alIthat,api$0; C.eMinnissiori . 4.4aall b,iti4cirid;• StieCify;nature El .. d.contingent* —', e deferred: Woo ' i".„)athen„speeit 14. Brief Description of Services 0*1a..- or to Iii.nyierfonned°,ana Date(s)Of Schrift,including -ofittier(a),impkiyeecsVor member(s)contacted,for faymenfIndicatedln Ilem 1i:. kotrich Continuation Shcet(S)ifnedeasety) r—i• IS. .•CaiitinuadonSheet(s)attached; . YesEl No 1....1 ..' 1* InformaticatretgteStOltroughtliii,garin is authorized by 31,T1S.:C Section 1352,This disclosure of:lobbying reliance. Signature: vas iplatettbythetlet above*lieninS transactionicati;Wool' . •, entered into;Tine.cliselosure is required pursuant to 31 II.St. Print NaMe; i S4. This hifortnatiali. will be reported to Congress ,. . semiannually-and„.'will be Vallable for public inspection.Any Title person Who:faits*file the renn4e4dincicsure shall be subject to torial penalty Of tailless than Stipoo.and met more than TeIeriboneNoz, . „ bato;. $I9Q,-.00.0*reach 4e4::fnifure. M0-00ze4 foaocalltepreilnction FetierallIWOnlyt Standen:I Friini:-,ILL Standard,FormLLLRev,09-1247 ' • . C-26 • INSTRUCTIONS FOR COMPLETION OF EXHIBIT It DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form,shall be completed bythe reporting•entity„whether subawardee orprime Federal recipient,at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 aS.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a -covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance puhlished the Office&Management and Budget fora information. I) Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered Federal action. 2) Identify the status of the covered Federal action, 3) Identify the appropriate-classification of this report-If this is a follow-up report caused by a material change to the information previously reported; enter the year and quarter in which the change occurred Enter the date of the last,previously submitted report by this reporting entity for this'covered Federal action. 4) Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District if known Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient Identify the tier Of the subawardee„e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5) If the organi7ation filing the report in Item 4 checks"Subawardee"then enter the full name, address,city,state and zip code of theprime Federal recipient Include Congressional District, if known.. 6) Enterthe 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 Quard. 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 (RFF'):number, Invitation for Bid (IIB) number, grant announcement number, the contract grant or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, "RFP-DE-90-001.." 9) For a covered Federal action where there has been an award or loan ccounitment by the Federal agency,enter the Federal amount of the,award/loatt commitments for the prime entity identified in item 4 or 5. 10)'(i)Enter the full name,address,city,state and zip code of lobbying entity engaged by the reporting entry identified in item 4 ta influenced the covered Federal:action. G-27 (b)Enter the full names of the individual(s)performing services and include full.address if different from 1.0(a) Enter'Last.Name,First Name and Middle Inityal(M1)- 11)Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item,4)to the lobbying entity(item 10).:Indicate whether the.payment has been:made (actual) or will be made (planned). Check all boxes that apply If this is a material change report,enter the cumulative amount of`payment made or planned to be mile, 12)Check the appropriate boxes). Check all boxes that apply.If payment is made through an in kind contribution,specify the nature and value of the in kind payment. 13)Check the appropriate boxes) Check all boxes'that apply..,If other,specify nature 14)Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s).of any services rendered,hiclude 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(i) employees) or Member(s)of Congress.that were contacted. 15)Checkwhedier or not a continuation sheet(S)is attached 16)The certifying official shall'sign and date the form,prnt.hisier name title and telephone tin bet. Public reporting burden for this collection of information is estimated to average 30 minutes per response,including time for reviewing instruction,searching existing data sources,gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any-other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and -Budget, Paperwork Reduction Project(0348-0046),Washington,D,C.20503. By my signature.on this proposal I certify,under penalty of perjury under the laws;of the State of California, that the foregoing questionnaire and statements of Public Contract Code Sections 10162, 10232. and 10285.1 are true and .correct and that the bidder has complied with the requirements of Section:8103 of the Fair Employment.and:Housing Commission Reg 'illations (Chapter 5,,Title 2 of the California Administrative Code). c-2s EXHIBIT I FEDERAL LOBBYING RESTRICTIONS Section 1352, Title 31, United States Code prohibits Federal funds from being expended by the recipient or any lower tier subrecipient of a Federal-aid contract to pay for any person for influencing or attempting to influence a Federal agency or Congress in connection with the awarding of any Federal-aid contract,.the making of any Federal grant or loan,or the,entering into of any cooperative agreement. If any funds other than Federal funds have been paid for the same purposes in connection with,this Federal-aid contract,the recipient shalt submit an executed certification and,if required,submit completed disclOsure form as part of the bid documents. A certification for Federal-aid contracts payment of funds to lobby Congress or aFedetal agency is included in the Proposal. Standard Form- LLL, "Disclosure Of Lobbying Activities," with instructions for completion of the Standard Form is also included in the Proposal.Signing the Proposal shall constitute signature of the Certification. The above referenced certification and disclosure of lobbying activities shall be included in each subcontract and any lower-tier contracts exceeding $100,000. All disclosure forms, but not certifications,shall be forwarded from tier to tier until received by the Engineer. The Contractor, subcontractors and any lower-tier contractors shall file a disclosure form at the end of each calendar quarter in which there occurs any event that requires disclosure or that Materially affects the accuracy of the information contained in any disclosure form previously filed by the Contractor, subcontractors and any lower-tier contractors.An event that materially affects the accuracy of the information reported includes: A cumulative increase if$25,000 or more in the amount paid or expected to be paid for. influencing or attempting to influence a covered Federal action;or 2) A change in the person(s),or individual(s)influencing or attempting to influence acovered Federal action;or a) A change in the officer(s), employees(s),or Member(s) contacted to influence or attempt to influence a covered Federal Action. 0-29 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 535-5431, Fax(714) 374-1573 ADDENDUM NUMBER ONE For CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA impRovemENTS August 15,2023 Notice to.All Bidders: Pleasenote the following clarifications to the Project Plans,Specifications,and Special Provisions. 1) The updated wage determination dated 8/11/23 has been attached herein. This replaces the wage determination found in Appendix G of the project specifications. • This Is to acknowledge receipt and review of Addendum Number One,dated August 15,2023, filff-A1-1- eer.oz WYKr-501 Company Name By Date • 1 of 1 of Addendum No. =_iAIA Document A310TM — 2010 . .. . . ... . . .. . . .. Bid Bond No:N/A = Bid Bond CONTRACTOR: SURETY: (Name, legal status and address) (Name,legal status and principal place Contractors Bondingand Insurance Company BUILTALL of P Y 4712 E 2nd Street, Ste 520 9025 N. Lindbergh Drive Long Beach,CA 90803 Peoria, IL 61615 This document has important legal consequences.Consultation with OWNER' an attorney is encouraged with (Name.legal status and address) respect to its completion or modification. City of Huntington Beach 2000 Main Street Any singular reference to • :.. Huntington Beach,CA 92648 Contractor,Surety,Owner or BOND AMOUNT: Ten Percent of the Total Amount Bid(10%of Bid Amount) other party shall be considered plural where applicable. PROJECT:. .. .. (1lrame location or address,and Project number, if any) :Central Library Lower Level Restroom ADA Improvments;#1658 Project Number,if any:1658 The:Contractorand Surety°'are bound to the Owner in the amount set forth above,for the payment of which the Contractor and,Suretybind themselves,their heirs,executors,administrators,successors and assigns,jointly and severally,as provided herein:The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents,or within such time period as may be agreed to by the Owner and :Contractor,and the Contractor either(1)enters into a contract with the Owner in accordance with the terns of such bid'and.gives such bond or bonds as may be specified in the bidding or Contract Documents,with a surety admitted 'in the jurisdiction of the Project and otherwise acceptable to the Owner,for the faithful performance of such Contract and for theprompt.payment of labor and material furnished in the prosecution thereof;or(2)pays tote Owner the = 1 difference,:not to exceed the amount:of this Bond,between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid,then this :: ` 'obligation shall be..null and void,otherwise to remain in full force and effect.The Surety hereby waives any notice of an:agreement between the:Owner and Contractor to extend the time in which the Owner may accept the bid.Waiver of . .. notice by the Surety shall not apply to any extension exceeding sixty(60)days in the aggregate beyond the time for acceptance of bids specified in the•bid documents,and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty:(60)days. If this Bond is issued in connection with a subcontractor's bid to a Contractor,the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall he deemed to be Contractor. • When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project, any provision'in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein.When so :furnished;the.jtitefl is that this Bond shall be construed as a statutory bond and not as a common law bond. Signed and sealed this 21st day of August 2023 BUILTALL (Principal) (Seal) ::(Witne ) (Title) Contractors onding nd Insurance Company (Surety) (Seal) (Witness) V\ (Title) Ch istine oolford, y-in-Fact loft AIA Document A310,"—2010.Copyright©1983,1970 and 2010 by The American Institute of Architects.All rights reserved.WARNING:Thi".AfA�' Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA°`Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.This / document was created on 01/27/2012 07:23:12 under the terms of AIA Documents-on-Demand',"order no. 2008397483,and is not for resale.This document is licensed by The American Institute of Architects for one-time use only,and may nol be reproduced orinr to its comnletion.ne,,,o CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORNIA County Orange Oran a _} On AUG 21 2023 before me, Thao Nguyen Luu , Notary Public, Date Insert Name of Notary exactly as it appears on the official seal personally appeared Christine Woolford 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 THAO NGUYEN LUU person(s), or the entity upon behalf of which the person(s) `�:;; Notary Public-California acted, executed the instrument. $ / Commission#OranseCounty + ��My Comm.Expires Jul L 2027 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal. Signature Q i/. Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of the form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s)Other Than Named Above: Capacity(ies)Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer—Title(s): ❑ Corporate Officer—Title(s): ❑ Partner ❑Limited ❑General ❑ Partner ❑Limited❑General ❑ Attorney in Fact RIGHT THUMBPRINT ❑ Attorney in Fact RIGHT THUMBPRINT ❑ Trustee OF SIGNER ❑ Trustee OF SIGNER ❑ Guardian or Conservator Top of thumb here ❑ Guardian or Conservator Top of thumb here ❑ Other: ❑ Other: Signer is Representing: Signer is Representing: . ' POWER OF ATTORNEY RLI Insurance Company Contractors Bonding and Insurance Company 9025 N.Lindbergh Dr. Peoria,IL 61615 Phone: 800-645-2402 Know All Men by These Presents: That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the approving officer if desired. That RLI Insurance Company and/or Contractors Bonding and Insurance Company, each an Illinois corporation, (separately and together,the"Company")do hereby make,constitute and appoint: Yung T.Mullick,James W.Moilanen,P.Austin Neff,Irene Luong,Emilie George,Danielle Hanson,Christine Woolford,Alexander R. Holsheimer,iointly or severally in the City of Mission Viejo , State of California its true and lawful Agent(s) and Attorney(s) in Fact,with full power and authority hereby conferred,to sign, execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all bonds and undertakings in an amount not to exceed Twenty Five Million Dollars ( $25,000,000.00 )for any single obligation. The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon the Company as if such bond had been executed and acknowledged by the regularly elected officers of the Company. RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have each further certified that the following is a true and exact copy of a Resolution adopted by the Board of Directors of each such corporation,and is now in force,to-wit: "All bonds,policies,undertakings,Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President,Secretary,any Assistant Secretary,Treasurer,or any Vice President,or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds,policies or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds,policies,undertakings,Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile." IN WITNESS WHEREOF, the RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have caused these presents to be executed by its respective Vice President with its corporate seal affixed this 15th day of February , 2023 . „,,mNC,,,,,.,,,, RLI Insurance Company ,0oao,Ne AND/1,5`.,, ``,�,,,,,, ..E c' A��,' Contractors Bonding and Insurance Company a.: 4oPPOHgr�9\ s� .0aPOR,4r• e•..y% ia.73- I 5 Ya. SEAL •;.6. = , SEAL . B Barton W.Davis Vice President State of Illinois l ',,, ituNo;s"'',, ',,��,6'"4 L,I,Nm�,°���`` } SS • County of Peoria JJJ CERTIFICATE On this 15th day of February , 2023 before me,a Notary Public, I, the undersigned officer of RLI Insurance Company and/or personally appeared Barton W. Davis , who being by me duly sworn, Contractors Bonding and Insurance Company, do hereby certify acknowledged that he signed the above Power of Attorney as the aforesaid that the attached Power of Attorney is in full force and effect and is officer of the RLI Insurance Company and/or Contractors Bonding and irrevocable; and furthermore, that the Resolution of the Company as Insurance Company and acknowledged said instrument to be the voluntary set forth in the Power of Attorney, is now in force. In testimony act and deed of said corporation. whereof, I have hereunto set my hand and the seal of the RLI Insurance Company and/or Contractors Bonding 23and Insurance Company this 21 st day of Auqust , 20 By: O 0, �j'-QLa RLI Insurance Company Catherine D.Geiger Notary Public Contractors Bonding and Insurance Company /— CATHERINE D.GEIGER NOTARY OFFICIAL SEAL t vueuc Notary Public-State of Illinois By: SILL, ,�i My Commission Expires Jeffrey icl l 37.C4C.' Corporate Secretary December 05,2026 0456659020212 A0058D19 No.3000-7 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, Contractors Bonding and Insurance Company of Illinois,organized under the laws oflllinois,subject to its Articles of Incorporation or other fundamental organizational documents,is hereby authorized to transact within this State,subject to all provisions of this Certificate,the following classes of insurance: Fire,Marine,Surety,Plate Glass,Liability, Boiler and Machinery,Burglary,Sprinkler, Team and Vehicle,Automobile,Legal,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 20'h day of March, 2015,1 have hereunto set my hand and caused my official seal to be /Seal affixed this 20'h day of March,2015. , Dave Jones Insurance Commissioner By Valerie Sarfaty for Nettie Hoge Chief Deputy NOTICE: Qualification with the Secretary of State must be accomplished as required by the California Corporations Code promptly after issuance of this Certificate ofAuthority.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. "906780.1 BUILTALL - 1 World Trade Center 8th Floor Long Beach CA 90831 OFFICIAL BID SECURITY— DO NOT OPEN Project Name: CENTRAL LIBRARY LL RESTROOM ADA IMPROVEMENTS CC #: 1658 Bid Opening Date August 22, 2023 at 2pm. 311 etipstv45,73 4wp StCTION C PROPOSAL for the construction Of CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS CC No. 1658 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON REACH; In compliance with the Notice Inviting Electronic Bids,the undersigned hereby proposes and agrees to perform nil 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 Cite Engineer of the City of Huntington Beach.The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach,and to enter into a contract at the following prices. The undersigned agrees to complete the work within 60 working days,starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications.Instructions to Bidders and all other contract documents,if this proposal is accepted for award,,BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the follovving 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 he based upon the actual quantities of work satisfactorily completed.THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT.his agreed that the Unit and/Or lump sum prices bid include all appurtenant expenses,taxes,royalties, fees, etc.,and will he 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. ithC-I .. ./ibet/Pe#6 0-kfr—hiLih/c /-01,cf-/14"/ tItY"cif 110otingtoo:15400,1 ItitiiiiitWO0.4150000011011. 20:30A4-01*-ree4 • Tet,(714).00, 431,#0x#14)'37:44014 DDENDUIVIi t4LIMBER IONE Far CENTRAL LIBRARY LOWER LEVEL Rosi*7104 sulk ImpAovemENTs. filkugostA IOU Notioo to Aittaidtletev • Moose note theictikholng,OlahlioettOtte.tothe Noloot moos i4O0offrott000t,orasottotat ..Proviot00% The updatea wat4.o,46tdftittatiOrt dated 81110 kos tvfleh attethett: ee1n This 0040.0s:Thgt wegelletertntnatiottkold ih•ApOohOli:0 or the prOiStepeciftfeetiOne, Ths is•to Aatfookitleitgo teoei.ot mitt review as Mtioolioto•N4tottiot 00*..410tdAt.0****04, 3M COnS,tr.014tiOn Corporation Hammond ..„ 00104)4areek ay 8/19r2-023 Date of 1 of AtitlenOutrt:Nicti, • If awarded the Contract,the undersigned agrees that in the event of the BIDDER'S default rn 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 F31DDER,the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid,find Bid Bond „ hi the amount of 10%which said amount is not less'than 10%of the aggregate of the total bid price,as required by the Notice Inviting Sealed OR-ELECTRONIC 13ids payable to the AGENCY. (Please insert the words"Cash";, 'Certified Cheek",or"Biddeestond forla%",as the ease may be)Any standard Surety Bid Bond form is acCeptable. Bidder shall sigrtify receipt of all Addenda here,If any: A,emen,tta,Ayik, .11'4'7'ir-EVrok-4,1004ter,Nfeel' 8/15/2023 • 0044.0.64, CITY OF HtINTIN4TON:BEACH! CENTRAL LIBRARY LOWER•LEVEL RESTROOM AbA PROVENT BID SCHEDULE' • Item#: , pesriptiott.of Work Quantity Unit Unit Price :: Item Total. , • .. .:: . ... 1 •Mobilizalion, ' 1 LS -$ $ .5;20040 :.! 2 cgrts.:INt1100:.Waste Manag,ement 1 ! LS . $, $ .3,00.0.,•00 . .• „ - 3 croseovf. i ; LS Hs $ S'.',:2.6:0:oo; 4 Demolition 1 '! ,LS: $ $ • 000000.• 5 Abatement 1 LS! : ..$ $., 15,00040 •! 6 concrete and Reinforcement . 1 • .L5 :$ $ 1040040 .' .... . 7 ,'Cci4pwark/Counfertop 1 LS, $ ,,S, '8000110 8 Blanket lrisulalion , I , :LS ,$. $ 1...000,00. 9' Joint tetilatitt.: ! 1 LS :$ '$ 1,000:00 , . . 12,0 Alumirium Door frames 1 ' LS $., $: 0 „ . i.t. .Wood Doors , 1 ' LS ! $, $ 0 :..„ 12 Access:Doors and frames ! ,1. !, IS -$ $ Z,500,00 . 13. Door Hardware, 1 Ls $ $ 0 14 !GlazinqtivItoor 1 IS '$: $ 2...,000.00 , 15. -.Gypsum Board . 1:, : LS '.$ $, $400,:,00 14. 100.101,stod.Framing ! 1 •', „LS $ • $ :540040 •. , . . 17 Porcelain! Tile FlOorPinishing! I ', :,L$ !$ -$ '3130.00 "... " " . 18 Porcelainille . WailFinishing 1, 'LS' •$ $ 15400,00.: , . •., ,. .19 Painting 1 LS $." $ 24.00,00 , 20 Signage • 1, IS $ Si 1;000,00 .. . . 21, ,Toilet AOOOslOrtes, • I LS $ $ 400 500 • 22. rivrnbing " *I .14 ...$ :$ 10;00040 : .23 .Mechanical, , 1 LS ..$: $ 4.,000.40 24- :,Elect itcdii: I . :LS $ .$ 3,1•0040 .:....:...""- Total in.14.wrober5 S :135i730,00: ,c..47'.1 • TWO Words one Hundred ThirtyfiVelhousand seven hundred thirty Dollars NOTES:: The estimated quantities listed in the Proposal Bid.Sheets are approximate and,are to be used Only as comparison of birtS.:PayltientfOrquantities will be made from/field measurements,if the actual quantities show either an increase or decrease from the quantities given in the.Proposet Bid:Sheet the COntract Unit Prices wilt prevail:.fUlltompensatiori Will be paid at the contract prite fOrthe att.:UM:work completed,:and 00addit at cornpensation;wlli be allowed therefor.,Payment will not be made for materialt Walited•Ord itposed of in a manner not;called for Under:the contract;this includes rejected Material not untoaded from: vehicles and material rejected after it has been plated No tompensation will be allowed for disposing of rejected or excess material The City reserves the right to reject all bids and to increase or decrease the amount of any.quentitsr.:ShOWn on the Proposal aid Sheets.In case of a variation between the unit.priceand the totals shown by the bidder,the unit price will be :conSidered to he the bid, Compensation for items of work not specifically identified in these bid items shall include all tabor,:Materials,tools,equipment,safety:measures,and supervision required to co mplete the WO*to grades and dimensions shown on Plans or staked in the field.There Shall be no compensation except for the bid items specified in the Proposal.The.costof alt workshown,in the Plans and Specifications but not specifically identified as a bid item or described within a hid item shall be included in related bid items,and no additional compensationshall become due the Contradorby nature of omoiante'with the Plans and Specifications. 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 sorvice 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. State Class . Dollar %of um L1it?,TSubcontractor License Registition# Amount- contract Number ) • None --- „ A By submission of this proposal,the Bidder cettities: I. That he is able to and will perform,the balance of all work which IS not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project NONCOLLIJSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND'SUBMITTED WITII BID I declare under penalty of perjury tinder the laws of the State of California that the foregoing is true and correct and that this declaration is executed on si21/2023 at Anaheim CA Date City State Yessica Barron ,:being first duly sworn*deposes and says that he or she is Owner„of 3 M Construction Corporation 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 sharp 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 riot, directly or indirectly, submitted his or her hid price or any breakdown thereof, ot 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 bicl‘ • Named Bidder. Yessiea Barron yes4te&t, ga.444te, . . Signature of Bidder 741 E Sycamore Street-Anaheim,CA 92805 Address of Bidder C-4 . UTILITY AGREEWrirr IIONORABLE.MAYOR AND CITY COUNCIL CITY OF RUNTINGTONSEACHI,CAUFORMA, Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract known as'the CENTRAL LIBRARY LOWER f AVM:ADA IMPROVEMENTS, Mwe)00 will employ and utilize only qualified persons, a hereinafter defined, to Work in proximity to any electrical secondary Or transmission.facifities. The term "Qualified Person" Is defined ift Tide S,California Administrative.Code,Section-21'00.i as follows: "Qualified Person:- A person whoi by teason,ofexperknee orinstructimIsfeonillar with the operation to beperformed an the hatardsinvolvect."' 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 Cit-OSHA requirements. The undersigned further,promises and agrees that the provisions herein shall be and are binding upon any subcoMmtor 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 subcontractoror441cOhttactors.with,the requirements contained herein, 3M Construction Corporation .• Contractor YeSsie.a tarron By DWaer Title Data: 8/21/21:0 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 Daoverninent project because of a violation of law or a safety regulation? CI Yes No If the answer is yes,explain the circumstances in the space provid d Note: This questionnaire constitutes a part of the Proposal,and a signature portion ofthe Proposal shall constitute signature of this questionnaire' . C4 COMPENSATION INSURANCE CERTIFICATE Pursuant:to Section,1.861 oldie State LaborCode,eachcontractOr to whoma public works contract has been awarded shall sign the&liming 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 eode, and 1 will comply with such proVisions before commencing.the performance of the work of this contract 3M Co TIStruction Corporation •Contractor Yessica Barron By Owner Title. Date: 812112023 C-7 BII)DER'S INFORNIATION BIDDER,certifies thatt the folloWing information.is true and correet YesSics Batron . .. Bidder Name 741 E Sycantore Street- BuSirtess Address ' Anaheim: CA '02f105 ., City, State Zip (323)385-41206 infog3mccorp.cont .. Telephone Number Email Address 1099433 A,8,C33 , ‘ State Contractors License No,,..and Class 12/07/2022 .. . Original Date Issued 12/07/2025 ExP, .. iration Date The work site was Inspected by Reda Hammond of our office on 8/7/2025 ,, The followin,7a are persons,*firms,and eorPorations having a Principal interest in.this proposal Yessfea Barron t Owiier The undersigned is prepared to satisfy the Council of the City oftfuntingtort Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance.with the plans and.specificatiOns:.set forth. .31\41 Construction Corporation Company Name at-l-de.. 2, gez:44A,z, gmature of Bidder ,, ..........„.4.a„— P°. `144-At.-j4c1/ Yessica Barron: Printed or Typed Signature IC-8 • NOTARY CERTIFICATE Subscribed and sworn to before me this„9,154ay of 41S4-ViRt4&'E-,20Z; A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document, to which this eettifiCate is attached, and not the truthfulness,accuracy,or validity of that document. State of + Irkt )7e County of 1.42g •Airxcle-lca` ) *--01 On arc , ,t7a...3 before:me,(De..34F•E.....v14 .4szst.fateekt. Ptc.gt-t Month,Day,and Year Insert Name and Title of Notary • personally appeared IcAdissavvit trriV44.6 Nanle(s)of Sign ( who Proved to me on the basis Of satisfactory evidence to be the person(*),whose tiame(skiatim subscribed to the within instrument and acknowledged to me that heiskeithey executed the same in hisiberittirir authorized capacity(i*,and that by ItisilrErittair signature(*)on the instrument the person(*),or the entity upon behalf of which the person( )acted,„executed the instrument I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official,seal. 0$180WALE"A#- Cowl,2454593 NOTARY P21.1C.MICORNIA Signature *nrcss Signatuti of Notary Public (PLACE NOTARY SEAL ABOVE) C-9 Bidder's Project.Bistory For the purposes of this*lea the contractor and subcontractor must have. in the last five yeas; constricted at least five (5) projects of Similar work specifically referencing the construction of Describe Spetifie Work and experience;necessary for project, for example"Reconstruction or rehabilitation of.existing public use facilities" Bidders are encouraged to submit supplemental relevant project history in addition tO the projects`fisted herein. The following list.of projects meet the requtrertterits of above: 1. Santa Ana College 153017th, Street Santa Ana Name and Address at Reference Nye and Telephone No. of Owner Tim 56 577 0295 58 800.00. . Renovation and painting 8t13/2023. Contract.Amount Type of Work Date Completed Provide additional project description to show similar work: 2_ Desert Moon 888 S Brockhurst St Anaheim,CA Name and Address of Ron Name and Telephone NO.of Owner: Sam.Nouredine 714-473-3766 Compelete Remodeling ,Tan 2023 Contract Amount Type of Work Date Completed 225,000 00 . Re doRest Rooms Burad Banquet Room,Patio and Kitchen Feb/2.023 Provide additional project description to show sinularw•ork:: Rest Rooms;,Kitchen.Patio..Storage Area and Dining Room.Complete.Construction 3 ,Dream Cafe 830 S Brookurst-Anaheim:CA 92804 Name:and Address t f'.t eterence Name.and Telephone No.of`Owner:...Morr'is _ 323 3.03-80S' Remodeling two restrootris Contract Amount Type of Work DateCompleted $145,000 00 Complete Remodeling Feb to IVlar2.023 Provide additional project description tc she w si filar work • :C--:l0 4. City.Of Sierra Madre Name and Address,of Reference Name and Telephone No,of Owner f)ainien 1)ppemy 626,2644906 34,000,00 Ex:Wrier replace broken wood,Patching and Paint March,2023. •Comma Amount TYPeof Work Date Coriplited Provide additional project description tO show similar work: Complete ex.terior work,replace Wood Gutter, Spouts,Patching arid Paint 5. Name and Address of Reference. Name and Telephone No,of Owner: Contract Amount Type of Work Date Completed Provide'additional project description to show similarworic C-1 I Bidder's Critical Staff Listed below arc the names of the biddersproposed ConStrOction Project Manager.and Superintendent For each Of these erificalpositiona* ,lease list at least three projects for winch the critical staff has performed similar work within the,last five years,These projects do not have to be under the employment of the bidder of this project.Bidders,are encouraged submit supplemental relevant project history in addition to the projects listed herein. I. Reda Harturioud Name of proposed*Project Manager Santa Ana.C011ege $5/1,$064,011 Eltribr Paint 8/13/2023 Project.Narnea Contract.Atnount Type of Work Date Completed Desert Moon- :225,000.00 Renovation and Remodeling 2/2023 Project Name&COnttaei Alt aunt 'Mae of Work Date Coniple.ted San.Bernardino Housing Kitchen aod kestrooms renovation Feb 2021 ProjectName&Cooeact Amount Typed Work Datetompleted Z. Name ofproposed Superintendent Telephone No.of proposed Superintendent . - Project Name&Contract Amount Type Of Work Date Completed Project Name*Conttact Amount 'type ofWork Datecomplete,4 Project? áme&Contract Amount Typeof Work bate Completed 641 CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 834 (citing Labor Code Section I 771.1W) passed by the California State Senate on June 20,2014,established anew public works Contactor 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(DIRY. 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. Dfit FACT SHEET on Sf3 854 httPSwww„dir.ca.goviOLSE/PublicVitorks/S13854FactSheet 6.30.1 4,pdf DIR's Contractor Registration Link—Call(844)522- 734 https://efiling.dir.ca.goviPWCRIActionSenilet?actionr-diaplayPWCRegiorationFonn DIR's Contractor Registration searchable database: https://efiling.dir.ca.gov/PWCR/Search.action am aware and will comply with the provisions of Labor Code Sectiont 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 performanee 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 707.9.1 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 DIRAS the primary contractor, as well as for ALL subcontractors at the time of submitting the kid. 3M Construction Corporation Contractor YESSICA BARRON By info4.3mccorpcom Email Date4 8/21/2023 Owner PWC Registration.# 1001014995 c-u.. EXHIBIT A DISADVANTAGED BUSINESS ENTERPRISE(DBE) This.Project is subject to,Part 200.321,Title 2,Code of Federal Regulations entitled"Contracting with Small and Minority Businesses, omen's Business Enterprises, and Labor Surplus Area. Firms." The Regulations in their entirety are incorporated herein byes reference. It is the policy of the City that disadvantaged business enterprises MBEs), as defined in Part'200.32'1, Title 2 CT=R, shall be encouraged to participate in the performance of Contracts financed in*hole or in part with federal funds.The Contractor should ensure-that DBEs,as defined in Part 200:221, Title 2 CFR, have the :opportunity to participate in the performance of this Contract and shall take all necessary and reasonable sups,as set forth in Part 200.124 Title 2 CFR, for this assurance;The Contractor shall not.discriminateon the basis of race,color,national origin, or sex in the award and performance of subcontracts.Failure to carry out.tl a requirements of this 'Paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged:to obtain DBE participation in this project,although there is no specific goal for DBE participation. C-l-4 EXHIBIT B DBE INFORMATION—GOOD FAITH EFFORTS Federal-aid Project No. CNo. 16$$. Bid Opening Date 8i21a023_ The City Of Huntington Beach established 4 Disadvantaged Business Enterprise(DBE)goal of" for this Project.The information provided herein shows that a good faith effort was made. Lowest,second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency.Bidder DBE Commitment"form indicates that the bidder has met the DBE goal.This.will protect the bidder's eligibility for award of the.contract if the administering agency determines that the bidder failed to meet the goal for Various reasons, e.g., a DBE firm was not certified at bid °petting,.or the bidder made a mathematical error. Submittal of only the eLocal Agency Bidder DBE Commitment'form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The &flowing items are listed in the Section entitled'"Submission of DBE'Commitment" of the Special Provisions; A. The names and dates of each publication in which a request for DBE participation for this project was placed b the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified DBEs soliciting bids for this Project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested(please attach copies of solicitations,telephone records,fax confirmations,etc.);-, Names of DBEs Solicited Date of Initial Follow Up Methods Solicitation and Dates C-1 5 C. The items of work which the bidder made available to DBE firms including, where appropriate,any breaking down of the:contract work items(including those items normally performed by the bidder with its own"forces) into economically feasible units to facilitate DBE participation.It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items ($) of (YIN) Contract D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the:firms selected for that work (please attach copies of quotes from the firms involved),:and the price difference for each DBE if the selected firm is not DBE Names, addresses and phone numbers of rejected DBEs and the reasons for the'.bidder's rejection of the DBEs: Names,addresses and phone numbers of firms selected for the work above: ,1 . Efforts made to assist interested.DBEs in obtaining bonding,lines of credit or insurance, and :any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: C-16 F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms (please attach copies of requests to agencies, and any responses reethed, i.e.. lists. Internet page download,etc,): Name of Agency/Organization Method/Date of Contact Results IL Any additional data to support a demonstration of good faith efforts(use additional sheets if necessary)... NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. C-17 IF A SOLE OVSIER OR SOLE CONTRACTOR SIGN HERE: (I)Narne under which business is conducted • WA ., (2) Signature(given and surname)of proprietor (3) Place of Business (Street and Ntunber) City and State (4) Zip Code TelephoneNo. (5) E-Mail IF A PAWFNERSHIP.SIGN HERE: (I) Name under which business•is conducted MA (2) Signature ( iv ez and surname and character of partner)(Note:Signature must be made by a general partner) (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone'No (5) E-Mail C-18 . , / I • -ow . . ,,,....... .... . . . . . . , .. CALIFORNIA.ALL- PUR12' OS, E . „ C: Efer- :IFACA'. •Te,:: OF ACKNOWHLDG— MENT . . ... ... .. .. . .. .. . ... . . . . . . 'ik notary public'or other officer completing this certificate wiles only the ide::I 'i'' •'. el the individual who signed the document to which this certificate IS attached ;•4114 PietthetrOthitlineSavaOotitaowor tad of that Litocument .. ... . . :. .: ...,, . . • ..„. ,.. . . State Of California 1 , : ! - „ . , • . , toonty.of: .„ Lt2.:;,. . .•'; i •AP,s5,- • :•!eltz'' 1 . ,,, . .. ' ... :;,,k ;' Alimio ''.- - . - ' . 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(roet ,*...." ' SOO*nrenpornijin,:Ottionninn connii)****MoOnlondo*nortrom • SPittiter* . . -.• a Aigninn4n-of An*an!,!ONO nnot*nntaidnrsignninan on tirn*14.4.490fce.Ot 1 • . • ibtanoy akik. o Attetigty4Wfati + 'XilOiloont infonnanon!ta 10'nnininxt bora*botp.on astir* , ..: ti: Trittligt) :***0.06.004104.**04w**04.04404nonWoonrok*. : 13. Obit +. rniliannoideoilotorontliniOninnonnottintvtottfen. :' . ., , + ' Irnifinittitnkgspoliyanitoini toi.40:0004.ft.Oion.Phaltind OP*.tfk 4 :. ' „. , _ -.. .0000i0.40004itidk:strOthaVOit.#4,1(;Eqi:Mi.$004#.0,. , .: , .• *00410*0146404itnitit***-10****,401614******. • 1 I' 1 A IF A CORPORATION,SIGN HERE: (I)Name tinder which business is conducted 3M Construction.Corporation "‘ 464zinefrit, (Signature) () er (Title) Impress Corporate Seal here (3) 'Incorporated under the laws of the State of California (4) Place of Business 741 E Sycamore St (Street and Number) City and State Anaheim,CA (5) Zip Code - 928°5 Telerihone No, 323-385,4206 (6) E-,Mail NOTARIAL ACKNOWLEDGMENT OF EXECUTION By ALL SIGNATORIES MUST BE ATTACHED List below names Of president,vice president,secretary•and assistant secre .tary,if a corporation;if a partnership list names of-all general:partners and managing partners:. C-19 EXHIBIT C LOCAL AGENCY BIDDER DEE COMMITMENT(CONSTRUCTION CONTRACTS) NOTE PLEASE REFER TO INSTRUCTIONS ON THE REVERSE OF THIS FORM LOCAL AGENCY: LOCH I ipx..... PROJECT DESCRIPTION; TOTAL.CONTRACT AMOUNT.: BIIJ DATA B1DDER'S .rAME CONTRAC Va CON TRACT ITEM OF WORK AND DESCRIPTIONDBECERTNO NAME OF EACII DBEDOLLARAMOUNT ITEM NO. OR SERVICES TO BEAM)EXPIRATION. (Must be cethlied on the:date hidsD?BE SUBCONTRACTED OR MATERIALS DATE are opened-include'.ORE address TO BE PROVIDED Or.contracted if the and photre number) bidderis a DBE) Far Local Agency to Complete: Local Agency Contract Number .. TotPiccip DB>w Federal:aid Project Number, oho • Federal Shares Contract Award Date Local Agency certificthatall DBE certifications have:.-been verified and 41formnnon is cconplet and accurate. Sl9natlttc of RAW& .,.......... Oak._.. `(Atea Coide)Tel..No. _......_ Pant e . Signature, Date, Local Age ncy.Representative Person to Contact (Please.l`ype or Prat) (,Area Code)1'0Lephmt0!ut bet:•• Local Aaenev Bidder DBE Commitment(Canatmeiian:Contrac to) (Rev 6I26109) C-20 PLEASE NOTE: This information may be submitted with your bid.If it is not,and you are the apparent 10*bidder or the second or third low bidder,it must be submitted and received as specified in the Special Provisions.Failure to submit the required DBE commitment wilt be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local AgencY, Location, Project Description, Total Contract Amount, Bid Date, Bidders Name, and Contract DBE Goal, The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs;Primecontracters shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its,own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date. Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work(who must be,certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier.Names of the First-Tier DBE Subcontractors and their respective item(s) of work listed should be consistent; where applicable,With the names and items of work in the"List of Subcontractors"submitted With your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100%of item is not to be performed or furnished by the DBE,describe exatt portion of time to be performed or furnished by the DBE) See Section "Disadvantaged Business Enterprise paw'of the Special Provisions(construction contracts),to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award,Federal-aid Project Number, Federal Share,Contract Award Date fields and verify that all information is complete and accurate before signing and filing. C-21 EXHIBIT D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder 3M Construction Corporaion . , _ [proposed subcontractor None ,1 hereby . _ certifies that be/she/it has has not -participated in a previous contract or subcontract subject to the Equal Opportunity clauses,as required by Executive Orders 10923, 11114,or 11246,and that,Where required,he/she/it has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(1)) (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. (ceoc.gov/employersieeolsurvey/index.cfrn) Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract Subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such , contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director. Office of Federal Contract Compliance, U.S. Department of Labor. , Signature: y f 4',/-ael• 0424-4110.' Date, 8/21/2023 Print Name:, Yessica Barron Title: Owner Ca2 EXHIBIT E NONCOLLUSION AFFIDAVIT .(Title 23 United States Cede'Section 1:1,2 and Public Contract Code Section noo iNAmE OF-CONTItACTI To the city of Huntington Beach In conformance with Title 23 United States Cede Section I 12 and California Public Contract Code 7106 the bidder declares that the bid is not made in the interestof„or on behalf etany.undisclosed person,partnership.COMpaity,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 hidding;, 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 thebidder.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,pa titership,company association,organization,bid depository, or to any member or aaent thereof to effectuate a collusive or sham bid* Note: The above NoneolltiSiOn Affidavit is part of the Bidder's Proposal. By signing the Proposal,the Bidder has also signed thisNottcollusion.Af6davit. Bidders are cautioned that making a false Certification may subject the Bidder to criminal prosecution, Signature: - -;;,-.4"...w.,„ .4r44.4.4, bait: '8/21/1023. Print Name: Yessica Barron Tide: Owner EXHIBIT F DEBARMENT AND SUSPENSION CERTIFICATION TITLE,49,CODE OF'FEDERAL REGULATIONS,PART 29 The Bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated with Bidder in the capacity of owner,partner,director;officer,manager: • is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any Federal agency; . has not been suspended,debarred,voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending;and * has not been indiated,convicted,or had a civil judgment rendered against him/her by&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 WM not necessarily result in denial of award, but will be considered in determining bidder responsibility.For any exception noted above,indicate below to whom,it applies,initiating. agency,and dates of action. Note: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Signature: ,.. - esote.:a4,- ,e4244,0frk ey Date; 8/21/2023 Print Name: Yessica Barron Title: Owner C-24 EXHIBIT 0 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: I) 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 intfuence 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 Federal grant,the making of any Federal Icon,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-LI,L, "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 I 352, 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. S ignature: ee yft4,' aititpb Date: 8/21/2023 Print Name:—Yessica Barron Title:. Owner C-25 • . . • EXHIBIT!-! • DISCLOSURE OF LOBBYING ACTIVITIES ,. ........... COMPLETE THIS FOltNit TO DISCLOSE.LOBBYING AetivilitsiNgsvANT:TO.11 U.S.C. 1152 1. Type:of IzederatActionr ..l...Status of Federal Action: 3.i ReporrType:. 0. El a.a.a.tract: atiaidatemiticii...... ta„.40.41: b.gazit b.initial ward b.'material chan.v. ;,cooperative agreement .t,post- ward ii,lean For Material Change.0.04,; P. KVIIS,UarP.Itgq year quarter • 17,loan insurance date of last report • 4. Name itiniAddress of Reporting Entity S. If kepotting Entity in No.4 iis:,8uhattrardee, Enter Name and:Address Of Prime: 0 ithimo iji Subawardee ...._ - .'•Tier, Of known tofigife0I0041 District.if Itfii)*ti Congressional nistliq irknowa ‘4, Federal OppartmeinritAgoier :7. Federal PerightniNtittielDesitiplitint CEPA.number.,if applicable .. $i Federal Action N.qmitert,if known 9. Award Amount,if kiniWni. 10.. ii,,Name and.Adatiessri(Lobby totily. 'b. Individuals Performing Services (including (If individual.last name,first Mi) address if different.fisopyt1-4,i'00: (last name,first name,MI) (attach qpntitiggiqt;:$.11q0.(s).if necessary) • : 11. Amount of Paymeni(thistii.n14:11m1appiY1 :.13:: Type 41'EnYtiient.(ghtekAtitwat'Appl) $, c:i:Actual :E3 planned a.retainer 'bi one-time fee.: 4 Form of Payment cheek all that apply):: a,commission E] A.cash -. . h.ih-kitd.,41:itelfy::nature i....: , 4,contingent tet, . . a deferred value .,...... f.either....spenify: ..: -lit Brief Pq.sriPiioft'o!*otigo..sPg.t.torntitt or to iii orkon44.A40tottoisyorSowitei,inei#.dino . . ofliotio.,ontittiite(ot or iOembei(S:contacted,for Payment Indiented in Item II: (attach Continuation Sheet(s)if necessary):: .. . r.,-e 15... Cont $4.egi(s)4tt.at.hed; Ye 13 NO Li, . . 16. :Information requested tinting(this rota i,s•dullibi.i.iiid by Title 31 VS-C:Section 052,Tili:%.di closure of lobbying Itilittqa. Signature. . wa*01.40d.bYthd-iiiledboyo who hi$Illiisalidif9itil made or entered into This di Insure is required.pursuant in 31 VS.0'. Print Name: 1352. This 146;1114A* will be reported tn: entigteta. semiannually and will he available for public int7Peiicirt403i Title person iikin,:fnitsto.tile„theinutitretidistrostift Shall be subject in a civil penalty of not less than S10,004 and:not more than TOeplitmeNn.i ,„,,, ..... „..„. „...,....._.„....„.„,.......,,.. ....Nig„.. Siii0.titifi for ette.ly-suett failing, hattliniftri for Local Reproduction Federal Irs'eChity.t Standard Form,--LLL Standard Form LI.1.Rev..09-1247 0426 INSTRUCTIONS FOR COMPLETION OF EXHIBIT FL 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. tale. 31 U„S:C; section 1352 The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action.. Attach a continuation sheet for additional information lithe 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 Offi e of Management and Budget for additional'information. l) Identify the type,of covered Federal action for which lobbying activity.is and/or has been, secured to influence,the outcome of a covered Federal action. 2) Identity 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 tfiling the report in Item 4 checks "Subawardee"then.enter the full name,: address,cit R 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 levelF below agency name, if known* For example, Department of Transportation,United States Coast Guard. 7) Enter the federal program name or,description for the covered Federal action (item I). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements,loans and loan commitments, 8) Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e g, Request for Proposal OUP)number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or lean award number, the application/proposal control number assigned by the Federal agency.;), include prefixes,egg:, "RFP-DE 90:0ill. ) For a.covered. Federal action where there has been an award or loan commitment by the Federal agency,enter the Federal amount of theaward/loan commitments forthe prime entity identified in item 4 or 5. 10)(a)Enter the full name,address,city,state and zip code:of the lobbying entity engaged by the reporting entity identified in item 4 to influenced.the covered Federal action. C-27 (by Enter the.full names of the individual(s)performing services and include flail address if different from 10(a). Enter Last:Name,First Name and Middle Initial(ill). I l)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 he made (planned). Check all boxes that apply.If this is a material change report;enter the cumulative amount of parnent made or planned to be made, 1, )Check the appropriate.box(es). Check all boxes that apply. If payment is made through an in kind;contribution :specify the nature and value&the in kind payment. 13)Check the appropriate btix(es) Check all boxes`that apply. If other,specify nature. 1.4)amide 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 officers)employee(s) or Members)-of Congress that were contacted. 15)Check whether or not a continuation sheet(s)is attached. 16)The certifying official shall sign and date the form,print hislher 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 informationf including suggestions for reducing this burden, to the Office of Management. and Budget. Paperwork Reduction Project(0348-0046), Washington,D.C.20503. By my signature on this proposal I certify, under penalty of perjury under the laws of the State of California, that the foregoing questionnaire and statements of Public Contract Code. Sections 10162, 10232 and 10285.1 are true and correct and that the bidder has complied with the. requirements of Section 8103 of the Fair Employment and Housing Commission Regulations: (Chapter 5,Title 2 of the California Administrative Code). • C g EXHIBIT I, FEDERAL LOBBYING RESTRICTIONS Section 1352, 'fide 3 I. United States code.prohibits Federal funds from being expended by the recipient or any lower tier subrecipient. of a Federal-aid contract to pay for any person for influencing or attempting to influence a Federal agency or Congress in connection with the awarding of any Federal-aid contract,the making of any Federal grant or loan,or the entering into of any cooperative agreement. If any funds other than Federal funds have been paid for the same ptuposes in connection with this Federal-aid contract,the recipient shall submit an executed certification and,if required, submit a completed disclosure form as part of the bid documents. a A certification for Federal-aid contracts regarding payment of funds to lobby Congress Or a Federal agency is included in the Proposal. Standard Form- LEL, "Disclosure of Lobbying Activities," with instructions for completion of the Standard Form is also included in the Proposal.Signing the Proposal shall constitute signature of the Certification. The above referenced certification and disclosure of lobbying activities shall be included in each subcontract and any lower-tier contracts exceeding $100,000. All disclosure loth* but not certifications,shall be forwarded from tier to tier until received by the Engineer. The Contractor, subcontractors and any lower-tier contractors shall file a disclosure form at the end of each calendar quarter in which there occurs any event that requires disclosure or that materially the accuracy of the information contained in any disclosure farm previously filed by the Contractor,subcontractors and any lower-tier contractors. An event that materially affects the accuracy of the information reported includes: I) A cumulative increase if$25,000 or more in the amount paid or expected to be paid for influencing or attempting to influence a covered Federal action;or 2) A change in the person(s),or individual(s)influencins or attempting to influence a covered Federal action:or 3) A change in the officer(s), employees(s), or Member(s) contacted to influence or attempt to influence a toVered Federal Action.. • • THE AMERICAN.INSTITUTE OF AR- CIIHITECTS „-= ...... ,:.p.,...,. AIA.DocuntentA).10: . Bid Bond • , . . . .KNOW ALL MEN BY'.*:, ESE PRE$.ENT Si..that we (flontoiwootramItmooftessixi.ogotioe:ootanttottor) 3M Q.00$04etimi,COrporation . • . 741:E..Sycairforg'.'StrgOti Anaheim,„CA 92805 as:;Prinetpai,hereinafter imago th*Pft-101;:Afict Meta rid**04,9r 401,10$00,800: 0401'4 indeinnikyChrporatioh 21:11.,',N..califottiii Iiiva.,.#300;WAInut•Cteek,CA 94596. „... . *copcgatior$duly organized undatthe thein dtthe:Statit,drina Surety ]hereinafter 0.104thd Sid'ati4-.ant:beltidni thy*hound unto ifietatasefttualegiatiandteetettat taaattatOorOmy*I. ]Cipir afthhhhgton Reach, • ...20.00:Ntaill Strot.;.riogtitigroti:i0eaiiT,CA 92648. AS:Obtigee,hetelitittertalted UtC9011tRe.in 003,Hounvot • , . To EgNotIt of amount:bid' D011arsli 10%,of amount hid); for 1..h.4 payment of V4)1011sUM:ssed and lady'th be made,:the said ftnnIdnal and the Said tairts*ly,.bind atasalyea our hens executors.adrninafrAtOt*.*#0.0Pt44*::03441045i:014Y:and severally, 141(dii,by these,presents WHEREAS,thoeiscipathas:ationftettot foe! :ftrelivett tuft:pant*inftitatitaitct deim of*olgct), Ct.:NT:RALE,-IBRAR Y LOWER,.LEVEL REST:ROOM.Ap,A.INIPROVEMEIM NoVt"010R.EFO,K,IfthotblkalettittaultedeOttitoblirefthliffrik441:PirthefenOoditataltentatillt04.C.00:84., 8410114-0,0aseelqacco.rdartc#40—lha lemko.0 4tuckbfddoviAltltsgthboocit.boildisit hiay'i.bii5p01,60.0*•6441100:0 Cdittflict.Docuiiiiiiit**INOOPt041.18404usety*tholi. 0*09TquladOrsuctiCOntractanefeittlid prompt 14fx.ir anct***:Wished frolt*OtOs0 OutiOASM440101P eisPitOthe failure at the 04$16 erdersuO.Connacttnd foe ennead:4w.toande.'dthe,,Flengpailhadnqtathiiebgnatitha:dgeldnnetatidaXnanetin0 of.taityhemcif between the:g!TiOgilk000101164010 kid ON.isith.taii*OrOunt*.041001e.Pkirdeitt,m4y issdiodcafth tanti**416**sx poly*potent tho•;.46,04tearored!* 1600•Ord..0*IdoinIgfsatinnshaOtenuatneynkkOn**.i.dolin f..em.iOnto tnifforctiandeded 4101904nd seatad ibis, 17th day of August,42'3', ... C.cfristr441130:•CorPoratioti .. . , • ..- .0W.P00-: g.0011 , ,..... "- • _ _ „_ : . — , ' - ' 17.701V; . " -- -, •-• Oapit0i.fodernnity..Corporation ..,, :..„ .... . , , - ...- • .. -.- ..-..-,-. . .„..,• . . . .- ?--"Z.,--r............---", • 65"7.14 :._. 7.. , , . . : ...„ Meal). • . , , . ..,,, ,. Atidtesk Syvit ' PIA4 . Attornerin-Fact .. . .. . . .. . .,. , . •-,,---, , - ',. . . . .. .... . .. -:.-_-• -.--. --- - AitidOtIVIENT oh-80,80$6.,,nok4Eanudwriamp.-ThEAMERrAN 11s4=4(tt bkAntSTEOsiitadtof AVE.,NYC WASHINGTON0:04, MOO .. ...: :.° ":''',7":' ''.- •e-,7 '''' ;7/ -. ' ::-:-4.; 47:: '''''''""' — •-`,-.-', . ' „,,. „,,, „ .......,. ...., . . .„ . ,.... — -,-,..,..,......,-..-', ..., ' ,',.%\:''' • ' ,... . CALIFORNIA AL L-PURPOSE ACKNOWLEDGMENT CIVIL CODE 41its 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 nottthe truthfulness,accuracy,or validity of that document_ State:of California Y County of Orange ) 7 n. t before me, ysytt,Notary Public, C)n 14�1srza Date Here Insert Name and Title:of the Officer personally appeared Andrew SYsyn: Name'(s),of Signer(s) who proved to me ori; the basis of satisfactory :evidence" to be the persons) whose names)" is/are subscribed to the within instrument and acknowledged to me that he/shellthey executed the same in. his/her/theirauthorized capacity(ies),and that by his/her/their signatures)on:the instrument the persons}`, or the entity upon behalf of which;the persons}-acted,executed the instrument, 1.certify under PENALTY OF PERJURY under the laves of the State•of California that the foregoing paragraph ry true and correct.i A& •3121.,ANL �. r.r.r r.r �,. r ,. f, ktAAIA Y-SY'NIF WITNESS my hand and official'°°seal. ' Notaroubtie 11.6rnta 1,1- "`R,." 074113e Goy tttS , Cc(t r sstr)#2311715' ,,.a MY Comr'..ExPi'es tie,7.2tt23 Signature, Signature of Notary Public; Place Notary Seat Above OPTIONAL Though this section is optional completing this inffornmation,can deter alteration of the document or fraudulent reattachment of this form torn unintended document. (Description ofAttached Document Title or.Type of Document:_._ Document Dates Number of Pages: _ Signer(s) Other Than Named Above: Capacity(ies)Claimed by Signers) Signer's Name: _, Signer's Name: Q;Corporate Officer Title(s): Corporate Officer—Titfle(s).; ®Partner - Limited iI General Ci.Partner ..Limited Cr:General • El Individual Attorney`in Fact i Individual 0"Attorney in Fact In Trustee 0 Guardian or Conservator CJ Trustee Ci Guardian or;Conservator El Other . 0.other:. Signer is;Representing:_ Signer Is Representing; ©2016 National Notary Association•www Natior.alNotarycrg 1 �800US NOTARY,(1-8O0.-87e-6827) Item#5907 CAPITOL INDEMN1T—Y'CORPORA VON ,B8SU7565 ..... . _ .. ..,. POWEll,OF ATTORNEY tleita Nankai, NNOW Att.,MEN EV'TH,I,:S.E PRESENTS„,,:that the oketrort,0411trry.:c.oRpori•ArroN,n:enFpoyet.n.)0...qf Ole Statevr,Wi$eensnk,linVing iti PrinelPidi Olen*in theltY,Of Mid:04M,Wisetinatit„:distes makcconstitittennitappoint • ANPBF1,.1r$YWNI.,PAMEEA P.,GOETliss:,.....-...:..::::.--.•-.-..: :••:. .... , ...___—. its true and lawful AttorneytOitib-fitet, to Make, eiteetite„.Seal and deliver.for and on it beItetE n'ti:'Intety,, in us its act and deed,any and all Nods,v100440.0 twit!,:contitete of saretysliit4"proyhjed that no:IntniVor andertaking.or Contract Of suretyship eNgentedwilo lb* 4tAtiotiky..filial.i. exceed in amount the stun of ---- ,,..»•ALL.sWRITT.VNINTFRINHNTS::IN AN AMOUNT:NOT TaEXCEEDz i,20,0001)0(1.. . ....._ ., ,. , This:power orAntittiqv:igti4Ailthd4thi ia..siang4 and$egled by facattrille lanterand.hY,theitUthority of theTollowing I:Result:0On:ettupted hrthetioard of 0-irvr.4031:or CAPITOL.18001t4IITYCORPQR-8140N at A.motibg.:401yottod atabold.dit:the:15th:day,orl VIA 'RESOLVED;that:the.president:psccuptiu‘rtuu eteumant,„•Vieu pt-64ddn.t.,:seereopynTlfel§nrq*ling liddividnally Or othetwine,be and:they hereby are granted the power iitid:Mitlutritaintt to appoint by ay Power of Attorney tsar the p poses only of execution..anti Mtestinghrind$And:-nntletteIonns and other witiogs obligatory:in the nature ther0E Olt:or iriott resident viCe•prolderits assistant secretaries each appointee tolaye die pe*ers•nnd duties Usual lo such:011ie:es:4P the business Of this company the Signature of such:officers and seal of theCtimpanY may be"allbteit to iiity.sueh power Of attorney or to any certificate klatitig.thereto by facairoile.,and'ally.•such,:power.Of attorney or.0in:fiats:to Shoring:such ragsittik$fgtworie$..or .. . . . ... facsimile seal shall be et*binding upon tb4(.OttipailYi.and any'440.mvor$0,pr40.40.1 and 0ttitIOit b$:,1--4ditti&Signatures and facsiittile tealshall. ,,.. ... be Val id,itabiiiding.upon the COmpenY-.'in,the 4*.ca*.ith...respect tO4nY.hatter undertaking or other writi.V.ObligatOtY in the nature thereof-CO Whielt it is attached,Any:such,appointment ineytteretioW.,:fors cause,or•tiNithotit paw,by any.of 010:ortices,i itiAtity Mae" In connection"with Obligations tit favor of Florida"department Of Transportation:only t•it:IS agreed that the power and:-,agthority-'hereby eiyen to.the Attorneyp.in4act:includes aiw and Wt:.consents for the release of retained:percentages and/or final estimates.0'engineering and construction contracts mutated by#10 State or Florida Department oeTransportatitini ItM)MIty understood thoteen$iiiting to the state of Florida Department,of Tratigiorcanciit makingpurnal PrIbe finaTestimate to theCtiiitintiterandior itakassignet4 shaft not rchogthts,St.trety CM........Ofany•efitSithligations under itsbnitd, , In artoeetiOn,witit obligaionsiil'favot of:the.Kentucky s Departm.ent;or bi(0,04)-1,only,,it is,agreed diet Ma dower and authority hereby given at:the Attothoiiii.-Eact cannot he modified or revoked.001,41,:pfi.0 written personal notice of such intent has been girth to the COrintiSSinniie—DepartMerit of Highwaysof the'COmmonWeidth of Kentucky at least thitfysidld)40,:i.:0101.04*.nindiEentinotit reimeatiom IN WITNESB:WHEREbE,the'CAPITOL'INDEIWitriCCOR.:FORMION has edit:sett these presents to be signed hy its ollIkrundersigned and Mr cruppiratescalto he lierent•alfOted,thilyatteSted,this lat.daystiflattuariA 100, 00,:inl"llIfe4, Anstalt. •'s :CAW-01,iNDENINEry cORPORATION .,..:.L. 17' 1.16,—,---H' f 4,400-P.I•Fs•!•, Rcyan T . '.. . cs Senior Via President,ChiefFirntial Officer agOrogutt AL I Jo hnz.-.1.. .. t L Samoa,Jr .... :-.,.... i .• t...:4. •.•*„.,,,.. ...,* :- -chigfggio4tivie0fiko end IloaSident . ., ...,20413.4tk " .....- - — • .0.. .0. Strianue M,'Broadbent Jiimiiiinine, i'IL catattitit Seeretary. STATE OF WISCONSIN :'• COLINj'Y(IP DAME •. IS.,:,S.-: . On,the (St day'of,tatt itat,.,;i:.-.2020:-befores Trlq,.POSOPattY: 'gale John '.1.-•Sertriodi Jr, to me known,Who being by:me -414ty sworn •dtd•tiellcQ end.saY,,, that he resides in :the: Counts of Bedford,: State of Connecticut,: that hi. is, Chief eretattiVe:Officer and President :of •(.3,mr,01„ •INDENINTrir fCORPORMION:the corporation tiesetihed. in. and *liteli..tetiiii the.above instrument; that he knows :.the•Seel :Of the ,said Maporation), that ilat scat affixed to said instrument is.-tiati corporate watt that it so Affixed hy order oftite:Bitard of Directors of said corporation grid that he signed:his:name thereto by like order ,•;401°4"'44f0.45 .4,1, 1.- .„„...Z.,... 1. •• „ .f.,.":,:f . ‘• Yot-eigtft ,/,• Idayid,l,Rtigele ‘... ..,,,i:: .,1",, Netary•Ptiblie,..Danc Co,,,W I $TA'TtOP WISCONSIN. '. •,, -,,apti):1,.....„4.4...,‘A ,,,.y _.,.. .,.,„,...,... .... . COUNTY'OP CONE, SA., .4.',/i„,,,....* 00: ely,t,..otrmtssion.I$Permanent ,.. I.the enders-hind,tittle elected to the office,stated:WOW,now the incumbent:In(A FITQL:IND.CiuNtrY,CORPORATION,a'Wisconsin Ctsirpotatiort. authorized to make this ceridsate,..DO !IERgire•Cg,RTIFy, that the iIneoing nttnehed Power:of Attorney remains in hill hire and has riot been:, revokedr and forthermore,that the Restitution.of the Board of Directors,set forth blithe Power nE.Atttnno k..4300,,in:Enet, ...,‘...• $ivetf ond:*aladzat.110 Ow of Middleton.State•ofWisconain this 17P+ .„,. .., ..... day of Auguat 20. . - . , . .... ,4,,; 1, Eny,a&""":.•.•••... : 44\ ..e.. ,-- 1 EAL P S i . • ',/fl 1...1.. , i_.• ' ' 4., k -.: • - s• , • ‘ ,•;, :\,, -,: g - _ • AndretitB,Diaa.Mottis -0414,1401.. Senior Vice Fro-004:ps,itterat'COttmlArittleeretaty THIS DOCINPNT flAS. BridiN (IENERATEDi FOR• A iSPECIFIC: BOND, IF• YOU :HAVE ANY •014...v$TION..$ cr'ONCIFT04.11s0 17,jr, AUTHENTICITY OF THIS D.00VN4Wr.c8L,L06,47s445o:._ cic•-ei)0.04.0tov, ��0� 11N6pti City of : :untington Beach �PQR ° ` <9��� 2000 Main Street ♦ Huntington Beach, CA 92648 - - - a= (714) 536-5227 ♦ www.huntingtonbeachca.gov ��4 Office of the City Clerk �UN - 0 00 Robin Estanislau, City Clerk December 29, 2023 CAMP CONSTRUCTORS INC 33648 Spring Brook Circle Temecula, CA 92592 RE: Central Library Lower Level Restroom ADA Improvements—CC No. 1658 Enclosed please find your original bid bond for CC No. 1658. Sincerely, e6./441Z14144) Robin Estanislau, CMC City Clerk RE:ds Enclosure Sister City: Anjo, Japan Z� 4e . - SECTION C PROPOSAL for the construction of CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS CC No. 1658 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 60 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications,Instructions to Bidders and all other contract documents.If this proposal is accepted for award,BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses,taxes,royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded,the AGENCY will reject all bids and will 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 i ff i i If awarded the Contract,the undersigned agrees that in..the event of the,BID.DER'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 Ibis bid and the acceptance hereof may,at the ACEN.CY'S option,be Iconsidered null and void. i e.Biddees Bond Accompanying this proposal.ofbid,find in the amount of NA which said amount is not less than 14%a of the aggregate of the total bid price,as required by the Notice Inviting Sealed OK ELECTRONIC Bids,payable to the AGENCY. 1 insert "Cash",rr � ri ;n o (Please the wordsCertified Check",or Bidder'sBond for /a.", as the case may be)Any standard Surety Bid Bond form is acceptable.: I Bidder shall.signify receipt of all.Addenda here, if any:':. Aden i ,ri�`Rie „, drs r Addendum 1 08115/2023 1 r 1. 1 I 1 1. 3 41 8 4 1 I a C-2 s 1 Is 1 CITY OF HUNTINGTON BEACH CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENT BID SCHEDULE Item # Description of Work Quantity Unit Unit Price Item Total 1 Mobilization 1 LS $ 5,000.00 $ 5,000.00 2 Construction Waste Management 1 LS $ 1,006.00 $ 1,000.00 3 Closeout 1 LS $ 5,000.00 $ 5,000.00 4 Demolition 1 LS $ 11,000.00 $ 11,000.00 5 Abatement 1 LS $ 5,000.00 $ 5,000.00 6 Concrete and Reinforcement 1 LS $ 4,000.00 $ 4,000.00 7 Casework/Countertop 1 LS $ 4,000.00 $ 4,000.00 8 Blanket Insulation 1 LS $ 1,000.00 $ 1,000.00 9 Joint Sealants 1 LS $ 1,000.00 $ 1,000.00 10 Aluminum Door Frames 1 LS $ 3,000.00 $ 3,000.00 11 Wood Doors 1 LS $ 7,000.00 $ 7,000.00 12 Access Doors and Frames 1 LS $ 1,000.00 $ 1,000.00 13 Door Hardware 1 LS $ 2,000.00 $ 2,000.00 14 Glazing/Mirror 1 LS $ 2,000.00 $ 2,000.00 15 Gypsum Board 1 LS $ 6,000.00 $ 6,000.00 16 Metal Stud Framing 1 LS $ 5,000.00 $ 5,000.00 17 Porcelain Tile Floor Finishing 1 LS $ 8,000.00 $ 8,000.00 18 Porcelain Tile Wall Finishing 1 LS $ 23,000.00 $ 23,000.00 19 Painting 1 LS $ 4,000.00 $ 4,000.00 20 Signage 1 LS $ 2,000.00 $ 2,000.00 21 Toilet Accessories 1 LS $13,000.00 $ 13,000.00 22 Plumbing 1 LS $ 34,000.00 $ 34,000.00 23 Mechanical 1 LS $ 7,000.00 $ 7,000.00 24 Electrical 1 LS $23,000.00 $ 23,000.00 Total in Numbers $ 177,000.00 C-2.1 Total in Words: One Hundred Seventy Seven Thousand Dollars and Zero Cents NOTES: The estimated quantities listed in the Proposal Bid Sheets are approximate and are to be used only as comparison of bids. Payment for quantities will be made from field measurements. If the actual quantities show either an increase or decrease from the quantities given in the Proposal Bid Sheet,the Contract Unit Prices will prevail. Full compensation will be paid at the contract price for the actual work completed,and no additional compensation will be allowed therefor. Payment will not be made for materials wasted or disposed of in a manner not called for under the Contract;this includes rejected material not unloaded from vehicles and material rejected after it has been placed. No compensation will be allowed for disposing of rejected or excess material.The City reserves the right to reject all bids and to increase or decrease the amount of any quantity shown on the Proposal Bid Sheets. In case of a variation between the unit price and the totals shown by the bidder,the unit price will be considered to be the bid. Compensation for items of work not specifically identified in these bid items shall include all labor, materials,tools,equipment,safety measures,and supervision required to complete the work to grades and dimensions shown on the Plans or staked in the field.There shall be no compensation except for the bid items specified in the Proposal.The cost of all work shown in the Plans and Specifications but not specifically identified as a bid item or described within a bid item shall be included in related bid items,and no additional compensation shall become due the Contractor by nature of compliance with the Plans and Specifications. C-2.2 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. 11 arise°and Address I�,S�tate Glass DIR PW Dollar %of . te�n(sj subcontractor License I egistrationr## Arnou t Contract •... `n..... ,���. , ,i . •.:. ,r. 'Fi•�3�1,i,/...i Number } ;sjf� 'x, ..f•(��/f!i// n .�.3 '�ak,��;.s,a ot* McKeown Plumbing 1000840869 22 1945 Laguana Canyon Rd. #2 1052408 $33,437 19% Laguana Beach, CA 92651 C36 STROHM Energy Systems 1099223 1001020993 $20,000 24 28012 Marguerite Pkwy#D C-10 12% Mission Viejo, CA 92692 Hartmanaire C61 1000046902 23 12 Gardenia 1017713 & $2,000 1 Lake Forest, CA 92630 D62 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 on98/22/2°23,at Huntington Beach , CA Date City State 1 _ William Camp being first duly sworn,deposes and says that he or she is. President of CAMP CONSTRUCTORS I INCthe 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 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 agreedwithany 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 orindirectly,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 teeffectuate a collusive or sliambid, • CAMP CONSTFIUGTORS INC Name of Bidder Signature of Bidder 33648 Spring Brook Circle, Temecula, CA 92592 Address ofBidder • C4 DIY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL: CITY OF III.TNYIN:GTONBEACH,,CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work spedified in the contract, known;as the CENTRAL LIBRARY LOWER LEVEL.ADA IMPROVEMENTS, (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 MD,as follows "Qualified Person. ;Apeman who,by reason ofexpenence'orin struetio` n, isfamiliarwith the Operation to be peiformed 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 prorniles 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 shalt take steps as ate necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained CAMP CONSTiitiCTOR$ INC Contractor 1 BY William Camp. President Title ate 00/22/2023 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. 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 INSUR CE CERII ICATE 1 Pursuantto Section l86il.of the StatetaborCode,ea. hcontractorto fli wh apubI a works contract has been awarded.shall sign the falloWin cert cafe. am aware of`the provisions,of Section 3700 of the tabor Code which require .every employer to be insured against-liability for workers compensation or to undertake self- insurance i s accordance with the provisions of that code, and I will comply with such provisions before:commencing the performance ce of the work of this contract. CAMP CONSTRUCTORS INC Contractor By Iliat Camp President Title 1 DateF08/2212023 1 C7 • i 1 . BIDDER'S INFORMATION 4 . BIDDER certifies that the following information is true and correct: CAMP CONSTRUCTORS INC 1 Bidder Nahat, 3640 Spring.Brook Circle i . Business Address Temecula, CA.92592 City, Slate Zip 1 williarn@earnpOonstructors earn 1 ( 951)514-5086 -, - ' Telephone Number Broil Address ,i 1 GA‘Licenself107$542 Class 0 State Contractor's License No.and Class 1 ' 05/11/2021 Original Date Issued 5/3112025 EipirationDate, The work site was inspected by.. William CamP of our office,ori August 8th ,2023 The following are,persons,firms,and covorations,having a ptiticipal interest in this proposal: William Camp I . 1 , The undersigned is prepared to satisfy'the Council of the City of Hrintingtori Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. CAMP CONSTRUCTORS INC . ., Company Name .1, . i Signature of Bidder I William Camp I President 1 , Printed or Typed Signature i 1 NOTARY CtItTIFICATE NOTARIZE pter?'. ,....,,,, CaTiliICATE Subscribed and sworn to befor e this day of ,LA:14.7. ATTA ..cliED ¬ary public or other officer completing this certificate verifies may the identity of the individual who signed the document, to which this certificate is attached, and not the ' truthfulness,accuraw,or validity of that document. State of dim 644-4 6- ) County of A vet‘11 IN-7 ) On Aie•cfAcr ).. before me,. tfOit,V dit; ffr...• -- (1"- 414.4.p•M'A I mItiern-y AAA-ft Month,Day,and Year Insert Name and Title of Notary 1 i s personally appeared liv1144 pipk. c.irio Name(s6f Sign.ez(4,- who proved.to me on the basis of satisfactory evidence to be the-perSoncg)whose name(a)is*e subscribed-to the within instrument and acknowledged to me that heisOft.407 executed the same in his/ker/tKeir authorized capacity(isos),and that by hisilsrithair signature )on the instrument the 4 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 paragtaphis true and correct , i.,,... MARY JO AS41,1.E P,110110 WITNESS My hand and official seat ' --:. Notry.Public•California 1 ....a.,..r,-z-:, = ,Rixerstde County Commission'42364213 My comm.Expires Jut 5,2325 1 . . Signature , 'Public (PLACE:NOTARY SEAL ABOVE) 1 1 i i i ; I 1 C-9.. I I -,, g g ' • i • I • ., CALIFORNIA ilURAT WITH AFFIANT STATEMENT , GOVERNMENT CODE f 8202. ,,...,,...,,,,,,, ,,,,,,„,..,,,,,,,,,,.,--„::,,,,,,i,,„,,,,,,,,,,,, ::,,.:;,,,,.--..-„...:,„,,,,,,,,,,,;,.....-„,-.-t,..-„:„.:,,,,,,-.4:::• .g.. .7-,747RAn'-4.te. ..-!, :;;:':<•; 4!.7.,'-. ..i, 4 j•kdee.Attaoned',Docurnent.(Naary to prose out.1.1nes•10.OelOw) Otee8tatenientl3elovit(Lines 16,:to:be:.CoMplated:tinty by dOdurrient. nellej,,riot:NotatA I I . . . " • 1 6 ' „. . . . .. . . . .. .... .... .. .. , . . . .. , . ..,.._ .„, „....., ... • ..., • $1gnatute of PocumentSlanerNoy I. $1074.torq Pf Pp $1,977-Pr$4,2(if 1 A.notary public or other officer:completing:thie certificate verifies only the identity..d.the,individual who signed.the .1 dotuteht to*Ilidil thit,OOrtitit Ate.lt atAthed,andgnot-AtemittfuletwAccuracy,or:validity ofthat,document State of.California . Coo*'of' el lie111067 Subscribed And SWOto AO '(titarfrait.ted), before me on this. I 1-0:cfay' at. Date Motith, Year. • T by :(1), MO..14' . Perin, , . (and (2) .• , •-g-4:, ,Niltary.'Put*-Olifor* :z. .-71c.:::1, . f(Neri.i4e,..COutly•.., A NaMOVOtSignerW'l,s:toe:T A.,•ccrrnissta?#13641.7'. 1 .y Coot:Opite,s Jul.%2025. proved to"rtle,on the',Cas(s of• •satisfactory evidence: ., .„ .., tO be. :the pereOhg) :Who appeared befoto trio, g Stgnature 1 .), .4 • Piece NoterySeal,Above :Signe re '.',N;,- ,.,Public - - • - 01410NAL. - --- -- • ::: - .1 ., 71.1.ough,,010,so-010p is:eptropai;'pop:plot:pa:01s ThfmmatiOn can deter Oteratioa of the document at 1 fraudulent.teattachment Of this fbrril to an tiiiintetideddoCUttent. i . 'Description of Attached DocuMent 1 Ooc Title.c:),r Type ozof.Document AtO)94,-,it t. 1. 4.4,7N...4., Oment Date: AA t- 1 NurriberotPages: . 1 SignerfeOther TriartNampd Above: . .. . 0201:01Net10001 NOtMAt6OPiatiori••1,AN0V,Mat1otlaiNotworg-,.1,713PQ,U$NOTARY(1.-000:-.476-.6827.):: ,Itein#59.10 . , • . , 1, Bidder's Project History For the purposes of this project the contractor and subcontractor must have, in the last five years, constructed at least five (5) projects of similar work specifically referencing the construction of (Describe specific work and experience necessary for project, for example "Reconstruction or rehabilitation of existing public use facilities". Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. The following list of projects meet the requirements of above: 1. Steven Klein 201 Vallecitos De Oro,San Marcos,CA 92069 760-703-9313 Name and Address of Reference Vallecitos Water District 201 Vallecitos De Oro,San Marcos,CA 92069 Name and Telephone No. of Owner: _ $49,800.00 Boardroom Ceiling Replacement March 2023 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 2. Steven Klein 201 Vallecitos De Oro,San Marcos,CA 92069 760-703-9313 Name and Address of Reference Name and Telephone No. of O Vallecitos Water District 201 Vallecitos De Oro,San Marcos,CA 92069 $20,000.00 Administration Building Tenant Improvements March 2023 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 3. *** FOR PROJECTS AND REFERNCES SEE ATTACHMENTS *** Name and Address of Reference Name and Telephone No. of Owner: _ Contract Amount Type of Work Date Completed Provide additional project description to show similar work: C-10 4. Name and Address of Reference Name and Telephone No. of Owner: _ Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 5. Name and Address of Reference Name and Telephone No. of Owner: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: C-11 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. William Camp Name of proposed Project Manager 951-514-5086 Telephone No. of proposed Project Manager *** FOR PROJECTS AND REFERNCES SEE ATTACHMENTS *** 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. William Camp Name of proposed Superintendent 951-514-5086 Telephone No. of proposed Superintendent *** FOR PROJECTS AND REFERNCES SEE ATTACHMENTS *** 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-12 CAMP CONSTRUCTORS INC's References Name Company/Owner Phone Number Email Address Minh Nguyen Vallecitos Water District 858-678-0150 mnguven@mbngroup.net Steven Klein Vallecitos Water District 760-703-9313 SKlein@vwd.org Brian Knoll Webb&Associates Engineer 951-830-3389 brian.knoll@webbassociates.com Jesse Martinson Jemstar Construction 714-883-1324 bossiemstar@aol.com Kash Tacke Ames Construction 801-910-2766 kashtacke@amesco.com Scott Sharpies Jemstar Construction 702-245-8044 scottsharples@hotmail.com Bruce Despain Alder 801-518-5902 bruce.d1@comcast.net The following is a list of projects William Camp has managed over the past 5 plus years. William Camp's Experience for 2017 through 2023 2023 Boardroom Ceiling Improvements and Admin TI Vallecitos Water District $ 70,000 2019 Encina SCADA Phase 2 • Encina Wastewater Authority $ 1,509,105 2019 Leprino Foods Company-Mechanical Only Leprino Foods,CA $ 39,255,016 2020 Saratoga Springs WTP Clay County Utility Authority $ 17,091,194 2020 Monte Vista Water District,Plant 30 Wellhead Treatment Monte Vista Water District,CA CAD 2,986,882 Northwest Langley Waste Water Treatment Facility-Alternative Evaluation Metro Vancouver,Vancouver,Bntish 2020 (Options 1,2,and 3) Columbia,Canada CAD 23,282,465 2020 OCWD PFAS,Garden Grove,Well 21&Lampson City of Garden Grove,CA 2021 Rand Park PipeLine Tunnel Iowa $ 60,000,000 2021 Annacis Island Wastewater Treatment Plant Bypass Columbia,Canada CAD 1,035,018 2021 Sisk Darn Raise,10'Raise i Bureau of Reclamation,CA $ 350,000,000 2021 Saratoga Springs WTP,60%Update Clay County Utility Authority $ 15,493,605 2021 Cactus Corridor,90%Design Update EMWD,CA $ 56,466,017 San Francisco Public Utilities Commission(SFPUC)Southeast Water Pollution Control Plant-Biosolids Digester Facilities Project Contract No. 2021 WW-647R Scope II ARCADIS $ 100,000,000 Kerr Lake Regional Water System,20 MGD WTP Improvements-AG Mech 2021 Piping Only,2nd Estimate City of Henderson,NC $ 5,974,319 2022 Corwin Booster Electrical Replacement Eastern Municipal Water District(EMWD) $ 794,645 2022 SD404 Oakland CA East Bay MUD $ 5,032,527 2022 Anaheim PFAS Phase A Anaheim,CA $ 57,354,438 2022 Horse Thief,Elsinore Valley Municipal Water District,CA-Mech Estimate Lake Elsinore,CA $ 31,000,000 2022 Pojoaque TINA compliance Pojoaque,NM $ 6,000,000 2022 Anaheim PFAS Phase B Anaheim,CA $ 74,000,000 2019 Emergency Rehab of Sanitary and Combined Sewers by Shotcreting NYC-DOC $ 8,473,350 2019 Jones Falls Structural Sewer Rehab Pkg 2,Contract No.19013 SX)(Re-Bid) County of Baltimore $ 3,973,300 2019 US Route 13 Force Main Rehab Kent County Levy Court,DE $ 2,393,392 2019 6"-12"CIPP Uning Phase IX Anne Arundel County,MD $ 1,273,300 2019 Joint Outfall"F"Unit 3 Trunk Sewer Rehabilitation Phase 1 County Sanitation District No.2 of Los Angeles $ 6,327,630 2019 Sanitary Sewer Main Rehabilitation/Lining Jersey City Municipal Authority,NJ $ 797,423 2018 Sanitary Contract 964 City of Baltimore $ 17,433,000 2018 ESR-NOS Unit 18 City of Los Angeles $ 20,817,052 2018 Combined Sewer Reconstruction and Rehabilitation-10YR Contract North Hudson Sewerage Authority $ 573,975 2018 Sewer Trunk Line Rehabiliation Ctiy of Davis,CA $ 2,138,438 2018 Belvedere Trunk Sewer Rehab Phase 1 LACSD $ 2,274,270 2018 Water Contract 1339 City of Baltimore $ 7,330,000 2018 CMP Rehabilitation FY 2017/2018 City of Chula Vista $ 4,169,940 2018 Alum Creek Trunk Middle Rehab Phase B City of Columbus $ 7,393,239 2018 North Outfall Sewer(NOS)Unit 8 City of Los Angeles $ 8,672,555 2018 Main Trunk Sewer Rehab-Phase II Middlesex County Water Authority $ 7,560,308 2018 Summit Conduit Rehabilitation,SSA Metropolitan Water Reclamation District $ 2,773,300 2018 Water Contract 1385 Urgent Need Water Infrastructure Rehab and Improvem City of Baltimore $ 5,833,000 2018 Phase IVBriery Run Sewer Rehab City of Kinston,NC $ 2,549,633 2018 North Outfall Sewer(NOS)Rehabilitation Unit 13 City of Los Angeles $ 10,306,679 2018 Contract 196 Combined Sewer Rehab Cleaning&Geopolymer Spray On Uning Altoona Water Authority $ 4,613,879 2018 WC 1386 Urgent Need Water Rehab&Improve PH II-FY-19 City of Baltimore $ 5,573,300 2018 Sanitary Contract 956 City of Baltimore $ 7,843,310 2018 NOS Rehab.Unit 4 Trinity from 41st to Alley S.of 23rd St. City of Los Angeles $ 11,469,569 2018 Jones Falls Structure Sewer Rehab County of Baltimore $ 2,619,531 2017 Sanitary Contract 953 City of Baltimore $ 12,233,000 2017 Phase 3-4 Sewer Rehabillation Jersey City Municipal Utilities Authority $ 27,523,300 2017 Water Meter Replacements Casitas Municipal Water District $ 849,500 2017 Utilities Maintenance Services Project-Contract B City of Pasadena,CA $ 968,500 2017 Sanitary Contract 910-Improvements to the Sanitary Sewer Collection Systerr City of Baltimore $ 23,553,300 2017 Water Contract 1359-Urgent Need Water Rehabiltiation City of Baltimore $ 6,193,300 2017 Water Contract 1366 Urgent Need City of Baltimore $ 6,543,300 2017 Water Main Rehab Program WCP-122 Greenville Utilities Commission $ ' 1,222,348 2017 SC 930 R Clinton Street City of Baltimore $ 8,733,000 2017 Sanitary Contract 965 City of Baltimore $ 8,933,000 2017 Water Contract 1369 City of Baltimore $ 1,973,300 CONTRACTOR REGISTRATION WITH CALIFORNIA', DEPARThIENT OF INDIJSTRLkL'RELATIONS(DIR) CERTIFICATE Pursuant to SE 854(oiling Labor Code Section 1771.1(4))„.passed by the California State Senate on June 20,2014,established anew public works Contractor Registration Program,which requires all contractors and subcontractors bidding and performing work. on Public Works Piojects V register on an annual basis (each July 1 through June 30 state fiscal year) with the California Department of Industrial Relations(D1R).Currently the annual non-refundable registration fee for Contractors is'poo.Each contractor to whom a public works contract has been.awarded shall sign the following certificate. I DIR FACT SHEET on.SE 854, Ihttrtiwww.dir.a.goviDLSE/PublicWorksISB854factSheet 6-.34114•Pdf D1R!s Contractor Registration Link—Call(844)522-6734 •1 https://efilingslitcagoviRWCWAohon8ervlet2action#disPlaYPWCRegistrationFonn I DIR's Contractor Registration searchable database: https://efiling.dca.gov/PWCR/Searcli.action i I am aware and will comply with the provisions of Labor Code Section 1771,1(a)Which:states:, "A contractor or subcontractor shall not he qualified to bid MI, 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 1 pursuant to Section 1725.5 at the tune 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, William Carnij 1 Contractor i 4• billcamp-121@Ornalle.om I Email i Pratidant Title Date: _ 08/21/2023 i PWC Registration 4: , 100.13760. 1 C-13 i EXHIBIT A DISADVANTAGED BUSINESS ENTERPRISE (DBE) This Project is subject to Part 200.321, Title 2, Code of Federal Regulations entitled "Contracting with Small and Minority Businesses, Women's Business Enterprises, and Labor Surplus Area Firms." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in Part 200.321, Title 2 CFR, shall be encouraged to participate in the performance of Contracts financed in whole or in part with federal funds.The Contractor should ensure that DBEs,as defined in Part 200.321, Title 2 CFR, have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps,as set forth in Part 200.321,Title 2 CFR, for this assurance.The Contractor shall not discriminate on the basis of race,color,national origin, or sex in the award and performance of subcontracts. Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project, although there is no specific goal for DBE participation. C-14 EXHIBIT B DBE INFORMATION—GOOD FAITH EFFORTS Federal-aid Project No. CC No. 1658 Bid Opening Date 08/22/2023 The City of Huntington Beach_established a Disadvantaged Business Enterprise(DBE)goal of 0% for this Project. The information provided herein shows that a good faith effort was made. Lowest,second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder DBE Commitment"form indicates that the bidder has met the DBE goal.This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement Compliance News www.compliancenews.com 08/17/2023 B. The names and dates of written notices sent to certified DBEs soliciting bids for this Project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested(please attach copies of solicitations,telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods Solicitation and Dates Triton Concepts (Electrical) Certified SBE 08/08/2023 emails C-15 C. The items of work which the bidder made available to DBE firms including, where appropriate,any breaking down of the contract work items(including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items ($) of (YIN) Contract Electrical No electrical scope $20,000 13% Plumbing No plumbing work $30,000 20% HVAC No HVAC $2,000 1% D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved),and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: From the list of contractors with a DIR#for the scopes of Electrical. Plumbing, and HVAC, there were not many on the Caleprocure site. Triton Concepts was one of few contacted and they were non-responsive. Names, addresses and phone numbers of firms selected for the work above: Firms selected are on the subcontractor list above. E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: N/A C-16 F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: N/A G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results Compliance News Websites like the Calrprocure website were used to look up contractors emails to over 40 contractors in the Electrical. Plumbing, and HVAC scopes were sent out starting around August 1st. H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): CAMP CONSTRUCTORS INC is a certified SBE. We will be self-performing over 50% of the work. NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. **The following is a copy of CAMP CONSTRUCTORS INC's Certification as an SBE. ** Following the certification is a copy of the ad placed in Compliance News. C-17 Printed on:5/22/2023 7:00:57 AM To verify most current certification status go to:https://www.caleprocure.ca.gov 7G5 RF.IWQR tiF OMDZ M Yxi:'.' GENERAL SERVICES' Office of Small Business&DVBE Services Certification ID:2029574 Email Address: Legal Business Name: william@campconstructors.com CAMP CONSTRUCTORS INC Business Web Page: Doing Business As(DBA)Name 1: Business Phone Number. 951/514-5086 Doing Business As(DBA)Name 2: Business Fax Number. Address: Business Types: 33648 Spring Brook Circle Construction,Service Temecula CA 92592 Certification Type, Status From To SB(Micro) Approved 12/06/2022 12/31/2024 SB-PW Approved 12/06/2022 12/31/2024 Stay informedlNEEP'YOUR CERTIFICATION PROFILE UPDATED! -LOGIN at CaleProcure.CA.GOV Questions? Email:OSDS HELP(aIDGS.CA.GOV Call OSDS Main Number.916-375-4940 707 3rd Street,1-400,West Sacramento,CA 95605 t.(800)599-6996 My Account EST. aaa 40. WHAT WE OFFER DIVERSITY TOOLS ABOUT US Contractors&government DBE:,M/WBE:,Vet Biz click here Info&useful services Trade Journal CAMP CONSTRUCTORS INC .41 is seeking certified and qualified DBE,DVBE,MBE and WBE subcontractors and/or suppliers to provide Electrical,HVAC,and Plumbing CONSTRUCTORS PROJECT NAME: OUTREACH COORDINATOR: William Camp Central Library Lower Level Restroom ADA Improvements TELEPHONE: BID CONTRACT#: 9515145086 951-514-5086 FAX: AWARDING AGENCY: City of Huntington Beach Not Available PROJECT LOCATION: ADDRESS: 7111 Talbert Avenue,Huntington Beach,CA,92648 33648 Spring Brook Circle,Temecula,CA,92592 BID DUE DATE: I Send Message 08-22-2023 at 12:00 PM PROJECT DETAILS: We are an Equal Opportunity Employer. If you are.planning to bid this project,we encourage your participation and welcome your bid. All qualified bidders will receive consideration without regard to race,color,religion,sex or national origin. Plans&specs available upon request To request plans and specs send an email to william@campconstructors.com or info @campconstructors.com. This project is a prevailing wage project,labor rates are provided in the bid documents. All contractors must be Licensed with the California State License Board and registered with the State of California to do Public Works projects. This project includes the renovation of two existing bathrooms. The bathrooms will be demolished and remodeled to ADA requirements. Back To Trade Journal Have any questions? YOUR NAME Send us your message and we'll get back to you within one business day at the very latest. YOUR EMAIL ADDRESS • Social Media 1 COMPANY PHONE YOUR MESSAGE i SEND MESSAGE WHAT WE OFFER? DIVERSITY TOOLS -CONTRACTOR SERVICES -GET CERTIFIED -GOVERNMENT SERVICES -EVENTS CALENDAR -SEE ADS&NOTICES -CONTRACTOR NEWS +TRADE JOURNAL -FIND SUB PROJECTS +FOCUS JOURNAL +TRADE JOURNAL +FOCUS JOURNAL ABOUT US LEGAL DISCLAIMERS -FAQ&INFO -TERMS OF SERVICE -EASY TO USE FAX FORM -PRIVACY POLICY +Contractor fax form +Government fax form Copyright C©2023 Compliance News All rights reserved. IF A SOLE OWNER OR SOLE CONTRACTOR SIGN HERE: (1) Name under which business is conducted N/A (2) Signature (given and surname) of proprietor (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail IF A PARTNERSHIP, SIGN HERE: (1) Name under which business is conducted N/A (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail C-1 8 i •i . . . i . I . ..1 I , : •. . I: • IF A CoRPOItATION.i.SIGNIIRE:. . :• t , 1 (1)Name under whieli:busieoss is conducted .. CAMP,CONSTRUCTORS iNC i . ... - . . . .• . _ .:.Nor.ARIzED 1 ...„ (2) - , -•:- .:::,,f77 ;4-.,7, --: ::,:•,: - , . , . , , • :..„ ,:ftFiCATE • . ,.,.:.: (Signature" fA:KrACHED '''. 1 William Camp I President '4 •(Title) 4 , Impress Corporate Seal here• : . :.(3) Incorporated under the laws of the.State of California :1 .. .. .., (4)Place of Business t .0$644 Spring Brook Circle . :„... . 0 treet.andNOtthet) "-a I . city and State Temecula, o.A. ..., ..., I . , (5) Zip Code 92592 . Telephone No 951,514.4086 i., (6)E-mail , :, .tbiflcarnp121@gmail.com. 1 . 1 ',OTARIAL ACKNONVLEDG.MENT-40 FitECUTION DV ALL SIQNATQW:E,:$WAIST BE ATTACHED , . List below names of president,lice president,secretary and assistant secretary,if a corporation;if a partnership,list liattles.ofa-d general polders and Irianaging.partoe* . . . . , r0!7 ‘,4,t,: :e°' ••4 'S'7.11 :4'2.:: . ''....:,*1: , .•• : •:• . id 1 .... .. . _ .. i .I . .... . . •• 1 . . : . 1 , •C-19 •• I . • •k . ) , < . I . .. , I CALIFORNIA ALLoRDRPOSE ACKNOWLEDGMENT , CIVIL CODE§-110 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 decilitent. State of California ) County of ..,./?:. tire-Mite , ,. _ . , ) 'i. an Avt64,611 21.,X443 before me WWI 4 11 hv4%-a-7 A jii. 410-ri• tyJne-po,t P4/"..0 t i Date- Here Insert Name and Title of the Officer personally appeared ,. 'Ifti. 1 L-L4 1414 1 Name()of who proved to me on the basis of satisfactory evidence to be the perto4;tig,whose nerneter istare Subscribed to the- within instrument and acknowledged to me'that heisb4 executed the same in hisiberitkreir authorized capaoity00,and that by his/heriti4ir signattge(sionthe instrument the persorls) or the entity upon behalf of which,the persor*acted,executed the instrument. • L certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true a and correct. , hvkaY 40 AME P,.114)-rAti •' 40,4i't.,.,e-f*? • - ' . , i ....,il..f..,......:•-t; ,Ootary.P1.11!.lic-Caltform4 z, -WITNESS my hand and Official seal, Riv•!F'5, e.Canty -t i : ,''', ,Ile, S CoMmitssion,#2464275 : .i . . Signature, 46; . S go re' '''INiPtatY Public 1 Place Notary Seal Above 1 OPTIONAL Though this section.Is optional, completing this information can deter alteration of the document or 1 fraudulent reattachment of this form to,an unintended document. Description of Attached Document „ Title or Type of Document: . It !Sri- tl, :p:A -. )744144,,,ii-s-10,i- edu lAi-oni, rpfbi(r7 Document bate . . . A1A C-I40' '21) 4 0-- 3 Number of Pages: ( 1 'Signer(s) Other Than Named Above: Capa0ity(les)Claimed by Signer(s) 1 . Signer's Name: .._..... _ , , Signer's Name:' O Corporate Officer - Title(s): ,. , ,. 0 Corporate Officer -TRIO): 1 LI Partner-- 0:Limited 0 General 0 Trustee 0 Attorney in Fact 0 Partner- 0 United 0 General 0 individual 0 Individual 0.Trustee •IqAttorney in Fact Cl Guardian or Conservator '0 Guardian,or Conservator o Other:1 . El Other Signet Is Representing.' . . .. . . Signer Is Representing; 1 ,-..:-.____.-_ __,-,-..-.,„__.;___ _>-._.-..- , . C2016 National Notary Association•vvww.NationaiNotary.org-140-US NOTARY(1-800-876-6827) Rein 4t5907 4 . 1 1 ' 1 . • i . , . , . , f . 'EXHIBIT e I, u. t • LOCAL.AGENCY:MODER DBE,•COMMITMENT(CONSMITTION'CONTR.A,CTS) • NOTE: PLEASE REFER TO 114STRUCTIO*S ON THE.REVERSE SIDE OF THIS,FORM .LOCAL AGENCY:, .cj.W pt Huntington Beach , LocApc.N200 Main St., Huntington Reach,CA ,i. pRoJattiEseitimo* Gentrali Library Lower Level Rest ADA.Improvements 1 , TOTAL CON CrAMOUNT:$•• , • -•• •• ••• • • , $t50.000:00 TItA, 1, - • 1 - „ 1 80..ium ,081202.8 . f. I •BIDDER'S NAME: CAMP CONSTRUCTORS INC i' '"CONTRACT.DBZOQ.a.1 .. 0% „ „. .,. .. .. ; '..,. ' ., : ' I . • . CONTRACT :OEM.OF'WORK'AND.DESCIUPTIONDBECEarNa. ,t4AME -OP "WIC .D$15:001, 13.,-040.M.4T : regig<NO. :OR .SERVICES TO 13F,.A1D, .:FiNPARATIPIS :,(Must bwcOttig,..44*the liatel*1013E I. SUBCONTRACTED OR MATERIAL DATE are opened iiidliid0.:DBE,addielis .TO pg.ggpv.ip.p,p(or contactedit the phonen, 11:tid&t&k0130, an.d,: iimbd) . . I : Items 1-21 GeneralBDueimidoirlagnsdcnp s12/31/2024 2029574 :: CAMP: $112,000.00 L CONSTRUCTORS I. ,i •, INC i• " ••. . , . . f . t , I , . „'. . ,,:• . • _ • . . .,: .. . . . , tortoialAgeiii4ii):Conijoetat teito.:00i4tsgt •} $112,000.00 ,. . Local AgeAceixttrant Isitinibee .m . , _ , . Faxii4ettmt [ , , . . Feck.traPaid Pi*otNtillibet 63. . P41ernV$Itater . :. Conir4dAward pa*., • . , . ,-: •• , 1 '4001.Agwy:ce.04es,thatanDBE„certifitationt tmation is ca hive tideiivekified.and in* tit lest4tufattlittlt. , • . ., ,• I : •,., OieAif.Biddet I . , • : - 134 1 ' ,Oitii Code)Tel.NO. Piint-Naniii 'SighatIve• Ditp., 1 . • Local Agency P- :`:t.ii.Conta,dt, •(PlatO•Typtlit.F.Iiiit); 1 • . : 1. ,(Area C.p40)7,0ephpne 14.940er, „ Vicar- icyEidderDBE Commitment(conetruntiOnContinci0 : 1 •(tpv 0460). i: • 4 . i . iI C-a0, t . i ! 1 1 i ! k • PLEASE NOTE: This information may be submitted with your bid.If it is not,and you are the apparent low bidder or the second or third low bidder,it must be submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs.Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date.Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier.Names of the First-Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable,with the names and items of work in the"List of Subcontractors"submitted with your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100%of item is not to be performed or furnished by the DBE,describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise(DBE),"of the Special Provisions (construction contracts),to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated-by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award,Federal-aid Project Number, Federal Share,Contract Award Date fields and verify that all information is complete and accurate before signing and filing. C-21 i . 1 , I 1 i 1 I ' Exuma,a ; . i . EQUAL EMPLOYMENT OPPORTUNITY CERIIFICATION The bidder CAMP CONSTRUCTORS INC [proposed subcontractor ,]hereby certifies that heishelit has x „hag not ,participated in a previous contract or subcontract ..„ subject to the,Equal Opportunity clauses,,as required by Executive Orders 10925,211114,or 1,1246,and that,where required,he/she/it hag filed With the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former Presidents Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note The above certification is required by the Equal Employment-Opportunity Regulations of . the Secretary of Labor,(41 CFR:60,1.7(0(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 604.5. (Generally only contracts oristibcontracts of$10,000 or under are exempt) I . , I Currently,Standard Form 100(EEO-1)is the only reportrequiredhythe Executive Orders or their • J implementing regulations, (etoc.gov/ttnplbyas/eeol.surveyfindex.cfm) Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CYR. 60-1.1(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 A. ..-chnims tration or by the Director, Office of Federal Contract Compliance, U.S. 1Departinent ofJ4bor, i Signature: ' , ' Date: ,Q8/22/2023 _ I Print Name: William Camp Title: President . , I , 1 1 , 1 , I I ' C22. I : , I , , I I EXHIBIT E 1 NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) . t . 1 , [NAME OF CONTRACT} f 1 To the City cofHuMingtoaBeach i i In conformance With Title 23 United States Code Section 112 and California Public Contract Code i ! 7106 the bidder declares that the bid is not made in the interest of,or on behalf of,anyundisclosed person,partnership,company,association,organization,or corporation;that the bid is genuine and not collusive or sham;that 14'--,bidder has not directly or indirectly induced or solicited any other bidder to put false 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 11 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 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 thereofto effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. By signing the I Pmposal,the Bidder has also signed tbi*Noneollusion AffidaYit- Bidders are cautioned that making.a.false Certification-may subject the Bidder to criminal, prosecution. I • I - Date: 08/22/202$ # Signature: IPrint Name: William Camp I Title President , _ . i , i •,, t • , 1 , .,, 1 I I . C-23 I 5 1 I . i i EXIBBIT F i DEBARMENT AND SUSPENSION CERmiCATION 1 TITLE 49,CODE OF FEDERAL REGULATIONS,PART 29 The Bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person,associated with Bidder in the capacity of owner,partner,director,officer,manager: . is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by anyFederal agency; . has not been suspended,debarred,voluntarily excluded or determined ineligible -5 by any Federal agency within the past 3 years; i 1 • does not have a proposed debarment pending;and • has not been indicted,convicted,or had a civil judgment rendered against him/her t by a court of competent jurisdiction in any matter involving fraud or official misconduct , 1 within the,past 3 years., I If there are any exceptions to this certification,insert the exceptions in the following space. ii Exceptions will not necessarily result in denial of award, but will be considered in determining , . bidderTesponsibmty.For any exceptionnoted above,indicate below to whom it applies,Mi fialng agency,and dates of action. 1 , Note: Providing false information May result in criminal prosecution or administrative 1 ' sandtions. The above certification is part of the Proposal Signing this Proposal on the 1 signature portion thereof shall also Condit-de signature of this Certification. I I i t Signature: 08/22/2023 Date: Print Name.. William Camp 1 Title: President i . 1 1 g i C-24 i I 1 4 t EXHIBIT G NONLOItRY1NG CERAlitiCATION 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 attemptiag to influence an officer Or employee of any Federal agency,a Member of Congress, an officer or employee of Congress,or an employee of a Member of Congress in connection with this Federal contract,grant, loan, or cooperative agreement,The undersigned shall complete and submit Standard Form-LLL, "Disclosure • of Lobbying Activities,"in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this • transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352,Title 31,U.S. Code.Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than,$100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all,lower tier subcontracts, which exceed$100,000 and that all such subrecipients shall certify and disclose accordingly. Signature: Date: 08/22/2023 Print Name: William Camp President 1 C-25 EXHIBIT H DISCLOSURE OF LOBBYING ACTIVITIES. COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ❑a.contract ❑a.bid/offer/application ❑ a.initial b.grant b.initial award b.material change c.cooperative agreement c.post-award d.loan For Material Change Only: e.loan guarantee year quarter f loan insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No.4 is Subawardee, Enter Name and Address of Prime: Prime ❑Subawardee Tier ,if known Congressional District,if known Congressional District,if known 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number,if applicable 8. Federal Action Number,if known: 9. Award Amount,if known: 10. a.Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual,last name,first name,MI) address if different from No.10a) (last name,first name,MI) (attach Continuation Sheet(s)if necessary) 11. Amount of Payment(check all that apply) 13. Type of Payment(check all that apply) $ ❑ Actual ❑planned a.retainer b.one-time fee 12. Form of Payment(check all that apply): c.commission Ha.cash d.contingent fee b.in-kind; specify: nature e deferred value f other,specify 14. Brief Description of Services Performed or to be performed and Date(s)of Service,including officer(s),employee(s),or member(s)contacted,for Payment Indicated in Item 11: (attach Continuation Sheet(s)if necessary) 15. Continuation Sheet(s)attached: Yes1:1 No 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352.This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into.This disclosure is required pursuant to 31 U.S.C. Print Name: 1352. This information will be reported to Congress semiannually and will be available for public inspection.Any Title: person who fails to file the required disclosure shall be subject to a civil penalty of not less than$10,000 and not more than Telephone No.: Date: $100,000 for each such failure. Authorized for Local Reproduction Federal Use Only: Standard Form-LLL Standard Form LLL Rev.09-12-97 C-26 INSTRUCTIONS FOR COMPLETION OF EXHIBIT H, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1) Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered Federal action. 2) Identify the status of the covered Federal action. 3) Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last,previously submitted report by this reporting entity for this covered Federal action. 4) Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5) If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address,city,state and zip code of the prime Federal recipient.Include Congressional District, if known. 6) Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation,United States Coast Guard. 7) Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8) Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9) For a covered Federal action where there has been an award or loan commitment by the Federal agency,enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10)(a)Enter the full name,address,city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. C-27 (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (M1). 11)Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4)to the lobbying entity(item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12)Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13)Check the appropriate box(es). Check all boxes that apply. If other, specify nature. 14)Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15)Check whether or not a continuation sheet(s) is attached. 16)The certifying official shall sign and date the form,print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project(0348-0046),Washington,D.C. 20503. By my signature on this proposal I certify, under penalty of perjury under the laws of the State of California, that the foregoing questionnaire and statements of Public Contract Code Sections 10162, 10232 and 10285.1 are true and correct and that the bidder has complied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5,Title 2 of the California Administrative Code). C-28 EXHIBIT I FEDERAL LOBBYING RESTRICTIONS Section 1352, Title 31, United States Code prohibits Federal funds from being expended by the recipient or any lower tier subrecipient of a Federal-aid contract to pay for any person for influencing or attempting to influence a Federal agency or Congress in connection with the awarding of any Federal-aid contract,the making of any Federal grant or loan,or the entering into of any cooperative agreement. If any funds other than Federal funds have been paid for the same purposes in connection with this Federal-aid contract,the recipient shall submit an executed certification and, if required, submit a completed disclosure form as part of the bid documents. A certification for Federal-aid contracts regarding payment of funds to lobby Congress or a Federal agency is included in the Proposal. Standard Form LLL, "Disclosure of Lobbying Activities," with instructions for completion of the Standard Form is also included in the Proposal. Signing the Proposal shall constitute signature of the Certification. The above referenced certification and disclosure of lobbying activities shall be included in each subcontract and any lower-tier contracts exceeding $100,000. All disclosure forms, but not certifications, shall be forwarded from tier to tier until received by the Engineer. The Contractor, subcontractors and any lower-tier contractors shall file a disclosure form at the end of each calendar quarter in which there occurs any event that requires disclosure or that materially affects the accuracy of the information contained in any disclosure form previously filed by the Contractor, subcontractors and any lower-tier contractors. An event that materially affects the accuracy of the information reported includes: 1) A cumulative increase if$25,000 or more in the amount paid or expected to be paid for influencing or attempting to influence a covered Federal action; or 2) A change in the person(s)or individual(s)influencing or attempting to influence a covered Federal action; or 3) A change in the officer(s), employees(s), or Member(s) contacted to influence or attempt to influence a covered Federal Action. C-29 1 TO — —_— Surety Group TKIO MARINE L801 os S.Figueroa Street,#700 Los Angeles,CA 90017 HCC Bond Number: BID BID BOND KNOW ALL PERSONS BY THESE PRESENTS: That we, CAMP CONSTRUCTORS INC (hereinafter called Principal), as Principal, and AMERICAN CONTRACTORS INDEMNITY COMPANY , a corporation organized and existing under the laws of California , (hereinafter called Surety)as Surety, are held and firmly bound unto City of Huntington Beach (hereinafter called Obligee)as Obligee, in the penal sum of Ten Percent of Total Amount Bid percent( 10 %)of amount bid not to exceed Ten Percent of Total Amount Bid Dollars($ 10%of Total Amount Bid )for the payment of which the Principal and the Surety bind themselves,their heirs, executors, administrators, successors and assigns,jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH,That,whereas the Principal has submitted or is about to submit a proposal to the Obligee on a contract for CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS,CC No.1658 NOW,THEREFORE, if the said contract be awarded to the Principal and the Principal shall,within such time as may be specified, enter into the contract in writing, then this obligation shall be void. If the Principal shall fail to do so,then the undersigned shall pay the obligee the damages which the obligee may suffer by reason of such failure up to and not exceeding the penal sum of the bond. Signed and sealed this 18th day of August , 2023 . • Principal: • CAMP CONSTRUCTORS INC NOTARIZED CERTIFICATE By: ATTACHED GeA y/ L:z C /o /,`"rs cde�7� Surety: AMERICAN CONTRACTORS INDEMNITY COMPANY By: Ryan Tash, Attorney-In-Fact HCCSZZA_BIDBOND 1/2017 Page 1 of 1 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 Sacramento ) • On S IS 1 before me, Katherine DuPont, Notary Public (insert name and title of the officer) personally appeared Ryan Tash 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. KATHERINEbP2SNT U •c ; _ 8_22 WITNESS my hand and official seal. 0" .fse78 NOTARY PUBLIC-CALIFORNIA 2 tw4r^ SACRAMENTO COUNTY C) L,OAN COMM.EXPIRES OCT.12,2021 Signature (Seal) . k:E.A..i'' ,i4.; =,.':-.'.. 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''.:'•,Y''',c:','"','' i.:V..4...r..•....''‘' POWER OF ATTORN,,..-L-...Y AfiEt;bAN CONTRACTORSiNiiiNITY 6OikNtiti4-4.i'g aNDI4•':..246'.-4.::COMPANY,r'.?:'3'.,„:,,..:';".,,,,-,;:,,.,",.''.,,..:,,;,,,.,,,., ,...'41..-:',,,,,,-..1,,,,:1k,':7:!.,.,.',i.,',..,f'.,-.,i:.).;v3l;:;.,,..,;i.'„•-"„..•,,.,!.,,:.:,.;-,,,',,',,„,.,,,!::!.,,.,.:'.;<;.•,...),UNITED STATES SURETY COMPANY U.S.SPECIALTY INSURANCE COMPANY , ., . .„...... i •:'''::;': "- : NOW ALINE.4 B*1,-Hgs„E,,t,ip,REsENteitti•I'itAtp0.ricen.:p.. ontractd...i‘i: .):00em,n.ity. ono,,pa,ny, a 0ettforriacorpo_ratiOnjexas 9,51ngln,g,,,:,.\ 06mpanY.:,'attiessulried)ritta00.1Amerroak0OhtiactOrsffiderinity, Company ifrijfe.d States Surety Company alVlaryland corporattolv .a.,,,,.,.4. .„...,.-...., ''' "'' ... • . ke• and U.S. SPeCialty Inatirancet ompani'atekaicarpbration (colleCtively:Ahe."COMpanies"), do by tli ese presen f s ma , coiiiiii64 and appoint: CYAN TAS0RSUAA,N,..,:E0yR,NIER OERA140-JOCORDOVA,CAJBORNIA::- ; ,:r,,, ,:-.0.„Al„r:. „,„... ,.,,, ,..,„: .,,::;:r '.')ig'.?;:':' •;',', 7-'i' ::4-,f., ,,,,,f.-.t4 !f;a: .,- .'.;',...'"".::,'d ...7..i W-.., '''',,, )4'...,:-',' ,..?!; i.:''.: ,-,:.1:•.'5 .?;,' ,,vm.,. :•z:.,. ;.,.4::-..,.:.; ..;• i:.,.'.. .•...?..,•;',. 1;,,,,, J-,.:',,::•.:. 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'c7',",:-. •W., "',/,'q ..>.1:‘, ---,,. .:.:, -,...,; • ..;.1•I'::'-f.'''.1‘-,'..'. &true arid':.1a4a1 At1'Orhey(s)lih-fact, eaCli'in'-iheieeeparatetapacity'if More than one is-named above;-,wit-lull power and iutlitirity: hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, . undertakings or other instrumentsor,contracts of,:sretyship4o include ride , am.e.n.idirn4yents, ,,, and consents of surety, , 4-providing the bond'penalty does niA ei,..vect,.' :::...' .1,•*f.t"•':., . ,,,i,!.74.izi a',;c",'",*:"",!3;000;000.00 ..,4'1.:::.,.. :,,,, ..: ,,,,,,, ,,.....,, ,'Dblrats> •1V.-.i,?:,4.::•(lt**$3,000;000:00*,:i!)Mils‘Bower of AttOrhey,'shallekpire*Ithout falter actionon..APIO113....,rd,2026',,T.,.ftitPo-yy'..:.9..T,'.kof..:. tfi!.ney is'irenietti ,.:.: ,..,?.." .:,.,.,.;. under and by ibthciity of the following reiciliitioris idcgitedby the Boards of Directors of the C ompanies: - Be it Resolved,that the President,any Vice-President,any Assistant Vice-President,any Secretary or any Assistant Secretary shall be and is hereby.. .._. ..5, vested withitill:Poivar'ind:-.authOrdy to appotnt'iorkorre'er)Tore,,eoitable persons as Artbihey(s) fact to repres1)enf aOtiforjand on behtf0f:,!1-ei •i,:5 ..11 Company subject to the 41ii*OtiO,'r.provisiot#,Ni: ., ,'V.:., V;i.':::41 r,':.,, i.:'.'.;,4.:,,t.i;•.Q.:1 ,. ,,i2' d d e ii '..0,.;(...;;P'.4i1 • A-Ilomey-inI.F"'a."b-t rna'ilie-'g'ivvehluliPOwer anifeUthrifity'forindihthe'hame of.aiiiPotefigltof the.CoMpany,to-diecute,acknow edge an i and all all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any and all consents „for the releas of.retained percentages and/or final estirnates„.on engineering and c9ntructiT contracts,and any and all notices and documents ."-,_;,::3"':•'..-, canceling oeieritiHnatif101tie Germany's liapillildthereOhderj.andOpy such ipsttItrhents ,o executed by any sy0:A:tt6'..ttriet:itact,..1:111 be binding t, :,'..,,,.4.`1'&,t, ,i.:::',..‘•.i.. he Company aS if signed by Oftipsident*,.,,Ipd::.:#:90.,':eiFel,1,..by the"-0, Oil3orteSecretaryc r•-:. "4!:,' •;:,Y..',..1.•...,2-; ,,,,,;: ,,-,:;;.(,'.., -4.,..w,,..4:.:.;,,:. ..,.,,!.:7 .„,,,, ,7 .1 '''. ' '' l'i ttomelr' r;Y' ''''-',-," , > Be it Reso/Vdd"that triegrure'Of any atithbrited officer and seal of the Conipany heretofore dr-hereafter aftnTdto anY power o a. y . . certificate relating thereto by facsimile,and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding ,..,upon the Company,wigkfespecttp any bond pr,yridertking to which it is ateach.ed;.g, .„F....:,.,...,s‘%.,.;.ani ,,..:,.. . o,.,,p..,:i:-,,:v;;ke,,;.,•: oi;,. ..,"l.-:• ! •, 4 : k•,,,, f14WITNEt§MEREOPitieomparleiiiieCaUSei;flkinstruMerittol?e'0igdrd4heir corpgatesalsTlpi?hereto affixed:t;,r;:,, . - ..,' . %. • . ''. AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING OMPANY .,... „, ,.,..„,. .„U,NITED STATES,,,SVREVA,GQIN NipANy,),Ls564„,ar4,9AL1716,.,41145, yRA NcE coliY, 0:..,-..t.,..,:. .:;.:,.. zolp: AfV, V , AV '-'..S.::k Ati:l7te'P'4,'',4°61,•?••-•47,;t " .••••,•^AP:18,',::eseitr,":7•Wt,..,',,, .fp?t".&E,t iik'1;I:;',)• ;(:Sik ei;'':;.'il t.,'..l 3,14= J,`"'M A.1-51 *,..': i.2...-r, 4't-...1;••,'"':..',' .i.T•..4. .4.6Pi., .1.. ..ViZW,A.4Ptr.Z .Nrititee. .4.-'1,4.•,,PX'. '00U.:',:, ;7•• -`'4 '''V :1`''' ‘".t$ .,::,,...2'....,...,..._,..,,',...s .'•::::',i!":'.i.Sj.1 i::•'''' ::',:',':, :' -' State oflOajtfqpniq,,,,,,,-;, ;fp:; -. 0.,(-?:j:•-,M;'q.irAg,I,— -'P'' I of .:Ilp'"1:.-..7...,':.0,,,47..-:, -`.•:?.,t.... "'"!.. ), ..‘,- '...; 'zi s'4•!' \',!:;;:-:;' 41.' '&' iti. 1:4217:4FIL-7 1'4' if PuViZr411:b°...igt, "•fl•A';4 S • County of Los Angeles %.•*;-`, ...VI s,,,,. 41 '4-,.. ..... i ‘.,... s / i BY. ...,.........ii,,,,, v.,,,,,:............V., '3,.?',..-...,•re -......., e 14nip,IP.Agyilaryice President .,... ,._ ..-:.. ..:': •., ‘,z: ,..e.,•4•V 14:1A NotaquPtic,fpriioppr,,,Oftcopr com*at in 4:',411.4,e.c4;iiifi.,:aireverifies.:07:njiy:4:60:::14*litz:;6fthe indiad6„W-,i4;ho;'-s'i4ned4h .docurn.pp(tplff llif hich th ie.:66 dif'• idate3t-atath ed, andlia ttieWiithfulrfe$, accuracwor vailditstotitia'i'do cumen.`f,:q.ZS';.21 „,',.1-g:'.'i-h.t' '',.....', ''11!:,, gq: ''.Z.-,::,7," ;q;5' On this 18th day of April 2022, before me, Sonia O.Carrejo, a notary public, personally appeared Daniel P.Aguilar,Vice President of •,--p-...,,, rnericanrltRpt9f§;Inde97.0ty Company,,Texas:Bonding CompanyA)ritted,qtates..Surety Cornppnyand,,..•4S,. Specialty Ineuzahoe.A ,, ,, ,;„ -g?..'•: &., Company who proved Ito;irrs.th the basis of satisfactory evidence tcioe,.:1„heperatki*:.00;e name is subscribed to tha•within inr0mapt• nd ged tome' '-that he executed r the, '4.m6'iti' his aLiilitifiZed capacity,...an that ti,,,4644,!.*10004,66.4-ie irlit-F,14M,,..,60t,', ---"'"" - the person, or the entity upon behalf of which person acted,executed the instrument. .Carcertify under PENAiV cfPERJ U RY':tr..,ni..,ir 1,tie.la..-ws:41'A,the StatelottaliftirniethatAhe forego[40ragr—ph issiirae and cptectiiJ;, t...., :;'.A ';..:.. ...:.::::, i.,.'•:. .-'..:.'d.z. . -...,'„Y,.,.,,j.i.. .--,..,' i',.1' i: i,,14,I.43:,,:,,H., :•.kcf.;‘, ,i tjk %.0 , 1,,,,,- ad 0-44,4 , ,.:;. f:2! .,6 zkt,13!;;,,„,;:i wiTNES4iitiiild'atidcittibiatteal. "'''': '44. '''• ,-Y. 41Y ''4'' ,,,,,. ,.., ,* ;,-4... ... .....,,Neary Public•CallfOCr.iti'' '"" '•;'' ' 1 k"°;• mL"r M"Cggi 0 Coml . ticlil,„ply Comm.COMM'S 40,3.PO L ',••• '",-,z, . ,-;:,:i.l,:i' 5t,SignatgrOTs,':„.:':..,'; : ..I.'t! .,.,L ,....m "-.,:. ....,...,.:,..(sebl) .,:',.y:.,(',4: 1••::•'?',.'i'.. i: . ':,.4, '?'j',i . ., iMAJA !'I' i'i: .4',•1c: ''Ve.,.'.,..:41.'iri':AKio LO'ili',A,H.i'ls":''ta-'9''p'.1,40':C.fgatTy'l.._.; • Anl'-',6iic"p.).1. 0..Opti,:ctilianderrint(y.„ 8iiip0.0yi.1:1-4xao,:::Bondit**,bit,ipoye;.,uottestatesp:!ply.,,,,,,t4,10.,..,.r.,,.,,,, COmpany 6riti US.Specialty Insurance Company,do hereby certify triafthg altiOVe and foregoing ia'alKie aiicrio6'6ct cbpy of a Par' - - of Attorney, executed by said Companies,which is still in full force and effect;furthermore,the resolutions of the Boards of Directors, Apat out in.the.•.13!..wyerl:rf Attorney are in fP111PriCe.,. • ' 0Itck"!e-y ; „,-..-,...; ' ,,.;,.!.:;5::4.-a,,', 1,..„" , ,.."„:..!.;: ,..?.:,v' 4 ) ,- • In vitnewferetf.i'hiv4tierevidcg:i; ,40114ikfixed' 4,44ipt0 qpmpanI6i:: 6i:Ai0iiecalifoNAAt* IC day of -_UUSp ),'i•.z!,e,,,,.I,,,,.,/,,,,. ..A,.,m. ::::,:, /4•;•,.., .',>.,1 .,i; i*•-• -??,,,'„,:,; .t-.., '',-/I560'4 .4;71::4•7>G " 5''''.11.f>'‹XF,,Ke1;74°•?.?;*N -,..i.,;.,%=:"E..-...t ",,,• .,.:,. ...,,:, •—i.,,,,, -,'.., :..::.; ...,-.. . •••q‘"';',:t, porPorat,.-7.p.,§4 , ,,„., ..„A,4, !,.., .1.,i,,,, ,! .v ,*.....f,,-.. ,:•,::,-.,-,\I‘Viiff*+-'‘,,,‘ I.,,i., ,il:z;-•4 -',,I. ,11,,.a....P: ,,,x r bond Ng!:', !...•:-1 Casiti.1; :LI.,', Ag.:wz '4171. ,:4..,:; ,ibigt 1,141,7 ••v,i •• iLs,4,• -‘,. NI -.:.,,4$!:...,!t..1,A .,' ei;;tic "<*.':=Kd Z". ''''..,'.-WV. "•.:..! ''• '4?:i.;e:' C.1 1.-'0. '''. ..b; ',.:, ''.'?..-'. , .,;;:,5,;, tz '•=1.t.0.01.2.A.10:44 V,', g:..-itie.:'. • = ZIA v" s ter.? '' '''' - ' .'0, '44•'•-- ... ,!I 4,5N.. ,.4/ 1=-"ia-,... ........... ‘ ,..... ...." i Kio Lo, Assi- -• Secretary Agency No. 7523 ' ite v1-.F,.............. .0S ""*,,,, iowo's , ..... „. „ 4- .,.,n...,!,.'' 4.4..:F. 6iS t',.' '''': .f•V',:,,:':: :;`;';',>. •.;..:ZW. , 'Pl,''4!•7', .f.;:_;:,-;•/,)'. !i: ',.:..1 i:•'?,. :' ,N, .. ',.',•,.;;. •..gs:y:-:,!.:1; ..,') ,...,::, ..v„).. .c,ticcsmATRop2/ApF3:4.,,,,,,:;,,. .z...,., ..'...?.'" '`!:. .•-q, ".'"'7,1',. .'',.. •-., .-.-:: .,,,..,, . .,7::,. ..-P ,- 4:,•. .. 1.;‘,,".;,',': •'i,',:',': •'z',' '''',.,-7 v:>. '''"''' '''''..''' isittmhthcoth/surety formore information i. , AE'.-: , , . ... , :,1;`;' ::.!:.: ,•:-•..„ . .1%,-.:''. ,.,.:!.:".i,':' .-'..,... ,'''•:,m •''',.• 4,:?-..,-,, i.'....".:, .41A,... .,,:•. n -, •• •11'.!1.',.:‘..,.": Z• '..,:.P e;,,,,,,, ',.; --... '.%, ,,o.;:.>::7, •••••:.-.,,3:-.),. .z.?,,,:,' .,.:,,,;.' .i:;, .'•,i;',: ...i.-. ::: '..:'. ,-VA' IP::-'.,. 'i,A:4,-'... . "•!' '': ''' ,..;'"'-:!.';',.1! '.:4i;--..,,':'. !..':::'''.''''''..•!;7-...: :.:;;:; \ 30 ::;;• ''' ''''''.' '...:. ,.:*,-. '.. ..,.!,:?,;• ,,,.;T V,:, ","-'....;• ''„"..,' .'..'.•:.', .:!"... ' -.- •'-''" . -.'' ."4",' ' ', ''' •.. ,,,, .4 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 Rl VtY-ii D� ) On M C-o f l! 7-I, w�) before me, P"*I.-y VI) A-'44 / 1t-u.t-ne-. 4rT*l4' Date Here Insert Name and Title of the Officer personally appeared W I U-1 iNh C,tim iA Namejs)of Signer(( who proved to me on the basis of satisfactory evidence to be the person( whose name( is/art subscribed to the within instrument and acknowledged to me that he/ire/thy executed the same in his/IeF/tir authorized capacity(ies),and that by his/her/tpeir signature(*on the instrument the person*, or the entity upon behalf of which the person(sfy 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. MARY JO ANNE P.JUCUTAN WITNESS my hand and official seal. Notary P..b.ic-Caiifornia 0 Rive-side County �3FF�rxL+` Corr-fission 2364275 c',(Ifoo My Comm-,Expires Jul 5,2025 Signature Sign ture �N%tary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document . Title or Type of Document: Jt+' Qc N A Document Date: 44A C. r )- ys Number of Pages: I Signer(s) Other Than Named Above: 1'-Ynterf Capacity(ies) Claimed by Signer(s) - Signer's Name: Signer's Name: ❑Corporate Officer — Title(s): ❑Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Partner — ❑Limited ❑General ❑ Individual ❑Attorney in Fact ❑ Individual ❑Attorney in Fact ❑Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑ Other: ❑ Other: Signer Is Representing: Signer Is Representing: 4`✓:�✓R�%S`,:�•�'•�:\�:�✓,:�✓L�,:\!:�%:�:\�:�✓,G�i✓G�i`✓,.�4�✓:�:�':.:�:�✓L`;.�✓,i�i\✓i�✓i\�4\✓i�✓..�✓i�✓,i\�.�:.«.ice,i�✓iC✓,i�✓ii\:/ir�✓,i.�✓i. ©2016 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 William Camp CAMP CONSTRUCTORS INC 33648 Spring Brook Circle Temecula,CA 92592 CA License#1075642 DIR#1000976081 OFFICIAL BID SECURITY-DO NOT OPEN Project Name:CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS CC#1658 Bid Opening Date:August 22,2023 2 pm City of Huntington Beach Public Works Office 20C0Main Street Huntington Beach,CA 92648 \ /1/ City of ._�':untington Beach •� yr °4, 0�� 2000 Main Street • Huntington Beach, CA 92648 z (714) 536-5227 • www.huntingtonbeachca.gov ,- \�o �64 Office of the City Clerk c e;�7 909s C��NTY Os,„."� Robin Estanislau, City Clerk December 29, 2023 Corral Construction & Development, Inc. 5211 E. Washington Blvd., #2-122 Commerce, CA 90040 RE: Central Library Lower Level Restroom ADA Improvements—CC No. 1658 Enclosed please find your original bid bond for CC No. 1658. Sincerely, 17401/ 9,6/4lUdield Robin Estanislau, CMC City Clerk RE:ds Enclosure Sister City: Anjo, Japan aratialchwityx.. SECTION C PROPOSAL for the construction of CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS CC No. 1658 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 60 working days,starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications,Instructions to Bidders and all other contract documents.If this proposal is accepted for award,BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses,taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded,the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the Contract,the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER,the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find 5 t D Q-iu1NY) in the amount of 'Loll 10,1.O which said amount is not less than 10%of the aggregate of the total bid price,as required by the Notice Inviting Sealed OR ELECTRONIC Bids,payable to the AGENCY. (Please insert the words "Cash", "Certified Check",or"Bidder'sBond 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 i alis170 K2-7?..se-1 C-2 CITY OF HUNTINGTON BEACH CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENT BID SCHEDULE Item# Description of Work Quantity Unit Unit Price Item Total 1 Mobilization 1 LS $ 10 t O $ 10 (5-1 2 Construction Waste Management 1 LS $ 3Sov $ 36b0 3 Closeout 1 LS $ 3oc2C7 $ 3006 4 Demolition 1 LS $ 12006 $ ( 2b00 5 Abatement 1 LS $ I b66 $ l S'000 6 Concrete and Reinforcement 1 LS $ R coo $ `l o00 7 Casework/Countertop 1 LS $ $ ccoo 8 Blanket Insulation 1 LS $ 3000 $ 3 000 9 Joint Sealants 1 LS $ Lobo $ (0 00 10 Aluminum Door Frames 1 LS $ L-4000 $ C 00U 11 Wood Doors 1 LS $ (0 000 $ (0000 12 Access Doors and Frames 1 LS $ ( S o $ t 5-00 13 Door Hardware 1 LS $ 4000 $ 144:x-)0 14 Glazing/Mirror 1 LS $ 2.00 0 $ Zoo° 15 Gypsum Board 1 LS $ (0 000 $ (;Po06 16 Metal Stud Framing 1 LS $ ( ,0b0 $ )z000 17 Porcelain Tile Floor Finishing 1 LS $ q,000 $ R op() 18 Porcelain Tile Wall Finishing 1 LS $ (S 00 U $ 15 00o 19 Painting 1 LS $ 3S'U O $ 3 S b0 20 Signage 1 LS $ 500 $ $D0 21 Toilet Accessories 1 LS $ 1b00 $ -woo 22 Plumbing 1 LS $ 131..S0 $ 132 SU 23 Mechanical ' 1 LS $ 1000 $ 1000 24 Electrical 1 LS $ l 1 Sa o $ H51)0 Total in Numbers $ <(D' i10' C-2.1 Total in Words: 0Are I 696F y 1.--uate/rftwelv0 e,ev4}J th v IUU. Do l 4-1L5 NOTES: The estimated quantities listed in the Proposal Bid Sheets are approximate and are to be used only as comparison of bids.Payment for quantities will be made from field measurements.If the actual quantities show either an increase or decrease from the quantities given in the Proposal Bid Sheet,the Contract Unit Prices will prevail.Full compensation will be paid at the contract price for the actual work completed,and no additional compensation will be allowed therefor.Payment will not be made for materials wasted or disposed of in a manner not called for under the Contract;this includes rejected material not unloaded from vehicles and material rejected after it has been placed. No compensation will be allowed for disposing of rejected or excess material.The City reserves the right to reject all bids and to increase or decrease the amount of any quantity shown on the Proposal Bid Sheets. In case of a variation between the unit price and the totals shown by the bidder,the unit price will be considered to be the bid. Compensation for items of work not specifically identified in these bid items shall include all labor,materials,tools,equipment,safety measures,and supervision required to complete the work to grades and dimensions shown on the Plans or staked in the field.There shall be no compensation except for the bid items specified in the Proposal.The cost of all work shown in the Plans and Specifications but not specifically identified as a bid item or described within a bid item shall be included in related bid items,and no additional compensation shall become due the Contractor by nature of compliance with the Plans and Specifications. C-2.2 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 5 (vo`la Aiwa_ Twos G Li 000OOb' 2. 12.1000 77. 44--vf't Frr sw um's l c4 aofirto 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.S to of California that the foregoing is true and correct and that this declaration is executed on'ellzL141,at Co►-nkta ee Date City State (L( sorb ,being first duly sworn, deposes and s ys that he or she is f4e(Irn.N' of owl-Gbwiatia V*i d OCR° parley 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. a(rrtwc.ruw 4. 11 c v1:Zoif'te74/r Name of Bidder 7hed Signature of Bidder 524( E. wm-s4fiif ri 31. 19. 4—iz2 a:envWe$tL 44- Address of Bidder goa si o C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH,CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the CENTRAL LIBRARY LOWER LEVEL ADA IMPROVEMENTS, (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. �12s�rL a.Wlrm./Ari") + /Se.t 000ntcS14. 'Arc, Contractor RY11-1( By f akai ieN'r Title Date: (22,-)2vz3 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. j•i & Note: This questionnaire constitutes a part of the Proposal,and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code,each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. CoI..s t cswsCnucn.«, a ew.1,45penour /NG Contractor By Title Date: tb`n)emu, C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Co L- umsoutc 2f4 t o6vEr-op fneaur /A/G Bidder Name 5 4/ G- L.NO Business Address Cuvvlatet G c/l. �o0yo City, State Zip (510L ) /(oZ- told3 Z urre4. Cotthuctwd yahoo Telephone Number Email Address '12Vboc 51 C3 3 State Contractor's License No.and Class Original Date Issued SA VI) 2424' Expiration Date The work site was inspected by (('NFL' 5070 of our office on S I IS- ,2043 The following are persons, firms,and corporations having a principal interest in this proposal: V.e e ('4 (IAeMr The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Low. coW S/1/441--114'W t-t7 LvAtoPrlleWr/V7 Company Name Signature of Bidder rbetaeLs S o RI Printed or Typed Signature C-8 NOTARY CERTIFICATE Subscribed and sworn to before me this 22 day of AV')U St ,2023. 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 Gwl1 f ovv►kq ) County of I,OS AY19'2lV5 ) On AV k1 Sk 2'2, WS 3 before me, 3'CtbY mot f 011) N oTowy POD((C. Month,Day,and Year Insert Name and Title of Notary personally appeared .t Vf'2 c(bt Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(b'f whose name,4 is/e subscribed to the within instrument and acknowledged to me thatj7/6/she/tty executed the same in l(s/her/tVir authorized capacity,and that by$s/her/tl}e[r signature(61 on the instrument the person(4, or the entity upon behalf of which the person(rs'jacted,executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. s'• SABRINA ANN SOTO•; WITNESS my hand and official seal. • - COMM # 2390883�z �"` Los Angeles County 2 Aot• ,f -� I California Notary PublicIT .1-0 Comm Exp Jan. 15,2026:- ��.... .........................»......«.• Signature Signature of ota ublic (PLACE NOTARY SEAL ABOVE) C-9 Bidder's Project History For the purposes of this project the contractor and subcontractor must have, in the last five years, constructed at least five (5) projects of similar work specifically referencing the construction of {Describe specific work and experience necessary for project, for example "Reconstruction or rehabilitation of existing public use facilities". Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. The following list of projects meet the requirements of above: 1. or/ C L -warm' I5egoo L . S T. tit GA i l-I'-ty Name and Address of Reference r ydtNtarLo `aitue&Ct` .ori Name and Telephone No.of Owner: Ti)ld 1,) D i M rklzt a L Uo) 4,ss - I r l 1 u9') R-Ofitorwvi 17.trsWtobtt- 4 Ai0111rN 242,5 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: jZ6l,1-Mvt u ritTw aF E)ll sn w 6- T owl f W 614) r.644110.4.au t) oY— s fnY ktscz P•b om A'r LA- Pktswris P/HLIc 2. blz'Ntrt Gauary A-unto/24 ry I Ft ru' unt-oiz t M 12✓i NL 1 G.+ `l u°2. Name and Address of Reference Sul�a$amck-"ter c7 0CFA .0ri Name and Telephone No. of Owner:SIA.L4 G- sit nitiu c i dot)t) 513 - 4 Di 3 4 Icto oo0 (?-C-61Vzoom 11-einoni L 1112.022.. Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 4lkkett ? rLa.) v.(; r,N6- 1 gng.0om kT f-Irz Sr.t-r.ocr 42. 3. t lri ,i- El $t&u%-410 3c0. fvl sae-G a c4 Name and Address of Reference *Jo (a e-1 sty do , ort Name and Telephone No.of Owner: 1111-(kNKC 1301A (31v) S 2A-{ - L3 1 SU) 17-0t1400111 fi-eYvtona L. 6 Zz Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 12014-4-0 (-t rA-rt ord w- c`i t s rl N6- (2,..a517' IYI c .140,0 Pbl.La6 e:19/1-14-11minvr v C-10 4. airy ortr cuL'L. C4f q,'l'lo LtJLV . (34-4, Gu4.v/611.. ICY , Alt otoL3L Name and Address of Reference d` .s zy Mrs i d c walec-a+i Name and Telephone No.of Owner: D I 4-n/4 52•1 filk1uS14 (3(o) 153 - 5-1°Z 3 d 100l 06o ,JC£1,1 Cow Srrutcri l GC- caSrADowts 4 irmfue ivz-o Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Nat) CA I Stiu tcAZt) 124 tYovwt i t v�Gf/�t.L B C4 b(4 6. trr (,14tt411- c fly 'k 5. C!rY 0f I l-u0rr oJl- -► B6/hZ-1 f w oes M/ru1 sr. 1hiturt &rr givItit, c,. 4I 244 Name and Address of Reference �, tr�� I i - In b or sas on .Ttn Y - 5 Name and Telephone No.of Owner:SAS or., Tlkowl rot-1 (- I N) 3 7 S - 5t S 4 1 g Z 000 P?-I;S (( i Zo 1 cl Contract Amount Type of Work Date Completed Provide additional project description to show similar work: • j4-/A*P tt,tr,rruw AC CYICrwc,- jLat'attryytc fir ct. L t-1&a-kg-.f c-I Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager,and Superintendent.For each of these critical positions,please list at least three projects for which the critical staff has performed similar work within the last five years.These projects do not have to be under the employment of the bidder of this project.Bidders are encouraged submit supplemental relevant project history in addition to the projects listed herein. l c L 1. _ :�`► &- ,1 Q,1 Name of proposed Project Manager C5/02) 5 2s - (cud, Telephone No.of proposed Project Manager 4iDoer: 'SWYuo 1 1,,t,vovnel4 l+nPrrwanlM3 3.y , a-c1 . . te12.727 Project Name&Contract Amount Type of Work Fel coon f+-€' .50(L Date Completed rii s r trl ant N z £6(flGo an/ (Le coons;L 1 qO 1 06 c, t 7.17v ZZ Project Name&Contract Amount Type of Work p...orkeopti pamuocr. Date Completed Gfovr144-L a/21rza-F-Y F 1/�(Vt wm int/gr C.onnc-ckWW'. t 1412 IOW l l I ID(et Project Name&Contract Amount Type of Work rd rrl.0orn pensfogLoDate Completed 2. _ MO.12 5 Nj- Name of proposed Superintendent (.2-1 '- Up - 3 Li(o Telephone No. of proposed Superintendent MIoocc Rareux-imanofrrot4 c mP2on o f] 3 3g'b)811 to(t 452..3 Project Name&Contract Amount Type of Work (Zdsritoam Runt',' Date Completed ?Too s r.trn,uw 42. (LCSCuoo'rn F 0Ds- vl.u i 006 111 2.o 2,2„ Project Name&Contract Amount Type of Work pet ry20oh7 11 (aWOCLDate Completed Gtrlv(ful�L I.l6,44-f / 114.4 Otaufri I-au. it cawt n Li twee- /H 21 vG v l l I to l' Project Name&Contract Amount Type of Work ReSrywGrn (2,61,40 pa, Date Completed C-12 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 httpsJ/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. to t4M, umA f 'u hevr Wt fl 'r I*/( Contractor • Tilt-4a' By Email ?us toei r Title Date: 80\7.2)74u7 PWC Registration#: 10b00 VIVA K C-13 Registrations 5/21/23,7127 PM Public Works & Prevailing Wage Contractor Registration Search Enter at least one criteria to display registered Public Works&Prevailing Wage contractor(s)matching your selections. Note:Search results will display all of the Public Works&Prevailing Wage Contractor Registrations,both current and expired.Make sure a proper registration fiscal year is selected when performing a search. Input Label From Date: To Date: 928805 (mm/dd/yyyy) (mm/dd/yyyy) 08/21/2023 08/21/2023 County City Search Reset Crafts Registrations (Select Search Results:1 found Showing Page 1 of 1 1 Previous Next all that apply) Print PDF(3 Export t Add all to my list My List(0)- Asbestos Boilermaker- CORRAL CONSTRUCTION&C filiF,Ualtfut Nir 0100 My Ust Blacksmith Bricklayer/Brick Tender Carpenter Carpet, Linoleum, Resilient Tile Layer Cement Mason Consultant Driver (On/Off Hauling) Drywall Detail: Registration History InstallerllatheriRegtlon 1000019244 Effective Date Expiration Date Electrical Number. 7/1/2023 6/30/2024 Utility Status: Active CSLB Num... 928805 7/1/2022 6/30/2023 Electrician Legal Entity Corporation Elevator Type: 7/1/2021 6/30/2022 Constructor Mailing Ad... 5211 E.WASHINGTON BLVD#2.. 7/27/2020 6/30/2021 COMMERCE Field CA 90040 8/19/2019 6/30/2020 Surveyor County: Los Angeles General Craft General Building 6/26/2018 6/30l2019 Building Email: corral.construction@yahoo.com 6/30/2017 6/30/2018 General 7/28/2016 6/30/2017 Engineering Glazier 7/20/2015 6/30/2016 Inspector/Field Soils, 4/15/2015 6/30/2015 Material Tester DBA Iron Worker Name Laborer Landscape Marble Mason/Finisher Operating Engineer Painter • hops://catlir.mysalesiorp-silea.tom/ConlractorSoareh7lnpulSeareho028805 Peon 1 of 2 Registrations 9121123.7:29 PM Public Works & Prevailing Wage Contractor Registration Search Enter at least one criteria to display registered Public Works&Prevailing Wage contractor(s)matching your selections. Note:Search results will display all of the Public Works&Prevailing Wage Contractor Registrations,both current and expired.Make sure a proper registration fiscal year is selected when performing a search. Input Label From Date: To Date: 776105 (mm/dd/yyyy) (mm/dd/yyyy) 08/21/2023 08/21/2023 • County City Search[Reset Crafts Registrations (Select Search Results:1 found Showing Page 1 of 1 Previous Next all that apply) Print PDF 6 Export 3 Add all to my list My List(0).• Asbestos Boilermaker- CASTLEROCK ENVIRONMENTMev Nails +Add to My List Blacksmith Bricklayer/Brick Detail; Registration History Tender Registration 1000003462 Effective Date Expiration Date Carpenter Number 7/1/2022 6/30/2025 Status: Active Carpet, CSLB Num... 776105 7/1/2019 6/30/2022 Linoleum, Legal Entity Corporation Resilient type: 6/13/2018 6/30/2019 Tile Mailing Ad... 10040 PAINTER AVE. 6/13/2017 6/30/2018 Layer SANTA FE SPRINGS Cement CA 90670 6/9/2016 6/3012017 Mason County: Los Angeles Craft: Laborer 7/112015 6/30/2016 Consultant Email: kim@castlerockenv.com 12/4/2014 6/30/2015 Driver (On/Off DBA Hauling) Drywall Name Installer/Lather/Finisher Electrical Utility Electrician Elevator Constructor Field Surveyor General Building General Engineering Glazier Inspector/Field Soils, Material Tester Iron Worker • Laborer Landscape Marble Mason/Finisher Operating Engineer Painter MrOs:llcadir.nry.selesforce-sites.comlContrectorgearch7inpuigearch=77e105 Pogo 1 0l 2 EXHIBIT A DISADVANTAGED BUSINESS ENTERPRISE (DBE) This Project is subject to Part 200.321,Title 2,Code of Federal Regulations entitled "Contracting with Small and Minority Businesses, Women's Business Enterprises, and Labor Surplus Area Firms." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in Part 200.321, Title 2 CFR, shall be encouraged to participate in the performance of Contracts financed in whole or in part with federal funds.The Contractor should ensure that DBEs,as defined in Part 200.321, Title 2 CFR, have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps,as set forth in Part 200.321,Title 2 CFR, • for this assurance.The Contractor shall not discriminate on the basis of race,color,national origin, or sex in the award and performance of subcontracts. Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project,although there is no specific goal for DBE participation. C-14 EXHIBIT B DBE INFORMATION—GOOD FAITH EFFORTS Federal-aid Project No. 1 G S1?) Bid Opening Date The City of Huntington Beach established a Disadvantaged Business Enterprise(DBE)goal of 0% for this Project. The information provided herein shows that a good faith effort was made. Lowest,second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder DBE Commitment"form indicates that the bidder has met the DBE goal.This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening,or the bidder made a mathematical error. Submittal of only the"Local Agency Bidder DBE Commitment"form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement IA' B. The names and dates of written notices sent to certified DBEs soliciting bids for this Project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested(please attach copies of solicitations,telephone records, fax confirmations,etc.): Names of DBEs Solicited Date of Initial Follow Up Methods Solicitation and Dates �.k C-15 C. The items of work which the bidder made available to DBE firms including, where appropriate,any breaking down of the contract work items(including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items ($) of (Y/N) Contract CIA' D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved),and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: NIA( Names, addresses and phone numbers of firms selected for the work above: NIk E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: • C-16 F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: tk G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms (please attach copies of requests to agencies and any responses received,i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results H. Any additional data to support a demonstration of good faith efforts(use additional sheets if necessary): NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. C-17 IF A SOLE OWNER OR SOLE CONTRACTOR SIGN HERE: (1) Name under which business is conducted 11 t A' (2) Signature(given and surname)of proprietor (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail IF A PARTNERSHIP, SIGN HERE: (1) Name under which business is conducted I PC (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail C-18 IF A CORPORATION, SIGN HERE: (1) Name under which business is conducted COW4Vtt- C 5 4 J 4- 4W ov iagrlW (2) ( ignature) (Title) Impress Corporate Seal here (3) Incorporated under the laws of the State of C/ 0711-41R(t (4) Place of Business 61 ll l% W/�S/f//u/,-wyd (. &(4i 2. (Street and Number) City and State 60WIeYt L1G Uk (5) Zip Code 0 0 14'U Telephone No. 5 )2- - Z to 2.- te 403 L (6) E-mail CoYiG,(. GWi(h'U&hn.. ) y abuio c cvlj-j NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED List below names of president,vice president,secretary and assistant secretary, if a corporation; if a partnership, list names of all general partners and managing partners: 9,t ti S QTO ?Wioe-wr lO ' SeLv r C-19 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 Lo c hg'r'1 ps ) On AkIVEt 22, 202? before me, &CIOlV CI (coil) , Jo-1-on Pvb)lc (insert name and title of the officer) personally appeared R h re cfo m who proved to me on the basis of satisfactory evidence to be the persons whose name()is/are subscribed to the within instrument and acknowledged to me that be/she/t}aey executed the same in hi$/her/ttigir authorized capacity(ies), and that by big/her/Mr signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. 1 3"' — SABRINA ANN SOTO:i WITNESS my hand and official seal. �.�' COMM # 2390883 E. � Los Angeles County •'� � California Notary Pub!! Z Comm Exp Jan. 15,202851 Signature (Seal) EXHIBIT C LOCAL AGENCY BIDDER DBE COMMITMENT(CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS11 ON THE REVERSE SIDE OF THIS FORM dl' j.LOCAL AGENCY:aft 4UMltioni 6e/t-cl- LOCATION: 1Itt T/t4;4 KliteIJUE. !1/,p! t 6Eit',L l 64 PROJECT DESCRIPTION:GIi''Mt 1, Li(btt. Until +✓ Uo'Lt.'L 174Sf1,OOm PrM IWIO/1614.F IRAITS TOTAL CONTRACT AMOUNT:$ BID DATE: 114-ini.St 221 2421,41j BIDDERS NAME: Go 44111, t fn4lb n1A4' 'J 4 De vats t Oi air (I1 0 CONTRACT DBE GOAL: C7 CONTRACT ITEM OF WORK AND DESCRIPTIONDBE CERT NO. NAME OF EACH DBEDOLLAR AMOUNT ITEM NO. OR SERVICES TO BEAND EXPIRATION (Must be certified on the date bidsDBE SUBCONTRACTED OR MATERIALS DATE are opened-include DBE address TO BE PROVIDED(or contracted if the and phone number) bidder is a DBE) For Local\Agency to Complete: Total Claimed DBE $ O Local Agency Contract Number. Participation Federal-aid Project Number: 0 Federal Share: Contract Award Date: Local Agency certifies that all DBE certifications have been verified and • information is complete and accurate. Signature f Bidder 012z 1 z°z3 (s6s2-) 1 6i,-610.5 Date (Area Code)Tel.No. Print Name Signature Date W S 6 re' Local Agency Representative Person to Contact (Please Type or Print) (Area Code)Telephone Number: Local Agency Bidder DBE Commitment(Construction Contracts) (Rev 6/26/09) C-20 PLEASE NOTE: This information may be submitted with your bid.If it is not,and you are the apparent low bidder or the second or third low bidder,it must be submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs.Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date.Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier.Names of the First-Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable,with the names and items of work in the"List of Subcontractors"submitted with your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100%of item is not to be performed or furnished by the DBE,describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise(DBE),"of the Special Provisions(construction contracts),to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award,Federal-aid Project Number, Federal Share,Contract Award Date fields and verify that all information is complete and accurate before signing and filing. C-21 EXHIBIT D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Colt up/trvIU,(.c k) +- 2of vvzc -r [proposed subcontractor WRIER taDitcbi~►v tta• At. ,] hereby certifies that he/she/it has ✓ ,has not ,participated in a previous contract or subcontract subject to the Equal Opportunity clauses,as required by Executive Orders 10925, 11114,or 11246,and that,where required,he/she/it has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. (eeoc.gov/employers/eeolsurvey/index.cfm) Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Signature: Td;Y,( Date: lb(1L1 2-0 Print Name: (Zts'WLe S Title: P S/Pe"P'1" C-22 EXHIBIT E NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) [NAME OF CONTRACT] To the City of Huntington Beach In conformance with Title 23 United States Code Section 112 and California Public Contract Code 7106 the bidder declares that the bid is not made in the interest of,or on behalf of,any undisclosed person,partnership,company,association,organization,or corporation;that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid,and has not directly or indirectly colluded,conspired,connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication,or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead,profit, or cost element of the bid price,or of that of any other bidder,or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true;and,further,that the bidder has not,directly or indirectly,submitted his or her bid price or any breakdown thereof,or the contents thereof, or divulged information or data relative thereto, or paid,and will not pay, any fee to any corporation,partnership, company association, organization,bid depository,or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. By signing the Proposal,the Bidder has also signed this Noncollusion Affidavit. Bidders are cautioned that making a false Certification may subject the Bidder to criminal prosecution. Signature: Tent4-. Date: 6(24- wz3 Print Name: PalVe6 on, Title: 12/2a!lleltir C-23 EXHIBIT F DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS,PART 29 The Bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated with Bidder in the capacity of owner,partner,director,officer,manager: • is not currently under suspension, debarment,voluntary exclusion,or determination of ineligibility by any Federal agency; • has not been suspended,debarred,voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted,convicted,or had a civil judgment rendered against him/her by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility.For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Note: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Signature: Tilt45 Date: it,f/LI zoz3 Print Name: ti'L S a W Title: P sta ' C-24 • EXHIBIT G NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies,by signing and submitting this bid or proposal,to the best of his or her knowledge and belief,that: 1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan,the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment,or modification of any Federal contract,grant,loan,or cooperative agreement. 2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Signature: Tkr"?-fDate: $(Zz+ Z02 2, Print Name: S(Tv Title: P 12ESl,avr C-25 EXHIBIT H 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 S a.initial b.grant b.initial award b.material change c.cooperative agreement c.post-award d.loan For ;. rial Change Only: e.loan guarantee year quarter f.loan insurance date of last report 4. Name and Address of Reporting Entity 5. If Repo :1 Entity in No.4 is Subawardee, Enter ame and Address of Prime: ElPrime El Subs ee ts Tier ifkno Congressional District,if known Congressional District,if known 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number,if applicable 8. Federal Action Number,if known: 9. Award Amount,if known: 10. a.Name and Address of Lobby E ty b. Individuals Performing Services (including (If individual,last name,first ame,MI) address if different from No.10a) (last name,first name,MI) (attach Continuation Sheet(s)if necessary) 11. Amount of Payme (check all that apply) 13. Type of Payment(check all that apply) $ Actual 0 planned a.retainer b.one-time fee 12. Form Payment(check all that apply): c.commission a.cash d.contingent fee Pa b.in-kind; specify: nature e deferred value f.other,specify 14. Brief Description of Services Performed or to be performed and Date(s)of Service,including officer(s),employee(s),or member(s)contacted,for Payment Indicated in Item 11: (attach Continuation Sheet(s)if necessary) 15. Continuation Sheet(s)attached: Yes ❑ No El 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352.This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into.This disclosure is required pursuant to 31 U.S.C. Print Name: T7.4W f UT-41 1352. This information will be reported to Congress semiannually and will be available for public inspection.Any Title: Pitatocpr person who fails to file the required disclosure shall be subject e I 7-/A14yj to a civil penalty of not less than S10,000 and not more than Telephone No(feZ) 1(/Z- 1443 Z Date: $100,000 for each such failure. Authorized for Local Reproduction Federal Use Only: Standard Form-LLL Standard Form LLL Rev.09-12-97 C-26 INSTRUCTIONS FOR COMPLETION OF EXHIBIT H. DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient,at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1) Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered Federal action. 2) Identify the status of the covered Federal action. 3) Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last,previously submitted report by this reporting entity for this covered Federal action. 4) Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5) If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address,city,state and zip code of the prime Federal recipient.Include Congressional District, if known. 6) Enter the name of the Federal agency making the award or loan commitment.Include at least one organization level below agency name, if known. For example, Department of Transportation,United States Coast Guard. 7) Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8) Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9) For a covered Federal action where there has been an award or loan commitment by the Federal agency,enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10)(a)Enter the full name,address,city,state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. C-27 EXHIBIT I FEDERAL LOBBYING RESTRICTIONS Section 1352, Title 31, United States Code prohibits Federal funds from being expended by the recipient or any lower tier subrecipient of a Federal-aid contract to pay for any person for influencing or attempting to influence a Federal agency or Congress in connection with the awarding of any Federal-aid contract,the making of any Federal grant or loan,or the entering into of any cooperative agreement. If any funds other than Federal funds have been paid for the same purposes in connection with this Federal-aid contract,the recipient shall submit an executed certification and, if required,submit a completed disclosure form as part of the bid documents. A certification for Federal-aid contracts regarding payment of funds to lobby Congress or a Federal agency is included in the Proposal. Standard Form - LLL, "Disclosure of Lobbying Activities," with instructions for completion of the Standard Form is also included in the Proposal. Signing the Proposal shall constitute signature of the Certification. The above referenced certification and disclosure of lobbying activities shall be included in each subcontract and any lower-tier contracts exceeding $100,000. All disclosure forms, but not certifications, shall be forwarded from tier to tier until received by the Engineer. The Contractor, subcontractors and any lower-tier contractors shall file a disclosure form at the end of each calendar quarter in which there occurs any event that requires disclosure or that materially affects the accuracy of the information contained in any disclosure form previously filed by the Contractor,subcontractors and any lower-tier contractors. An event that materially affects the accuracy of the information reported includes: 1) A cumulative increase if$25,000 or more in the amount paid or expected to be paid for influencing or attempting to influence a covered Federal action; or 2) A change in the person(s)or individual(s)influencing or attempting to influence a covered Federal action;or 3) A change in the officer(s), employees(s), or Member(s) contacted to influence or attempt to influence a covered Federal Action. C-29 • BID BOND NO. 72578070 KNOW ALL MEN BY THESE PRESENTS,that we Corral Construction&Development. Inc. 5211 East Washington Boulevard#2-122, Commerce,CA 90040 as Principal, hereinafter called the Principal, and Western Surety Company 101 South Reid#300,Sioux Falls,SD 57103-7045 a corporation duly organized under the laws of the State of South Dakota.and authorized to transact a general surety business in the State of California as Surety,hereinafter called the Surety, are held and firmly bound unto the City of Huntington Beach 2000 Main Street. Huntington Beach. CA 92648 as Obligee, hereinafter called the Obligee, in the sum of Ten Percent of the Amount Bid In Dollars( 10% ), for the payment of which sum well and truly to be made,the said Principal and the said Surety,bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally,firmly by these presents. WHEREAS,the Principal has submitted a bid for Central Library Lower Level Restroom ADA Improvements—CC No. 1658 711 Talbert Avenue Huntington Beach,CA 92648 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 seale ' 22nd day of August , 2023 Corral Construction&Development, Inc. • (Principal) ' (Seal) (Witness) By: W/Wie„.< I�u lz'S(OalkfI' (Title) Western Surety Company ( rely) (Seal) (Wit s) By: Bla A. ist r,A , ir.-Fect • • Printed in cooperation with the American Institute of Architects(AIA)by the CNA Insurance Companies. The language in this document conforms exactly to the language used in AIA Document A310-Bid Bond-February 1970 Edition. • G-108041-A ' 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 LOSS P�ngeIN ) on .i<{U oct 22, 2023 before me, (fO1bVina COO N otalvy Public (insert name and title of the officer) personally,appeared Rehte Toil) who proved to me on the basis of satisfactory evidence to be the persona)whose name(s) is/are subscribed to the within instrument and acknowledged to me that be/she/tlaey executed the same in tis/her/ti iir authorized capacity(ies), and that by bi /her/tii€ir signature(s) on the instrument the person(s), or the entity upon behalf of which the person(a) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. *611,4 • 'FT SABRINA ANN SOTO ) : - COMM # 23908.83 WITNESS my hand and official seal. ''z it Los Angeles County a' Z � � California Notary Publi .� • Comm ExP Jan, 15,Z026:; Signature (Seal) • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§11139 A notay public or cgher 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• O r a n a e ) On August 14, 2023 before me, Lianne Nahina, Notary Public Date Here Insert Name and Title of the Officer plj appeared Blake A. Pfister Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person* whose names) is✓ap subscribed to the within instrument and acknowledged to me that he/Stisliii* executed the same in hisill11011W authorized capacity**,and that by his/110.8011t signature )on the instrument the persons, or the entity,upon behalf of which the persan(1)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. ' LUPINE NAHINA WITNESS my hand and official seal • a teiR:y*. COMM.0 2314283 • NOTARY rU1LICZALIFORNA �. M = ' ORANGE COUNTY N MY QMM•EXR DEC 5,2129 L Signatur Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document Bid Bond 72578070 Document Date; August 2 2, 2023 Number of Pages: 1 Signer(s) Other Than Named Above: N/A, None Capecity(les)Claimed by Signer(s) Signer's Name; Blake A. Pfister Signer's Name: O Corporate Officer— Title(s): 0 Corporate Officer—Title(s): 0 Partner— Q Limited 0 General 0 Partner— 0 Limited 0 General 0 Individual . ®Attorney in Fact 0 Individual 0 Attorney in Fact 0 Trustee 0 Guardian or Conservator 0 Trustee 0 Guardian or Conservator O Other: 0 Other: Signerwses terrnn sun a Ly Culupd�ny Signer Is Representing: • e2014 National Notary Association•www.NationalNotary.org•1-800-US NOTARY(1-800-876-6827) Item#5907 Western SuretyCompany • 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 • • Blake A Pfister,Individually • of Mission Viejo,CA,its true and lawful Attorney(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 11th day of August,2021. WESTERN SURETY COMPANY pPPOgglal,@ =W44 lAFaz 74:701./.iR S�AV e aul T.Bruflat,Vice President State of South Dakota 1 I ss County of Minnehaha On this 11th day of August,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 s NOTARY PUBLIC /22. March 2,2026 , SOUTH DAKOIA�'=7 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 22nd day of August,2023. „111��MI ��.triT}4,,, WESTERN SURETY COMPANY -f a-?Oq4 j�3og =W.4 -aG IZe V'.xxxn '� • - L.Nelson,Assistant Secretary Form F4280-7-20I2 Go to www.cnasuretv.com>Owner/Obligee Services>Validate Bond Coverage,if you want to verify bond authenticity. j 0 cy VI 0 1 3 c - 1 1 l...,... fp 9 I8 � 0 ivp .... 1...„ a -2 --. . a .,::: " (---- . . .r • U kJ b' t-;., ON )...,. I f, oLr, e 0 N O O CO O •p uO O CD u O _ -� ph� C O` 1p -- -1 NI O ,O O - . C3!f)C,lf1 u „ poi INr<ae City of :untington Beach t�° C,LPvC5a ee 40 � 2000 Main Street ♦ Huntington Beach, CA 92648 tt _ (714) 536-5227 • www.huntingtonbeachca.gov �� •F �� �A� Office of the City Clerk p�NT� did Robin Estanislau, City Clerk 0' December 29, 2023 Global Builders, Inc. 1740 E. Garry Ave., Suite 205 Santa Ana, CA 92705 RE: Central Library Lower Level Restroom ADA Improvements—CC No. 1658 Enclosed please find your original bid bond for CC No. 1658. Sincerely, ( 174(41. q%)./4441,1444) Robin Estanislau, CMC City Clerk RE:ds Enclosure Sister City: Anjo, Japan aft6h.4-,81114L/1-4) City Ofl-kintinOtori Beech Public Works Department 2090,Malh-Btreet Tel.(714)5364411,'Fax 014)v4403 ADDENDUM NUMBER ONE FOr CENTRAL LIBRARY LOWER LEVEL ResTatitim AtrA IPAPROVENIENTS Auggst15,2023, NOtice to-Ailticidefs; Please note crerifiPelions141he Project Plans,Specifications,and Special Provisions The updated wage determination dated E111723 has,been attached herein This replaces the wags Osterniihatiprt tdatitt ithVgehdik e„ofthe projectspsciPSitiahs. This is 10:acknowledge irtaipt and,Miiiew of Addetirk*Nuather One,itatad,Auguat45,.2023. y VA; 0,414.1 qsitega NNO Company Name By bate 4,arl OrAddeadtitilfba. SECTION PROPOSAL for 41.e.',0.01sttudtioft,.of CENTRAL,LIBRARY 14.0.100 LEVEL 0.0111.0014,ADAIMPRMMOTS. • C0,1444.s US$ in the, 0fTY--QFRONTINOTON:BEACH To Tilk AND MEMBERS Or THE COUNCIL. _ . _ . . „ fiWTINGTON BEACH: In compliances Electrohicaysi.thehhdersighealterebyproposesand agrees to perform allt*.w9**rgt described,and TObittithitilibor„***044*0004 incident insurance necessary tribitto4 in accoOggwvAth the 0,04 and specifications on:flip. #ie:',400 Pft40*Rogiroor of the CityHuntington Beach.The undersigned the*ark therein 310 'the tiSfectiOtt of and under the supervision of the City Engineerof the City of 'Main*Beach,and to enter into a oottiot,#*010.11awiiig prices. The agrees to oothpletethe.Workwithihr60.woriowdAyA starting tfOin the date ot:he Notice to Proceed: BIDDER declares that this proposal is based osh careful examination of the work site; plat- vedittcAtIO0A,;JOAtrhetiOhA to Bidders and other contract documents. proposal is accepted for 0*.af4BIDDEitagreptq.pntgrigtqA4AntrgorvitittiAdtilttt at t&mititan4(014mixsItul prices set forth in tfielAmiivIalktSeliedole. BIDDER understands failure ul enter ifit.6.,,a,,tohtfadt in the manner and time prOSOrjbe4 will result in forfeiture to AGENCY of theguaranty otoottoolilgthigjiipp9§4 BIDDER understands that a of41. required for the entire work, thatthe estimated quantities set forth in the Bid Schedule are solely for ttiwoutpo*000paringittiogg4-Agtros*opeostiott. under the contract be hAAed upon the actual quantities of'8,8!(*.$404004.,:dotolototIm: A0010 RESERVES IDELETE ANY ITEM otom THE CONTRACT.It agreed that the unit and/or Imp sum prices bid include all appurtenantexpenses,: axeo, royalties, fees, etc., and will be guaranteed:for a period of sixty days from the -poi*date,If at such tithe the contract Awgrcledille18MNOr will rejectall bids andwill ie44Y*7**Kojegit In the case of discrepancies in amounts bid, unit prices shall tiVd.f4W:dtiddd amounts, and words shall geveto:over:figtireA:. . . if awarded the COntrAet,the undeOkne4',4tetlilat in the event ntthel4MMRSdefnlUit in executing the-tegtlitect contract and:tiling-the necessitty:hotids and insurance certificates within 10 weikIntdvs2fferthe date29fthe AHOZsicr$notice of a**of contract f..9 the BIDDER,the proceeds oflhe security accompanying this bid 01411 become the property of the AGENCY and this bigizfteLfbe acptançe hetecif may, at the AGENCY'S option be ‘'eosiderodDliff otid'void. Ae'oompatw*taCPtotidsd6fbid,f1nd Bidder 'firAe'amOwit ttril*s which saciAtttpttot:IS,:ns4lest:thatt.10%tirtheaggifegee citthefolai.bid*Feel as,reqtiirecl by the Notice 1xvitmg Sealed OR EtEcTRoNits*payAbjewthe,,AGENct, (Plesse,fttser(the words-'tsiti!' "'Certified Cheetefr or 1$14der'SBOnelfer %is the case may be)Any 80,1111darci$4rptr414A0o4 Bidder shall.slattift receipt of all Acilciettlahete;t:Ii"anY'. Addenda,No4 bate-Received ; WelertsAignatate 1 A7nagt 15,2021 , . , CL2 • CITY Of ligNINOTO140.0A0.14 CENTRAL rugRARy-;sLOWER,LEVEL,'.RESTROOM ADA,IMPROVEMENT 01041.01014.0. . .„. . iterti# ; Description of Work AggniitY Unit Unit Price Item fotat. ir• "Mdbriito•i.t8i • • •• 1 $ 441*, $ • • , . ! 2 Ortgrotilb.il Waste Mcngerneñt 1 11.5 $ 3,000 4.400 . . , . 3 3,200 4 ,.$20:0 • • ; 4 Demolition : : ,,6-;:tfixt 4 Um! • _,_ •7 • „.••.,. • • • • .: ,A00f0WOrtd 1 IS $ 1 00 :$ i oo • • Concrete ncL Rittiftitte-teteff 1 , LS $ 44200 7 to$6wok-iCaltitertOp, 1 1 34 . „ „... . . c:15 Btank&Insulation 2' I IS $ 11300 $ .2,800 • Aoto;s,eolonitsf , I '1 $ 1744 4200 Alkointtra aoot'Aoimos:, • $ 4,200 11 Woo tt 1$ $ • . . , _ . 12 Access Ioors andiFrames I LS $ 900 $ 900 . . Door Hardware t -14 4 0' • 4 '%,$.0 • .. • ... 14 -0I4tItVfMettOt H3;.200 . $ . , 00 15 1 ": ,:;$ $ 3,500 . 1:61 Metal Stud Fiaming I ; IS $ 1;2Q0 1;200 ' • 17 PPF9051trtlitO toor Finishing: .:•14 , 0000! • •,8,500 . , . rfo Porcelain Tile Wait FINOWng.;19 Painting t :j,0010 3.200 Signage . t . $ 500 $ 500 Accessories ;, . • , - =i 2.2 Plumbtna $ 1;5,800 $ 1,S400 • 23 Aitechant,cdt 5,200 ,4200 . . . . 24 4$; $ 12,800' 1104: . „ 10t0.1 it)tiOrritPr4• $149,888 . . . • • Total in Words: atte Hundred Forty Nine Thousand,tight Hundred and Eighty 044 NOTES: The estimated quantities listed 4-tligilprotio$aft4t400ts,:Ar0 alOtito*ititte,'aiitti*tO'be used only as comparison of bids. Payment for quantities will be made from field r,nea**ents.If the,actueUquentitiea:00*tithei,-.ati itiOreclio'ortlecree ftemIhe-quentitigai. given,in Proposal Bid Sheet,the Contract Unit Prices will prevail. Full compensation will be paid at price:forlheactualiwodi completed,andno additional compensation will be allowed therefor.PaViiientwittoof be made materiais'w-gtetter disposed of fo,a: manner not calledfor under the includes rejected not unloaded frOm:. vefitiloanikffiAtoefat fOlootoil:aftotit:60-.5 been placed.No compensation will for disposing Of rOjeOtetfOr'excesitlieriiklfietity,retervestheitigh**tekct all bids to 10.000*Ot40-0000:elheartioOrit of any quantity shown owthe,Propasifigid Stieetq,l*V40. of a variation 4014fleg!Ytt*011it.ilike'*i_ittholgititt shown 1:iithel.-bidder the unit price will be tooaderett*o,b'444g'00. Compensation for items of work not specifically'ideittifiecVin these hiti items shall include all labor,materials, equipment,safety measures,and supervision required totompleta;ihe work to grades and dimensions shown en'the'Piansor,stakee,111 the field.There shall be ompentatien:oeeptiorthe,bid itethipecifiedlitthePrope441*-0,40 all work,A60*Alti the Plans and Specifications but not specifically identified aS';.‘a bid item described withfo',0 bid item shall he.inctui000.1n r04100,140:ite.tr*,:!Pci no aOcritioOOkom000tfori4hall become 40-:16e,rojiti*tdr by nature of comOiancewiththe'Plansa0 Specifications.. LTS ,©F, s CQ1 )ALTO Tit accordance viith G00t ihent Code Seetiort 41.{l4 tie Bidder shall set forth the mime and business address o f each subcontractor peifor n% orkorrender,service to,,the bidder on.said,contract to artamount in.excess of one-hall one percent o `thettal bid or ]'Oj)OO whichever ts.greaters, and the, portion of the, Ork to be, one by .such s . couttAttdr Bid artd Add�re ,f State PiAst M P� Dollatal 4f Xtem(s ubcQtrartt � gstra Amount Contract' lion OM Castlerock Environmental Inc 776105 C-22 #1000003462 $19,800 t; 13.2% 5 10040 Painter Ave,Santa Fe Springs CA 90670 13y sub issiOn'tif thi4iv lvsai the Bidder certifies:. I; That he isAble to and w ll perform Thee baiatice: all work which Is not'covered in:the above subcontractors listing:: That`theAGENCY will be.furn shed coptea.ofall:subcontracts entered ►to said bonds furnished by subcontractor fOtthis Project NtENCOILUS101, 014:AIT T0:11g AUC.Vrt0AyAjj01)..EiRj-Atfti:.:SVIEtlttljgtiNvjnt BID • 401001MitetPengtty orporjwion40,r111.0 lkW : ttiottat6 iegOoftt ittio;trid.tottitetkiittliethit t4ttieatiohiaexectited,06812246a g'0:14:-**, ,D:00 -'011Y Wakr:Titi*O!' -114:ngMtitity•AvforA,irepoodAvlottpkihAt he ot she is Owner., Ati.6.1itittylOkii*/hoi ''tprog041.'11$1.4ibatEtlie',Iiio4411440.4.00..10:tholiktotaititor on the behalf ofany undisclogedpattft, *2.ae partnership,gomP4,11, 4.:$49004. :gpnunie.and iot °Ilti:*6:tit4haikthgt*^bI.400b4,00t-41i401titiOitqC#Y,'Ibi:4004:040.40:W.,:00othdebtddit to put in false çr sham bad, and,hasnot dfrecdy ot indirectty colluded, conspired,connived, or Vetal'aiithi!oxtfickter PranyoofWgtoP.4(i:k4:***tif40..t.ti4tailyorit4hOito:**4000*tiftltilz that the baddç kasiiaot in any manner,directly or inthrectly sugit 1y communication, ,0,:.,0000040 wixh anyone to 0(the bid price that of any iitheibiOckpr to secure any advantage Apitittihe public body awardmn the contract of anyone interested 10 the proposed coitiact, ',01441 statements contained ikthe true;and,',fuilhetr*AAt not, directly or hidfrectty,submtrd.hs br her bid price or any..b60141..0:WIlt1100t qr the contents ..;thereof ,or,..41141.104 information or data',relative thereto, or po4 iand will not pay fee to,any corporation,15-attilt4$*:::ootopoy•AsStolatrrit4:Organitatioiti,:bid depositor oito any member ik ..4;g0ritiligtt701,0:0401000.. .itilitifitev,t14,100.4 01.400t Si ,,tytotgo Address i otl*Opr VMEITAGMAUNT 1110100$1,A NUNIIRallerCOMT,Cm.f.: CtrY.• CALIFORNIA Gottlentett; Th*"mderOpea:;horihypittittio, Akid Vee§,',thit in the peeformenm'ofthe woricspeeffied Ta the contract, aiqw4 as the CENIRAL LZBRMY Liti*TER LEVEL 08 17g0youivrsi... Mootxttl will vmrilc:ty. and utilize only oatillea poison4 ,hereinafter tiefiti64 to,;•work 1# proximity to an electrical secondary or transmission facilities The:tom 040.04*:.4 Person" is ,Witoniia:A4oki*gtNg 00.40;,SOttort104 fotto .: INWieittersoitt A'poksoo who,by tieAtOit tfeveileneebeiitsitiletidit w&Ilie • , ' ..130e#4.*.o.k:4010:P.g.004:00.4#10 figeie**oW The:tillattlitideitalsGpromised and agrees that all such'WO*shall.tg.performed in accordance with amilloo*oigoiral utility oftvatiy:'$tolviidtieht*, PibIlc Utility CeMinisa0..A orders, ant Staof Cetlifornkic-4140SttiVIngkgVerit% The 44400044,e4-1thergroolwatikivott that the herein sia1I be and gtelii40$ tipoit any $0.1ti.mtractoror subcontractors that may':'•tieretairte4,0'01.0.1400**0:04*.*Red* and that the *00404 shall take steps as are Ae003sgy. to assure compliance by ary said sttht.ettroeoteti$obeet*Aeor04th the reckireotento ebb#00041terefrte,. 000;:$4.440*Itk Cetittaeter , . • Date:, 1)1S0trikLIFICATION :-QuEsT.loNzicAm huseentdnitoeVitit goveminent Cede SoOition 16162,the Bidder shalteoinpleteinnderpe40.%Y ef Perjullt the following questionnaire., 141.1ESTIONNAIM Ma the Blilder,any offieer'of theBidder orally titillOyee-ethe Bidder,Whd lida aptoprietary interest in the,aliidet'eveibeen diagnalifier4tenioverf,or,-Othermitse prevented from hiddingoitor completing a Pedernii,Stste or local.government'project beeauae.of aviolation of law or a safety tetrigAociti? allo y, rf thennaw y the %an or;ai, e nietre;Int •ees spaee„provided, Note: This questionnaire constitutes a part cirthe Propos4 and a signature potionrof the Proposal shall constitute SignSturerif:thfsAnesIninnaire.. "COYVENSATIONINTS:LiWe* Ftirsuantto,Seetiori I861:oftheStatetabor Codeieachemitractor to-whomapithfic works contraot has at hail sip.the::followhigeettifi-eate.. I wit aware of the provisions of Section 3700 of the Labor Co*Which' -require:gvg ettiplOy0'14.be iiiturecf against liability ftr'worker's compensation or te undertake self, hiSiiithee hi iettirdence with the vrovisjons,of that vo4e1 ApftI gill.4007* 1Aiit1,swth provigoavotait dOntatittrig tti6Tfedbttno.tifthe,work°MIS-cop:0.4.ot .00bakEilOildershze eghtrAcitOr WatidTi*pxy ay - ,cgo Title -8/12/1023' 011)„.Rta,$:010:0110041ION. rinprotoortifiwthat*,utowiot iot41-itattot tsitot ,.„Job1Büikfers 13idddfNatne Sgite.ZS 1311tOts.AdOitS !.$444144,ig, . . , :Vi% • State.‘ Zip ) 06balblit*,411$.4114.0'40#1„..„ „ T*Ootle,14001110e Email.Address CtSB#iO4O58 C1as BState :ContitattteE!Licott*NattdCIAsi •, , Mt/2018 . „ OttitiO4tDat.e:Tpsg.0 P)/3112(124 • . . , i.,E*plrAtioo p*o. the 0;edo:d by N044.7.491 '.6fourofficelott 8/8 , , T,40-$0.1togot.oreq).0t$00,:ttnis;Atid oottiOtttkitihaiiifittpkihoipdViotergitlitihi*propop.* 61W4111014o0Ao . . . . " • " . .„ . , • • -" " • " • " . _ , . the-Eittiderit010*PrOOgirS.t#:Pat1s14. ,,Cogq011.0f16.0 City Otlitofliiii-004.ff.:0404 of its.,:,0114i, Oixos.O.olly r other to peiform the totttrtOt for the proposed work an4 improvements in 40cgt4,44c0A?vitbAii,g414PP:ign-4PPOOMP,44,141$s',Oilotth • 010.0.4!IN0.1410r4T„gq. v. • Bidder aflu I:11119;k . „.. . 0ilypo4:-Sitmorio. NOTARVCEIIVICATE,, Sitbscrilleil,and tWoro to beforOttle tifiS4-1 40.6r.mitio* ,204, A poto.y.public or other Of0:01,0 completing'thi . certificate;verities only the.identity of the ; 111.41*(4at who signed the d000thoot,, to which this certificate is Itt4thetL'and not the tr400.#45.4.,Acomoy,cotWidity.sit that trodittOnt. ..:State of Countyof.olt-towl,t: . a . • .. On :01,/ V 110 ."2--$ , g ita . titrimo%,, beforetrw '.0tft8.0iit", tt . ,„. „ . .„ ,... , MoOtk-5045ii 44 Year •JttsdttNainga.t4 01.0 OfislOtzu),t'persotallpopearog :VA: gliA,a,, #1"-vvmor..-, ;', , --, N-., !40)asiPeit.4 Itri . „ vyhqprotod-to ino oostiotaiig Ofsatisfactotreliikme foto Iliolotwo*whosd:oameftwajp . , subscribed to the within histrottetit and acknowledged to me that tolowtHvsy-tleatl*:tto ST011)0 in 1us/hefr taVadV*4.*tiallat-703rhi4gnatur600;11 the'tits 04-iii6nt4110 posont6 Oftlie-ontitY:IWO:b0h*Wot wdfihevetvg*4cf.0;*edtgedttoio„slhg000t. r odd*,owor PENALTY OF'II:MOURN!miler the laws Of theState of: 01,0000.that the .,. ._ fotOgotol0f4gpoh is true and correct , „ WttNt'S.Staylatidand offici*49* 2 -,1111't.1 --coartozostar- - . , - .-,/,.- ,; iat*Woc.4.,440* . , , oameacatiart. , Caiiittipitee , ,., dir : .12,,I . oriN9likrYktilAYO, 01,4 ,E1,....14QTAAY SEAL ABOVO `.c.,, ' BUtderlottofeettitstory For*he potposesotitlits ptaieglio004,440%4011.- subcontractor mist have, the last fiyg..Sta**, constructed at 104 The($) 1E604 of siinitar'-wOriii speaficalty,referencing the construction MesOiht,',•sPetifit'Ivotikari4 e*Patf000i1104.441/40:project,*it,example‘qteconstrilatilnitbe rehabilitation of eiglink Bidders are:encouraged to submit supplemental ,i101*,104$00*inkiiiitii;V:A01P40004,4,0ttbarelit, Th#40.110014:WAopiroig,-*;:mgoihe:rg000temsla4titivdt, o*otL**l'Rka7*.ge41'*t;*rWoritleitipct.maadVtchedltenovtiiions 6lakbrOf Air,o;,14114-q,*04,** Name aid:Address of Reference City Lagenalleacti,;,-themba:Nteg940y3e.too. tigtook$7.41:00o*..N.0,,,orOwndtt, •' • : ,..• . V.21.1.028 Itettit*SitOtidit Otegi*g.iptibtiifaCititrit*. 11131022 • . .. • . ..- 00t0.4.4.40,044 'Typd4fwaik .:0,..:.Ipplotc0 PiovideladiffoottiojotAijektiotioti ;bi01:6*tholod6cdoet.orrOlti*oli*:464ADA,14:041#00#(l ****0*****Mit*C4:410*-PRP.11 **P*:flli*i.'„OO9rApp*:..*itkoaokspfaO&:togotPatiWongiI4iitilg:'fikurckvrdttioiihtvyiitittunew Water andswer hnes asbestos and lead 2, 'PiitY PipultotrItOtpitio.#1404 tkosottiOtio Otnita :10140ItbealAiediptii0y:CA490. 4p .1:40ittOr404.A4400•00aere00. „. . . 0ett gittorPow00.'.,..70.001,01..704$62)-9•0•+,71•10'' gastnnannandAeconsOnc.tion . . . „ . COniatt Antonnt IiyijealPOrk DataCornpiated „.. ProAdaadditionaproject description to ilicny*Offarrork. oe#io:.*ag*ttooq*Aof000tois.Foo§w*000t*tok#4,,:Atoopttok,o4Tog, thysvakattiationfixtoringate*;pitiiii*Itaiiiiiiiiii4eieetne4.iiiitiir**4.pcogaignow, • • ritSifRoadOcccnA•41101001T00.00.3.-0 1zRcYA*4i.,giv9p63o a. . . • • . • Natlioi,041A:41.*SAiMer.too , *C„Sipiad,,,Allisteedlititit,061)4g148998: 'Nzitile;4114117010.010tItNo,....a.vvifn •,..• ••••-••,:. •-- 0%470,i89 . . , totittadtAinontit h*sof Work Pat4ompleted .:,•Pg07440igg1.4.iffortarolot description tø 0.„how0:mikwoi.lo: qpo*s-;.coitogoopte*outioilt foi',$90.0raoge',Cctin*'.0coo-an*iktCollege :•Distri000-00.0031.40.004vilic`,Contta0Dp.come4W,.01,1tKoletquir**44;* ::.e4y!,01,414,,on-,..*$00tro 410-,,thitdoorThiiinok*o.001,04 *:t;t-po"#:oi.t4*,oiito„..cA.; - • „ . „ 'Ni.nlel$107440$.$ , cerence .2N-4#1.00,0 TOkittotidNii downert. -#4.0.4444;900•,:ora totititadtAitiouig'i f.tgltift.g'..4rttionel project dadiPtiTT:t4YANZW-4f411101NIOild 171*SCIVPSiff•wPikettfiiii*0:0.01.*:40#10titiffi*011wa4 OifOlgirtilAtOfiii.'4$1*0130 the attached corti.froodi* . . , . rityviriong Beach-LongBeaeh 1ire flepa eire Drill Tower Restoration ''N.I401,4',01.A4.41701$.01101010 Telephone .NO,of,'.00410t. Andrew)200*#40.1614,56400410 • ‘40/14/ 't40760 2021 • Provide WAWA]project dekriptimitqi§howdmilarwoik niarriyirrisodr,no'totrithe:00htoi:,. 60$11741,Arenr,r!t,A 000 CA.The contractAittainits4, the40*40060047t0oi.:1* ,ce.149ropitlowei, • • • 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 Walid Timory Name of proposed Project Manager 323-321-7373 Telephone No. of proposed Project Manager City of Laguna Beach $227,028 Reconstruction of public facilities 12/31/2022 Project Name&Contract Amount Type of Work Date Completed City of Downey $311,351.56 Restoration and Reconstruction 5/11/2023 Project Name&Contract Amount Type of Work Date Completed City of Cypress $98,876.80 Renovation 5/3/2023 Project Name&Contract Amount Type of Work Date Completed 2. Oday Mohtasebzada Name of proposed Superintendent 949-351-7872 Telephone No. of proposed Superintendent 3750 Vinton Ave,Los Angeles CA-$126,728 Residential Renovation 6/20/2023 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-12 CONTRACTOR gELpisTRATION WITH CALIFORNIA DErmamtpet OF INOVSTATA:LitttATIoNs(Dg),ctguncio,..g Pursuant to SB$541. Labor Code Section 1771,104),passed by the California State Senate 0*,100.e:.1(c.:414e4tgbitshe44'.0e*Nbtle*Oiks Contractor Registration PtOgf4tii,,'WhieliveMtite* all ;„.• P00,4400-t , and 4000.0#4:4011 bidding and performing work on P441,*Works Projects to tqgT§:tte on an annual basis (eAldk,July 1 Oit010.100010'gat0;41001 Y04.d with the California Department ofIndustrial Relations(DIR). Currently the annual non-refundable registration fee for CPT04000.i $30,(L.taelieetittteteite49tp*ptibligNY0400.01ilthethAsi*en awarded shall sign the following certificate. DR Mar StAIT.on SB 8.54 4.440VIP.L.SEZPOR4701*.s/S110.0*.` •:qa0;114:irt.at 0:1:TVot'ontrootor:t:001.0000M4-i-YC411.(8•44).$44.744 •.booti1O.614ogAir4igoOvi(ORI:Aaloo.*Ofia4btioo-44:fttilayft-ckegUtratiooFoiro,DtIVs Contractor Registration 404t411:01t database: htttielling4irm.44010Y010::$ootb.5etio0 Tigim'awaroltlit will tidin******podioa.of tibor,Codo.soop*:1771.1(45 which states: ,1,keeritract.:Prvr 4010000ot shall bott6,041ifi4te bid Kini,,11'•oliatiLlitA,•tid proposal, :stibleet:tolt*teohernents.of seg**4104 of the Public Contract Code,cireritg4-0: in the „ performance of any Ao7-00110 work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to $ectiOrt1.,'*$4, It is not a violation of thi$,$eetiottfor 0.0*-tegOtOtetUttotroototb:4401,415i$t that authorized by i$0.0400 of the I*144.c0.404.:0000,5001$44 Or by$00.0k1044:::br of . the POttie.,:cOotraeti.0.6404z*evitJet the#1.00#0.to is registered to performt oblit,,work. ptr$0.010,-$40.tibti 1725.5,2eft*tocithpootratitooaiiii.el I furthermore liiitt comply*;:tifovidLipgproofof registration wiiiii,DPRAS the*Wary contractor, as well as for ALL subcontractors Atth6;time9174011:01..ps:tholiaGlobal Builders. Inc 004400 •-•*404:Trotoey By *Wtiotidoomtitooniacom Email CEO .„ . 7410 8/12/2621 Date: • , Registration '140,16: 49-' PWC •• • . „ ,c41 EXHIBIT A VgAtiVANTAGEDIAIM ASS,ENTERPRISE MBE) „ This Project is subject to 200.321,Title 2,Cede of Federal Regulations entitled "Contracting, with Small and Minority Businesses, Womett*Si Business Enterprises, and Labor Surplus Area Firms."A The Regulations in their entirety are inco ! :.,t0Aorol:4 by this reference. It is policy orthg. City that disadvantaged business enterprises (DBEs), as defined in, Part 200.321, Tide.,‘,Z,CER, shift he encouraged toPartiefpate. in the performance of Contracts financed thWhele,erigPart With federal funds.The Contractor should ensure that DBEs,as defined in Part 26024 Title 2 CFR, have the opportunity to participate in the performance of this Contract 0-ef 4lioittAke, jtneg$.54.42nitrgasOnable steps,as set rctrt)t in Part 100;374 pttozcPiR,, far this„aSteradoe.,Tho Contractor shall tibt 44P'..rtitnalt0,0ttthO'basit.eo:cf:ot'gdliir,; .nationalDrigin, or sex in the sward,and performance r&subcontracts.,Failure to carry out the requirements of this paragraphahgl-APAstitOte'*hreaeh-efCeeftaet and may reSelt in termination of this Contract orOtheekeinedythe,Cityhay deem appropriate. Bidders shall be fully informed respecting the requirementsetthe'Replatiet*arid are urgedto obtain DER:Pattklistioll in this project,although there is no specific pot for DBE participation. 044 EXHIBIT B DBE INFORMATION—GOOD FAITH EFFORTS Federal-aid Project No. 1658 Bid Opening Date 8/22/2023 The City of Huntington Beach established a Disadvantaged Business Enterprise(DBE)goal of 0% for this Project. The information provided herein shows that a good faith effort was made. Lowest,second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder DBE Commitment"form indicates that the bidder has met the DBE goal.This will protect the bidder's.eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the"Local Agency Bidder DBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified DBEs soliciting bids for this Project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested(please attach copies of solicitations,telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods Solicitation and Dates C-15 C. The items of work -which the bidder made available to DBE firms including, where appropriate,any breaking down of the contract work items(includinithose:itemslnermally Performed by the bidder with its own forces) into eeononlicallYeaaanilOttnitSio facilitate DBE parjinipntion, It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE tints. hews of'Work Bidder Normally Breakdown of <Amount Percentage Performs Items ($) of (YIN) Cont_,agt D. The tames?-addresses and phone numbers of rejected Oat:firms,'the reasons for the bidder's rejection of the DBEs, the firms-selected for that work (please attach copies of quotes from the firms involved),and the price difference for each DBE if the selected firm is nor a DBEt Names',add*sses'.and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: Names,addresses and Phone numbers-orffrIns„selecte4 for the work above:7 E. Efforts Inadet&astist,interested DBEs in obtaining'bonding),lines of'credit:or insurance, and any teahnical assistance or information related to the,plans, specifications and requirements for the which was provided DBEs: ,C-Lb Efro.Ao-. to': ,',47(.$1$t tototottif o6fahlii* necessary 'equipment -supOlies, materials or ig01*4 assistartce or sory...fgros,.;mil:Kan suppliesand equipment the Dag $413- 00.00400t1j0ith*g Oritage4 ThOrn OV..P;am,e;cottaotottorits trilage:? . . O The nanes citagencies, organizations or groups, ccintactd to 0,0140 assistance contact recruiting and using attach copies ortocpo$o tø agencies mooltyltospottotgoiy.44 itos-ifiltotot.--page4own...,:jo.4004: Name of M...4114.0atoote.4titadt: Resitits. ..„ . . . , data foto:pod 4AethoilAtation ofgqq4::.f4itkofkisHitig.00:00:004tshooto ifflgg0.440); . . , . . , N:01*:; ttSt ADDITIONAL SHEETKOFPAPERAF • IF A.:::Stitt OWISTEk:Oit,SOL.gACONT CTait SION11 HERE. Name up:clef whttti.ttiuttles6 , . . „ Sittl-atvo- (gwen 4tod surnatri ).of popriir (4)?tact titHtigifie§o (beet OiPS.12.444 Sit.4,td Coti6. No A.PAESP.gtoglititgt (I),Ntile inidefAvhieh business iweeilditeted $i*.gpaittir0.(0,:y0ft.304.tottAtoe,...0.0& hot.40te,o'f'Oatifie!) 'SIOnture..inust.be made by a $010-raf P.a„ttrt, ..(q) CityUrtdStat!&. _ . i(4) Zi Code, . , 'rdtep:,tititit No: IF A CORPORATIbN,„gtdisi,14Ekg: ,Olobtratiiitters Inc ‘ct),..Xe.tii;e'uttiOit-Ohfehltiustriest,i •whiluered . . (2) .„ 4c1r0 0.4 Ii4Z, ot, Iv Impressi..Covorate Seat here or, (3.1•Irrcompratectutatt the:laws of the State-of: C41*H. (it) Placq of Business. 1740-E-CearTY Ave'suite 165 ,(Street 4Ntibtti. Satkialiaa,'CA CO.Ott'StatO, :- - (5)Zip Code 9165 . . 3233214173Tdeffforieitsier., , (0 E-lian, balbdliders*t4ggr7.0'-c° NOTAIUAL:AekNOAVLEDGIVIENT OF EXECUTION BY ALL BIGNATOltIES MUST BE ATTAlitt) .0WMaPlect7Pitegider1it?'vice Prqstikkti-s00,etarY'and 44si4,111ti,49TP.,41:I:ii.fa'cgorPeratiON if "a narne:smf alt gent,ratP401100',1411,001:00.40g7Partritt$:: AValidtmOY- klit0.0 c-19 ACKNOWLEDGMENT • A notary public o ,other officercomplleting this certificate verifies only the identity o#.the individual who signed:thefdocume to which•thitcer:tificate la attached,and notthe truthfulness,accuracy,'or .. validity of that document. State of tali"fom[a County of, ONCE on 0 Si ( U -- before me, + '} rate_ (insert name.and titiadf the o fder); personally appeared t . who proved to mee on the basis of satisfactory euiden e to be the persons)whose name(s))Ware subscribed;to the within instrument and.49,01PW104 ,CIPO to me that h helthey executed the Sari-let histherltheir authorized capacity(res), and that by his/her/their signature fs)4n the instrument the persoh(s), or the entity upon behalf ofwi ich the person(e),acted,executed the'instrument.-; I certify under PENALTY OF PERJURYPERAMY-underthei.laWe of the State of California that the foregoing paragraph is:;true and correct. WITNESS my hand;and official seat. G ELEI IA Ala&• coat awn Notg Signatu Seal , EXHIBIT C LOCAL AcE$cy BIDDER DBE volvatzmia,Ivr-(,COSTRu.ctfON):CONtgAcTs) „ . . ! 1%.100; PLEASE ligri3A TO iNSTRUCTION$'0 .TuzgrgyERsE SIDE OrIBIgtogs .1404.-AGENCY: 1004116.0 . .„ PROJECT tt§titiiitioNz; TOTAL CONTRACT AMOUNT: BID DATE: BIDDERS NAME: CONTRACT DBE GOAL: CONTRACT TOO OF WORK ANa.DtSditiPTIOADBECEtttNO. 140,1+4Z OF EACHt DEiltijOttAkimoioutir Ittakci• SERVICES TO 140015411(#iltlitioN (Must he the date f.(g010.40t 40.OR,::.1441.441W4 DATE arc opened-include DBE addrcs '0 BE PROVIDED(or contracted it the and pfisgmnumb4 . . „ . . „ . . . Agencylor.Lticat. *y,c0opligto Total tialtudthDBE Local Agency Contract NumberParticipation 1040F4i4 Project Number - • . . Federal Share: ecinOaet,A#aaAatel , . . , P#001'Agenoi'eett44.4104HPBO:afitiff04000'T144*O*Y001144404, •kijOrtil*R.**40iloretkarta4:064:r4* . : Signalu e of Bidder 4* Print Name Signature ; : Vitt " • • , "nni414ti,1 „ Local AgencyPerson '.(P14,54TypgprPtifit) liyirqa'CocleYrde0ippc'.:,$q0er., Ldtaf4OFY-POkrOOKOovpiii***(0.00=40410#,.0.0t*i) 6/26100.. „ . C-20 • • . . „ „ „• PLEASE NOTE: 'This 10.00Atiok nttlyt,,te.H2OMil.itt0040.b' $00e,bitl,If it not,and you** the 4op*reitt ilovibidd*P0e,th $000:41.0thitAio*hidde4ft fitit#401**0404i. tiriii as specified in the Special Provisions. Failure tqA0Mitlit0 rooted DBE commitment be#04101*I:germ:Ohl the bid nonresponsive The too irequires t*aid information regarding the construction contract: Local Agency, Location, DOso•Opilov•trotiftmtkid Amount. Date, Bidder's Contract,..„ DBE oott. The font 44:a column for the Contract Item Ntithber. Item W0*do Description" • . or $„er*igo.AO•tgSooritgootroaor Materials to be provided by DBEs.Prime contractors all work to,.1•,0:.pqtfoollso4tly•tiOtsrotii41g,itPthopritg::14*Dakvotk performed by its own forces, if a DBE. The DBE shall.provide a PO.fk1400111.*:0,grWthtttitiirtotor and expiration. ,tlattLEnt&tne_DPATIO and sthoontaotoii::,tottiftcati9rt:;RO*Aa-oiIvt;haia toiaift,ts.ar. :the N4010*of IOW;eitiiitradtors to pedOm the work 0,110,iitat„be,,e.driffierif cc*:$4.0.date 014 are opened and include the DBE address airtktitieii&inut4cr);, „. . :IMPORTANT: idtotifyItilDBEfirmspatif446gittifit project regardless of tierliarties,',!of the First-Tier DBE Subcontractors and their respective item(s).orvok listed 0904 be consistent, $91i0r40140.0*.;:wAiit*:04#10,M1 ti.0. 4.:r7.4rotki11010 Subcontractors"submitted your bid. There a column for the DBE participationt dollar amount. Enter the Total Claimed DBE Participation 11*rs 00. amount of items '10*• 013.„.'tnittoct„ your bid pursu go* IiidSpialaUPtovrkipmf: (If 10:04.011tml .tiotttitid;fidformedwir*rnhilg4 by t.40 DBE,describe exactportiott of time to be performed or furnished the DBE.) See a4dtionfmri440404:04-- Busirt0§POrptiwatltr Otht,:00edfit Provisions(construction 4000 ),146:',4toftiitieffiGw to count of DBE Exhibit 15-G must be 40..*:041tiyitto person:$100.-4, listphonenumber in the space and print of ttO?#04011,*4-00404 U0.01 agen0i0ihoiit(LO*PlOte:#1 Local 4gocy Contract Award, Federal-aid'Project'Number, P''t.40t0$1146;;Ooltrutlikwota Date fields that information is complete accurate •.:• • • • - before signing • • .:„.„ EXUAltitt) E-0:,,VAI4•VISItt )YrOZIT00.10.010.$11IY otitillneATtor4 The bidderGlobal Builders Inc . , [proposed subcontractor • .,,j,werel* certifies.tlidt he/she/it flgj has not ,participated in a previous contract or subcontract subject to DOgettunity.,:elaysesi.as regeireAby'.tuatiii,tOrders 1094.,11114,or 14240$and that,where tetoltd44:he/she/it haSifiled'wo the Joint Reporting Committee,the Director of the Office of Federal ContractCompliance,a Federal 0oyetifitoit.:060tractiPg.*. administering 4.40**/,4*thofIrito:f Committee on Equal.tktOtoymoilt Opportunity,„ all reports due tiliddr the applicable filling Ito* The*NO gortifkaikoils:...1040Wiby the Equal Opportunity Regulations of the Secretary of Libot.(41:.iCERt041.170 and must be submitted by bidders and proposed subcontractors 9#13flir 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 fOrtfil# (Generally only c9POgg*At Otib00.0401.S.otSti400(1::-.ar under are Currently,Standard Mitt 0,0'(FgO1)i$40.:1400:Topoolect4tro*OyitlietxecottyOrde:ta',,O.eth6rt implementing regulations. i'(egoo,!:01*0.10yer401-4:4o0:.... 4.ex,otioi) Proposed prime contractors and subcontractors :4480 participated in ov*.1400$contract poboxitra4isutoot-to*godocivo'.0tcWt ftna:44-WootOlgcltht required ,r4Aptiklit*ihot 41 tflt-:',60-11(14 prevents the award of contractsand subcontracts:unless such contractor *submits a report covering the delinquent:petted or such other pow specified: by the Federal Highway ,Administration or by the.Direeterf Office of ittititeAdt Compliance, Dopaltplq0.:,:oftgt1:04 8122/2023 Signature: Date. ,Print:Name: • ..„ . „ CEO • EXHIBIT E $0':$MLXAISM11:-,Arvwoo ,• (Title 23 United States Code 112 thititrietenfrace.citat Section.:1160 (NAME Of CONTRACT] Totho<Citytiffinntingyjn Beach • In conformance with 110023.0tifteAstook.coosgotiot:t12,04.04001#)4,M110.c040.4004.o II00thatAadq declares that 1$110'411Witt the interest of;ormytooff of,any person,partnership,company,association,organization,or corporation;that the bid is genuine and not ooitn$ivoot4igng ttot,thot000ettOS#0,t 400*or indirectly induced or solicited any other bid4ortootttlitaiso,orAoni..JW4;404:1t4:00talkOW0:::ktctfrOOOoOlitdotkjtlotAeOdi.Ot*t.YO4;; ofggrcg4.**any bidder or anyone else to put in a sham bid, or that anyone aiaThrgftainfroin. bidding; that the bidder has not any;:manner,., directly or indirectly, sought agtoomm oomotilo4goi or conference with anyone to fix the bid PtiOgftlw•bidder or any.94*1:414m orto fix any oyotho4-p0fitt.,9r.cost element of bid ijilet,...tdbfthatbt any other bidder,Oftti kdit&aity,ig*:41100401mt the public body awarding the contract ofattywo interested in the pnvose(f'.ggiing,g4th441-00*00*0041.444140F,Nd are titoo;*tifntthot;;tfintibe:tioot has not,directly*40000tbi; submitted his 0.ehot bid price or the 0000. thereof,or divulged information att data relative thereto, or paid, and*taltotoosooy::1"*f0.any corporation,ottootittttwtotootty association,organization,bid:doposfatty;,,oi,to-any mignitgfoi „.. . . aggntlbergor collusive Mfg!. The is part of the Bidder's Proposal., By signing the Otopos4tift0.1..44.-otha.$itso.,'sigivi4i101104.0.1107544,Mf.404 Bidders are cautioned thAt taking a falseeatititotiox may subject the Bidder'4.:!oxittlit..to, prosecution. Signature: Date:„ . . . , Print Name: 104014,Tr 404 „CEO • • • • EXHIBIT F 1. DEBARMENT AND SUSPENSION CERTIFICATION Itttlir49:ccil3torPEDEIA1 REGULATIONS,PART29 The Bidder, under penalty ofperjury, certifies that, except as Actgcl*Ibwf ArtrOligr, pottowatto4ated*Iiii0itiibtlitio.,capacity of owner,partner, director,officer,manager: • is not currently §Pgw:iOny4OtjArmntiYPJPPtAXY';eAqtt4.5to.11f or determination of ineligibility by any Federal agency;; , • has not beenZ$Q$PenddiikitOkarted,8611infailyttOtt4g4 or determined ineligible ... 4 e.` by any Federal agency within the rotP$?yoagg • [ does not 1**nPrOP0404 404rrnerg:tie.04,ing4#4, • :11451.i.pf been 114tetgoi,:appyfgfosi„or figtt.,AcONTI,g4olloto rendered ogoiristfA: mill or' by a court ofcompetent jurisdiction in any matter invelving fraud or official misconduct within the past 3 years. If there are any exceptions tf.)this 0014fitOtiOftijt:tott(tho-otqoptloo$to the following space. Exceptions will not necessarily result in denial ofaward, but will be 400$4004 in determining 113144crYgPcm00#3,4.:P1#.40iy,e240010.4..40044t5i.vi indicate bel whom it applies, Ogoi*t'4ii0•ilgteWifttddic4i. Note: Providing false totiitwatioti may result in criminal prosecution or administrative sanctions. The above certification ispart of tlx.#PrqpciP.41. Signing this Proposal on the signature pOittOkIheitbt shall also constitute signature of this Certification. ‘, Signature: fDate: 84012 3- Print Name: Audittit- ofk Title: CEO C-24 tlamtirr G NCinOttlYING etRTIFItATIONVOIIIEDERAL-AID,CONIVACTS The prospective participant certifies, by signing and submitting this bid orAPPoSaLlOihtbitat6f his Othot,kolOWidage and beet the: i) 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 Atoiriloyte,of Any Federal agency, a Mentor of Congress, an bffiqet or employee of Congress, or an employee of a lMemberofCongress in,connOlotiOn with the awarding Of any Federal contract, making of Federal grant,the making of 40,,y Federal loan,the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment,or nin4ifidAtiOnnt74nyfdtiorojotnnraot,gratiti,1004OVOOOttatrve agreement. 2). If any funds other than Federal appropriated funds ttqye. been paid or will be paid to any person for influencing or attempting'to influence artiaffiooror employee of any Federal 4_,F04...„%ri‘gtf600'et Congress, an Officer or AlliPtiveOr dongitaa,or air•cipplOye. ofa Meer POngte$$'44 Onnti0Otinif thiS Fdderaj ventraitkigraot,tom; .0000etative, agreement,,the undersigned shall'complete and submit Standard ForniuLL4 "Disclosure ofLobbying Activities," conformance with its instructions. This certification is a material representation of foot 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 Section 1.3512,. Code Any person who, f0.14:wal0th07:1.04ttited certification shall be subject to a.civil penalty of not es&than'MOO And, not more than S100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of thts-certificationbe included in all lower tier subcontracts, Which 01(004$404#00,AnatOtAlt such stihre4pients:,'shnil eettifi.and4Iseloseaccooliivbri, • •Signature: e Date: Inn: 623 Print Name: AVaterithoi7 • CEOTitle: e:45 • EXHIBIT H 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: Ela.contract ❑a.bid/offer/application ❑ a.initial b.grant b.initial award b.material change c.cooperative agreement c.post-award d.loan For Material Change Only: e.loan guarantee year quarter f.loan insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No.4 is Subawardee, Enter Name and Address of Prime: Prime 1:1Subawardee Tier ,if known • Congressional District,if known Congressional District,if known 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number,if applicable 8. Federal Action Number,if known: 9. Award Amount,if known: 10. a.Name and Address of Lobby Entity b. Individuals Performing Services (including • (If individual,last name,first name,MI) address if different from No.10a) (last name,first name,MI) (attach Continuation Sheet(s)if necessary) 11. Amount of Payment(check all that apply) 13. Type of Payment(check all that apply) $ Actual planned a.retainer b.one-time fee 12. Form of Payment(check all that apply): c.commission 8 a.cash d.contingent fee b.in-kind; specify: nature e deferred value f.other,specify 14. Brief Description of Services Performed or to be performed and Date(s)of Service,including officer(s),employee(s),or member(s)contacted,for Payment Indicated in Item 11: (attach Continuation Sheet(s)if necessary) 15. Continuation Sheet(s)attached: Yes No, ❑ 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352.This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into.This disclosure is required pursuant to 31 U.S.C. Print Name: 1352. This information will be reported to Congress semiannually and will be available for public inspection.Any Title: person who fails to file the required disclosure shall be subject to a civil penalty of not less than$10,000 and not more than Telephone No.: Date: _ $100,000 for each such failure. Authorized for Local Reproduction Federal Use Only: Standard Form-LLL Standard Form ILL Rev.09-12-97 C-26 PISTAII&ION,Si:FOR:cot:44114k*OF txfffAfra.. DISCLOSURE Th4,41kIt*Ilttfiittn't be bYthAtOPtijigP010';*heiheratthaVVaitkabtfpintiF040tal V0010,1itlitAgiiiiittatiott or t,00:0iptagovitgafideral agtipp,or AlpagtJOO*000 to,preiftitis-fiat* pursuant to title 31 U.S C section 11:51,„'The fith.4 of a Ionic is required for such patent cot Qt'odttPtjtAPttik4,4YtllenftP 1,04730W0rilty for fiffueholhgot;attettiothigto.tiff**'4;"404pgr: „ employee of any ',Member of Congress n officer o.oplOyeo of Congressor an employee of Memberof Congress in 04%dd:inn with 7,9,„ ygtga.',Nag-to action. Azio-it a continuation‘4ffOtf4040:041,'..thfathio,Oh*if Spagg the:forth is inadequate ,Ot;iooloto,au items that apply for both the initial tiling and i:tnat00a1 .0.114in$0 report Refer to the ithpletnenting ghi.dotxoe:fhhttihedhttheoftkgofzqoogekhtht thitL.Uudgot da'alnital 111Antat100*- , I) Identifythe type of-emoted#itde*:040 fbr whieh lobby-14'*Why is and/or has been mfluence 4-itaivetettledgrat aottok 2 Identify:,Ah6,',gtatW of OP:!;9,YAM41040r440000, 14eLAti*-:the appropriate classification ottilis:tgpottAi 1ahts45,of011oottotepottstitited,by material*.h44.-gg to the informatoo previously reported4 enter the ygg and quarter mwhich the thane iketitteiL Enter the clate,gtholgoto pielii,00sly*itittiitteitioortliyth*tepolog entity forthtkovete4LtedettLetioh, Enter the address,t _ ieit4 state and ;094 of the:#00fitbo Includety,, Include.f.,::oggr4aaiooat!Plattittiflookb, Check itio appropriate orthe•report1ng entity that designates if it is or expects to kibta,:ot sibiwob*toofpigot,Identify tier of .,kibawardeefirt*vrigto is the tlrst tier,Subawards include but are fnot Iinii*110i4bPOOtta0tS,,:lnboatitSati4 tOnttattawat.&000r.0:010, :‘$) . filing the report in Item;-41iOliecks:080bowage tberi*,„titortho!,04) additt4eitY.ot001,0141p:,:cokofthiginlg Federal recipient Include Congressional District, 0gM4. Enter th0 nature ofIl*V0404.Logeoey04klitotht award or loan crqo4v000ktk:it,ro-sl Oti‘t,:organization 30.4 below i.agginq name, if'loom. tot i:e141#01.e..1)0pattntont ct itaovoctutoti,United States Coast:G=4, 7) Enter the federal program name or toiettoo:for The covered LP0.404t,action'item f,tr:' 10.04,40for they full Catalogof Federal Assistance 00.460;:ninnt).0t for grants,, 00040*407-toicto00044.1 00.14 togi ommimeow• 1.0 Enter the niost 004PtlatO Federal,ti401tfit*8 number Ava1lah.10 for the 00004,adtiim identification in item Request izio•'Ptopotat(OKI,-number, 400104 .±,.0.i,,,04,,,(tpt) rumber grant announcement number,, the .t,;Ohttg:pt rotot loot award titittibtti„icifig. Oplication00posal 400.tentnither*pahrikd Federal agr040)4b010.4*114d104;',C , "IFF,IJE46.00,1.7 FOr a covered Paderal,::401bit;where There has been au org.d.gr, loan 4001011:tftlit by the Federal age/IP3ffcnt0r11*Y00.00,1,AnIonntot:tko:aWak,4ikiat toiinnitthentSfot*gpt*g,-rg*t.tx: 14000.04inatitt TO)( )E00 the fiiit'liAti*oddrO4OttY;**40ailoz,0040 fitOto.1041itg*tittty ehgAged.rhyjhe- t ept.440htity eiagnifft-4.4ititgni-4;to 10004004 the opygtgaNaetat a0tiOn., „.. Illiiwth4 mlioattes of the vofkolittit.orifoesi 04*Igo Ain 4-asit*it ;<tiftoottzeom t 0.141 EotousIXato;,Ift0'NotteatuffM144. ..Nti41040, 114-titot*0 amount compensation P.#14.or r0.000#1*expected be paid',1tty2tho roorOnentft (itemg • 410 the lobbying entity(item InOloto whether the payment has been made (actual)or will be thade (-0.10#0. ) 0001.0 Atbox.o,$;that•400,Ifiliii**.m.4t.014;•-.0.4.000. XPP4O*rtiVV-WtttdtttiVe arñaunt.tifptfm00100',prthrtaettoliottidido., 14theeTkAhcAPPrAmirgtg box(es) Check allboxes that apply gpqmot srnadenude through art the tlattitO witi.Vdttiti•;aftlP inkmd payment 11Ktigli;:ttigNOVP11.00, chtditiirtgow thg.voy,,If other;-,406•64iiturc, 440tdoidd a VOillc‘ 4410:404.40.4 descrtptton of seryi0§4atjheirto.hseit hoottetibtd.vr WO*040000:tO"PetifOtai**31410-440(s):04pltoot000vtkkoCI-04idd all preparato1 and',itototo4L'actt*ity:*.k.1*Onle spent in actual,',00:**11:t0:4204.oftiófaia. 1de-0161fia. #04041:otrieeifiy.,ot-, 045-loyoe(s) o. 0:4404 or the employee( ) or gettiborti)of Congress that were otitac, , J*01.0k*hether.9t;Pcli...4:.c0W044 tiott sheet(s) 4ttgehed.,-., 16)nieteiti6i#g official and datethglatirA*Prilith. 1:**Ottito title and Public reporting burdPITOrcftvplioptiowalotorittuildi Is est1matdlo average 30•tolittit4 not iresponse, naatitio time tbr teviewjjerl§frOkm4.0,0todoo 0-.ittstbig data sources,ggthe4t404, In40-4:44 the data.needed,.and•tethileti#:wand 170:101*.all*Oittoitottof formation. end comments'AV:01#$ the hooka•orti:ittoe:3*,4tly.,other aspect o1 eii ..4611:40.00:: information, 010.144104 suggestignafor ire:OW1v, this 1,400.0, its the Office of-1400igotoot andRudge 0.4.0.twoktiteikottooli.tojett(0.48.44.4 NVaititoof.00010,40,.._$6i, #1.'-gtOet0te on this proposal Iort40 0.04erVIIAIOt tteOtillt01004148,9$of the:411007 eardotrak that the foregoing, questionnaire and statements" Moto Contract Code Ssettioot tQI62, 10232 Mii110285.1 are true:mid correct And that the bidder has compliedloth the requk*40-04o ectzni;kta fof thd-,•Fait EthAVITtent and kf0410$tOttittittSibti Regulations (Ch4Ptde5 Titia2 ofthoVelifom:4-80.edoreitIme 064.0..„ • • -• EXHIBIT FEDERAL LOBBYING RESTRICTIONS .:$0000 1352,Title 31, United Sit;:*g.:.00defrtshillits Federal funds from being expended by the recipient or any lower tier subreci0011t of a Federal-aid,contract to pay for any.person for influencing or attemptingl to influence :a: Federal agency or Congress, in connection with,.,.the otattlitio,,bizarlyTed0414j0 contractilhe3.:inalt4 of Federal grant or hIgnijortiwedteritv into of any operaii*.eagoehierit, , .„. . If anY'fat:14&otherthanTederal,funds liaye haanva,Kfortho same popooirtconnOotign With this Pe4ral4i4;contraOt,i,tha'redipitnt Shalt StibMitiah20x0.0te.cltorOgatio and,if required,submit. , . completed displosoraformaspart orthomd4nomonts, kvertiftc*Qh,for,.Federal-aid'0fitruti*****gfPaYment"afallOt4;riobby.'Citsfigres ora Federal; agency included in the Proposal. Standard Form "Disclosure of Lobbying With instructions fOrg9411414;wg47:*0.$tandartikeriifts araiiinehg4ktf.kp.-Vreposat:goi*tho Proposal ihaltenn4ittittiignature,nithe.certigeacinn, The above referenced ccrtific400041441$0104.4it,'OflOblv.iiit activities shall be included in each siihcoltraot and any lower-tier contracts exceeding $00,00. All disclosure forms, but not certifications,shall be forwarded from received by the Engineer..: The Contractor, subcontractors and leweNtier contractors shall file a disclosure form et the end of each calendar quarter in which there occurs any event that tdrinirea disclosure,or that ITrAtetiolly'Oec$':,the ae.OutacYatbe-intetlettett cOnt4fne004113r4.1$0ToaUtfeterni previously fPed by the Contractor,anbcOnfraCtersand:aiirlower-tier contractors. thatlnateriallyiffeats the accuracy of the information reported nOlirlOst 1) A cumulative increase if:$15;00ott...;iiitite in the amount paid or expected to be paid for influencing or-4,tqmPtiAttqinthlehoo:,a•;100vood Federal-action;or ::2;) A change.tm-th person(4,q b1.0444(01.4fltieneingorattemptingftw'influence a covered Federal action; A change in the-effiee:04ttriPloYeesiMi or Member(s) contacted ta influence or attempt to*fitionM4 covered Federal c40' Surety Group It TOKIO MARINE 601 S Figueroa Street,Suite 700 kii:L.‘' H C C Los Angeles,CA 90017 USA Tel:310-649-0990 Bond Number: BB2021846 BID BOND KNOW ALL PERSONS BY THESE PRESENTS: That we, Global Builders,Inc. (hereinafter called Principal), as Principal, and American Contractors Indemnity Company , a corporation organized and existing under the laws of California , (hereinafter called Surety) as Surety,are held and firmly bound unto City of Huntington Beach (hereinafter called Obligee) as Obligee, in the penal sum of Ten percent(10 %) of amount bid not to exceed Sixteen Thousand Five Hundred&00/100 Dollars ($16,500.00 ) for, the payment of which the Principal and the Surety bind themselves, their heirs, executors, administrators, successors and assigns,jointly and severally,firmly by these presents. • THE CONDITION OF THIS OBLIGATION IS SUCH,That,whereas the Principal has submitted or is about to submit a proposal to the Obligee on a contract for Central Library Lower Level Restroom ADA Improvements • . NOW, THEREFORE, if the said contract be awarded to the Principal and the Principal shall, within such time as may be specified, enter into the contract in writing,then this obligation shall be void. If the Principal shall fail to do so,then the undersigned shall pay the obligee the damages which the obligee may suffer by reason of such failure up to and not exceeding the penal sum of the bond. Signed and sealed this 18th day of August , 2023 , Principal: Global Builde .,Inc. By: LJ.- Surety: _American ractors Indemnity Company By: . . Eric J.Fedors Attorney-In-Fact ' • Any claims under this bond may be addressed to the Surety at the following address: American Contractors Indemnity Company 801 South Figueroa Street,Suite 700 Los Angeles,CA 90017 Attention: Eric J.Fedors • Tel: (310)649-0990 E-mail: EFedors@tmhcc.com HCCSZZA BIDBOND 7/2017 Page 1 of 1 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORNIA COUNTY OF SACRAMENTO } On_2U /13before me , NHUNG H. SAEPHAN Notary Public, Oat (here insert name) personally appeared Eric J. Fedors 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/heF/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. *- NHUNG H. SAEPHAN ( "Br NOTB PURL?2317 RNIA L) J SACRAMCNTO CO2UNTY 33 <iF°PN COMM.EXPIRES DEC,lA,2023-` Signature: (Seal) OPTIONAL INFORMATION Description of Attached Document Title or Type of Document: Number of Pages: Document Date: Other: • TOKIO MARINE k1116-61114' HCC POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That American Contractors Indemnity Company of the State of California,a California corporation, does hereby appoint, ERIC J FEDORS its true and lawful Attorney-in-Fact, with full authority to execute on its behalf bond number BB2021846 'issued in the course of its business and to bind the Company thereby, in an amount not to exceed Three million and 00/100 ( $3,000,000.00 ). This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the Board of Directors of AMERICAN CONTRACTORS INDEMNITY COMPANY at a meeting duly called and held on the 1n day of September,2011. Be it Resolved,that the President, any Vice-President,any Assistant Vice-President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorneys)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney-in-Fact may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts, and any and all notices and documents canceling or terminating the Company's liability thereunder,and any such instruments so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached." The Attorney-in-Fact named above may be an agent or a broker of the Company.The granting of this Power of Attorney is specific to this bond and does not indicate whether the Attorney-in-Fact is or is not an appointed agent of the Company. IN WITNESS WHEREOF, American Contractors IndemniLRrompany has caused its seal to be affixed hereto and executed by its President on this 18th day of April,2022. �o�a�PPCTOgs��i, ot•. •;io% AMERICAN CONT CTORS INDEMNITY COMPANY e:; . . U f INCORPORATED i-1= A 2I SEPT.25,1999 i"CS BY' Ada S. Pessin, President A Notary Public or other officer completing this certificate V 'Wlies 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 this 18th day of April,2022,before me,Sonia O.Carrejo,a notary public,personally appeared Adam S.Pessin,President of American Contractors Indemnity Company,who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person,or the entity upon behalf of which the person acted,executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of CALIFORNIA that the foregoing paragraph is true and correct. WITNESS myhand and official seal; soNiA0.CARRE3o Notary Public-California Los Angeles County Signature ,.'(I . I I (seal) 7 ,�v;. Coos Angeles s County 0 [- 7 My Comm.Expires Ayr 2_016 I,Kio Lo,Assistant Secretary of American Contractors Indemnity Company,do hereby certify that the Power of Attorney and the resolution adopted by the Board of Directors of said Company as set forth above, are true and correct transcripts thereof and that neither the said Power of Attorney nor the resolution have been revoked and they are now in full force end effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seals of said Companies at Los Angeles, California this 18th day of August 2023 „own 1117/1/1��i .. ........ :..... .: \;co:• :ors Bond No. BB2021846 a,' Z Gf7 Agency No. 4596 INCORPORATED '' Kio Lo,Assist-M-ecreta 2% SEPT.25,1999 rY Visit tmhcc.com/surety for more informatior°jr��A,;F�R;�"" HCCSOZZPOAACIC07/2023 TOKIO MARINE HCC ' Fraud Warnings and Privacy Notice Fraud Warnings Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. 'APPLICABLE IN ALABAMA Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or who knowingly presents false information in an application for insurance is guilty of a crime and may be subject to restitution, fines or confinement in prison, or any combination thereof. APPLICABLE IN ARKANSAS, LOUISIANA AND WEST VIRGINIA Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. APPLICABLE IN CALIFORNIA For your protection California law requires the following to appear on this form. Any person who knowingly presents false or fraudulent information to obtain or amend insurance coverage or to make a claim for the payment of a loss is guilty of a crime . and may be subject to fines and confinement in state prison. APPLICABLE IN COLORADO It is unlawful to knowingly provide false,incomplete,or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment,fines, denial of insurance, and civil damages.Any insurance company or agent of an insurance company who knowingly provides false, incomplete, or misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a settlement of award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies. APPLICABLE IN THE DISTRICT OF COLUMBIA WARNING: It is a crime to provide false or misleading information to an insurer for the purpose of defrauding the insurer or any other person. Penalties include imprisonment and/or fines. In addition, an insurer may deny insurance benefits, if false information materially related to a claim was provided by the applicant. APPLICABLE IN FLORIDA Any person who knowingly and with intent to injure,defraud,or deceive any insurer files a statement of claim or an application containing any false,incomplete,or misleading information is guilty of a felony of the third degree. APPLICABLE IN HAWAII For your protection, Hawaii law requires you to be informed that presenting a fraudulent claim for payment of a loss or benefit is a crime punishable by fines or imprisonment,or both. APPLICABLE IN KANSAS Any person who, knowingly and with intent to defraud, presents, causes to be presented or prepares with knowledge or belief that it will be presented to or by an insurer,purported insurer,broker or any agent thereof,any written statement as part of,or in support of, an application for the issuance of, or the rating of an insurance policy for personal or commercial insurance, or a claim for payment or other benefit pursuant to an insurance policy for commercial or personal insurance which such person knows to contain materially false information concerning any fact material thereto; or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act. APPLICABLE IN KENTUCKY Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance containing any materially false information or conceals,for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act,which is a crime. APPLICABLE IN MAINE It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties may include imprisonment,fines or denial of insurance benefits. TM HCCZZM_FRAUDPRI VACY01/2023 TOKIO MARINE H C C Fraud Warnings and Privacy Notice , APPLICABLE IN MARYLAND Any person who knowingly or willfully presents a false or fraudulent claim for payment of a loss or benefit or who knowingly or willfully presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. APPLICABLE IN MINNESOTA Any person who files a claim with intent to defraud or helps commit a fraud against an insurer is guilty of a crime. APPLICABLE IN NEW JERSEY Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties. APPLICABLE IN OHIO Any person who,with intent to defraud or knowing that he/she is facilitating a fraud against an insurer,submits an application or files a claim containing a false or deception statement is guilty of insurance fraud. APPLICABLE IN OKLAHOMA WARNING: Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any false, incomplete or misleading information is guilty of a felony. APPLICABLE IN OREGON Material misstatements, misrepresentations, omissions or concealments by an insured that are fraudulent or material to the insurance contract, the risk assumed, or the interests of an.insurer and are relied upon by an insurer may result in policy rescission,cancellation,or denial of claim. APPLICABLE IN TENNESSEE,VIRGINIA AND WASHINGTON It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company.Penalties include imprisonment,fines or denial of insurance benefits. APPLICABLE IN VERMONT Any person who knowingly presents a false statement in an application for insurance may be guilty of a criminal offense and subject to penalties under state law. NOTICE TO NEW YORK APPLICANTS: . Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act,which is a crime, and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation. TMHCCZZM_FRAUDPRIVACY012023 Rev.January 1,2023 FACTS WHAT DOES TOKIO MARINE HCC DO WITH YOUR PERSONAL INFORMATION? Financial companies choose how they share your personal information. Federal law gives consumers the right to limit some but not all sharing. Federal law also requires us to tell you „; how we collect, share, and protect your personal information. Please read this notice carefully to , % r; understand what we do. The types of personal information we collect and share depend on the product or service you have with us.This information may include: ' f, . Account and transaction information; ti ■ Contact and demographic information; ;R- ■ Financial information; ` • Claims information; and ■ Credit histo nter ry_ ° All financial companies need to share customers' personal information to run their everyday business. In the section below,we list the reasons financial companies can share their customers' personal information;the reasons Tokio Marine HCC chooses to share; and whether x you can limit this sharing. 1" -lush v��c I.e on • ) o a e D s' , 0 s� 0 2 '^ my p I - For our everyday business purposes— j such as to process your transactions, maintain your account(s), respond to court orders and Yes No legal investigations, or report to credit bureaus For our marketing purposes— j to offer our products and services to you j Yes No I For joint marketing with other financial i ! i _.._ Yes —__ No companies � �__—_.____ I For our affiliates'everyday business purposes— information about your transactions and experiences Yes I No l I For our affiliates'everyday business purposes— ! information about your creditworthiness Yes Yes I For our affiliates to market to you Yes i Yes CFor nonaffiliates to market to you I INo N/A .� i 4, • Call (888) 688-0775—our menu will prompt you through your choice(s). `" ■ Email us online:privacvpolicv a(�tmhcc.com. Please note: When you are no longer our customer,we continue to share your information as described in this notice. itiOleVittigrai�,, However, you can contact us at any time to limit our sharing. s. Ar `s , Call (888) 688-0775 or send us an email at privacvpolicy(a.tmhcc.com. TM HCCSZZPRIVACYNOTICE012023 Page 2 , J� fY 55�wW S g„k id r3F i C4 µ'8��"�f^o-nk�p .$�`: ".Q A ., yfyr ,.4, d kffi:✓6 e6x. ;MPo., - -t »ct. 'rw P ., . . ., ,, la d -. rr , y.,h.,, '� r 'f F�k:r Who is providing this notice? I Tokio Marine HCC is the trading name of HCC Insurance Holdings, Inc. I i How does Tokio Marine HCC protect my I To protect your personal information from unauthorized access I personal information? ' and use,we maintain reasonable administrative,technical and physical safeguards designed to protect your personal information 3 against accidental, unlawful or unauthorized destruction, loss, 1 alteration, access, disclosure or use. � How does Tokio Marine HCC collect my We collect your personal information, for example, when you: personal information? ■ Sign up for and use our services, including when you choose to provide us with your information online or offline; • Interact with our website and mobile applications; j j • Obtain an insurance product from us through a broker,where we 1 1 may collect personal information from your broker in order to prepare your quote and/or your insurance policy; and/or • Submit an insurance claim, so we can properly handle your claim. • j i We may also collect your personal information from others, such as credit bureaus, affiliates, or other companies. ______ --____ . Why can't I limit all sharing? Federal law gives you the right to limit only: • sharing for affiliates' everyday business purposes—information ' 1 about your creditworthiness; I • affiliates from using your information to market to you;and • sharing for nonaffiliates to market to you. 1 State laws and individual companies may give you additional rights to 3 limit sharing. y 1 What happens when I limit sharing j Your choices will apply to everyone on your account. , for an account I hold jointly with . someone else? 1 36* 1° - -T q, C ,may F k ..,.,k� a � , ,- . M�'Sa.:�. ... .� x`�nl��.h,�Sba3:S. v �x ,af'�E.,t:.� d ���. '1P � d ::�,� ,. `4 . Affiliates Companies related by common ownership or control. They can be ' financial and nonfinancial companies. ; ▪ Our affiliates include our family of companies, available at https://www.tokiomarinehd.com/en/company/about/group.html. I Nonaffiliates ' Companies not related by common ownership or control.They can be financial and nonfinancial companies. i i I i ' Joint marketing ± A formal agreement between nonaffiliated financial companies that 1 1 together market financial products or services to you. • ■ Our joint marketing partners include categories of companies such as insurance companies. For more information, please review our privacy policy, located at https://www.tmhcc.com/en-us/legal/privacv-policy. 1 1 I I TMHCCSZZPRIVACYNOTICE01 f2023 t obdl 151MCWES Inc o Ho E boxvi Rvt sviit 205 Somata Ara Ca \t'Or 1olk azi 0 5 Off.‘c-ica aid BELAYMM 10o No-} o?tr 'I ro lac % Nerve. C.e veA L:b T Doty Lt.- 1 %e s't r000N AD t\ Vr yr e.n tS Cc- * % 165$c?)* d Ope,tioNi " oierc'• vc) s Z.Z i 20 23 2pr `� \�NTINGin City of Huntington Beach 0 is O �� a��ee,•• GC) va �U 2000 Main Street • Huntington Beach, CA 92648 tt, __- (714) 536-5227 • www.huntingtonbeachca.gov se�o� Office of the City Clerk 00 Robin Estanislau, City Clerk � uUNTI December 29, 2023 Kazoni, Inc. dba Kazoni Construction 150 Paularino Ave., Suite D160 Costa Mesa, CA 92626 RE: Central Library Lower Level Restroom ADA Improvements—CC No. 1658 Enclosed please find your original bid bond for CC No. 1658. Sincerely, 9•6/4441,1444) Robin Estanislau, CMC City Clerk RE:ds Enclosure Sister City: Anjo, Japan Pity/711c-, SECTION C PROPOSAL for the construction of CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS CC No. 1658 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 60 working days,starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications,Instructions to Bidders and all other contract documents.If this proposal is accepted for award,BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work,that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed.THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT.It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses,taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded,the AGENCY will reject all bids and will 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 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714)536-5431, Fax(714)374-1573 ADDENDUM NUMBER ONE For CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS August 15,2023 Notice to All Bidders: Please note the following clarifications to the Project Plans,Specifications,and Special Provisions. 1) The updated wage determination dated 8/11/23 has been attached herein. This replaces the wage determination found in Appendix G of the project speafications. This is to acknowledge receipt and review of Addendum Number One,dated August 15,2023. Kazoni Inc dba Kazoni Construction April Kulpinski, President Company Name By 8/22/2023 Date 1 of 1 of Addendum No.1 Zf awarded the Contract,ft undersigned agrees that Yn the event of the BIDDER'S default in executingthe equired contractand f: ng the necessary bonds andinsurance certificates' within Lb Wo kin g da after the date of the AG C.Y'S n ;ofotice award of contract.to the Bipp,R.XTttie proceeds�ofthe security accompariymgthis bid shall become the property€tf the AGENCY'and this bid and"the acceptance hereof may,at the AGENCY'S option, be consilered'nuli anduoid, Accompanying is proposal of bid,find Bid Bond um the arboount of"10% winchsaid amountis uot.less than-l4 o of the ag regateofthe.total hid price,as required by the Notice Inviting Sealed OR,ELECTR01I1.G Btds,.payable to the>AGENCY (PleaSe,insert the words"Cash","Certified Cheek",or"Brdder'sBond fbr1{1' " as the case;rnay be);Ainy standard Surety Bid Bond;forin iaacceptable. Bidder shalt signify receipt of Alt Addenda here,,fang !ArtdendreEYo._. .T''t-Date,Recexve City of Huntington Beach Line Items for Project Central Library Lower Level Restrooms ADA Improvements (CC-1658) Issued on 07/24/2023 Bid Due on August 22, 2023 2:00 PM (PDT) Exported on 07/26/2023 Item Item - Unit of Num Section Code Item Description - Measure Quantity Reference Unit Price 1 Section 1 1 Mobilization LS 1 $25,000.00 2 Section 1 2 Construction Waste Management LS 1 $77,000.00 3 Section 1 3 Closeout LS 1 $20,000.00 4 Section 1 4 Demolition LS 1 $23,000.00 5 Section 1 5 Abatement LS 1 $10,000.00 6 Section 1 6 Concrete and Reinforcement LS 1 $ 12,000.00 7 Section 1 7 Casework/Countertop LS 1 $8,000.00 8 Section 1 8 Blanket Insulation LS 1 $2,510.00 9 Section 1 9 Joint Sealants LS 1 $2,500.00 - 10 Section 1 10 Aluminum Door Frames LS 1 $6,000.00 11 Section 1 11 Wood Doors LS 1 $3,000.00 12 Section 1 12 Access Doors and Frames LS 1 $6,000.00 13 Section 1 13 Door Hardware LS 1 $7,000.00 14 Section 1 14 Glazing/Mirror LS 1 $800.00 15 Section 1 15 Gypsum Board LS 1 $7,500.00 16 Section 1 16 Metal Stud Framing LS 1 $7,400.00 17 Section 1 17 Porcelain Tile Floor Finishing LS 1 $ 13,000.00 18 Section 1 18 Porcelain Tile Wall Finishing LS 1 $25,000.00 19 Section 1 19 Painting LS 1 $4,000.00 20 Section 1 20 Signage LS 1 $1,000.00 21 Section 1 21 Toilet Accessories LS 1 $9,000,00 22 Section 1 22 Plumbing LS 1 $49,000.00 23 Section 1 23 Mechanical LS 1 $16,000.00 24 Section 1 24 Electrical LS 1 $20,000.00 Total in Words: Three hundred fifty four thousand seven hundred ten dollards and 00/cents NOTES: The estimated quantities listed in the Proposal Bid Sheets are approximate and are to be used only as comparison of bids.Payment for quantities will be made from field measurements.If the actual quantities show either an increase or decrease from the quantities given in the Proposal Bid Sheet,the Contract Unit Prices will prevail.Full compensation will be paid at the contract price for the actual work completed,and no additional compensation will be allowed therefor.Payment will not be made for materials wasted or disposed of in a manner not called for under the Contract;this includes rejected material not unloaded from vehicles and material rejected after it has been placed.No compensation will be allowed for disposing of rejected or excess material.The City reserves the right to reject all bids and to increase or decrease the amount of any quantity shown on the Proposal Bid Sheets.In case of a variation between the unit price and the totals shown by the bidder,the unit price will be considered to be the bid. Compensation for items of work not specifically identified in these bid items shall include all labor,materials,tools,equipment,safety measures,and supervision required to complete the work to grades and dimensions shown on the Plans or staked in the field.There shall be no compensation except for the bid items specified in the Proposal.The cost of all work shown in the Plans and Specifications but not specifically identified as a bid item or described within a bid item shall be included in related bid items,and no additional compensation shall become due the Contractor by nature of compliance with the Plans and Specifications. C-2.2 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Bid Name and Address of State Class DIR PWC Dollar %of Item(s) Subcontractor License Registration# Amount Contract Number 4 KARCHER ENVIRONMENTAL,INC. gE481416 1000007940 532,600.00 10.60% 5 19 Paint Blast US 1084260 C33 1000853906 $2,600.00 0.8% C17 10 VERNS GLASS CO LLC 1043213 1000063692 $8,822.28 2.85% SO CAL ELECTRIC COMPANY 910902 1000033604 24 C10 $14,570.36 4.75% CONTINENTAL MARBLE C54 18 19 AND TILE COMPANY 394 1000002594 $36.509.00 11.80% 22 517012 C36 COMBS COMPANY 8.90% PLUMBING INC 1000027354 $27500.00 21 YTI ENTERPRISES INC. C61 830286 1000005750 $8,300.00 2.68% 16 T-WALL ENTERPRISES, INC. C9 17 926261 1000004574 $14,674.00 4.75/o 0 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 . NON()NCO. AFI,I.I/ T T BEE CUTED BY BIDDDER AND L �I TED .I 'Hr.BID • . _` i declare under penalty of perjury under;the laws of the State of California that the;foregoing is true.and corre '' • ' ' .. „. ct a trthat,th s declara:tion„isexec led on 81 at Costa MesaF ,CA • • ... 01e: , ,State Apnt kilipitio ; ,ban first.duly sworn,depssoe and says;that he or she is Presidents - pfKazoni Ic adba Kazon Constrictionthe party makinng.the: . fore afng•bd'#hat the bid is not made in t• he•interest of,or on the behalf of,any ttndtsciased person, partnership,.ycor parry, association, organization;or corporation, that the bid is genuine and not collusive or"sharii,that the bidder has•not directly orr indir ctly,ii 0.20,d �r solicited:an otlher bidder" o. to put in a use or sham hid,and has,not dii ctly or indirectly colluit4 conspired,;connived.. or agreed w•ith. ny bidde4.ror anyon444:e else t6 put.in,a.,sham bid,or thatanyene shall.i`eefrain from bi ding • _ � �, thatthe bidder has'not in any:manner,directly or:indirectly soughtby agreement,cointniinication,. or conference will anyone to fix the, bid price, or that of,a iy o!t aer`bidder, or secure any . .. 4. advantage against th public body awarding ttie contract of anyone interested£�in the proposed contract that all.statements contained in the bid are true, anti,d, further,that the balder,has not, _ . directly or>rndirectIy, submni ed.,his..di her bid,price or any breakdo vn thereof, or the`contents thereof,.or divulged information;;:or,data relative thereto, oc':paid, and,will.not • a fee to an p y ' corporation,:partnership,company•assoctatioii,organization,.bid degository,,or to any member or agent thereof to effectuate"a collusive or sharn�.bt4, Ktitte• ni�nB tila az lni Construction April Kufpinsfsi,P ': i:ri :t • Signature of Bid;, 150 Paufarino Ave;�,D�t60,-,Costa:Mesa,CA'92926 _ lddiess cif Bidder Cat, UTILITY AREEIONT HONOR ►B ,MAYO.R AlYD CITY'CQPINCn; CITY 00 0,19TII t-0,$agi,tM CALib .RIM A Gentlemen: The undersigned hereby promises,and agrees that in the perforrnarrce ofthe work specified in the contract, knOwnias.the CENTRAL LIBRARY LOWi Ei EYEL A 4 .IMP'ROYE TENTS (I)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to-work in proximity to any electrical secondary or trap n sssion:faciIrti s The-term "Qualifieded Person" is defiled in:Title 8,California Administrative Code,Section as foilnw "Qualified.Person . A person..who,by easarr.ef experience or instruction,isAmiliar with the operation:to he perfprrrred and the htteardt invvolved, The undersigned also promised and agrees that all such,work;shall be performed in accordance with:all applicable:electrical util"it} company's requirements„ .orders, and State of California Cal-0$IA requirements, The undersigned further promises and.agrees tl at.,the,provisions'herein shall be and are binding upon any..subcontractor ore subcontractors that may be retained or ezxployed;by the?undersigned; and-,-Mat the undersigned shall take steps as are necessary .to assure compliance by any said subcontractor or*heilntructors.with the:require rents contained herein. Kazonr.lnc dba_�azorn Construobon Coitractor Bj? President. Title rats 8/22 2023 c4; 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 0 No If the answer is yes,explain the circumstances in the space provided. • Note: This questionnaire constitutes a part of the Proposal,and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION:INSURANCE CERTIFICATE Pursuantto ection 18 .I.oftheStateLaborCode eaehcc tractorto'vhorn.apublicworkscontraet has been awarded shall sign the followirzgcertifiate [ am aware of to provisions,of Section 370G of the Labor Code which require every employer to be insure u ainst liability for Worker's eomper satiop or to Undertake Self' insurance in accordance with the proursians of that.code, and I will,comply with such provisions=i efore,commencing the perfo mance;,of the work of this contract.. Kazoni incdba,Kazoni Construction Contractor By President Title Date:8i22023: • C7 BII)1►ER'S INFORIVIATION , ' BIDDER certifies that the following information is true;and correct: Kazoni inc dba i Construction,,, Bidder Katie , : 150 Waulanno Ave D160 - Busness address Costa Mesa CA �y ,92626"-.. City, State; dip ( 714 ),.. 882'1,088 .. .3 ape iCc>?kazoni=inc.com ; Tele honeNumber mail Address P 3 974982 Ctass.A,:E : StateContractort fl e No:and Class �� to erns., 07116/20/2 r Original Datefssaued 0713112024'_ Expiration Date , 'l"he*Ork site was inspe ed by of our office on w : ,"20 The following are persons;firms,and corporations Navin a prncipalnterest rn this proposal ApniKulprnslct Keith Ktilpinski A . ". - The bttdersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, .` ftnar rutty or otherwise, to perform the eor et for the proposed work:and improvements >n. accordance itht plans.artd spectfcations n forth - icazorn itie dba Kazctni Construchen Company¢ Caine x , Signature of Bidri Apni Kr ipmskr Printed or Typed-Si attune p 1 r <N lTAR C..A.TE Subscribed and•sworn to bfure•me thrs ,day,:uf � Q . notar public,or other of•ficer cempletng this certtfxcate ue e-s only4 the;identity of t•l�e .. mdw�rdual.who signed>'thet document ac •t is certi£rcate `is tache , and nit• the,- - tcuthfulnees,accuracy,or validity ofthat d4curuent, State o :`: ) , . County of V' ark . ) Qn ...•-'3'•4.•'-''} =� before me, sl f t Mm Nc4 - .: rep . • onth b and°°Year Insert.l ame atnd'I itl I+T tart' :C' a . . personally appeared ,i I ? tintkt t::—. g . +Tame(s)cfiner(s,. who proved-to me.on the°bass cif satisfactory evidence to be;the per oa s whose name Ys ax • subscribed'to the within instrument and acknowledged to me that. .- ..- e hey executed the sane . . '�t nd thatb hi er e r si tun on theinstrument:the person or the entity upon::behalf'of r itch tl a persoi s)acted,ere uteri the instrument; T certify under P) tL'I Y OF PER L RY under the laws;off'the State off'California that the t`or orn ara has true acid correcit, . ri 4 ru'tttov, cauo I ES 'my hand and official weal: taiitornta r . ... .(,), County mission 24t741 M Comm Iris tcC t1,2i)2i4 -Signature Sign F re ofatary public T.ACE NQP3�SEAL ABQYE ` - - .:9 Bidder's Project History For the purposes of this project the contractor and subcontractor must have, in the last five years, constructed at least five (5) projects of similar work specifically referencing the construction of (Describe specific work and experience necessary for project,for example"Reconstruction or rehabilitation of existing public use facilities". Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. The following list of projects meet the requirements of above: 1. PLEASE SEE ATTACHED LIST Name and Address of Reference Name and Telephone No.of Owner: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 2. Name and Address of Reference Name and Telephone No.of Owner. Contract Amount Type of Work Date Completed Provide additional project description to show similarwork: 3. Name and Address of Reference Name and Telephone No.of Owner: Contract Amount Type of Work Date Completed Provide additional project description to show similarwork: C-10 4. Name and Address of Reference Name and Telephone No.of Owner: Contract Amount Type of Work Date Completed Provide additional project description to show similarwork: 5. Name and Address of Reference Name and Telephone No.of Owner: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: C-11 . .. ... .. : KAZONI�•:INC,:DBA KAZONI'CO.NSTRUCTION- , • - :Project:List • • • • • *PUBLIC WORKS N P Project Name • Project Value r�mpletloo 'Owner Architect Description Customer Contact Project Location Ending Value.. Untvenity of CA Asset Managment..: CCv1-vvessw000zenrernurt � � ... Omar Newland 12/15/2022 •Department Parking $159,427.00 Make existing accessible parking compliant by restitping accessible Jennie Redner 10920 Wilshire Blvd.Suite 815 Los Angeles,CA 924 Westwooc HIvo-LDS Angeles, parking spaces IN progress'90024 • CA - • ... .. .. 213-309-1499 10/24/2022 . V5Ff MTetropoiTan SNF tiWg-ROparr J.C.Chang&Associates,Inc. Repairing water damaged ceiling,including reinstalling acoustic Department of General Services ' Project $2,877,826.00 ceiling system,patch and repair wall,painting,removing glazing at Debbie Wohiford • iw trim bi.wes 5atfamento,LA door transom and inMM with fire resistant panels. IN.progress 95605 11401 Bloomfield Ave.Norwalk.CA 90650 916-696-1007 'Costa mega Police department Gillis&Panithapdn Architects, 10/24/2022 City of Costa Mesa • Indoor flange Project $1,931,076.77 Inc Indoor Firing Range Remodel Bobby Fouladl ';IN progress 99 Falr Dr.Costa Mesa,CA 92626 77 Fair Or.Costa Mesa,CA 92626 714-566-4152 8/30/2022 CroWn Castle USAinc, `Crown Castle $69,050.20 None Cheri James euuu tut pulate Lot Ldltuttwutg,rn Irvine Plant Wall Renovations;Remove the existing live ..12110/2022.15317 200 Spectrum Suite 1800 Irvine,CA92618 walls,repair wails and Install new wall covering 832-301-1982 -: Saddleback HS CTE Digital Media.Lab BPI $1,995,775.00 WestGroup Designs-Michael Selective demo of nun-bearing Interior partitions and related This Rubatcabe(Bern/lidsMP 05/06/22 Santa Ana Unified School Dittrtet. Cecconi finishes and equipment to accommodate a new CTE digital media PMI .6/12/2023? 1601 East Chestnut Ave.Santa Ana,CA*92701 28025 Flower St•Santa•Ana,CA92707 9.494504880 studio. 818-294-3373 university or[AwssetManagment.. ,iIltUt1BUMeaiCaTPlazaAUA Kit Upgtaae $311,613.00 ADA Restroom'upgrades Jennie Redner MP 6/1/2022 Depart • 'Department ' . . 4th&7th Floors 64North Architecture,Ltd-719 N ':10920.wriemre Blvd:Suite 1115 Los Angeles,CA $422,596.12 Fairfax Ave.NC Los Angela,CA 213-309-1499 IN progress 90024 100.Medkal Center.Plaza,Los Angeles,CA . .... 90049 • NTP uclACont,racts Ailininistration':• MP200 ORS 9 8.10'A/V Upgrades $156;633 00 Sabin-Ha,te Architects-Jeff Sobin Audio visual System upgrade and Integration Jacqueline Raves 05/09/2022 IN progresi•.:1060 Veteran Ave.University of CA Los 200 OCLA Medical Plaza,los Angeles,CA 1635 Pontius Ave.Los Angeles,CA 310•125.4072 Angeles.CA 90095 90095 90025 Luno Architecture Interiors 3104189- Luxury'Retall Tenant Improvement 3/8/2022 Essequattro SPA Technogym LA Boutique $ 38,973.85 Valentina Lurch'+39 0444 41 7772 Noel Fedosh • .4/8/2023 Via Del LavoroN.8-36040Grlsignanodi2131'N.Robertson,Bevere/HUB,CA90211 $. 94,998•58 noel@lunodesignswdlo.com 8669 MP Civie•Recreational•IndusMal Authoilty(Ci11Ai::'EXPO Center.Avalon Room 51,539,899.0a p yuiis ayton@Isdgl.com • Update aheMechanical;Electrical and Plumbing system of the Gerry Perez(CNC 02/10/2022 Improvements Rebid IDS Group Avalon Room only,Including paving a ADA path EnxlneednRl 7/16 023 15625 Mayor Dave Way,City of Industry,CA 16200 Temple Ave.City of Industry,CA $1;904,460.70 626-945-0527 cell /2 91744 90744 YuOs Ayton 999 387-8500 ext 189 goerez[sscnc-eng.com NTP tleiA-Acset Mana ement $369,663A0 Chemotherapy drug mixing room Inside medical office building Jay llurlan-320-538.9638 01/27/2022_ 8 Dept ''' 19950 ginaldi Suite 310 TI GP Architecture,Inc-5301 N cell •10920 Wilshire Blvd.Suite 815,Los Angeles,CA 19950 Rlnaldi Street,Porter Ranch,CA Commerce Ave.ND Moorpark,CA 6/1/2023 90024 91326 &38q,933:OD• 93021 Jxurian@mednet.uda.edu Jan 2022 Dux interiors,Inc ouxlatma(WeHol $680,934.00 Studio Como•Inren Perry 316-371- Ti of retail space Douglas thee 133 N.Robertson Blvd.West Hollywood, $699,644.23.' : 5Z82• 619-318.2472 6/1/2023 235 E.58th St.New York,NY 10022 [A90049 iwen@Studkx0modestgn.com ,+.. }.1. •y 1 Ty..: d. T,cJ..0 i4. `-.l:::k ,.Z: 4..•:. ,.A.,:).,•.. r ram. .4. fa•- �.�- ,,r 4 �^f.• ; tic' yy� �,�,+j, t..."y�l' .��^�' y�l�•y :7yy.s.. ,9 Y` •cs:=S.,• �:k.�i:. v,;4y'��. ^e=.,- r�. �1"�;?"` H. fS• '.ki- iY fl ) ' " '.Vii*'t'`,. q ?.,'3 ,0:9 `-iti i' _� -•?:r g Js4YA: <- '�f. s.•• �' ,,- �P�' e F �;,? t ' I�y� 1 '1 S2 87058 �.; � :.. �• '..•: �,'.•'��';r. r • ,.. •'!i',[ -.�i t i`.'. �{�T ••"}:�.�... j�{� �t �r ,er a � ( •. rt' f 1'9?�w ..x,�C. .r '��t:. :�:.�#. ..•�r..'•' ��:¢:::%,. t .3..e *l�i��a t;..J••. . . .•�;�� ..`}'r�"'-�a'`l=.�.:.;x:qz: ,,�.F,;�•.... .��...,{� �,r�:Fi;' 4?' ' ,-`•. s ;.n..:-'-•.'..i�7>:^...;Y.:. ir....-• ._ �, ,: :�...�Ay^ e .r. :��?}.";.,:,. �F :C:!,'v..c..•:.,A�+ f'�; + .)•:''•� .''�5��:: ':•�.a� "}, ..�e._. .. . , .. . . ::L. Cr�..r ... ... ..f r 01/11/2021 Uncoln PropertyCoompany Echo Hospice 530,032.00 None New finishes In suite Jeff DuChateau 03/31/2021 9j 01 ova Ste 1600,Newport Beach,CA 660 765 The City Drive Orange,CA 92868 527,97234 949 558-0617 Haverty Vista School Site Modifications $2,147,547.00 Scope of Work: 'and Enhancemunls Package No.2 Restroom upgrades,new drinking fountains;new Lance Blair(818)521-2606 03/01/2021.BeverlyHilk Udified SchoolAlstdcC WA Architens Dean Hawkins(714)9 PE lockers,new light fixtures and installation of new mechanical 11/19/2021 255 South Lasky Drive Beverly Hills,90212 •200 S.Elm Dr;Beverly Hills,CA 90212 $2,440,86091 system for locker room and MPR. Jance.hlalr(fi)va nn.t:rt nx NTP 3/8/2021 Department of General Services CA Science Center Phase 1 ADA Elevator $1,284,386.00 181 Group 213-769-0011 Scope of work Includes tenant Improvements of existing Roland Allnea 916.247.0126 conference room,modifications to the visitor/reception area and -'IN progreis!;700 Third SC Wes Sacramento,CA 95605 •700 ExpositIon Park Dr.Los Angeles,CA $1,635,731.24 Installation of new ADA elevator. jtoland.Allneat®das.ca.Rov ... 90037 Angela Ban $413,532J10 • • retrofit of pedestrian-corridor In the Center for Health Sciences Fernando De La Torre NTP 9/6/2021 Uhiversity0 f CA Asset.ManagmenP.Department CHS B level Su:U SA:1y Corridor The Neiman Group Building for pedestrian safety 760 Westwood Plata,Los Angeles,CA $456,050.00 310-562.7151 03/04/2022 10920 Wilshire Blvd.Suke 815 Los Angeles,CA' 24 cneiman@theneknangroup.ne NIP S2,757,079.33 Our portion of work Includes the General package Includes security David Joseph 10/11/2021 Santa Ana UnfledScheel District Jefferson ES increment 2 Morrissey Associates,Inc fencing,playground equipment,specialty operable wall systems, IN prograu,`1601 East Chestnut Ave Santa Ana CA 92701 1522 West Adams St.Santa Ana,CA elevator,and eft 909-376-1462 92704 714 836 6137 12/14/2021 Equlnlx LAI Security Glass Replacement $13,517.00 None Security Glass replacement Maria Gut 12/31/2021 1920 E.Maple,El Segundo,CA 90245 600 W.7th St.Los Angeles,CA 90017 $13,517.00 213.270 7401 • Yt T• �XY�� 2� ��.�)x :-.]t2��, •�'4?.•f ••2 i! ,-I!• t.F•� ••4:��:. �Pr1i eels 6 ,�'v� �'. ,.. .N �i.. :r.;...-:,...,>- .\.,.: ( ,f+. .�` � :�., t • btal'•� (6�989`4�7aa:• .� W . , .n . .-,. .....:,v..�.q...�Y,i9A:�iGV�'Gw�....f.?�1'�i•:8{•c�.:,.l..ait s>,.�!+f:3`r;. J i ;.e'•s:phi:a:: ,1'y . ..i ,.. .I .Q. etc _e::,�.. �.:\ .t.ea.. �S'si`.�w d:v � sJ,.l�.,1 t. .k. . _c.. ... .. _. .?S. �r• ."-.S .:. . _.. .. r'�vh ....... ..';'�}. - .:�..�_.., ti,-`•�w�F�';'-i'.ii�3.•v -i�':.r b."i. . 1/15/2020 Orange Canter Tower,LLC C/0 LPC West,INC.CareerstaffUnlimited $39,797.73 SAA•Jose Ruelas 310-743-B978 office Ti Rachel Watson 02/25/2020 95 6N8 State College Blvd Ste 730 Orange,CA 500 N.State College Blvd.Anaheim,CA • 539,797.73 Iroelas@saala.com 714.978 4525 1/35/2020 Lincoln Property Company West 14th Floor-Men'r8 Wunuat's Shower 925,607.27 Men and women's restroom remodel Nathan Morales Repair SAA-lose Ruelas 310443-8978 05/12/2020 915 Wilshire Blvd.a2050,Los Angeles,CA 915 Wilshire Blvd.Suite 950,Los Angeles, $25,607.27 truelas@saala.com 213-283.4904 90017 CA90017 03/31/2020 Cedars Sinai Medical Center MOB Cardiology Suite 200 5337,858A0 CSA.Daniel Ginger 2nd floor Ti medical office suite within existing Bldg•TOTAL 1,503 Brandon Allen S.F. 01/11/2021 200 N.Robertson R101,Beverly Hills,CA 90211 8501 Wilshire Blvd.Beverly Hills,CA $3T5;939.00 310-909.6836 310 385-3456 04/06/2020 Cedars Sinai Medical Center MOB-Suite 915 East Tower $19,999.71 None Install privacy glass at the reception and cheek out area counters. Brandon Allen Remove and replace the millwork et the coffee bar to 04/08/2020 201 N.Robertson 10101,Beverly Hills,CA 90211 8631 W.3rd SI.Los Angeles,CA 90048 $19,999.71 accommodate the water filter system and coffee machines 310-385.3456 NIP 02/28/20 Santa Ana Unified School Disrict . HenhtgerK-8Expansion S2,203,543.00 BakerNowickl Design Studio Mehdl Exterior site upgrades;Interior remodel for student and staff Albert Bolanos • Hetaveh 859-663.8933 restrooms;construction of new dance studio,music studio,°frees, albert.bolanosdasausd.us 01/15/21 1601 East Chestnut Ave.Santa Ana,CA 92701 417 Walnut St.Santa Ana,CA 92701 $2,251pj9•.46 MHelaveh@bndeslgnstudlo.com and reception. 714.788.8822 NTP 01/28/20 Cty of:lieverly Nils • 1945 La Clenega Remodel $1,547,309.00 KCK Architects Michael Morgan 310•Interior Improve to ground floor lobby and restrooms,new ADA Zara Farimanl-310.560 4483 455 N Rexford Dr.Room 290,Beverly Hell CA 1945 La Genege Blvd.Los Angeles,CA 31,69 2100 452-7505 restrooms on 1st floor and 2nd floor;upgrade elevator equip,new 02/25/2021 y0210 90D34 mk:hael@kckarchitects.com roof,rephce'S existing NVAC roof lop uMts;.new main electrical xfarlmam@tfalexander.com ju.. n.nA nan,JM�,Ae•nr,unl.y l.nnr..un,nnn,e•n.,,..MnNnn•m 2/26/2020 Essequattro SPA Tecltnogym S.P.A. $398,53117• Wno Architecture Interiors 310 889• Remodel of the Interior and exterior facade.63 days completion Valentina Luechl.39 0444 41 7772 Noel Fedosh originally.Orlgtnel completion 04/03/2020 COVID Hit 229 8669 21/05/20 Via Del Lavoro N.8-36040 Grls,gnano dl2o Co 131 N Robertson,Beverly Hills,CA 90211 $463,751.00 noel@lunodesIgnstudlo.com extentlon with competion 11/5/2020 (VI)Italy 09/29/2020 Cedars Sinai Medical Center CSMC a3272 MOT 1191W 8-1195W $457,858.00 TI for 11th floor medical office suite within existing medical office Brandon Allen CSA-Daniel Ginger Project 19-12 • Pro West 3rd St.Ste 1190W&1195W building.Scope Includes the two suites to be combined fora total 03/15/2021 200 N.Robertson ir101,Beverly Hills,CA 90211 S599AT6.85 .. g10 909.6816 sq ft of 4,073 all now construction. .310-385-3456 las Angeles.CA 90048 • Famished Marquees for Advanced $187,549.67 Install of owner furnished marquees at multiple locations in district Dennis Chavez 714-913-3839 10/28/2020 Santa Ana Unified School Mulct Learning Academy,Cesar Chavez High Uonakis-Klee Vo(949)955.1919 C1.4,.1.1..J•....4.•,..4..et... Ext.220 Hieu.Vo@llonaklt.com 02/26/2021 1601 East Chestnut Ave.Santa Ana,CA 92701 Multiple locations 5187,549.67 Dennis.Chave:@sausd.us ..T T _ u , • .�'.i 4� ..1..P��yy' . ..1 i�.'b tv � CGLS �. �:r•:. 11/15/2019 Orange Center Tower,LLC C/O LPC West,INC.Careerstaff Unlimited $39,79fi.73 Shimmer Al Gate Associates Renovation to the existing suite to accomodate new tenant Rachel Walton 02/25/20I0 SOON.State College Blvd.Ste 730 Orange,CA SOO N.State College Blvd.Orange.CA $39,795.73 949 724 8958 714478.4525 91868 92868 09/06/2019 Uncoln Property Company FLIGHT-Butane F Tenant Improvements $534.634'70 OKB Architecture&Construction Interior tenant Improvements of sprinktered office building Megan Crabtree 150 Peelarino Ave Suite 0182,Cosat Mesa 1785 Airship Ave.Building F,Tustin CA including finishes, new seUwchange Interior nonrated partition,ceilings, 03/30/2020 92626 92782 5589,076.40 Carmel Rodriguez 213.999.2os finishes,lighting.No change W existing re.slrooms;no change to 949-333.2116 06/14/2019 Orange Center Tower,LLC C/O LPC West,INC.Spec Suite 1400 5267,341.00 SAA-Jose Ruelas 310-743.8978 Renovation to existing suite to open up suite for leasing Rachel Walton 02/25/2020 SOO N.State College Blvd.Ste 730 Orange,CA SOO N.State College Blvd.Orange,CA $311,410.37 start date 7/15/2019 competon 9/10/2019 58 days 714-978.4525 92801 92868 Iruelas@saaia.com 08/21/19 Lincoln Property Company West Commercial Bank of California $108,B2B 02 SMA-Jose Ruelas 310-743.8978 Tenant Improvement to an existing office Nathan Morales 02/06/2020 915 Wilshire Blvd.e2050,Los Angeles,CA 915 Wltshlre Blvd.Suite 950,Los Angeles, $180.480.73 Iroelas@ieala.com Completion date 4/2/2010.total 226days 213-2834904 90017 ,CA 90017 06/18/2019 Lincoln Property Company West Empire-Suite 1054 $23,952.43 None ienant Improvement to an existlog 1100 sq ft suite Perris Moss 08/10/2019 9151 0 17 Ishhe Blvd 02050,Los Angeles,CA 360 N.Pacific Coast Hwy.El Segundo 523,952A3 310.3674536 NIP 2/4/19 Uncoln Property Company West BLDG 300 2nd Floor Spec Suites,Corridor $2,018,881.40 SAA-lose Ruelas 310 743 8978 TI of 5 spec suites,2nd floor common are upgrades with restrooms Perris Moss and Restroams to meet ADA.New elevator lobby lighting and finishes.Trades 03/03/2020 915 Wilshire Blvd.42050,las Angeles,CA 360 N.Sepulveda Blvd.Suite 1080,El $2,145,618,83310-367-9536 90017 Segundo.[A 90245 _ fruelas@saala.com Included:drywall/framing,millwork,doors/frames/hardware, 10/23/2019 Cedars Sinai Medical Care Foundation Suite 200 Millwork Refresh $141,974.65 Scope of work Is to remove the existing millwork and Install new Brandon Allen MOB-8501 Wilshire,Beverly Hells,CA CM Architects 21021 Ventura Blvd. millwork with the same configuration 3/2/2020 200 N.Robertson 11101,Beverly Hills,CA 90211 $191,050.96 8330,Woodland Hills,CA 310-385-3456 90211 07/15/2019 Cedars Sinai Medial Cara Foundation MOT1195 West 545,247A0 Refresh finishes In Suite 1195 Brandon Allen CSA Architects 21021 Ventura Blvd. 08/28/2019 201 N.Robertson 8101,Beverly Hills,CA 90211 8631 W.3rd Street Los Angeles,CA 90048' $45,247A0 8330,Woodland Hills,CA 310-385-3457 11/06/2019 Cedars Sinai Medical Care Foundation Cubicle Curtain Installation Only 59,588 53 None Install owner furnished cubicle curtain track and curtains. Brandon Allen 11/2019 202 N Robertson 11101,Beverly Hills,CA 90211 200 N.Robertson Suite 101 Beverly Hills, $9,588.53 310-385-3458 CA 90211 05/07/2019 Chapman University Hashinger Silence Center Suite 428 $29,674.94 None Remove rho existing cabinets and FRP from the walls Greg Mork) 09/27/2019 One University Dr.Orange,CA 92866 346 N.Center St.Orange,CA 92866 529,674.94 714-997-6588 07/08/2019 Chapman University Financial Services S13,727.72 None TI-Furr,out existing concrete wall to align with the existing column Greg Deserto to 7'AFF;paint furred wall and existing walls 09/27/2019 One University Dr.Orange,CA 92865 One University Dr.Orange,CA 92867 $13,727.72 714497 6588 05/21/2019 Chapman University Henley Hail Fitness Center $1,008,581.00 Adayda4 Architects-Troy Aday 626.963-Renovation of an existing student lounge area Into a fitness center.Greg Desarlo 01/16/2020 One University Dr.Orange,CA 92866 One University Dr.Orange,CA 92867 $976,674.00 437 S.Cataract Ave Suite 6,San 714.997.6588 Dimas.CA 91773 NIP 6/10/19 Rancho Santiago Community College District Bidn1372 Child Development Center $63,296.00 None Scope includes:painting of student classrooms and restrooms; Ave HUI fppsl@rued.edu Phase 3 at Santiago Canyon College replace sink counter-tops in classrooms;repair of flooring; 08/19/2019 2323 N.Broadway,Santa Ana,CA 92706 1530 West 17th StSanta Ana,CA 92706 $63,296A0 retractable sand box cover replacement;remove and reinstall 951441.4829 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. Keith Kulpinsld Name of proposed Project Manager (714)882 1088 Telephone No.of proposed Project Manager Saddleback HS CTE Digital Media Lab 1,995,775.00 Tenant Improvement 6/12/2023 Project Name&Contract Amount Type of Work Date Completed Expo Center Avalon Room 1,904,480.70 Tenant Improvement 7/16/2023 Project Name&Contract Amount Type of Work Date Completed Beverly Vista Site Mods&ADA Enhancements 2,440, 91 Tenant Improvement 11/19/2021 Project Name&Contract Amount Type of Work Date Completed 2. Chris Weber Name of proposed Superintendent (714)882-1088 Telephone No.of proposed Superintendent CSMC MOT 1190W&1195W 559,476.95 Tenant Improvement 3/15/2021 Project Name&Contract Amount Type of Work Date Completed Beverly Vista School Site Modifications $2,314,644.00 Tenant Improvement 11/19/2021 Project Name&Contract Amount Type of Work Date Completed Expo Center Avalon Room 1,904,480.70 Tenant Improvement 7/16/2023 Project Name&Contract Amount Type of Work Date Completed C-I2 CONTRACTOR R";i G,ISTRATIt l��V '1`li CALIF R iA D PARTI NT TIDUSTR ANAL RELATIONS;(DIR)C.ERTIF'ItCAT'E. Pursuant to 85M-(citing Labor;Cad section"1771..1(a)) passed by:the California-State Senate on Tune 20,20G-4:',estabhished anew public works ontractor R gtstration Pirogram,which requires.. � r • all contracts rs aria;subcontractors Bidding and;perfermuig work an Public orl s Proiects to register on:an annual basis (each' July l through June 'the California Iaepartinent os$300 f Industrial Relations(DIR)�Currently the annual non refundable registration fee fora Contractors i Each.contractor to-whom a public works:ccntr,actlltns B een awarded shall sign the following certificate, I IR FACT SI-ILl?T on SB 854 http 1lwww;dir ca.gov/DLSEfPublicWorks/SB85 RactSheet 6.30.1.4.pdf' DIR's Contractor Registration Link—Call"(8�)522.-673 .laps ifefiiing.dir ca:gov/I CRIActionServet`?action displayPt�VCRegisti trc niFarm. DIR's Contractor:Registration• searchable database: • https/lefiling dr ca gov/PAWCIVSearch4e feu I am aware=and will comply with the provisions ofLabor Code-Section 1771-1"(a)which states; contractor or subcontractor shall not be qualified to,bid on,be listed in.a bid proposal, subject tall a 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 AO perform public works pursuant to:Section 17253; It is not'a violation o fthis section for an unregistered contractor to submit a bid that is=authorized by Section '.,t129 L_of the Business and Professions Code or by Section 10164 or hot.03.5•of the.Public:Contract Code, provided the'contractor is;registered to perform public work pursuantto ection 172:5,5'at the:tune the contract:is:awarded'." I furthermore will comply'by`providing proof of registration with D1R as the:primary contractor, as well as for.ALL subcontractors at the time of submitting the bid; J oni.1.nc dba-K oni Construction Contractor April Kulpinski By dp ril kazoni inccam Email` . President Title Date .8/22/2023 PWC Registrati: i OQo0O22'l2 C-13 -, . .. _, EXHIBIT A DISADVANTAGED BUSINESS ENTERPRISE(DBE) This Project is subject to Part 200.321,Title 2,Code of Federal Regulations entitled"Contracting with Small and Minority Businesses, Women's Business Enterprises, and Labor Surplus Area Firms." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in Part 200.321, Title 2 CFR, shall be encouraged to participate in the performance of Contracts financed in whole or in part with federal funds.The Contractor should ensure that DBEs,as defined in Part 200.321, Title 2 CFR, have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps,as set forth in Part 200.321,Title 2 CFR, for this assurance.The Contractor shall not discriminate on the basis of race,color,national origin, or sex in the award and performance of subcontracts.Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project,although there is no specific goal for DBE participation. C-14 EXHIBIT B DBE INFORMATION—GOOD FAITH EFFORTS Federal-aid Project No. Bid Opening Date The City of Huntington Beach established a Disadvantaged Business Enterprise(DBE)goal of 0% for this Project. The information provided herein shows that a good faith effort was made. Lowest,second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local . Agency Bidder DBE Commitment"form indicates that the bidder has met the DBE goal.This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening,or the bidder made a mathematical error. Submittal of only the"Local Agency Bidder DBE Commitment"form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified DBEs soliciting bids for this Project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested(please attach copies of solicitations,telephone records,fax confirmations,etc.): Names of DBEs Solicited Date of Initial Follow Up Methods Solicitation and Dates C-15 C. The items of work which the bidder made available to DBE firms including, where appropriate,any breaking down of the contract work items(including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items ($) of (Y/N) Contract D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved),and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: Names,addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: C-16 F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE finns (please attach copies of requests to agencies and any responses received,i.e.,lists,Internet page download,etc.): Name of Agency/Organization Method/Date of Contact Results H. Any additional data to support a demonstration of good faith efforts(use additional sheets if necessary): NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. C-17 IF A SOLE OWNER OR SOLE CONTRACTOR SIGN HERE: (1)Name under which business is conducted N/A (2) Signature(given and surname)of proprietor (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail IF A PARTNERSHIP.SIGN HERE: (1)Name under which business is conducted N/A (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail • C-18 IF A iCORP.ORATION..SIGN HERE: (1).Name under r hzc h buss ss is:conducted Kazanr Utcdba,Kazrani ab1.struct►o-II _. . -_ (2) me .. µ: (Stgn .) President (Title) .. impress wrporate Seal}ere - , , a. (3)Incorporated our der:-the'laws.of the State of Galtfortiias !`, 4 ,l'Jace of Bosmess 150-Paularino Ave Discs ,, , ..,; k ( (Street and Number) ' , , ..ram .. µ City and.State Costa Mesa;GA '. a Zi CQde 926z6. Telephone No t7 t4) 1 . -. (6)'5:Mail apr kazortainc com . . • , NOTARIAL ACIOTOWLEDGMENT OPINZECUTION:BY ALL SIGNATORIES MUST BE ATTACHED List below:iianmes of presu ent,vice president,secretary;and_assistantsecrettary,if a corporation,if apartnershi listnames of.all- enetAL artners and managing;paritiiers: ° µ.. p g p .,April Kuipinski res w ei t. . .' .. . Keith Kulpiriski, c President; .. : Keith Kutpinsli 8ec�etary, • C=19' fr.",.., . , . .. . . 0000-1041A,g,afP4.0.POSEAORSOWLED,00.#11. :trvii,tOt*k1149' .,„ . . . . . .. Alitotatyttiiblk,orcitherOffk6tCortiplOtingthi4,tertifi00:#erifieS:oRlyth4'identitt ofthOitidividU0Whqsi§hedthwdaturnent: ..„ ..... • • •• _. • ... • : - Iti:iyttlOttlh4tottificatnAtottaconOtk and not thelnithtounOsi'noctiencw or vOitllty4oftnnt0000% .... •. State OrcaltforOla• County of. ... •••. . ... , ..- . „ , ..„ _ , ._ '. : . Ott..... 41/••__:',t ..-.ni. ao,,,,x,,. before me- , ill.bly— lit 'An:. .:,, 41971•—• ' 4V647:6,- kt.S: ...' 3 ' I ' - : ait 7 • Atit0-.. Here'In. ri.:Naiiie.,0pd7Title.,di.the.Officer ' ' A ' ailei't -Opt tset ,61-1 t.i44 VI'plits...& L '''L --i pereotially.1ppeare .f;,• •• -•• . •• : , :' 11 . '. , - • : • , .•.. ., •, , • , .,:. •.,. • :•, • ,. , . • ,.:. :, ' -.- ,g0ifie(a):cifSigneretf who proved to ef,..<0q.,.ifia Oaara,,gt satisfactory evidence to be tlip,ip-gr.ppiisi vv.60$q rigrpk(4:101ark;OttiibOd 16,tile#Itoiti.lostrptiler0a4aOkripiMeOgedlq:-1*toat heleheltilgteiteqitfdlhe apraalrialh'•`.Z71.001F., aoffigrizod'icapacMia*:ad tha by on the IrietriAlierit the•pertOri(s):i or the entityupon bensItorvihipti4AVOrpoo.(4 e#q0,-,:isXedOtsittlipinstriiinent: 1.;000 voctorPist_Ak--;TY.,,...0r.p: 014:3y opoor,the toyio,of--ttle:State of California-:tfi*:thg,fOragoino , . .. „ „•,. , . : ,•, ootagfaph is dOttett ;KTHAYV,14 ' •,., ,....,6,f,,,,, ,. .. . :,,,,,: .- .1tIpsoo, AcP!yiPublIc-0111forlI4 : WITNESS my hand and official seal ii'',",",-;,, -,0••=.. .,: ,,.,,'901g. 'criiiliY: . ,8,„, • tommission#2417419 : ::', , - .:44.CommAxpires.Oct 17i 2026: • : 3."1,. . ... .. ......,-- , ..„. . . .., „:. . .',..,: i.. •..0.)./- ,•,' „: • ,,',.;',.;-„,_ , : signature :. ; :. • „.: .., . , .. -- , : . , . • .: .... , . . , . .. . Place:-Notary Seal and/or Stamp Above : .-i,04totor,otMgorypitok '..o.MIONAL .: . ... - , 1 • - . .... , ... . Completing ff140fOrfroflOo.cop-#.0r agOcitiOn'Oc#10.';O:otoporgo, fro4dtilentro‘ptiachrtynkotitiO*rrn',.63,:art Otlfiltoildoctdocymapt Description of Attached Document '.:Title or Type-of Dournent: - , • Dociallietit Dat.-4:, . • - NumberofPagge• • • - • . ,..• •Skgrot(s),Other Thaii.:Islafti:eci AbOve!.:. . , ., .,:: . •„,, „..,•„.;, : . • -. ,.• , , _.:. , • , , , - •-••, .0aPOC1*,Y0P4.010Med:by*.gner(e). ' Signers:tstattiet., -, . . . -Signees Name t,.:C• O:.rpo.,r.ate O• fftat-• Titie(,e,) C.CorOdrat.e‘. cfCar-,Titie(,a) D Partner- i Limited C enetal D Partner - D Limited a:Ga:re r*., ., ...•11.Individual ' •0 Attorney in Fact ,i3. Individual ti Attorney in•Fact . . a It:0010: :13 GilardiaitalcOrisetOtor ,1:1 Trustee CI GuardiamolCiptiservetor 1:1Other: , . • . 1:10ther: - - •-•- ; - ; . •• - • , Si re gner IS RepSentiOg; • 'Signer is.ROPresenting:-, . . '• ' : -. • ' . - . , , : ., , • ,; . . , „,, . ; C)2017 Nati*"01,NOtOr*;!tistpc.icitio.n :•, . i 1 EXHIBIT C LOCAL AGENCY BIDDER DBE COMMITMENT(CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY: **TBD upon Award LOCATION: PROJECT DESCRIPTION: TOTAL CONTRACT AMOUNT:$ BID DATE: BIDDER'S NAME: CONTRACT DBE GOAL: CONTRACT ITEM OF WORK AND DESCRIPTIONDBE CERT NO. NAME OF EACH DBEDOLLAR AMOUNT ITEM NO. OR SERVICES TO BEAND EXPIRATION (Must be certified on the date bidSDBE SUBCONTRACTED OR MATERIALS DATE are opened-include DBE address TO BE PROVIDED(or contracted if the and phone number) bidder is a DBE) For Local Agency to Complete: Total Claimed DBE $ Local Agency Contract Number Participation Federal-aid Project Number. Federal Share: Contract Award Date: Local Agency certifies that all DBE certifications have been verified and information is complete and accurate. Signature of Bidder Date (Area Code)Tel.No. Print Name Signature Date Local Agency Representative Pelson to Contact (Please Type or Print) (Area Code)Telephone Number. Local Agency Bidder DBE Commitment(Construction Contracts) (Rev 6/26/09) C-20 PLEASE NOTE: This information may be submitted with your bid.If it is not,and you are the apparent low bidder or the second or third low bidder,it must be submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs.Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date.Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work(who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier.Names of the First-Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable,with the names and items of work in the"List of Subcontractors"submitted with your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100%of item is not to be performed or furnished by the DBE,describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise(DBE),"of the Special Provisions(construction contracts),to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated by the person bidding.. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award, Federal-aid Project Number, Federal Share,Contract Award Date fields and verify that all information is complete and accurate before signing and filing. C-21 EXHIBIT D. E4 1 L EMPLUYME1' , <vrORTVNI Y CERTifiCA` 1O KazvnC lnc dba Kazat�r4r5shucfian The bidder, [proposed subcontractor. s .. , -hereby certifies that helshelit has ,has t +�,participated hi' n a previou contractor,subcontract subject to the,Equal Opportunity clauses.as..regnired`byExecutive Order, TO 25,;:1 i 114t;or I.12 ,and<thats where required,he/she/it has.filed with the Joint Reporting Committee,the Director of he Office of'Federal Contract.Compi:anee,a Federal Government contracting or adm tiisterang agency,or,the former,President's Committee on equal Employment C pportunity all reports due endIv:ear the-app l`icable filluig equiremeixts Notes The>:abov certification is,re uirec b the B al Ehi 1 ens DPP OpportunityRe;ulations:of q y P : the Sect of.Labor 41 CFR:60 1 7 T ;:and must be spbmjtted by bidders:and proposed subcontractors only in connection wtth.contracfs and subcontracts which athesubjectequal opp• ortunity clause are' et foicth.U%41 CFR d4 1 5 Generally only..contract or:subcontracts cif 1 Q,Otlil or under are:exempt) :..; Currently,Standard Form.100(EEO-1)is?the only report required by.tl?e Executive Orders or their unplementingregiiluhops eec e.Govferraploy sl eoisurveytiride cfin� Proposed prime contractors and;subcontractors who have participated. an a:previous contract or subcontract subaect to the Executive Orders and have not filed the required reports shouldnote that 41 CFR b4 7(b) ` l}pveats,the award Or:contracts:-and subcontracts unless salt,contractor. submits a,report coverini the delin went eriod. or such other period specked by the Federal g q p ighway Administration ar by the `Director, :Office. of Federal.Contract Compliance If S: Deb ent:of Labor Signature Date . Print April Kulpinskr v Preside t C 22 EXHIBIT.E • NUNCQLLUN AFFIDAVIT. (Title.23 hIted SICStates Code Section 112 and; P.ubllc Contract Cade Sectlan T1=04) [NAME O CONTRACT]' . To die City of 1=funtington:;Beach In conform ee it-it ia. 3 United S't'ates Code Section 112 and Cahfbnha Public Contract Code. 7106.the bidder declares.that the°bad is not made:in the nterest:ot or oit behalf of,any".undisclosed person,partnership,company;ass ociataott;,.organ nation,.or corporation that tho bad Is genuine and not collusive or sham,,that:the bidder has not•directly or Indirectly biduced or solacited:any ether bidder to put;an a fare or sha m bid,:and bas not da re4ly,or indirectly colluded,conspired;connived, . or agreed With any'bidderMor anyone etse to`pat:an a sham.bid,,or that anyone shall;refrain from bidding,, that.AO bidder has not.in any 4110004.:dire*or Indirectly, sought by agreement; • eojnunication or conference with anY one to.fix the bid price of tbeibrdder:or any other bidder, or_ o ix any overhead,profit,or cost element o the bid:price,ar of thafof any other bidder,or to secure any adirantage against the,publao lbociy a arrrding the contract•of anyone interested in the proposed cotitracfi that all'stateme lts contaaneclian the bid are true,and further that the bidder has not,directly o indirectly,,submitted hi4 of iierl1a l price or any,bre do wn thereof,or the contents: thereof or l"xvulged uaformation or data relative thereto,or paid,.and%wall.not pay,,any fee to any corporation,:partnership,companyassacataon,organization,bid depositary orto any memberor t#here-, age,..n. . .. . of to effectuate a colluslve,or.sham bicl Note: The above Noncollusaon Affidavit Is part of the„Bidder's Proposal:. By signing:the Ptoposat, tie Bidder has also signed this l'daczcotlusion ida lt,. Biddders ai cautioned that i akin a se;fal Certification niay suutiject rise Bidder to cri ninat • pr05ecut10n. Signature:; . Da te. (4' '1" 8/2212023 PiintName, .April Kulpanski: Title; P esadent G25 ;" EXHIBIT F DEBARMENT AISTEi SUSPENSION CFRTIFICATION 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 associatect With Bidder in the capacity of owner,partner,director,officer,Rmanager • is notcurrently under suspensi. ;debarment,voluntary exclusion,or,. determination of ineligibility by=any Federal agent • has not been suspended,debarred,voluntarily excluded or determined ineligible by any Federal:agency within ttl#PACS years;; • does not have,a proposed debarment pending;and has not been indicted,convicted,or had a civil judgment renderediagainst him/her by a cou of competent isdiction in anY matter involving fraud or.offacial.misconduct within thepast 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.Far any exceptions noted above,indicate below to whom it applies,initiating agency,and dates of action. Note: Providing false.information may;result in criminal.,prosecution or administrative sanctions., The above certification is part of the Proposal. Signing this Proposal on the signature Portion thereof shall also constitute signature of this;Certifcation. Signature: Date 8/2212t123- Print Name: April kulPinski Title:, Presiderxt. C'-24' EXHIBIT G NONLOBBYTN : RTIFICATION.FOR DERATSAID CONTRACTS The prospective participant certifies,by°signingand submittingthis bid or proposal,tothe best of his or her knowledge and belief,that: I) Ng ederal;'appropriated.funds have been paid.or will be paid, by or on behalf of the undersigned to any :person Ter'-influencing oar 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'awaarding of any federal,contract,the making of anyfederal grant,the making of any Federal loan,,the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment ormodification ofany Federal contract,grant,'loan,or.cooperative.agreement. '2) If an y funds other than Federal appropriated ds have been paid or will be paid to.any person tor influencing or attenipting,te,infinence an officer ficer or employee,of any Federal agency,a Member of Congress,,an officer or employee of Conngress,.,oran employee of a Member of Congress in connection w =this.lyeieral contract,:grant,.'loan,or cooperative agreement,the undersigned shall complete and submit'Standard Finn LLL, "Disclosure of Lobbying Activities,"in conformance with its instructions. This certification is a material represent tion of fact upon which reliance was placed when this transaction was made nor entered into.Su mission of this certification is a prerequisite for making or entering into this transaction imposed`by Section 1352,Title 31, U Code Any person who fails to file the required certification shall be Siabjectto a civil penalty of not less thanS 10,004.and. not:,more than$i00000.for each such:failures The prospective participant also agrees bysubmitting lis.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"subrec pienfs shall.certify and;disclose accordingly. t Date 8/22/2023 'Signature: April;Kui inski Print Name:p , President' Title: C-25 ♦ 1 • THE AMERICAN INSTITUTE OF ARCHITECTS '41$4 • AIA Document A310 Bid Bond KNOW ALL MEN BY THESE PRESENTS,that we Kazoni, Inc. dba Kazoni Construction Principal, hereinafter called the Principal, and The Ohio Casualty Insurance Company a corporation duly organized under the laws of the State of New Hampshire 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 bid amount(10%) , for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns,jointly and severally, firmly by these presents. WHEREAS,the Principal has submitted a bid for Project Name: Central Library LL Restroom and ADA Improvements CC#:1658 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 August 16th, 2023 Kazoni, Inc. dba Kazoni Construction - • &e }edict (Principal) /(�- (Witness) rR"4(. V.G LA v Se-. (Title) PaES 1 f ear The Ohio Casualty Insurance Company See Attached Notary (Surety) Seal) I • . (Witness) Michael R. Strahan,Attorney-In-Fact, (T le) AIA DOCUMENT A310•BID BOND•AIA 6•FEBRUARY 1970 ED•THE AMERICAN INSTITUTE OF ARCHITECTS,1735 N.Y.AVE.,NA..WASHINGTON,D.C.20006 1 i ' This Power of Attorney limits the acts of those named herein,and they have no authority to afr- r-, bind the Company except in the manner and to the extent herein stated. y, 1 rr‘/�% Liberty Liberty Mutual Insurance Company Ij , 11utuale The Ohio Casualty Insurance Company Certificate No:8208573-969576 West American Insurance Company SURETY POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS:That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint Allison Ocampo,E.B.Strahan,Michael R.Strahan all of the city of San Diego state of CA each individually if there be more than one named,its true and lawful attorney-in-fact to make, execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 10th day of August , 2022 . Liberty Mutual Insurance Company The Ohio Casualty Insurance 4?-0 0'14py0 / owPo++��'�y soP�o PCR,sy'0 West American Insurance Company Company J3 Fot0 Q3 `Poo a . tcn 1912 0 c 1919 0 &' 1991 0 y d0._ss'sCNU9 D ��y NAMPSa�,aL�O rs1 �NUTANA -da /�. .Z V 77 * P. 'NI * ti� 4N * *et, By: / '5. E David M.Carey,Assistant Secretary c m State of PENNSYLVANIA ss •- = F2 gi County of MONTGOMERY o = On this 10th day of August , 2022 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance 0 a)o m'Company,The Ohio Casualty Company,and West American Insurance Company,and that he,as such,being authorized so to do,execute the foregoing instrument for the purposes p,> therein. contained by signing on behalf of the corporations by himself as a duly authorized officer. >a 2IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at Plymouth Meeting,Pennsylvania,on the day and year first above written. 0 .�Por1 W Commonwealth of Pennsylvania-Notary Seal 0 '. 'Fr ' C Teresa Pastella,Notary Public d'cp f` o 9 Montgomery County /ail& E E o� OF My commission expires March 28,2025 By: ,o N C 1- ��P Commission number 1126044 eresa Pastella,Notary Public ¢ `o aj-i—, NSyt)1 Member,Pennsylvania Association of Notaries NN ARYP � er cm -t Q? This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual 3 o c Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: a co cv N ARTICLE IV-OFFICERS:Section 12.Power ofAttortey. o0 4- m Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject to such limitation as the Chairman or the c cro :2 m President may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal,acknowledge and deliver as surety = >-ro E any and all undertakings,bonds,recognizances and other surety obligations.Such attorneys-in-fact,subject to the limitations set forth in their respective powers of attorney,shall c ES have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation.When so executed,such o a) Z15 ci instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under the re provisions of this article maybe revoked at anytime b the Board,the Chairman,the President orthe officer or officers grantingsuch power authority. d � Yby P li a ARTICLE XIII-Execution of Contracts:Section 5.Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president,and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings, bonds,recognizances and other surety obligations.Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation-The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attorneys-in- fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. • Authorization-By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I,Renee C.Llewellyn,the undersigned,Assistant Secretary,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American Insurance Company do hereby certify that the original power of attomey of which the foregoing is a full,true and correct.copy of the Pdilve7 of Attorney executed by said Companies,is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 16th day of August , 2023 . V%tawI�,, ,:c1 INs& a 1NSUR A.stb&PON-74, A?*C' 6P aexPo�f�si:+ . ,i.......d..„..„ , ,. . 1912 n - 1919 0 ` 1991 B • d�,'ss,,�N�,,e'1$' so y,N,,,,,, 6- Ys lNnuNi 4• a'ro Y Renee C.Llewellyn,Assistant Secretary 4%7* 1•(1 4.1 * *4 'N * 1:V LMS-12873 LMIC OCIC WAIC Multi Co 02121 c • 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 San Diego County of ) On August 16th, 2023 before me, E.B. Strahan, Notary Public (insert name and title of the officer) personally appeared Michael R. Strahan who proved to me on the basis of satisfactory evidence to be the persons)whose name(s) is/ace subscribed to the within instrument and acknowledged to me that he/she/they executed the same in hisTec/their 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. WITNESS my hand and official s E.8,STRAHAN yyf 7..; Notary Public•California San Diego County r flit: Commission#2406282 .01 My Comm.Expires Jun 25,2026 Signature (Seal) 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 0rdMlL, J} On L. (/LSD' �.�, �o 2-3 before me, 7li�l.`fhy V• Anot ers0r, No+dYy (� t,G Date j� '/ Here Insert Name and Title of the Officer personally appeared 1l I Wal pih5/�+ s)of Signers) who proved to me on the basis of satisfactory evidence to be the person(s)whose nameks)is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in hiss/tier/their authorized capacity(ies, and that by his/htheir signatureys)-on the instrument the persona), or the entity upon behalf of whit the person)) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing KATHY V.ANDERSON paragraph is true and correct. d — = Notary Public•California County Orange =a� •~, WITNESS my hand and official seal. 1.+ Commission#2417419 •.0 My Comm.Expires Oct 17,2026 Signature , 7. 0.1170041121- Place Notary Seal and/or Stamp Above egnature 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- Cl Limited 0 General ❑ Individual 0 Attorney in Fact Cl Individual 0 Attorney in Fact ❑ Trustee 0 Guardian of Conservator ❑ Trustee 0 Guardian of Conservator ❑ Other: 0 Other: Signer is Representing: Signer is Representing: ©2017 National Notary Association CA tC h CONSTRUCTION 150 Paularino Ave, Suite D160 Costa Mesa, CA 92626 CSLB# 974982 DIR# 1000002212 • OFFICIAL BID SECURITY - DO NOT OPEN City of Huntington Beach Public Works Office 2000 Main Street Huntington Beach, CA 92648 Bid Due Date: August 22, 2023 at 2:00pm =4: =x` Project Name: Central Library LL Restroom ADA Improvements CC#: 1658 - *r ,,9 M o<<�.." 1-TING,- -5 City of .`-:_:untington Beach "` Nla � 2000 Main Street ♦ Huntington Beach, CA 92648 k cp. (714) 536-5227 • www.huntingtonbeachca.gov o. =� e Q 44,4, Office of the City Clerk Comm CP6�r��� Robin Estanislau, City Clerk December 29, 2023 MBC Enterprises, Inc. 16601 Gothard Street, Suite G Huntington Beach, CA 92627 RE: Central Library Lower Level Restroom ADA Improvements—CC No. 1658 Enclosed please find your original bid bond for CC No. 1658. Sincerely, € $4IU4J4M' Robin Estanislau, CMC City Clerk RE:ds Enclosure Sister City: Anjo, Japan SECTION C PROPOSAL for the construction of CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS CC No. 1658 • 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 60 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications,Instructions to Bidders and all other contract documents. If this proposal is accepted for award,BIDDER agrees to enter into a contract with.AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes,royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded,the AGENCY will reject all bids and will 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-1 If awarded the Contract,the-undersigned agrees that In the event af the BIDDERS default in executing the required contract and filing die 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 considerednull=avoid.. 10%of Accompanying this proposal ofbid,find Bid Bond in the ainoun. tkiflakLarnount which said amount is not less than 10%,of the aggregate of the total bid price,as required by the Notice Inviting Sealed OR ELECTRONIC Bids,payable to the AGENCY (Please inert the words"Cash", "Certified Check",or"Bidder'sBorid fort "„as the case maybe).Any standard,Surety•Bidaond form is acceptable Bidder shall signify receipt of all Adde da here,ifanyt Addenda N4- pate Received -Bidder's-Signature 1 08/15/202 • RUDY SULTAN, PRESIDENT • C-2 CITY OF HUNTINGTON BEACH CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENT BID SCHEDULE Item# Description of Work Quantity Unit Unit Price Item Total 1 Mobilization 1 LS $ $ 2 Construction Waste Management 1 LS $ $ 3 Closeout 1 LS $ $ 4 Demolition 1 LS $ $ 5 Abatement 1 LS $ $ 6 Concrete and Reinforcement 1 LS $ $ 7 Casework/Countertop 1 LS $ $ 8 Blanket Insulation 1 LS $ $ 9 Joint Sealants 1 LS $ $ 10 Aluminum Door Frames 1 LS $ $ 11 Wood Doors 1 LS $ $ 12 Access Doors and Frames 1 LS $ $ 13 Door Hardware 1 LS $ $ 14 Glazing/Mirror 1 LS $ $ 15 Gypsum Board 1 LS $ $ 16 Metal Stud Framing 1 LS $ $ 17 Porcelain Tile Floor Finishing 1 LS $ $ 18 Porcelain Tile Wall Finishing 1 LS $ $ 19 Painting 1 LS $ $ 20 Signage 1 LS $ $ 21 Toilet Accessories 1 LS $ $ 22 Plumbing 1 LS $ $ 23 Mechanical 1 LS $ $ 24 Electrical 1 LS $ $ Total in Numbers C-2.1 Total in Words: NOTES: The estimated quantities listed in the Proposal Bid Sheets are approximate and are to be used only as comparison of bids. Payment for quantities will be made from field measurements. If the actual quantities show either an increase or decrease from the quantities given in the Proposal Bid Sheet,the Contract Unit Prices will prevail. Full compensation will be paid at the contract price for the actual work completed,and no additional compensation will be allowed therefor. Payment will not be made for materials wasted or disposed of in a manner not called for under the Contract;this includes rejected material not unloaded from vehicles and material rejected after it has been placed. No compensation will be allowed for disposing of rejected or excess material.The City reserves the right to reject all bids and to increase or decrease the amount of any quantity shown on the Proposal Bid Sheets. In case of a variation between the unit price and the totals shown by the bidder,the unit price will be considered to be the bid. Compensation for items of work not specifically identified in these bid items shall include all labor, materials,tools,equipment,safety measures, and supervision required to complete the work to grades and dimensions shown on the Plans or staked in the field.There shall be no compensation except for the bid items specified in the Proposal.The cost of all work shown in the Plans and Specifications but not specifically identified as a bid item or described within a bid item shall be included in related bid items,and no additional compensation shall become due the Contractor by nature of compliance with the Plans and Specifications. C-2.2 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 J COLAVIN &sons c15 1000001458 5323 ALHAMBRA AVENUE 260803 c54 36480 LOS ANGELES, CA 90032 MCKEOWN INCORPORATED dba MCKEOWN PLUMBING 1052408 1000840869 1945 LAGUNA CANYON ROAD A 33,437 BIDG 2 C36 LAGUNA BEACH, CA 92651 SO CAL ELECTRIC 910902 A 1000033604 9245 NAN C21 14,570 PICO RIVERA, CA 90660 C10 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 NONC(LLUS ON AFFIDAVIT TO BE EXECUTED BY.BIDDER ANI) SUBMITTED WITH BID I declare under penalty of perjury under the laws of the$fate of California that the foregoing is true and correct and that this declaration,is executed n $ ,at Huntington Beach CA, Date Cif State Rudy Sultan ,being first duly sworn,,deposes and says that he or is President of MBC Enterprise's'Inc the party making the foregoing bid that the bid:is not made in the interest of,or on t ie 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,directlyor indirectly induced or solicited:any other bidden 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 biddinx. that the bidder:has not in any ® s er,directly or indirectly,sought by agt cement,,communication; ar 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. MBC:Enterprises Inc. Name of Bidder Rudy.Sultan, President Signature of Bidder 16.601 Gothard, , Stet Huntington Beach:CA 92647 Address.of`l3idder C-4 UTILITY AGREEMENT 'HONORABLE MAYOR AN] CITY COUNCIL CITY OF IIUNTIINIGTON BEAM,CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract,'known as the CENTRAL LIBRARY LOWER LEVEL ADA IMPROVEMENTS {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.AdministratiYe Code, Section 2700,as follows: "Q011fled Person:' A person who,,by reason ofexperience or instruction, kfronilior with the operation to be performe4 on4r the ht7zat*invcilVec4* The undersigned also premised and agrees that all such work shall be performed in accordance with all applicable electrical utility.companyts requirements,, Public Utility Commission orders, and'State of California Cal-OSTIA requireMentS. The undersigned fiArtherpromises 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. PABG Enterprises Inc. Contractor Rudy Sultan By President Title August 22. 2023 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. Not Applicable 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 i am of the State Labor Code,each contractor to whom a public works contract has been awarded shall sign the followingcertificate. 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. MBC Enterprises Inc. Contractor By RudyanZ President Title. Date: August 22, 2023 C-7 BIDDERYSINFORMATION 'BIDDER certifies that the following informadon is true andcorrece MBC•Enterprises inc. Bidder Name 16601 Gothard Street.Suite G Business Address. Huntington Beach CA 92647 City, State Zip ( 714 ) 909-6558 biddincranibcenterprises.net . Telephone Number Email Address 1050671 —Crass & B State Contractor's License No. and Class 02/26/2019 Original Date Issued 02/28/2025 Expiration Date "The work site was inspected by Joey Santa Cruz of our office on August 8th 2023 The following are persons,firrns,and corporations having,a principal interest in this proposslt Rudy'Sultan- President/Se,cretarY/Treasurer MBC Enterprises Inc: The undersigned is prepared to satisfy the Council of the City of'Huntington Beach of its ability, financially or otherwise, to perform<the contract far the proposed work and improvements in accordance:with'the plans and specifications Set forth. MBC Enterprises Inc. Company Name of Bidder Rudy Sultan, President Printed or Typed Signature c-o NOTARY CERTIFICATE n Subsctibed.and swot to before me this.: .day.of rlu di ti5f 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 doetnrient State of "� 1Iltnr- ): County of rr ) On .68 .. 2/2023 before%no,: t ) Oi Month,Flay,,and Year Inse Name and Title"of No- personally appeared 'RUdi xi 14 .41 Name(s):of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(=s)..whose names)istare subscribed to the within instrument and acknowledged to me that hefs /44o executed the sant. in hisr, eir authorized capacityies),and that by°histlxheu signature(. )on the ' •d ®ent the person(s);or••the entity upon behalf of which the person(s)-acted,executed the in. *. I certify under PENALTY OF PER ILAY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. ' 91::':_ Colli M S 2350798 •; : ORANGE County 4:rz..#..) OcaN�torniie ,.N+oraryPublic ^y 1gna N `- („Signature , 'Notary Public (PLACE NOTARY SEAL.ABOVE G9 Bidder's Project History For the purposes of this project the contractor and subcontractor must have, in the last five years, constructed at least five (5) projects of similar work specifically referencing the construction of {Describe specific work and experience necessary for project, for example "Reconstruction or rehabilitation of existing public use facilities". Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. The following list of projects meet the requirements of above: 1. Santa Ana Unified School District, 1601 East Chestnut Ave, Santa Ana, CA 92701 Name and Address of Reference Name and Telephone No. of Owner: Etil Guillen / (714) 480-5355 $627,800 Interior Improvements August 2022 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Infill existing classroom openings with new non-bearing partitions and doors for classroom security. Extension of existing tube steel fence. 2. Long Beach Unified School District, 1515 Hughes Way, Long Beach, CA 90810 Name and Address of Reference Name and Telephone No. of Owner: Celina Sanchez/ (562) 663-3015 $816,100 Renovation/Improvement On-Going Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Replacement of ADA compliant drinking fountain and bottle fillers & related site work at 4 different schools. 3. Long Beach Community College District, 4901 East Carson St., Long Beach, CA 90808 Name and Address of Reference Name and Telephone No. of Owner: Sota Sunleng / (562) 938-4843 $379,133 Stage Floor Replacement November 2020 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Demolition of existing hardwood stage floor and replace it with new Harlequin Stage Flex dance floor system in Bldg J. C-10 4. Pittsburg Unified School District, 2000 Railroad Ave Pittsburg, CA 94565 Name and Address of Reference Name and Telephone No. of Owner: James Larry Scott/925-473-2438 $169,000 Security System Improvements Jan 2021 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Installation of security cameras at Pittsburg HS 5. Department of the Army, CA National Guard, Los Alamitos CA Name and Address of Reference Name and Telephone No. of Owner: Jesse Sluder, 1 SG/562-795-2399 $277,610 Renovation Jan 2020 Contract Amount Type of Work Date Completed Provide additional project description to show similarwork: Renovation of locker and shower rooms in Bldg 44. C-11 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. Joseph Kim Name of proposed Project Manager 714-595-1621 Telephone No. of proposed Project Manager Wayfinding & Signage II /$788,000 Renovation 2019 Project Name&Contract Amount Type of Work Date Completed Bishop ES Modernization /$24.7M Modernization 2018 Project Name&Contract Amount Type of Work Date Completed Marquee Signs at Various Schools /$187K Improvements 2021 Project Name&Contract Amount Type of Work Date Completed 2. Joey Santa Cruz Name of proposed Superintendent 310-806-8855 Telephone No. of proposed Superintendent Wayfinding & Signage II /$788,000 Renovation 2019 Project Name&Contract Amount Type of Work Date Completed Bishop ES Modernization /$24.7M Modernization 2018 Project Name &Contract Amount Type of Work Date Completed Marquee Signs at Various Schools /$187K Improvements 2021 Project Name&Contract Amount Type of Work Date Completed I C-12 JOSEPH K1M Project Manager joseph_2527@yahoo.com 0 714.595.1621 Project Manager with thirteen years of on-site experience in construction engineering,providing management, supervision, and coordination on public works projects such as new classrooms replacement/improvements(K-12), roadway improvements,public parks rehabilitations, capital improvement,parking lot renovations,and commercial tenant improvement projects. Experience MBC Enterprises, Inc. J October 2021 —Present Long Beach Unified School District I ESSER Drinking Fountain Replacement Phase 3 Project Manager October 2022-Present Served as the contractor's project manager during construction of the ESSER Funded Drinking Fountain Replacement with the Long Beach Unified School District. Responsibilities included RFI's,Submittals,Change Orders,Schedule Updates, Monthly Progress Reports, Payment Applications,Contracts,Coordination with the Owner and Subcontractors, Preparing and Implementing Site Specific Work Plans. Project scope of work includes replacement of existing drinking fountains with new owner furnished drinking fountains across four different school sites.Scopes include demolition,concrete, framing,drywall, stucco, painting, plumbing, and railing. Santa Ana Unified School District I Roosevelt-Walker ES Classroom Alterations Project Manager June 2022-August 2022 Served as the contractor's full time representative during renovation of the classrooms in Building A at the Roosevelt-Walker Elementary School in Santa Ana,CA. Responsibilities included RFI's,Submittals,Change Orders,Schedule Updates, Monthly Progress Reports, Payment Applications,Contracts,Coordination with the Owner and Subcontractors, Preparing and Implementing Site Specific Work Plans. Project scope of work included demolition of flooring,framing,drywall,flooring, painting,doors,frames, hardware,and signage in twenty four classrooms. Best Formulations I Gummy Bear Facility Project Manager October 2021-Present Served as the contractor's representative during construction of the new Gummy Bear Facility for Best Formulations in the City of Industry,CA. Responsibilities included RFI's, Submittals,Change Orders, Schedule Updates, Monthly Progress Reports, Payment Applications,Contracts,Coordination with the Owner and Subcontractors, Preparing and Implementing Site Specific Work Plans. Project scope of work consisted of building a new 14,000 square foot mezzanine level inside of their existing warehouse. Scopes included shoring,demolition, concrete,structural steel,framing, drywall, doors, and painting. CCI General Contractor I March 2019—September 2021 California Academy of Sciences I Collections Gallery& East Garden Assistant Project Manager June 2021-September 2021 Served as the contractor's representative during construction of the new Collections Gallery at the California Academy of Sciences in San Francisco, CA. Responsibilities included RFI's,Submittals, Change Orders,Schedule Updates, Monthly Progress Reports, Payment Applications,Contracts,Coordination with the Owner and Subcontractors, Preparing and Implementing Site Specific Work Plans. Project scope of work included framing, drywall, painting, plumbing, electrical, HVAC,fire sprinklers, doors,frames,and hardware.Assisted the Project Manager in reviewing the plans and finalizing the budget for the California Academy of Sciences East Garden Project. San Francisco Design Center I Tenant Improvements at Various Showrooms Assistant Project Manager May 2020-September 2021 Assisted the project manager in attending meetings with various clients at the San Francisco Design Center(101 Henry Adams Street&2 Henry Adams Street,San Francisco, CA)to review and discuss renovations to their existing/new show rooms. Responsibilities included Documenting Scopes,Creating Drawings, Field Measuring,Creating RFI's, Submittals,Change Orders,Schedule Updates,Monthly Progress Reports, Payment Applications,Contracts, Coordination with the Owner and Subcontractors,Preparing and Implementing Site Specific Work Plans. Clients included Artistic Tile, De Sousa Hughes, Riggs Distributing, Shears and Window, and Sloan Miyasato. R. Torre&Co., Inc. I Torani World Headquarters Assistant Project Manager March 2019-April 2020 Served as the contractor's full time representative during construction of the World Headquarters of Torani in San Leandro,CA. Responsibilities included assisting the project manager with RFI's,Submittals, Change Orders,Schedule Updates, Monthly Progress Reports, Payment Applications, Contracts,Coordination with the Owner and Subcontractors, Preparing and Implementing Site Specific Work Plans. Project scope of work included the tenant improvement buildout of the new 22,000 square feet office space including concrete,framing, drywall, painting,flooring,signage, doors,and MEP. USS Cal Builders Inc. I January 2010—March 2019 Sunnyvale School District I Bishop Elementary School Modernization Project Manager November 2018-March 2019 Assisted with the punch list work for the Bishop Elementary School Modernization Project with the Sunnyvale Unified School District. Responsibilities included tracking outstanding punch list work, documenting completed punch list work, coordinating construction activities with subcontractors and the school district. Project scope of work included painting,flooring,stucco,signage, landscaping, irrigation Bay Area Rapid Transit(BART) District I Lafayette Station Site Improvements Project Project Manager April 2017-March 2019 Served as the contractor's full time representative during construction of the BART Lafayette Station Site Improvements Project. Responsibilities included RFI's, Submittals, Change Orders, Schedule Updates,Monthly Progress Reports, Payment Applications, Contracts,Coordination with the Owner and Subcontractors, Preparing and Implementing Site Specific Work Plans. Project scope of work includes the demolition of the existing parking lot, pulverizing the base and subbase, installation of new utilities,concrete flatwork,unit pavers, landscaping,irrigation,AC paving, striping,signage,and electrical. Bay Area Rapid Transit District(BART) I Downtown Berkeley Plaza Improvement Project Assistant Project Manager July 2016- May 2019 Responsible for assisting the project manager and superintendent during the renovation of the BART Downtown Berkeley Plaza. Responsibilities included RFI's,Submittals,Change Orders, Schedule Updates, Monthly Progress Reports,Contracts, Coordination with the Owner and Subcontractors, Preparing and Implementing Site Specific Work Plans, Project scope of work includes demolition,abatement, installation of new utilities, bio-retention systems,concrete flatwork,unit pavers,structural/miscellaneous steel,glazing,painting, signage. South San Francisco Unified School District I Measure J Bond School Replacement Project Project Engineer March 2013-June 2016 Responsible for assisting the project manager and superintendent during construction of pre-fabricated modular classroom buildings across multiple school sites. Responsibilities included RFI's,Submittals, Daily Reports,As Built Drawings,Closeouts,Schedule Updates, Purchase Orders, and Contracts. Project scope of work includes abatement,demolition, • grading, utilities,concrete,framing,drywall, MEP,flooring, casework, plastering,and painting. City of Irvine I Orange County Great Park Western Sector Park Development Plan Project Engineer July 2012-March 2013 Responsible for accommodating City of Irvine requests during construction.Supervised installation of wet utilities, provided oversight of site safety,and ensured implementation of Stormwater Pollution Prevention Plan SWPPPs.Prepared Time Impact Analysis Reports, scheduled daily activities onsite and tracked progress, and procured material.Responsible for documentation of RFI's,Submittals,and Change Order proposals. Project scope of work includes the installation of new utility lines,soccer fields, basketball courts,amenity ponds, and the construction of a new restroom and operations facility and a Visitor Center Pavilion on a 30 acre site. 1 City of Anaheim I Water Recycling Demonstration Plant Project Engineer December 2010-July 2012 Responsible for accommodating City of Anaheim requests during construction. Supervised installation of wet utilities, provided oversight of pavement rehabilitation work, and ensured implementation of Stormwater Pollution Prevention Plan SWPPPs. Prepared Time Impact Analysis Reports,scheduled daily activities onsite and tracked progress. Responsible for documentation of RFI's and Submittals.Scope of work included installation of new utility lines, earthwork,construction of new industrial concrete building,and street improvements. City of San Marcos I Autumn Dr. & Buelow Park Street Improvements Project Engineer April 2010-November 2010 "American Public Works Project of the Year 2011" The upgrade of Buelow Public Park included street narrowing, roadway improvements, the installation of new irrigation and drainage systems, landscaping, and construction of a new restroom facility building. -Responsibilities on this project:provided coordination between city agency, utility owners,and traffic control and construction.Supervised street striping, road rehabilitation and ensured SWPPP plan compliance. Prepared periodic work progression documents. Junior Construction Estimator January 2010-April 2010 Researched upcoming bids, performed takeoff quantities for bids, prepared drafts of estimated project costs,assisted senior construction estimator finalize costs during critical bid time. Education M.S. in Civil Engineering B.S. in Civil Engineering California State University, Fullerton University of California, Irvine Construction Engineering Structural Certifications OSHA 10 a First Aide CPR a Confined Space c Hazwoper 40 Joey Santa Cruz Construction Management &General Contractor Ser- vices .EXPERIENCE As a Superintendent fOrmorethan is years,managed od supervised a large amount of: public work conbtinctienprojects to include coordinating different trades between subcontractors,managing inspections,generating RFIs,implementing construction 19 ADDRESS schedules,ereatingthree weeks look ahead,docuinenting As-builts,and supervising panellist work. Below artsomehighlights of heldpositions: 23703 Ronan Ave Carson CA 9°245. PHONE May-2020,—.Present SUperinterident MEC Enterprises,Inc. 3 to 806 8855 May zoo&—April 2020 joeyPinbeenterprkes.net, Superintendent—USS Cal Builders.Inc. 0 CERTIFICATES OS HA 3o/CPR/First• ik Aid/Confined Space/ lazwoper 4o/Scaffolding soFTwARE SKILLS EDUCATION All office suite programs/ MS Project/Primavera/ Brocore/ Carson High School—1994 Viewpoint_/ Blue.Beam/ Building Blocks/Idatiuns/ Ca4entrYAPPrentices1ip April noos South West Mien Carpentry COMMUNICATION Empathic Listener and Perguasive Speaker Multi Lingual:EngliSh—Spanish LEADERSHIP With over$245MM in direct supervision of Public,CommOrcial and Pr- vate Work Construction,and running Northern CA division for 7 years for a major Public Work General Contractor,Professional Communica- tion,Problem Solving,Delegafing,Training,and Motivating are skills that naturally developed in me and shaped my leading role at my current employer. REFERENCES .Au References ineludhig alist of managettennstructionprojects:are available upon.request. LIST OF PR()JECTS Construction Management Services Under LISS CAI,Builders Inc. • Franklin Hall Modernization—LACCD—2019-$13,858,999.90 • • Laguna BeachCanothus Residence—Two United Oil—2012-$1000,000.00 • Communication Cabling at Franklin Hall—LACCD—2011 $1,392,000.00 • Laguna Beach Alexander'Residence-Two United Oil—2012 $1,8o9,996.99 • Autumn Drive&Buelow Park Street&Park Improvements—city of San Marcos— 2010—$2,00.5,000.00 • Anaheim Water Recycling Demonstration Project City of Anaheim—2011,- $6,557,376.00 • Orange County Great Park Phase III—City of Irvine—2013-$22,840)574.17 • Project Frog Modular Project&Modernization—South San Francisco USD—2913— $116,00n,o0o,on • Westborough Middle School Classroom Remodel-South San aancisco USD—2015— $1447;377.00 • BART Downtown Berkeley Plaza Improvement Project—Bay Area Rapid Transit Dis- trict—2017-$8,970,909. • Lafayette Station Site Improvements—Bay Area Rapid Transit District—zoi7- $4,650,00o.00 • Bishop Elementary School Modernization—Sunnyvale School Distiict—2o17- $24,699,009.00 • NA7ayfinding&Signage II—San Jose Evergreen Community College District—2019- $788,000mo.00 Construction Services Under All3C Entel prises rue. • Marquee Signs at Various Schools—SAUSD—2921-$186,999 • Marquee Signs at Hoover&Washington ES—2021-$184„919 • CONTRACTOR REGISTRATION VVITII CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS(DIR)CERTIFICATE Pursuant to 813 854(citing Labor Code Section 1771.1(a)),.passed by the California State$enate on June 204014,established a new public works Contractor Registration Pi 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 on Currently the annual non-refundable registration fee for Contractors it:001 Each contractor to whom a public works,contract has been awarded shall sign the following certificate. DIR,FACTSTIBET on SB'854 http://www,dir.ca,gov/DLSE/PnblicWorks/Sl384FactSheet 0.30.14 pdf DIR's Contractor Registration Link Call(844)522-674 httpsl/efliing.dEca.gov/PWCR/ActionServlet7action=dWayPWCRegistrationFom DIR's Contractor Registration searchable database https://efiling:diEca,gov/PWCR/Searcli.action I am aware and will comply with theprovisions of Labor Code Section 1771.40 which states "A contractor or subcontractor shall not he 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 unregisteredcontr actor 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,Seetict 1725.5 at the time the contract is awarded." I furthermore will comply by providing proof of registration with DIR.as the primary contractor, 11 as well as for ALL SUbcon#4400.at the time of Submitting the bid. ,M13C Enterprises Contractor Rudy Sultan By . bidding@tn bcenterprises.net Email President Title Date: August:22, 2023 PWC Registration#: I 000064318 e43. EXHIBIT A DISADVANTAGED BUSINESS ENTERPRISE(DBE) This Project is subject to Part 200.321, Title 2, Code of Federal Regulations entitled"Contracting with Small and Minority Businesses, Women's Business Enterprises, and Labor Surplus Area Firms." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in Part 200.321, Title 2 CFR, shall be encouraged to participate in the performance of Contracts financed in whole or in part with federal funds.The Contractor should ensure that DBEs,as defined in Part 200.321, Title 2 CFR, have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps,as set forth in Part 200.321,Title 2 CFR, for this assurance.The Contractor shall not discriminate on the basis of race,color,national origin, or sex in the award and performance of subcontracts. Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project, although there is no specific goal for DBE participation. 1 C-14 EXHIBIT B DBE INFORMATION—GOOD FAITH EFFORTS Federal-aid Project No. Bid Opening Date The City of Huntington Beach established a Disadvantaged Business Enterprise(DBE) goal of 0% for this Project. The information provided herein shows that a good faith effort was made. Lowest,second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder DBE Commitment"form indicates that the bidder has met the DBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE Commitment"form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement PLANHUB 08/09/2023 B. The names and dates of written notices sent to certified DBEs soliciting bids for this Project and the dates and methods used for following up initial solicitations to determine with • certainty whether the DBEs were interested(please attach copies of solicitations,telephone records,fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods Solicitation and Dates TO BE PROVIDED 08/09/2023 EMAILS 08/15 UPON REQUEST C-15 C. The items of work which the bidder made available to DBE firms including, where appropriate,any breaking down of the contract work items(including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items ($) of (Y/N) Contract CONCRETE TO BE PROVIDED DEMOLITION UPON REQUEST DRYWALL DOORS AND HARDWARE PAINTING D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: TBD Names, addresses and phone numbers of firms selected for the work above: • TBD E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: DBEs ARE ENCOURAGED TO PARTICIPATE AND WILL BE PROVIDED ASSISTANCE C-16• F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: H6 G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results LANikl1r3 H. Any additional data to support a demonstration of good faith efforts(use additional sheets if necessary): NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. • • - yg9 C-17 IF A SOLE OWNER OR SOLE CONTRACTOR SIGN HERE: (1) Name under which business is conducted N/A (2) Signature(given and surname) of proprietor (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail IF A PARTNERSHIP, SIGN HERE: (1) Name under which business is conducted N/ (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail 1 C-18 IF A CORPORATION,SIGN HERE (1) Narneunder which business is con .dueted MBC ENTERPRISES INC. {2) ignature) RUDY SULTAN, PRESIDENT critio Itnpress'corporate Seal here (3) Incomerated:under the laws of the State of CALIFORNIA (4)Place of Business 16601 •GOTHARD ST SUITE G (Street and NtinTher) City and State HUNTINGTON BEACH, CALIFORNIA (5),Zip Code 92647 Telephone No. 714.909,6558 (6) E-Mail biddingarnbcenterprisesnet NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACRED List below names afpresident,viceptesident,secretary and assistant'Secretary,if a corporation;:if a partnership, list names of all general partners:and managing partners: RUDY SULTAN, PRESIDENT, SECRETARY TREASURER ; C: 19 CAL I F 0 RN IA ALL-PURPOSE ACKNOWLEDGMENT A note :Ontitic•orddher officer completing this certificate verifies only.the'dentin(of the indiVidUal who ,signed the&imamate which thiseenificats is attached,and not'the truthfulness.accuracy,or validity of that document STATE OF CALIFORNIA COUNTY OF Orange On O8/22/2028 before me, Sandy Assi , Notary Public, personally appeared Rudy Sultan 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 hisiheritheir authorized ,capacity(iest, and that by his/her/their aignature(s4 on the instrument the person(s), or the entity upon behalf of which the person(s)rected, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California' hat the foregoing paragraph is true and correct WITNESS my hand and official seal. o'DY 0798 '41 • ee36 41'4* P , et • • O . ‘), 0, ;4 0 ^"" L.m2.*** ** *) V0,04f44i1;... ‘tc-A OPTIONAL INFORAMTION- , , TITLE.OR TYPE OF DOCUMENT Corporation-Central Library Lower Level Flestrooms ADA.Improvements DATE OF DOCUMENT NUMBER OF PAGE SIGNER(S)OTHER THAN NAMED ABOVE - - EXHIBIT C LOCAL AGENCY BIDDER DBE COMMITMENT(CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY:",, CITY OF HUNTINGTON BAECIrlacAmon PROJECT DESCRIPTION; REST-ROOMS ADA IMPROVEMENTS TOTAL CONTRACT AMOUNT;S TFID BID DATE; 08/22/2023 BIDDERS NAME: MEIGENTERPRISES CONTRACT DBE GOAL: CONTRACT ITEM OF'WORK AND DESCRIPTIONDBE CERT NO. NAME OF EACH DBEDOLLAR AMOUNT ITEM NO. OIL SERVICES TO 13EASIPUPIEtATIOti (Must be 7certified on the date birktiBE SUBCONTRACTED OR MATERIALS DATE are opened inFlude,PBS,address TO EE PROVIDED(or contracted if the and phone number) bidder-is a DBE) For'Local Agency to Complete: Total Claimed DBE $ Local Agency Contract Number: Participation Federal-aid Project Number: Federal Share: contract Award Deter, • • Local Agency certifies that all DBE eertffications have been verified and intormatigala complete and accurate. of Bidder .D8122/2023 714-909-.6558 Date (Area Cnde)-Tel.No. ,Print Name Signature Date RUDY SULTAN, PRESIDENT Local Agency Representative Pe Mom to Contact (Please Type or Print) (Area•COde)Telephone Number: LacatAgeney Bidder DBE Commitment(Construction .(Rev 6/26/09) C-20 PLEASE NOTE: This information may be submitted with your bid.If it is not, and you are the apparent low bidder or the second or third low bidder,it must be submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs.Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date.Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier.Names of the First-Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable,with the names and items of work in the"List of Subcontractors"submitted with your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100%of item is not to be performed or furnished by the DBE,describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE),"of the Special Provisions(construction contracts), to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award, Federal-aid Project Number, Federal Share,Contract Award Date fields and verify that all information is complete and accurate before signing and filing. A C-21 EXHIBIT D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder MBC ENTERPRISES INC. [proposed subcontractor TBD ,]hereby certifies that he/she/it has: X has not _,participated in a previous.contract or subcontract subject to the:Equal Opportunity clauses,as required.by Executive Orders 10925, 1 1114, or r 11246,and that,where required',he/she/it has`tiled with the 1'oint"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, .a11 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 604 7(b) (I)) and must be submitted by'bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from: the equal opportunity clause are set forth in 41 CFR.60-1.5. (Generally only contracts or subcontracts of$10,000 or under,are exen pt.) Currently,,StandarddForm 100(EE0 1)is the only report required by the.Executfve Orders or their implementing regulations. (eeoc.gov/etnployers/eeoIsurvey/index,cfmJ Proposed prime contractors and subcontractors Who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of;Labor.. Signature: .�--'..-- Date: 08122/2023 Print N e . RUDY DY SULTAN Title: PRESIDENT C'-22 EXHIBIT E NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) [NAME OF CONTRACT] To the City of Huntington Beach In conformance with Title 23 United States Code Section 112 and California Public Contract Code 7106 the bidder declares that the bid is not made in the interest of,or on behalf of,any undisclosed person,partnership,company,association,or.anization,or corporation;that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid,and has not directly or indirectly colluded,conspired,connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead,profit,or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true;and,further,that the bidder has not,directly or indirectly, submitted his or her bid price or any breakdown thereof,or the contents thereof,or divulged information or data relative thereto, or paid,and will not pay, any fee to any corporation,partnership,company association, organization,bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. By signing the Proposal, the Bidder has also signed this Noncollusion Affidavit, Bidders are cautioned that making a false Certification may subject the Bidder to criminal prosecution. Signature: Date: 08/22/2023 Print RUDY SULTAN Title: PRESIDENT C-23 EXHIBIT F .DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS,PART 29 The Bidder, under penalty of perjury, certifies that, except as noted below,. he/she or any other person associated with Bidder in the capacity of owner,partner,director, officer,manager: 1 is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any Federal agency; • has not been suspended, debarred,voluntarily excluded or deteimined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending;and, • has not been indicted,.convicted,or hada civil judgment rendered against him/her by a court of competent jurisdiction in,any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification,insert-the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility.For any exception noted above,indicate below to whom it applies,initiating agency, and dates of action. 'Note: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is,part of the Proposal. Signing this Proposal on the signature.portion thereof shall also constitute signature of this-Certification, Signature: Date: 08/92/20231 Print NgIe2UDY SULTAN Title: PRESIDENT C-24 EXHIBIT G NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies,by sighing and submitting this bid or proposal,to the best of his or her knowledge and belief, that: I) 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. 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 Member of Congress in connection with this Federal contract, grant, loan, or cooperative 'agreement,-the undersigned shall complete and submit Standard.Form-LLL, "Disclosure of Lobbying Activities,"in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S.Code. Any person Who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed$100,000 and that all such subrecipients shall certify and disclose accordingly. Signature: ---- Date:' 0109/2078. Print Na . 2iUDY SULTAN Title: PRESIDENT C-25 NOT APPLICABLE EXHIBIT 11 DISCLOSURE OF LOBBYING ACTivrilks COMPLETE THIS FORM ICY:DISCLOSE LOBBYING•ACTIWIMS PURSUANT TO 31 L.S.C. 1352 • 1. Type of Federal Aetloat 2. Status of Federal Action: 3. Report Typet a.contract a.bidrofferlappliegion 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,Ad4resS at Reporting Entity 5. If Reporting Entity irtNo.,416Strhawitrtlee,, Enter Name and Address of Prime: ......, 0 Prime U Suhavvardee: Tier ,y•Iffiglovtn• Congressional Diatriet„;if known tottgressintudDistric;if known • 6. Federal Departnient/Agencyt: 7. Federal Progrant NalitelDeacription; CFDA Number;if applibable. 8. Ferieral,ActionNuMber,ifknown: 1. AwardAmount,if known:. Ill. a.Name anciAddress:Of Lobby Entity 1/4. Individuals Performing Services'(including (If individual,last name,first name,MD address if different from No. 10a) (last name,granilh ,MO (attach continuation Sheet(a)if tteceseary) 11. Aron*,of'Payment(cheek all that apPly). 13, Type of Payment(check all that apply) .,..., 1111•1. $ 1:1 Actual U planned a.retainer li...one-tinte.fee 12. Form of Payment(check e°that apply)r c.commission , .....— a.cash d:contingent fee b.in-kind; specify: nature e deferred : vet*: • E,other,specifyl 14. Drier Description of Services Performed or to he.performed:tad JDate(s)of Service,including offieer(s),-employee(4,nr member(a)contacted,for Payment Indicated Item II: (attach Continuation Sliod.gs)if nge4saar7.) , 15. Continuation.Sheet(s)attached: El ,,,, 0 .. , . if. ritformatinn requested through'this farm is autherized,hy.Thre ., . 31 U.S.0 Section qsz This disclosure of lobbying reliance , was placed to the tietabevetatiihiftransaction was made or entere&into.'This clistiosure is required pursuant to Si:U.S.C.. Print Namev, ,RUDY SULTAN . 1352: This inftirmation will be reported to poultress. PRESIDENT semiannually<and will he available Fur public inspection.Any Title: person who raikto.Me the required disclosure:Aall'Og,Oblect to:a civil penalty of not less than 51000 and not more than Telephone No.: 714-909-6658 Date:08122/23 $166406 for each such,failure. , • . Authorized for Local Reproduction , ,. Federal Use Only:. Standard Form,-LTA, Standard Form Pl.Rev.W-4/47 ( ; C-26 ; INSTRUCTIONS FOR COMPLETION OF EXHIBIT H, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1) Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered Federal action. 2) Identify the status of the covered Federal action. 3) Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last,previously submitted report by this reporting entity for this covered Federal action. 4) Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5) If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address,city,state and zip code of the prime Federal recipient. Include Congressional District, if known. 6) Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation,United States Coast Guard. 7) Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8) Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9) For a covered Federal action where there has been an award or loan commitment by the Federal agency,enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10)(a)Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. C-27 (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (M1). 11)Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4)to the lobbying entity(item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12)Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13)Check the appropriate box(es). Check all boxes that apply. If other, specify nature. 14)Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15)Check whether or not a continuation sheet(s)is attached. 16)The certifying official shall sign and date the form,print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project(0348-0046), Washington,D.C. 20503. By my signature on this proposal I certify, under penalty of perjury under the laws of the State of California, that the foregoing questionnaire and statements of Public Contract Code Sections 10162, 10232 and 10285.1 are true and correct and that the bidder has complied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5,Title 2 of the California Administrative Code). 1 I C-28 EXHIBIT I FEDERAL LOBBYING RESTRICTIONS Section 1352, Title 31, United States Code prohibits Federal funds from being expended by the recipient or any lower tier subrecipient of a Federal-aid contract to pay for any person for influencing or attempting to influence a Federal agency or Congress in connection with the awarding of any Federal-aid contract,the making of any Federal grant or loan, or the entering into of any cooperative agreement. If any funds other than Federal funds have been paid for the same purposes in connection with this Federal-aid contract,the recipient shall submit an executed certification and, if required, submit a completed disclosure form as part of the bid documents. A certification for Federal-aid contracts regarding payment of funds to lobby Congress or a Federal agency is included in the Proposal. Standard Form - LLL, "Disclosure of Lobbying Activities," with instructions for completion of the Standard Form is also included in the Proposal. Signing the Proposal shall constitute signature of the Certification. The above referenced certification and disclosure of lobbying activities shall be included in each subcontract and any lower-tier contracts exceeding $100,000. All disclosure forms, but not certifications, shall be forwarded from tier to tier until received by the Engineer. The Contractor, subcontractors and any lower-tier contractors shall file a disclosure form at the end of each calendar quarter in which there occurs any event that requires disclosure or that materially affects the accuracy of the information contained in any disclosure form previously filed by the Contractor, subcontractors and any lower-tier contractors. An event that materially affects the accuracy of the information reported includes: 1) A cumulative increase if$25,000 or more in the amount paid or expected to be paid for influencing or attempting to influence a covered Federal action; or 2) A change in the person(s) or individual(s)influencing or attempting to influence a covered Federal action; or 3) A change in the officer(s), employees(s), or Member(s) contacted to influence or attempt to influence a covered Federal Action. 1 C-29 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax(714)3744573 ADDENDUM NUMBER ONE For CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS August 15,2023 Notice to All Bidders: Please note the following clarifications to the Project Plans, Specifications,and Special Provisions. 1) The updated wage determination dated 8/11/23 has been attached herein. This replaces the wage determination found in Appendix G of the project specifications. This is to acknowledge receipt and review of Addendum Number One,dated August 15,2023. MSC ENTERPRISES INC. RUDY SULTAN, PRESIDENT Company Name By AUGUST 22, 2023 Date 1 of 1 of Addendum No.1 Document A310 TM — 2010 Conforms with The American Institute of Architects AIA Document 310 Bid Bond CONTRACTOR: SURETY: (Mane,legal wanes and address) (Name,legal status and principal place e f businecr) MBC Enterprises, Inc. American Contractors Indemnity Company 801 S. Figueroa Street,Suite 700 16601 Gothard Street,Ste.G Los Angeles,CA 90017 This document has important Huntington Beach,CA 92647 Mailing Address for Notices with anonseque attorney Is encourag din 801 S. Figueroa Street, Suite 700 with respect to Its completion or OWNER: Los Angeles, CA 90017 modification. (Name,legal status and address) Any singular reference to City of Huntington Beach Contractor,Surety,Owner or 2000 Main Street other party shall be considered plural where applicable. Huntington Beach,CA 92648 BOND AMOUNT: $Ten Percent(10%)of Amount Bid PROJECT: (Nance,location or adores;and Project number,(Tony) Central Library Lower Level Restroom ADA Improvements, CC No. 1658 The Contractor and Surety are bound to the Owner in the amount set forth above,for the payment of which the Contractor and Surety bind themselves,their heirs,executors,administrators,successors and assigns,jointly and severally,as provided herein.The conditions of this Bond are such that if the Owner accepts the bid of the Contractor►within the time specified in the bid documents,or within such time period as may be agreed to by the Owner and Contractor,and the Contractor either(1)enters into a contract with the Owner in accordance with the terms of such bid,and gives such bond or bonds as may be specified in the bidding or Contract Documents,with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Ownei,for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof;or(2)pays to the Owner the difference,not to exceed the amount of this Bond,between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perliornt the work covered by said bid,then this obligation shall be null and void,otherwise to remain in full force and effect.The Surety hereby waives any notice al'an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid.Waiver of notice by the Surety shall not apply to any extension exceeding sixty(60)days in the aggregate beyond the time for acceptance of bids specified in the bid documents,and the Owner and Contractor shall obtain the Surety's consent lior an extension beyond sixty(60)days. If this Bond is issued in connection with a subcontractor's bid to a Contractor,the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been furnished to comply►with a statutory or other legal requirement in the location of the Project,any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement Arall be deemed incorporated herein.When so furnished,the intent is that this Bond shall be c orrnrued as a statutory bond and nut as a common law bond. Signed and scaled this 17th day of August,2023 • MBC Enterprises, Inc. (Principal) (Seal) oiliness) By:hUdy�11I}1�- resirJ (Bile) I American Contractors Inde i Company, ; . : (Surety) (Seal) (Winless) Lisa Pellerito,WitnessBrq o • Ail- • (Tide)Terah Lane , ttomey-in-Fact S-0054/AS 8/10 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 a I 11 I a 0 0 before me, Vanessa Copeland ,Notary Public, personally appeared Terah Lane Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose names-) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(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 `nYp VANESSA copELAND paragraph is true and correct. Notary Pu ebuc. an fornle Or�n{e County ! c:ri My[omCommmission Eicplres Ott a 0,2/393132026 �TjTN S my and o cal seal. �` Signatu e o Pu 'c Place Notary Seal Above ------- -- OPTIONAL — -- Though the information below is not required by law,it may prove valuable to persons relying on the document and could present fraudulent and reattachment of this form to another document Description of Attached Document Type or Title of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Capacity(ies) Claimed by Signer(s) Signer's Name: Terah Lane Signer's Name: ❑ Individual El Individual ❑ Corporate Officer—Title(s): ❑ Corporate Officer—Title(s): ❑ Partner: ['Limited El General El Partner: ❑Limited El General ® Attorney in Fact El Attorney in Fact El Trustee El Trustee ❑ Guardian or Conservator ❑ Guardian or Conservator El Other: El Other: Signer Is Representing: Signer Is Representing: _ Rev. 1-15 ...,,,„, :.,,..70:6,j c •:,4,;;ip e..•.,4, ,,!k. •••;‘,•::„',,,,,;,k:,:j S.:,!•..:.5., ',d,".' 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INSURANCE COMPANY KNOW ALL MEN BY THESE f.!3ESENTS:,,Thq&Arlevrican,p,o_ntractors Company,Indepnity , a California corporation, Texas Bonding tv otyiliriV aMtylaridZorporatiq4Anc ..;!..,T,.... j ,,,, ..U.Pited'StatesZUre-, C <,'.,.., ..5.-..!..,. . A.,..,.,,,..... -... :,..• ,.- , Cqmpany,an-;:40alia.5#4:6)..,,,e csfArneriacaTnegt!rai,,,:t.7:71.71i,Indemnity Company, .-1,..;•.: '''''''':l' "..qq-liq6tiqi-i AbdIfectiveli- U;t?.,Speciaitti.trisarq4ct,Om,..p.apy, kith:6.jimflef.;,,t,;O:o by tlt.,.,6pr,h1,..res.;,!Ifonstit4lithidi.••1-.,t.ii•;..!,1,;.f.,,.••) ,..,,,z,,,,,1 4V, ii5p8.fAt: •-...., 4,,,:• ,,,:,.3., ,..::, - • Eric Lowey,Mark Richardson,Kevin Cathcart,Vanessa Copeland or Tsrah Lane of Irvine,California g, ;,.,./.•,, 4 :,'-'.•.P,?4•,:, . •,-,.. ,,, .„,,..•••; i;„•;.k ,4,314ii, ,; . . tt i.;7.ilr, 'i-'i;; .....;•0%.:. •i e.,,,,.. 0 ..:::!:•,.; ,:v...,:.,, ,-.---,-; it true and ii,.14,i1,....,''''''41‘‘''`tti t1.44yIS).'40act, aCif''.44,0iirfirePitaik,'C'apacity.-•,.',IfiCr, t4r)icle4S1-,..0arned atitnie,;With'fall':;p0Wsr..and authority hereby coofeeigtrin'.1ti'n'lm4:•.et)olibe andestS4i4;46r?e.X8C"Cit:S.,41Ck4kswledgind-iteliVer,etni.'..and all boloilk.i-r'eO'cw.'"in"liill'O.. il','Ilnderiikiir1404 or other instruments or contracts of suretyship to include riders, amendments, and consents of surety, providing the bond) Dollars( $10,000.000.00_ ., "***Ten Million****** ..... penalty does,not exceed . ,. . .•.... -. -•._ r,A TtilSOower PFAPPOPt h.,‘It 0441,7 withontlarthat,ictian o6.. ..April 23rd,i';',g,10:741,s-row##AttornRY:ls-,,,,,?!.ta7,tidl'ird46;,..r.,4"'17d by atbNb1tY4 41!.'1,!•::;..,., ii,..;." g'1:e1„..,11S of the , resolutions adopted by thg.:13 cird,'•.S..-o't tirect44:#.the Companies ,..,.F%la %:,,..,,,,q!:::...9-4,.•':. s.1;.:••.,:,.0,41 d, i;;.--‘..iii.i,i; B'elResolved:16t the"PieSid'ent,any Vice-Pre•Sident,anY-AssistantVioe-President,'iM4Soretanj6rany AssiStanttSatcdreatcatryfosrhaanildboenanis behalf of the vested with full power and authority to appoint any one or more suitable persons as Attomey(s)-in-Fact to represent ...., . - •--- Company subject49he$01RwingRrovisions:‘,„ '''..:.• .,,,f.'Zks .,, AtiOrney-in-rObt:1:;14:4)0:914.9A ftpAyver and,vtiffitiriOdiiihdAn theriame of oillQ0''#.4ii.ofiiitille,thiiyirany,to,...,e*:.1-67ctiteleCini'kediaand delivasekiAy 4 ri'iiiritS'.•:6:finetein,n'OInd othe0ohbititMal*olliat4ty N',1 n..141,70 and all bondreodpiiiienge.,e', oontraots, ag..e,..,,,..,, undert#.7gSfc'f,OC,IU,dirig.'•anyiihefiddadllococu'irie6riti,fts,it: 'ty,3.:;;.‘:f4;;1 ''''!••forifie releaie-of*tarried' percentages andtorfinil eitiM'aterf'engineerifig':efieConitriidticiivcOritracts,andanyan.C1 eifiiof traei, canceling or terminating the Company's liabilidty thaFereduanndder,and any such instruments so executed by any such Attorney-in-Fact shall be binding upon fiected by the CorporatOecretary. 1..... .,..,,, the.Company aOf sigpsdpy, he President anti fter affRiii TO ariii5bwer:of:attorney Rimy cow ResolyeAA*,tp.ksignturtis,any mit onz ,,,..... , .P.,9,-1,4.13fkai4-nd Sia1'1,,of the Cptii4ny..,heretdfpFe.o0eree ,..., , ,..,.. aiiifioate relating therpto,hraCSiniiie,and'arir ppw‘ri4t,.,,,I.S.i.in.0:-.6.i.,cicesrtaifittcaaeltitiiibii:11.7 i-ta4s.1)Istlign jure or ittii,'e,I-1i.,allr4:oailici and bjp;diiii, ..2- ''-i;';'. ..Oiiptiii the CoMpany.viith'iiip.edie any bond orKundettaking,to Wilicli It IN.WITNESS WHEREO,F,The Companies hamcaussAthisinstrument,tchisi.ls,ign„sdrd their corporate seals to be hereto affixed,this 41ER r.1 4:•••5%:. :. ,,,,p,,?.:, ..---" :Q.N••. .,14.‘ .• <,.,..---:'V.:::,4•.:, P•,'A 7S:' ,•4:RD'..1.6S:laY 9LAP 2122 ' 0 el V;i: iN.:'14'olj.crog'14,i 0 4 .1),1,914„,„ "0..„1,4y;,. ?. vs..:v2y ikambiNd COMPANY,UNITEMSTATES SURETY COMPANY .?0,----...c,:x+0.4.444 %..5rs .-16' .c1V7*/ . 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''.V\'I-,.'-,,1.•A,,,,,r, -i,n,,,, -A,,t,,:'.,,.', ,4, c 0..e , Daniel P Agiyii a6 6ePr Oleld p':.,.r t <:-,•%,, P,ig,;,-,i',T.4n1 -',,';-,;,,,.,,4,,.,,,f.-.,...',;, 55 .!0;41,firo,,,, ,,-.::Q1,:o.-,,..:u •.,,,„,,,,t :,.,,,a, .._,,,e :.R v4;-...•..6-0 -,1,0,41,V,2,1r0A,f.,...,, -...niimiAiio 4" A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document to which , ns ,..ecoura ev,or validitwof that document, E••' ..;•34,,..4„, this certificatels,attached,andmot the tut,ies ,.% 1:,.,.,..,.or 14.8 ti,.tt l'.2,V.,,-.3' 3 ERR, tA(Nli:V,,ig ,PV Niti il.'.':ii i:i.iii:(.0;1:0 41--A qi.j.:.:t I.Live IA "tvr',:',:' '.4,6v.g:;'f' ',',.;, '''..'ll''t:4' '''%''' •'•:'''. t6. qar State of California ' County of Los Angeles • 04!this 18th.44:11Aptif20. 22. fore me--X61419.-._',.Zr.re10.4 notary,ipiibliCpsrs-dpall&p.„peared„..p0I,14f4-gultarOfce., Pres# OI;;; •?.,•,•',',. rtt n'antiliidliennifiZompatlyIii004Be0 •ii.,:-..,...4 m?:.'A,mSfloarl -Or.1,,f7, , ..::••,,,z,:•,,-- .t",, "'-' • *" r. kti011if:Within instrument,: • ,,.. .,,,,. 1O,.tiPbmpant.,;,I0:0d States Surety Conipata. anct• $'. Specialty Insu-annsl dirriPany wtierPfoiedtdifie•oti the basis Of•Sntkto.IY eVidShce to beghe persotm.ose.name is4"SiibSiiti:b .. and acknowledged to me that he executed the same in his authorized capacity,and that by his signature on the instrument the person, r4he ntity upon belialfctwhicti,the perscps.,,ctcl, ,sxtscutsdtthe instrumsnt.,, „.., „-„:„, c•-•, c ,.„ °•.:,.., e . , ..;.: 44q...E :.•M ';%. ,PIA 44,'?,•.f.r;•,:, 0.. ,:::,,t:. ,14,'•:A.k.,.....i.,:e: va, Atit.).: k:-..' 4-' ;.'',,',1 ,..1_,•,.' ,4.'•''''"'• • -graPh tie tttin..andtorrect'ivq ..., v.f.-, :, ;,:-M e1 - 1 % :.',,,, :..- ': .0 `.,1:',':,0 .•- iie-- f C rf troaltriatti a:imegoing paT ,.,,... . . ,.kP Mi ‘•." .',•,, ...,:., N.,:,-,-., ..s.,'• '' ') ...A kih-'la- ,-ft -State o ..#.10 .. •,. .„.;;;..,. '•:•••#t;;; ..i,„.::'"'E.,•iiailify unde*MNALTY,,QF PER URY Li'ltf.MV.(0, nc --" sow O.CARUSO WITNESS my hand and official seal. . , ,.,.. ,;, ,,, 7,., _ifii.liik,%.. 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'<t>. , k.:.x.:4,4o x,i... • :-. ,•,..,.:,..:',',.....5., '`,,e,•: emi •t•-•., • • I, Kio Lo, Assistant Secretary 9f Americazi Contractors Indemnity Company, Texas Bonding Company,, United States Surety "'• anipany anditS ,SRSCialty Insurance Copriany:.',,d %?fefiibfli,betrtify, th0114:04v6vAoci foregoing is,p,frpia„p• d.„'•06. ,tre,.ct..•.'00py of a po*ar.r! •— .P-.-: anie . isAtIk6in :,..17A-t,ariEd.. ,,,i6:43Q47n10, 6.,.iAttP4.,mell'*09PtO4* ct:,',°PP which.,-, ..wea 0 ,,,z;. ,,,„,,,,.: ..::„,.,„ .„:, ,,,,, ,:_,•.,.:,,,,i, -Gic ilipe resOliitidnkOffiisi-Ecalr-dspf DirnCii,::el,if).,:! c,,i,',.' .:•-• "•'"'--:. 'et out in the Pdviidt-bf Attdmey are.in full kit&and e . -, et my,band and.....:4Tfi Xeq: t...'1,c•-..1,4441 of .aid-.fic,...mpanies at ozhcs AhgsISss Californiatis In Witness Vyllereof, l,,have Ftsreon.t.i? e,,,.,3,,,, ; A.:',4•'k,.. :VA ,3: .',1?:-Ik, .,.,..1,-;w:-; .:,.:-,n, ,...,-:. .-4.- .V.:A.- All';''; ?*=.• ' !..::'•i A '.':"''''''.";'"" •••-"ADA'Y,',' -.,;•:,t. '1 ''''"'';'''''...• A,' tb• d of ..'A'. . 1•A& llAs "'''''"" '" " .,".:"..'",,,, •'- ',i 1...:4'1 ZW.00 ,„ W....'4'' 1‘:`:eiq .: '.•) 'I PI,-.,, *:: 4014.'6'1/4,, .'(.,>,•4.ePvq,:k.,•*''t,-.00EttfrP4,.0:• k."4.4'-‘4` ,...'" eir 'i="- ---'''' -''' ".-'• ' .4.• '''. '0....1 • VA, ' ,'-V' ‘,.. .4 .4,C.,*%. ‘""'. ''''' — 1 '414141';.': ' ScP": "..\ C4t'... '1 ' .. '' -'t4 f".%-lit -.i4. .. Kio Lo, A-It -nt Secretary • • '" '1'3.ond No. Agency No. 18200 \WI - ,,r" l...ti. •-4111 .! le.3,-i us! --"..."-, Iffi i Wu'i. ......:4- .12E...- 1 . ... - .i li•E F. •'t,r;r ilk— I,s i." ,-• e,• '."••7••,..... ?••'•%•%; ,,.. -,.,7,..:':.7,:, ,q;Y!...., :`. ,...,,,,,:,:,‘,,A, Ae.j.0,;.:•, 1.45, $3.' '..'.4/.....p.,4,55,-,.. . ..:•.--se i 1r6f,i.:,A,..4A-";cif eNg.,..--'. . '':1''',:.'":"''..:.".:'" .5.'''' iccsmANF*osizi0,, a 41tlit?114i.0 ''':Z$ .0%.`"0....:44''''*:.i."444.0‘oos t.:„:,,,‘,,,i 4,41 , o-'.!•.'" •,...:V.... -'-..: ........•.,•..,...: '''''' '''''''''* :'''.. '';‘-. '.4::...a''',•:?:2 -.'?'•‘••!•'•• V 4. ""b '4".",;;Iiit triitiCc.Cdm/SUrety for more information ,..4, ",..mw Q..F --,-• ,•,...;,,::,-., /.-,-,- ,..,. .:., .i, ",:;.'P:',t, itn.'., .. 7.-:::.•;P::'I ,.:•I''''''t 4;$.1. .::,...P:rr ,'',...7, f...;.T. ,..:.,...,, •:,., ....,.. •.., •.,,'.;-.. ':.': '-',.:A ,'41',',,,. ."'' `'...,`•' '''.8' •:41: :0'•,0'---,.:.,4.':,,:4. .-.•.:'.,' •-q .''' ;. ' ,i,-•, .,,.•:&. ? ::,...:. ,;,'; Ara5•..- ••:•,:..••:,::•.-::-,, . ,-,* • C LICENSE NO. 1050671 MBCENTERPRISES SIR NO. 1000064318 Management i Building.Construction OFFICIAL BID SECURITY - DO NOT OPEN Project Name: Central Library LL Restroom ADA Improvement s CC No.: 1658 Bid Opening Date: August 22, 2023 at 2:00 P.M. City of Huntington Beach Public Works Office 2000 Main Street, Huntington Beach CA °��®��NTINGT��m City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 • www.huntingtonbeachca.gov `;._;, -- --=ma's 8@ �17. ` a erg` $ Office of the City Clerk F 7 1 D... \�Q � CpUNT`I ��� Robin Estanislau, City Clerk December 29, 2023 MLC Constructors, Inc. 710 Rimpau Ave., Suite 208 Corona, CA 92879 RE: Central Library Lower Level Restroom ADA Improvements—CC No. 1658 Enclosed please find your original bid bond for CC No. 1658. Sincerely, �$dizzeattAd Robin Estanislau, CMC City Clerk RE:ds Enclosure Sister City: Anjo, Japan } SECTION C P:Ro `OSAL: for the construction of CENTIIAL.LIBRARY LQ ER LEVE-L RESTROOM ADA IMPROVEMENTS CC No.1658 in the CITY OF HUNTINGTON BEACH TO T . HONORABLE MAYOR AND ;MEMBERS OF THE COUNCIL OF HUNTII CToN BEACH: Incompliance with the=N otice l vit ngElectronic Bid.%the undersiignedhereby 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 ofthe City of Huntington Beach The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach,and to enter into a contract at the following prices,The undersigned agrees to complete the work within.60 working days,starting:from the date ofthe Noti ce 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 thisproposall 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.Ce'lltraet,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 RIMER,the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option,be considered null and void. Accompanying this proposal of bid,find Bid Bond hi the amount of 10% which said amount is not less than 10%of the aggregate of the total bid price,as required by the Notice Inviting Sealed OR ELECTRONIC Bids,payable to the AGENCY (Please insert the words "Cash",'Certified Check",or"Bidder's Bond for10%",as the case may be)Any Aandard Surety Bid Bond form is acceptable. Bidder Signify receipt of all Addenda here,11=Y: AddekrktNo. -4:Vac 'iddeest$1041043 ° 1 08/1.5/2023 C-2 CITY OF HUNTINGTON BEACH CENTRAL LIBRARY LOWER tEVEL:RESTROOM ADA IMPROVEMENT BID SCHEDULE Item# Description of Work Quantity Unit Unit Price Item Total „ . , . ...A to 1 :Mobilization I ' LS $ til i mo'$14 suit: ' 2 Construction Waste Management 1. '. LS $ pf506..o $ i5.w.CO .: ,.... 4;) a closeout 1 LS $ go,iip:,:.0 4 5 .u1ut,. 4 Demolition - 1 . LS $24,1$4:!'s 21 115q-.." 5 Abatement 1 LS $ 14-150,,:0.1)$ toq I:510..00' 6 Concrete and Reinforcement ' 1 LS $ 141•56,I°$ 1446-545;4P ..m, Co 7 CateWork/COUnterlop 1 LS $5/D10 r 1 5:1-cri:0.-- 8 Blanket Insulation 1 ',LS $.14.-- $ I i 325: 9 Joint Sealants $ : 1 LS -$Pr$5,C4 1'660, la Aluminum Door Frames 1 LS $1.1460# 411,116P-:Co 11 Wood Doors I LS $'2,'14.tt:4" $2t IWO-4* 12 Access Doors and Frornes 1 LS . 13, Door Hardware t 45 $let 46Pto $4 'Itzt itrti.Coea . . 14 ,G1a4evitolliTot , ' 1 IS $A 45a47 4 z,too,ev 15 Gypsum BOOrcl 1 .LS $44.175,43'$4)1/5-41. , 16 Metal Stud Framing : 1 LS $ if 40, $ It; 160..'e° ,1 ... . 17 Porcelain Tile Floor Finishing I LS $Of 17$::°; IP/ IZ:447 , .: ,.„18 Porcelain Tile Wail Finishing . 1 LS i$4,Vi-5(1).(4)$ 5A.01.y..",7 19 Painting 1 LS ''$. ,1 gal:av -$ 3ip:50.6D' , . 20 Signage: _ 1 LS $ 14-"0.10i° $ I tO4tt t*P 21 Toilet Accessories 1 LS, $210t: ;0) ,$ ::24741,05A.e0 , 2:2 Plumbing 1 LS $'454 044'$ 45•510. 28 Mechanical 1 c 1 LS $ -41160, $(1150/). o 24 Electrical 1 ' LS $ A:77-0;w411 ts20 Total in Numbers $ 224, - ",:t 4 4C1 C-2.I : Total ti Words: •Th 1,064114 to ttnifed Two thwitiyild wintken volays y v cen4.5. NOTES: The estimated quantities listed in the Proposal"Bid Sheets are approximate and are to be ;used only as comparison of bids Payment for quantities will be made from field measureMents.If the actual quantities show either an increase or decrease from the quantities given in the Proposal Bid Sheet,the Contract Unit Prices will prevail.PUB compensation will be paid at the contract price for the actual work completed,and no additional compensation will ; be allowed therefor.Payment will not be made for materials wasted or disposed of in a manner not called for under the Contract;this includes rejected material not unloaded from vehicles and material rejected after it has been placed.No compensation will be allowed for disposing of rejected or excess material The City reserves the right to-reject all bids and to increase or decrease the,amount of any quantity shown on the Proposal Bid Sheets,In case of a variation between the unit price and the totals shown by the bidder,the unit price will be considered to be-the bid. Compensation for items of work not specifically identified in these bid items shall include all labor,materials,tools,equipment,safety measures,and supervision required to complete the work to grades and dimensions shown on the Plans or staked in the field There shall be no compensation except for the bid items specified in the Proposal.The cost of ail work shown in the Plans and Specifications but not specifically identified at a bid item or described within a bid item shalt be included in related hid items,and no additional compensation shall become due the Contrador by nature of compliance with the Plans and SpecifiCatiOnS. ; C=1.2 LIST OF SUBCONTRACTORS In accordance with:Government Code Section 4104,the Bidder.shall set forth the name and business address ofeach 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, ---'‘-', ,*e*:044,4447.4.1 kit,$(410„:", /Vi47e4401. '113011P 0° q vet. 600 610 tOtAWle VI PrOnle.1 CA 41115 By subtnission of this proposal,the Bidder certifies: 1.. That he is able Wand will perform the balance of all work which is,not covered in the above subcontractors hstmg 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project C-3 NONCOMUSION 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 en 0151221202Pat Corona CA Date State James McCoy being first duly swom deposes and says that he or she is President of MI c Consfmninrs Inn 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 notin anymanner,directly or indirectly,sought by agreement,communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and,further,.that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative"thereto, or paid, and will not pay fee to any corporation,partnership,company association,organization,bid depository,or to any member or agent thereof to effectuate a collusive or sham bid. Name of Bidder MLC Cons uctors, Inc Sign of Ater 710 Rinipau Ave.08I Suite 208, Corona, CA 92879 Address of Bidder C-4 UTILITY AGREEMENT HONORABLE MAYOR,'OR AND:CITY COUNCIL CITYtOF HUNTIfNGTON REACH,CALIFORNIA. Gentlemen. The undersigned hereby promises and agrees that in the performance of the work specified In the contract, known as the CENTRAL LIBRARY LOWER YAWL ADA IMPROVEMENTS, (1)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities,.'The term "Qualified.Person" is defined in,Title.g.,.California Administrative Code,Section 2700,as follows; { "Qualified Person. A person who, by reason of experience or instruction,;isfamiliar w th the operation to he performed and the hazards i Ivolved' 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. MLC Construct©rs, Inc, Contractor By President .. Title: Data:08/22/2023 } C-6 .... i I DISQUALIFICATION QUESTIONNAIRE In accordance witli Government Code Section 1,0162,the Bidder shall complete,under penalty of Perjury,the follming 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 lallo If the answer is yes,explain the circumstances in the space provided. Note: This questionnaire constitutes apart of the Proposal,and a signature portion of the Proposal shall constitute signature of this questiatmaire. COMPENSATION INSURANCE CERTIFICATE Pursuant to Section.1.861 ofthe State Labor Cade,ea&contractor to whore apublie works cpn r* :has been awarded shall sign the followingcertificate.. I am aware oldie provisions.of Section 3700 of the Labor Code,`which require every employer to be insured against liability for workers compensation or to undertake self- insurance ._ in accordance With the provisions of that,code,and,I will comply with such provisions before commencing;the per ircmance of the work of this.contract. MLG Constructors, Inc: Co itraetor j7 By Pres10ent Title Date:'08122/2023 yy p BIDDER'S INFORMATION BIDDER certifies that the,following information is true and correct MLC Constructors, Inc. Bidder Name /10 Rimpau Ave.Ste.208 Business Address Corona, CA 92879 City, State Zip (951 )393-0781 estimating@mloconstructort.torn Telephone Number Email Address 1068632 A,E3y 010,036,C20,and C61 State Contractor's License No.and Class 09/0912020 Original Date Issued 09/3012024 Expiration Date The work site was inspected by James McCoy of our office onALIgust 22 ,202? The following are persons,firms,and orations having a principal interest in this proposal: MLC Constructors, Inc. Jarnes McCoy!president:/Treasurer Thomas Luby/Vice President/Secretary The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements In accordance with the plans and specifications set forth. MLC Constructors, Inc. Comp Name ture of Bidder James McCoy I.President ?tinted or Typed Signature GS. • ' " . .„, . , • • . . -i cAlIFORNiA 4urtgiii, GOVERNMENT CODE:18202 ....., ,,. ,.. ,,....... .. .. ,..,.... .... ..,. .., .... .,....... ..„.,.„ .,_..._.., .., .. . ..,.. .., .......„.............,... .. .„ . ., ....... ,._... , ktvtarypuplit or.0(1er-officer completing this:certificate verifies only the identity ofthe individual who Signed tiledoci,ithglitto Witioil'tiliS certificateit,ottaOrieci,Andnotthe trilthfulneSS,A00Oreqc OrVallditsofthat dOomeht . . .. .. . . • State Of CfOrfif t. i. Own*.of...Riverside Subscribed and sworn to Or affirmedl,before me on this 22 day of August .. a la ,,,.by i Dote ,11,1plitty Year ; - James McCoy ... . . a .. . ...... , , 1 0-a--2,*17z7 . 111.944iikt.Couoty I 01(44 ' — ' . -- Yi- .- .-.4.-A''f.1.7" 2. ...C.0.100001#2441064 : . .Nome(gi of Signets) ,.., .•.:,. , . -.99as.„, ,gyomm.Expires May M1027 . ., ... . . . . . . .. .. . . proved to me writhe basis-of a-1 .evidence to .. be the person )ViitioaO;ear7 e me. , .. _44111hL .. .. . , .,..-.-. ... .... - -_ :.. , . . , Signature . 'Place NOtorySedfoodiebt.Stump Above Sb at, of .tatyPiibitc . ., -.,........-.„. < • I .OPTIONAL ' . . .. .... . -- .' .. ,,,pompfellogrUILT infotrotkili tiiil:deter eritteltioil of the dbcurnentor .. .' . .eirlfelltleOttOchOlont Of thislcvM„to:an mintendeci+.1q0(1. .:: - -'. , . • : -• . , ;:..„ Description of Afteited Doeuine - ..,.- . - , .. Title or Type Of Document --""-' , . ' ' .. . .: "-• .------"----- Document oatet, -. . ,.. . tRoyisedi .... ,.....,. - . .... ..4eTtion.Named Above: •- • --.::. . - „ . Ct.20718•Ratiortal Notary.Astociation , •NOTARY CERTIFICATE Subscribed and,sWOrn to before me this day of ,202 . A notary public or other officer completing this certificate verities only the identity of the, individual who signed the document, to which this certificate is attached, and not the truthfulness,accuracy,or validity of that document. State of County of On before me, Month,Day,and Year intertNatne and Title ofNotary personally appeared Name(s)of Signer(S) who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s)is/are subscribed to the within instrument and acknowledged to,me that he/Site/they executed the same in Ws/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 certify tinder PENALTY OF PERJURY under the laws of the State of California that the foregoirigparagraph is true and correct. WITNESS my hand arid official seal. Signature Signature ofNotlYhiblic (PLACE NOTARY SEAL ABOVE) Bidder's.Project'11istory For the purposes of this,project the contractor and subcontractor must have,in the last,five years, ; constructed at least five '(5) projects of similar work specifically referencing the construction of {Describe specific'work and experience necessary for project,for example"Reconstruction or rehabilitation of existing public use facilities". Bidders are encouraged to submit supplemental relevant project histOryin addition to theprOjecta listed herein. Thg following iistof Projegts meet the reclOirgrOOnts.of above:: I. San Bernardino County '222 West Hospitality Lena;2nd Fiot)t.San Bemakiiiicc.,CA'9244$-0017 Name and Address of Refer.ence Name and.Telephone Nth of°Wrier!: JOseph Gallardo, 909-633-901$ • Site Improvements,.construction of $1,6924866 access roads and concrete slab 12/30/2022 Contract Typeef Work Date Completed. Provide additional project description to show$linilarlYerk; Reconstruction of.Access Roads 2. City of j'7'grpc1afe .38250 Sierra Hwy, Palmdale,.CA.93550 Name and Address:of Reference. Name and Telephone No.,of Owner: -9Yrus Nasser 661'267'5304 Consipichan:of tt-1,49aqtalash Mallon andIkzaa Sqhfuet thatopititathlit thacito.eidstlit4inaintetitaiest sestet,Asphalt. $1 A9%900 94concrete tiriprovkirOntg"n11.44.4tpr011insi s*InectitRia 'tcf OW:structures.: 09/30/2022 . . Contract AMount 'Typeof Work Date Completed. Provide additional project description to.show.simflarwork: Improyamonts in:-theOitys Maintenance yard Facility,. 3. The Metropolitan Water District gr.Setitnern California Name and Address of Reference Natne:and3efepbone No.of Owner Brian Higgs 7604906-0341 Building a retaining wall and aasoblatedsitermerk, .$448900 structural relnfurcsment,of rpotcoanettions:surd bracing interior:0mb,upgradingrite supiestiOn andalaini system 02/1612022 Contract Aitiount Type of Work Date Completed PrOyicte additional project description to show sindlarwOrk; ..site and interior improvenyirittafacklits(01400g &HI 4. South Coast Water District Name and Address of Reference. Name and Telephone No.of Owner: Mario Rodriguez 949-$=-0486 Design and Construction of a 2,250 scift $197,112 Metal Warehouse and Buildino Work 7/2022 Contract iktnoimt Type of Work Date Completed Provide additional project description to show similar work: New metal building installation and electrical work to building. 5. Canopy Structure at Lopez Elementary School Name and Address of Reference Name and Telephone No.of Owner: Jeff Coakly 951-529-2551 $214,000 construction of(1)Entry structure and Site.Work 08/06/2021 Contract Amount Type of Work Date Completed Provide additional project description to show similarwork: Site Improvements C-11 . , Bidder's Critical Staff •• . Listed belOvit!are the names of the bidders proposed Construction Project Managero and . •: Superintendent For each of these critical positions,please list.at least three projects for which the,oritiont staff has.performed similar•welt within the last-6e:yeats.These projects do not , ,•• • have to be under the employment ofthe bidder of this project Bidders are encouraged submit • supplemental relevant,project history in addition to the projects listed herein, 1.. Tgrn 14ft . . Name ofproposed Project Manage. g51-t65-$3a..5 • . Telephone:NO.ofpropoted.Projeet Manager Keep*Peak Transfer Station civil. and Structural Improvements Construction of access roads, . . 411,692;1M and concrete:slab 12/3012022 . Project Name&COntractArnount Type of Work DateConipletecl • FDr-712 maroteriakeYso irisopoltoi* vonsbuooriogAsetrontri*virtrtidis!a4 - $t 499.909 ,..d....tempto.ntondwffitylabwoo,.:04.0.13.: 0640)2022 torpy,:oliFkto*Project Name.4 Contract:Amount Type of Work Date'Completed. Apeclio,00,1.ake:Matilitivs, sulaiii.itifigtoiegind..aelatidsitewadt, i.., Reseivoir dfeasterlflicoveryfacilitk Upgrades Auetunoinforomentoporconnotonondtrithis rmsspo Jp.te.frofyfoopor.ackormsypairorvmsy040 02/.1012,022 . . . . i Project Name&Cotltra.O.Atilottlin Type of Work Date Completed ,.. 2. - 4.im,RcgOy .- „ . NameOfproposed Superintendent. 95:1429e44907 Telephone No,of proposed Superintendent : ..: : Heaps Peak Transfer Station Civil and:Structural kriprovemeata Construction Of access toad* Si,692;:866 and concrete sfab, 12/30/2022 Project &Contract AiriOnnt Type of'Work Date • PN471.1'Maintehance Yard,Improvements gr,;:*.e'unt;iliy ittaturZklattlItragl. end $1,490,900 , odcoaktdiniptcnitimeiptikendatiPtittelOrwiconneclona to'nevestmotabsi: " 09/30/2021, 1 PrOj. et:NOV A Contract Amount 'Typeof Work Date Completed. .t Spec No..190 take Matthews otitiimatelifiiingvatindgwerotthaiwoitia, „ .. Reservoir Disaster Recovery Facility 00006.0 ;=.12Zirmaedcanal-=',.4%. . :$44%son• 0211612022 . .. Project Name&Contred,Amount Type.of Work Date.Completed , . , , .... t 042: 1 . , CONTRACT©R`REGISTRATIQN 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 ContractorReglStration Program,which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each Ally 1 through June 30 state fiscal year) with the California Department of Industriat Relations(DIR).Currently the annual non:refundable registration fee for Contractors is$300;Each contractor to whom,a.public works contracthas been awarded shall sign. the following certificate. 1. DIR..FACT SHEET on S>3'854: littp://www.dir.ca„gov/DLSE/PublicWorks/SB854FactSheet 6.311.14.pd DIR's Contractor Registration Link—Call(844)522-6734 https lefi11ng dir.ca.goer/P CR/Actio eievletlaction=dispiay WCRegistrationForm DIR's Contractor Registration searchable database: htqw.11efiling.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 fur public work, as defined in this chapter,unless currently registered and qualified too perform pudic 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 70291 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 true the contract is awarded." I furthermore will comply by providmg proof of registration with D as th a primary contractor,. as well as for ALL subcontractors at the;time of submitting the bid. MLC Constructors, Inc contractor Bc:714 jim@rnicoonstructors.com Email President Title Date,: 08122/2023 PWC Registration#: °°°667976 Ct3 EXHIBIT A DISADVANTAGED BUSINESS ENTERPRISE(DBE) This Project is subject to Part 200.321,Title 2,Code of Federal Regulations entitled "Contracting with Small and Minority Businesses, WomeWs Business Enterprises, and Labor Surplus Area Firms." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in. Part 200 321, Title 2 CFR, shall be encouraged to participate in the performance of Contracts financed in whole or in part with federal funds.The Contractor Should ensure that DBEs,as defined in Part 200.321, Title 2 CFR, have the opportunity to participate in the performance of this Contract and shall take,all necessary and reasonable steps,as set forthin Part 200.321,Title 2 CFR, for this assurance.The Contractor shall not discriminate on the basis of race,color,national origin, or sex in the award and performance of subcontracts out the requirements to carry equirements of this paragraph shall constitute a'breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to Obtain DBE participation in this project,although there is no specific goal for DBE participation. 1 i.. :C-1 EXHIBIT B DBE INFORMATION—GOOD FAITH EFFORTS Federal-aid Project No. CC-1658 Bid Opening Date 08/22/2023 The City of HuntingtonSeach established a Disadvantaged Business Enterprise(DBE)goal of 04 for this Project.The information provided herein shows that a good faith effort was Made: Lowest,second lowest and third lowest bidders shall submit the following information to document Adequate good faith efforts.Bidders should.submit the following information even if the"Local Agency Bidder DBE Commitment"form indicates that the bidder has met the DBE goal.This Will protect the bidder's eligibility for award'ofthe contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g.,.a DBE firm was hot certified at bid, . opening,or the bidder made a mathematical error. Submittal of only the"Local Agency Bidder DBE Commitment"form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made: The following items are'listed in the Section entitled"Submission of DBE Commitment" of the , Special Provisions: , A. The MOOS And dates,of each publication in which,a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified DBEs solicitifig bids for this Project and the dates and methods used for following up initial solicitations to determine With certainty whether the DBR4 were interested(please attach copies of solicitations,telephone records,fax confirmations,etc.): Names of DBEs Solicited Date of Initial Follow Up Methods Solicitation and Dates , ' ; 1 e-i5 . 1 { } } C. The items of work which the'bidder made available to DBE firms inciudinng, where appropriate;:any breaking down ofthe contract work items(ncludingtbose items normally performed by the bidder with its own forces)into economically feasible units to facilitate DBE participation. it is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE.participation was made available to DBE firma: items:of Work Bidder Normally Breakdown.of Amount Percentage Performs Item Items ($) of (Y/N) Contract { D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the rims selected for that work(please attach copies of quotes from the frmsinvolved),;and the price difference for each DBE if the selected firm is not;a.DBE; Names, addresses and phone:numbers of rejected DBEs and the reasons for the bidder's rejection oftl a DBEs: is Names,addresses and phone numbers;of faits selected for the work above: is E. Efforts made to assist interested DBEs in obtaining bonding,lines of credit or insurance, and any 'technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: C-16 F. Efforts made to assist interested DBEs in obtaining necessary: equipment, 'supplies,; materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using,DBE.firms (please attach copies of requests to agencies f: and:any responses received,.i.e.,lists,Internet page download,etc.);. k: Name of Agency/Organization method/Date of Contact Results IL Any additional data to support a:demonstration of good faith:efforts(use additional sheets if necessary): NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY C-'17 :IF A SOLE OWNER.OR SOLE CONTRACTOR SIGN HERE: :(r)Name under which business is conducted' (2)Signature(given and:surname)of proprietor (3) Place ofBBusiness (Street and Number) City and Star, (4) Zip Code TeleploneNo (5) E-Mail �i. IF A.PARTNERSHlIP,SIGN HERE: (1)Name under Much"business is conducted . . (2) Signature (given and surname and character of partner)(Note: Signature must.be made by a general partner) (3)Place of•Business. } (Street and Number) City and Stat { (4) Zip Code. Telephone No (5) E-Mail C-18 { { 4 IF A CORPORATION, SIGN HERE: (1)Name under which business is conducted MLC Constructors, Inc. , . A (2) d ,,,,....., President (Title) Impress Corporate`Seallere . ,:',, (3) Incorporated under the laws of the State of California $ , (4)Place of Business 710 Rirnpau Ave. Ste.208, (Street and Number) City and State Corona, CA (5)Zip Code 92879 Telephone No. 951-393-0781 (6)E-Mail estimatincOnicconstructors.corn NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MST BE.ATTACHED List below names,of president,vice president,secretary and assistant secretary,if a corporation;if ' a partnership,list names of all general partners and managing partners'. James MeCoY rPresident Measurer Thomas Luby/Vice Presfdenti Secretary t ° ' C-19, ' CALIFORNIA ACKNOWLEDGMENT CIVIL:Cops§1189 .-s,,i,:.1....,t,....7„:„.•7,-.21,,,,,,.7.,,,,:::-.,i,,,Tezt-r,,,z,-..,:.::,:k,.4,,. ...z.,:.;:.,1,...,:,„:„}:;,/,,,,,,,:,,,,,,,,.„.„..,,,,,,..:„.„.„,:,:,.,,,,,,r..,:•„,: ::„:,,,F.,:n,y7,,,,,:,,,L,T.,:::„,,,:,,,:m,:;-4,,,?.,,,s,,,..1.,..::::::01i.,1(1,,::,:.1..:1.:,,Z,;:,)Z.Y:,..1::,.1v:::::'...1',,,,,l',..7, knotary pUblicorother officercompleting.this ortifitatevetifte4•0r4theitientitynftneindlykinal Witn.,Artedthe rinctintent, tawhiChthis certificate:is:attached;and not tWruthfulttes ,..aquticy,or validity nfthatdncutnent; ,, State of California 1 , County of.Riverside - . On August 22,2023 before trig,. Karma Jasmin•Chavez Notary Pupae. Ptitc,, Fig it 6'IhSert naille and Title°et,*Officer . :peraonally appeared :James McCoy Narneof of Sioneo, . , . . . who proved to me on the basis nf,setiefactOty evidence tp be the peron(*)14h0e:net*IS/41*subscribed ,,•,, to,the Within InOrument and acknowledged to'the that heishai4e34r executed the same in itialtier44eir authorized capacitypg and,that by hiaiher4*eignetureK on the Instrument the pereoncto,or the entity I-' upon behalf otWhiCh the,person(4•actect:00(ecutedthe Instrument . .v.e..46460.4641 I:certify under,PENALTy-oF PERJURYdnder the :i.A.4iii0,,,i\.., Notaroubut,wawa. r. ,,o,, • KmAi$J.A.414 Jil.Cnnif.z, laws,of the'State.*California that the • , „, a . ,..-- ,•, -:- foregoing :1, I Riverside County Paragraph is true and correct , 1 .COmm4094944104 myne4Atkrt :UpiresNay 10 2027 WITNESS , .. n - et:seat ,... . '''.. . Signature P , plx4g:INI.Oto:ty5,0taildlot STarnpAbove ',.Sigtier :„:,.....:: 0ply Public • OPTIONAL . . .. :-, ....„... .... . . • •- " . cOM:p(Ottrig..this'ipiciriptIt104. 00cf.etettltercittbn of the document.or • - : ' frouOtdentreo(tockrerg.9rfftis'ickm,to On opintonoo0 doodffinnt.: . - - , Dettiitgion of A'. = bed Document • ' Title or Type of Dacume. , . • .• . . - - , , , ',"-• . . . •I'''''',., 1:Iocuittent Date:, • , . • Numperofpngee: Signer( ).Other'Than Wanted Above:: — - - Capacity(lea)Claimedby Signertef , -.' ' ....• Signer's Note! -- - . Signe , erne: . a Corporate:Officer:,littefsp. . a Corporate 1,! cer—Titte(s)z: ..... . cf. Partner— 13 Limited 0 0'. -rei O Partner— 0 IL .,*.•:,'0 0'Peneral. .. 0. Individual . .:ia :Attorney in Fact o Individual, ' .:- 1,ttarneyln,Pea , . . , PI Trustee , . ,th Guardian Or Contervator ct Trusteer!'Gu., = .n or Conservator ci•other . .•. .ci Other: . : ., •Sign -... Reoresentingv • • Signer ie RePireSenting: , .. ::,,,,7::*,:•,..1,7.,,,,±Fi,,,z;%-.i.k.,: z :,..:,i'•:,,:-.1.,:,,,,.p:.t,..7.-,7„:.,:,,I..,,,z.-...,T.,:,;,,,:;•,,,,I;::: :::,:-..,,z,-:, ,z,,-;:.,- --.1,,,,i,;:,,-.,1.,i.,:,,,s,:..,:.-.-;;,:z.:,::::,:.:p..::f‘*,:e,,,:,,,,: i.,,,:, ..,,,,i,?.,.,,.1.,:,1,1'1,i,,'I..-,,,,,,,,,,z,,,,,z,.:..7.,,,i-.4f.,f.,i.,,,sii,E-,i.: , ,• 97018 Na'rioneI:Not.ary.Associotion ,. EXHIBIT C :LOCAL AGENCY BIDDER DBE COMMITMENT(CONSTRUCTION CONTRACTS) NOTE: I'LEASE.REFER:TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORS LOCAL AGENCY:: LOCATION: pg0.1EcTDEscm1oNi1i Vi - IAACWiV)1i4 ,tt.St+-of reillitorrIg TOTAL CONTRACT AMOUNT:$ 9014 BID'DAM BIDDERS NAME: 1‘410 ,:eettattl- —NVS It 1=VIC CONTRACT pp.E.,q944 ti CONTRACT ITEM OF WORK.AND DESCWTI.Q.NPER=PERT NO: NAME OF EACH DBEDOLLAR AMOUNT ITEM NO. OR SERVICES TO BtAisID'EXPIRATION (Must bevertified on bidOBE SUBCONTRACTED OR MATERIALS DATE arc opened-include DBE address TO BE PROVIDED(or contracted if the and phone number) bidder igca;pag , . For Local Agency to Complete: ••• TotaLCIeinted DEB: $ 0 Local Agency Centfa0Number: .Itiartinkeitrot. Federal-aid Project Number: , 0 Federal Share: • Contract Award Date = •Local Agency CeatifiesIbetell OBE certifications have been verified and , . , • information is complete and accurate. S star of Bidder • • , • =': ci-078t. Da e a a- .(Ax...4,C040)17e1.140., Print Name Signature. Date . ,••1/41 iv% •11.11 1 tettt Local Agency Representative Person to COntact, (Please Type or Petty (Area Code)Telephone lquinber: Local Agency Bidder Omentionen(Bonetro-tiengenfrac9. (Rev 040=10) C-20 PLEASE NOTE: This information,may be submitted with your bid.If it is not,and you are the apparent low bidder or the second or third low bidder,it must be submitted and received as specified in the Special Provisions. Failure to submit the required DBE,commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract;: Local Agency, Location,Project.Description, Total Contract A mount, Bid.Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract;Item Number and Item of Work and Description or Services to be Subcontracted or,Materials to be provided by DBEs.Prime contractors shall indicate all work to be performed by DBEs including,if the prime is a DBE,work performed by its own forces,if a DBE. The DBE shall provide a certification number to the Contractor and expiration date.Enter the DBE prime's and subcontractors'certification numbers The form has a column for the Names of DBE contractors to perform the work(who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier.:Names of the First-Tier DBE Subcontractors and their respective item(s),of work listed should.be consistent, where applicable,with the names and items of work in the"List of Subcontractors"submitted with !; your bid. There is a column for. the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100%of item is not to be performed or furnished by the DBE,describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise(DBE),"of the Special Provisions(construction contracts),to determine how to count the participation of DBE firms, Exhibit 15 G:must be signed and dated by person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract.Award,Federal-aid,Project Number, Federal Share,Contract Award Date fields and verify that all information is complete and accurate before signing and filing. C21 3 EXHIBIT") EQUAL EMPLOYMENT T OPPORTUNITY CERTInCATION The bidder MLC Constructors, Inc.. [proposed subcontractor ,J hereby certifies that he/sloe/it has ,has not.X ,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,heIsheiit 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$I0 000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. (eeoc,gov,/employers/eeo.1 survey/index.cfm) Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not tiled the required reports should note that` 41 CFR. 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Signature; d/h Date, 08/22/2023 Print Name: ones McCoy Title: President r C-22, EXHIBIT E NONCOLLUSION AFFIDAVIT (Title 23 United' States Code Section 112 and Public Contract Code Section 7106) [NAME OF CONTRACT] TO.the City of Huntington Beach In conformance with Title23 United States Code Section 112 and California Public Contract Code 7106 the bidder declares that the bid is not made in the interest of,or On,behalf of,any undisclosed person,partnership,company,association,organization,or corporation;that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid,and has not directly or indirectly colluded,conspired,connived, or agreed,with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from _ .. bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, of „ communication, or conference with anyone to fix the bid price the bidder or any other bidder, or to fix any overhead,profit,or cost element of the bid price,or of that of any other bidder,or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true;and,further,that the bidder has not,directly or indirectly,submitted his or her bid price or any breakdown thereof,or the contents thereof,or divulged information or data relative thereto,or paid,and will not pay, any fee to any corporation,partnership,company association,organization,bid depository,or to any member or agent thereof to effectuate a collusive or sham bid, Note: The above Noncollusion Affidavit is part of the Bidder's Proposal, By signing the Proposal,the Bidder has also signed this Noncollusion Affidavit. Bidders are cautioned that making a false Certification may subject the Bidder to criminal prosecution. _/4 , Signature: Print Name: J j es McCoy Date: 08/22/2023 Title: President C-23 EXHIBIT F DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,,CODE OF FEDERAL REGULATIONS,PART 29 The Bidder, under penalty of perjury,certifies that,except as noted below, he/she or any other person associated with Bidder in the capacity of owner,partner,director,officer,manager: • is not cutrently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any Federal agency; , . has not been suspended,debarred,voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; , . does not have a proposed debarment pending;and . , • has not been indicted,convicted,or had a civil judgment rendered against him/her by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. , If there are any exceptions to this certification,insert the exceptions in the following space, Exceptions will not necessarily result in denial of award,but will be considered in determining bidder responaibilitY.For any exception noted above,indicate below to whom it applies,initiating agency,and dates of action. ) Note: Providing false information may result in criminal prosecution or administrative sanctions., The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this.Certification. , Signature: Date: 08/2212023 Print Name: James McCoy Title: President , , •C-24 , , P.),CEItBIT G NONLOBilYING CERTIFICATION FOR FEDERAI.,-AID CONTRACTS The.prospective partidipant 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, amendrnent,or modification of any Federal contract„grant,loan,or cooperativeagreement. •, 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 0/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 1154 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 M0310%000 fez each such failure.. The prospective participant also agres 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 subrectients shall certify and disclose accordingly. Signature: :- . . ,Date:, 08/22/2023 es McCoy Print Name: Ja es Metoy Title: Preskient . , C-25 . 1 : EXHIBIT H . , DISCLOSURE OF LOBBYING ACTIVITIES ) COMPLETE THIS FORM TO DISCLOSE LOBRYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 ., I. Typeof Federal Action: I 2. Status of Federal Action: 3. Report Type: pa.contract Ili a.bianfibrlapPlieation a.initial b.grant b.initial award kinateriat change : c.cooperative agreement c.post-award d.loan For Material Change Only:: e.loanguarantee year quarter , f,loan insurance ,date of last report 4... Name and Address Reporting Entity 5. IfileportingEntity InNo.4 is Suliawardee, Enter Name and Address of Prime: 0 Prime El„Subawardee 'Tier ,,..if known Congressional District,if known Cengressionit Diatriet if known 6. Federal Department/Agency:. 7. Federal Program Name/Description: e„FDA Number,„Ifiipplicable .: S. tedetat•AettimiNiiiitheii,if known: 9. Award Amount,if known: . . , . to. a.Name and Address ot Lobby Entity 6. individuals Performing Services (including , (lfindividual,last name*first name,MI) address itdifferentfromNa.way (last mune,,firstinuna,.N14 (attach Continuatiork6beCO/ifilecasarn 11. Amount of Payment cheek all that-apply) .0. Type et'Payment(check all that apply) 5. El Actual planned a,retainer b.one-time fee 1-2, Form orkayaiiat(check that apply): C.commission A 4,,aiish d.contingent fee .:: b.inlind; specify: nature a:deterred value f;Oilier,speeige 141. Brief Description of Rehires Performed orto be performed and Date(a)of Service,Including „ tinicer(s),employee(s),or menther(s)Jetiatileteitt for Payment indicated in Item 11: (attach CentinuationSheet(a)if necessary): 15. Continuation Sliest(s)attached: Yes El No ID, 16. Information requested.through MIS form is authorized by Title 31 U.S.C.:Section:1152.This disclosure cif lobbying:reliance Signature: : was placed by the iier above when his transaction was made or entered into.This disclosure is requited pursuant to 21 U.S.C. Print Nettie:'‘'°11!'- '•ivF4''''!`ff . . . 1.352. This information will be reported to Congress semiannually and will be available for public inspection.Any Title: President personwhelailatafile the required disclosure shall besubject to'a.Ciyil penalty.of not leas than 5.10i006 and not more than Telephone No.: 951-393=0781S Date: 08i22i2023 u $1.6a,00t)for each such failure. Authorized for Local Reproduction Federal Use Only: StaridaniForm-LLL Standard Form LLL Rev:Q9I-12-97 C-26. ;City Of Huntington Beach Public Works Department 2000 Main Street Tel(TM)530-5431, Fax(714) 374-1573 : ADDENDUM NUMBER ONE , ; For CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA ! IMPROVEMENTS 3: August 15,2023 . Notice to AU Bidders: Please note the following clarifications to the Protect Plans,Specifications,and Special ., Provisions., n The updated wage determination dated 8t11/23 has been attached herein., This replaces the wage determination found in AppenOIXG ofthe project specifications. This is to acknowledge receipt and review of Addendum Number One,dated August 15,2023. . . . tet lt o. 6tikilVtielS 1 the..... ColliOany Name By ,,, ' i I 1 o6 1 1201,---.Date . , . . 'I of 4 of Addendum NO.I ! ' 1 , , MLC Constructors,Inc. Corporate Resolution of Signing Authorio WHEREAS,the Corporation is determined to grant signing and authority to certain person(s) described hereunder. RESOLVED, that the Board of Directors is hereby authorized and approved to authorize and empower the following individual to make, execute, endorse and deliver in the name of and on behalf of the corporation, but shall not be limited to, any and all written instruments, agreements, documents,execution of deeds,powers of attorney, transfers, assignments, contracts,obligations, certificates and other instruments of whatever nature entered into by this Corporation. Name: James McCoy Position/Title:President Telephone Number: 951-393-0781 Email Address jim@micconstructors-com •Signature. / The undersigned certifies that he/she is the properly elected and qualified Secretary of the books,records and seal of MLC Constructors, Inc., a corporation duly conformed pursuant to the laws of the state of California, and that said meeting was held in accordance with state law and with the Bylaws of the above-named corporation. This resolution has been approved by the Board of Directors of MLC Constructors,Inc.on March 4, 2021... I, as authorized by the Company,hereby certify and attest that all the information above is true and correct. Thomas Luby Secretary ' Bond No. NA 111 MARKEL" BID BOND KNOW ALL MEN BY THESE PRESENTS,that we MLC Constructors, Inc. as principal, hereinafter called the "Principal,"and MARKEL INSURANCE COMPANY, at 4521 Highwood Pkwy, Glen Allen, VA 23060, 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(10%)of the Amount Bid by Principal 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 Central Library Lower Level Restroom ADA Improvements Bid No. CC No. 1658 NOW,THEREFORE, if the contract be timely awarded to the Principal and the Principal shall within such time as specified in the bid, enter into a contract in writing or, in the event of the failure of the Principal to enter into such Contract, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the work covered by said bid,then this obligation shall be null and void,otherwise to remain in full force and effect. PROVIDED, HOWEVER, neither Principal nor Surety shall be bound hereunder unless Obligee prior to execution of the final contract shall furnish evidence of financing in a manner and form acceptable to Principal and Surety that financing has been firmly committed to cover the entire cost of the project. SIGNED, sealed and dated this 16th day of August , 2023. (Principal) MLC onstructors, Inc. BY: "L TITLE: SeCKetn 111 (Vie 1 iri'$id 1 Markel Insurance pan BY: Adriana lenzuela,A rney-in-Fact THE RIDER ATTACHED HERETO IS INCORPORATED IN THIS BOND AND MODIFIES COVERAGE UNDER THIS BOND. MSUR10 0318 CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT 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 ss. - County of San Bernardino On AUG 1 6 2023 before me, Rebecca Elizabeth Adcock, Notary Public Name and Title of Officer(e.g.,"Jane Doe,Notary Public") personally appeared Adriana Valenzuela Name(s)of Signer(s) - who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that she executed the same in her authorized capacity, and that by her signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. 91:7r 4 Rebecca Elizabeth Adcock I certify under PENALTY OF PERJURY under the laws of , /y. /§� , " .COMMISSION#2327252 Z the State of California that the foregoing paragraph is UI` �- I' NOTARY PUBLIC-CALIFORNIA true and correct. z \q- x SAN BERNARDINO COUNTY • ,. `1 "v My Comm.Expires: 3-May-2024 ITNESS my ha ndd official seal. OVA- Sig ature of Notary Public OPTIONAL Though the information below is not required by law,it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: - . Document Date: Number of Pages: - Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: RT THUMBPRINT OF SIGNER O Individual Top of thumb here O Corporate Officer Title - O Partner -- O Limited O General O Attorney-in-Fact • O Trustee O Guardian or Conservator Other: : Signer is Representing: STATE OF CALIFORNIA DEPARTMENT OF INSURANCE NQ 07500 SAN FRANCISCO • Amended. Certificate of Aiithority THIS IS TO CERTIFY THAT,Pursuant to the Insurance Code of the State of California, Markel Insurance Company of Deerfield, Illinois - , organizedunderthe laws of Illinois ,subject to its Articles of Incorporation or other fundamental organizational documents,ishereby authorized to transact within the State,subject to all provisions of this Certificate,the following classes of insurance: Fire, Marine, • Surety, Disability, Plate Glass, Liability, Workers' •Compensation, Common Carrier Liability, Boiler- and Machinery, Burglary, Credit, Sprinkler, Team and Vehicle, .Automobile,- and Miscellaneous as such classes are now or may hereafter be:defused in the Insurance Laws of the State of California. THIS CERTIFICATE is expressly conditioned upon the holder hereof now and hereafter being in ull compliance with all,and not in violation of any,of the applicable laws and lawful requirements made alter 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 tFac 16th dayof January 2002 I have hereunto let my hand.and caused rny.of ieial seal to be ajfIxed this 16th day of ..January 2002 • .1409 BY varam "frAp, • d.. - NOTICE: • - Qnaiifiration with the Secretary of State must be accomplished as req.' -. . - r orp. :.'.ns Code. ...ptly after issuance of this Certificate of Authority.Failure to do so will be a violation of Insurance.Code S: •.. I I ....-wilibe grounds for revoking this Certificate of Authority pursuant to the convensnts made in the application therefor an.the, conditions contained herein_ . Foax ca9 ®OSF 00 8894+ • POA# 510028 JOINT LIMITED POWER OF ATTORNEY • KNOW ALL MEN BY THESE PRESENTS:That SureTec Insurance Company,a Corporation duly organized and existing under the laws of the State of Texas and having its principal office in the County of Harris,Texas and Markel Insurance Company(the"Company"),a corporation duly organized and existing under the laws of the state of Illinois,and having its principal administrative office in Glen Allen,Virginia,does by these presents make,constitute and appoint: Jay P.Freeman, Cynthia J.Young,Christina Mount,Adriana Valenzuela Their true and lawful agent(s)and attorneys)-in-fact,each in their separate capacity if more than one is named above,to make,execute,seal and deliver for and on their own behalf,individually as a surety or jointly,as co-sureties,and as their act and deed any and all bonds and other undertaking in suretyship provided,however, that the penal sum of any one such instrument executed hereunder shall not exceed the sum of: Fifty Million and 00/100 Dollars($50,000,000.00) This Power of Attorney is granted and is signed and sealed under and by the authority of the following Resolutions adopted by the Board of Directors of SureTec Insurance Company and Markel Insurance Company: "RESOLVED,That the President,any Senior Vice President,Vice President,Assistant Vice President,Secretary,Assistant Secretary,Treasurer or Assistant Treasurer and each of them hereby is authorized to execute powers of attorney,and such authority can be executed by use of facsimile signature,which may be attested or acknowledged by any officer or attorney,of the company,qualifying the attorney or attorneys named in the given power of attorney,to execute in behalf of,and acknowledge as the act and deed of the SureTec Insurance Company and Markel Insurance Company,as the case may be,all bond undertakings and contracts of suretyship,and to affix the corporate seal thereto." IN WITNESS WHEREOF,Markel Insurance Company and SureTec Insurance Company have caused their official seal to be hereunto affixed and these presents to be signed by their duly authorized officers on the 24th day of January , 2023 • SureTec Insurance Company q c 0 �5 ro.�sa,NC,,F,,•o'i Marke surance mpanyRAN0,E` w` VI=I SEAL W W •�� /� By: SIX��, :•. Y By Michael C.Keimig,President -•-'' �'4,��thitt ••��.�� ndey Jenn' : .Vice President 11,II State of Texas County of Harris: On this 24th day of January , 2023. A.D.,before me,a Notary Public of the State of Texas,in and for the County of Harris,duly commissioned and qualified, came THE ABOVE OFFICERS OF THE COMPANIES,to me personally known to be the individuals and officers described in,.who executed the preceding instrument,and they acknowledged the execution of same,and being by me duly sworn,disposed and said that they are the officers of the said companies aforesaid,and that the seals affixed to the proceeding instrument are the Corporate Seals of said Companies,and the said Corporate Seals and their signatures as officers were duly affixed and subscribed to the said instrument by the authority and direction of the said companies,and that Resolutions adopted by the Board of Directors of said Companies referred to in the preceding instrument is now in force. IN TESTIMONY WHEREOF,I have hereunto set my hand,and affixed my Official Seal at the County of Harris,the day and year first above written. • JULIE E. MCCLARY ` • /� C 2'‘lg ` Notary Public State of Texas By: I v l �`• •`� Commission#12947680-5 Ju i McClary,Notary Public "•'•. of Commission Fires March 29,2026 M commission expires 3/29/2026 We,the undersigned Officers of SureTec Insurance Company and Markel Insurance Company do herby certify that the original POWER OF ATTORNEY of which the foregoing is a full,true and correct copy is still in full force and effect and has not been revoked. IN WITNESS WHEREOF,we have hereunto set our hands,and affixed the Seals of said Companies,on the 16th day of August 2023 • S nsur. •• Co .any Markel Insurance Company ,h By: By: M.Brent Beaty,Assistant Secretary Andre arquis,Assista ecreta Any Instrument Issued in excess of the penalty stated above is totally void and without any validity. 510028 For verification of the authority of this Power you may call(713)812-0800 on any business day between 8:30 AM and 5:00 PM CST. ."_ MLC Constructors,Inc a ^�' .. ,vr 'Lv A,`^*.y zc r �, ' 'k'kt M4 ,.. a a:- .d K"' 4, ..,4 ,{ 710 RlmPau Ave.Ste.208 ' ,' �'1r'Y=*L r `k�" �` `i.� " '+w" 'x ^'.^ - A''"' .:V5 +r c '�. - : "`�3 "a.�m-d''' Corona.CA 92879 ;. ^ygC�� • '" s a r .....A,[ «R Y,,,,., w;*a;;. Ph:951-393-0781 w,c. r1 :5' _'++: L°`r'� ;+ rtt Constructors,Inc. llo No.:1068632 -� r,g,.i,a c • °gr 7 ^'. DIR No.:3000667976 , t ,, • n ., -w �5. -K'traYp M'� ,7P, �4 r x �,� � w't� fi ''I x^5.. t -a,- x+2' N 10 * '; �. .,,.,,. w°_. • c ,e ` c,0" `.jai.f. ^4.-. k,%I' 2! a i .e.,.+ ... o-,... ... su •. +.y}�ca �'^ $gym #��{x Fl� r �a ,:s �.t'*'� Y ,y . y�,,,..F :.E^- a''' 'Y}� ti '""` " ..."E , : ':,= �+k t-4 ad^.Y" 'd of +ka- .'C sf:"1", ri„ �4 q. �.v> a 4 et E �,1t;x r ..,„ "4„ sy d' +„ .0 K k-'"e a "tea+ i' p N •- «u*t:.•° ' A '�-R • x r' '' � 7 x s. �r-w : x,..�,:�����''Sn�B '�+ ^. , •` •- V....- ,,n +` ',-, f�°wa"a.-4.--," •C" " a.. 'v,, v'N `4 i" ' F t ,,.i '$ .•t�� $ a "++''' 4. n ✓e+ of r" c*sr t x" ik M .f' ,,r, v S ,'"rs 3� ,' 4e�ysts x ," w' �� z�, x" a� r , ,2 T, ., m r„ .Z.4,- ,1, : *''' '*r rF •w;��`A" e *f w Xp,r2 Y: f ``;F 'wc'.: x. � - , *, r �' e g, w�s,__'� -4' Yn t "'A -1 ..; g`'''5`'. '-'—` c"x'' ta' r g',�'', , p' r ,,* .�",g"" .'`t` ': .-. e a ::; i a a;:i. "F"qr a .. ". ,.;,vx�,_ :*rs. ,„.r t.,.: ,."'t... ,>.�,.,.x s. �syy k - fy n ... e-tx ".tom .4. s'':s tx<) a' r .5"'wY f-"5S4f rt 4' snY�x«` tiyt ,�.✓( d 2 i 3b * y't ,� w. i./' �' Y �^kd'p'! Y.. NS'S'Y' '' ff , v J r 4 • M. i 4 ft T -5 # L ^X P f ktr Y`0 f C E ~„ '' x<"` �,,�, Y y 1 kf +1 R. r w a OFFICIAL BID SECURITY—DO NOT OPENr rr r Project Name:CENTRAL LIBRARY LL z s- M ▪ ,; ', RESTROOM ADA IMPROVEMENTS r! CC#:1656 Bid Opening Data:August 22,2023 at 2pm �f0o���NTING4Tp�� City of Huntington Beach < 2000 Main Street ♦ Huntington Beach, CA 92648 s 44 (714) 536-5227 • www.huntingtonbeachca.gov ® ,;F "0 /$1 Office of the City Clerk men N-- gip �� Robin Estanislau, City Clerk December 29, 2023 RHOME Profile Construction Corp. 19171 Magnolia Street, Suite 5 Huntington Beach, CA 92646 RE: Central Library Lower Level Restroom ADA Improvements—CC No. 1658 Enclosed please find your original bid bond for CC No. 1658. Sincerely, ( rici4u 9,64z/741.4J Robin Estanislau, CMC City Clerk RE:ds Enclosure Sister City: Anjo, Japan 'Chet-nit). .„ .„ S EC T ION • POOP0 SAt forth:0 Co #144-04:07 cENTRALLIBRARyLowEittrni4:. litOtteabATADAimpRoyEwNT$' • tbe OW-HOR.UNTIXOTQN)WACIO TO 'THE IO$00.80tt II/1 StAfiittgg OF TH iCOOT,01-, 4fgsnriN4TO$BEACH: btottiriltai*d*dahNotitel4vitin0100x#4:4,i4A.oaplArafgagOoOtoopowa-#444ita o poirOtotAt if*wok thotolitdescrihed ifidA6fimiigkaltIONTa*OALNOpmeat,:aodioolaos insurance T10:0004TYAMfbr3•, ixi,„:00404iNdee'With the plans 41 and speci&atlona on file in pfffpq, •3of thecitgPgiriger-afthetitrOffuotivoptea0cThe.-astitottigtaweeg.taipeeforth,the work thet4 to.the satisfaction, and 144dor the supervision of.the::.gity Engineer of the City of }1411014194 Beach,otifoo:enter into a contract At*01ifAviuorigoa,Itto undersigned agrees 0101t. 'with . **440lWtitA'tam Olo tholOtio0Ip Ptoog.04, !ODOM:401004' proposalA f*::04 apOTir 1•okainioatioir o.ftho.).7y4 ',$P,Ooliac40,10*11**.-. Ol000*:14qwagclAito..th,. or contract.. •clacuni, this proposal is accepted. for award )3JDPER agrees to enter rntaa con witl1AGENCY attheunit and/or lump sum prices settbitlyin the*Alf*Og'.1%.41.$‘4.0,4c4:::TMEg.•10.140rato4lbaxiiforo,fo enter into A contract IP the dilAtitiet and time -ptosOrib4 will result Jo„, ,foifoito,Te: AGENCY of the guaranty uoottliiitia§iitopoga, BIDDER underitantiv that a bid is tequitgd.;tcr the entire workthat the estimated q1aptit1es set forth in the Bid to1104:41.04te.Vtely./f!ciligi purpose of comparing ofds and that compensation pPderthe,rPtfttA4*a,lie*0 opoo.vio-.goto4t qoottlios cf:*ctk satlsfactoillytcnipleted,'tft AGENCY 11001tAtSIK::RIMITTO OKOMOW ITEM FROM T.00 tti*ItAOrt agreed iltat the u,ni attOf lump sum prices bid include all appurtenant expenses,ta;10‘.roynittesi fees,etc and will be guaranteed for'a,,pe od,,ofsrxt>i days ft0:04*bid:optiliiv date If at such tit00 the contact not awarded the AGENCY will reject All*(4544p4W.)TegyA*04*pro:qot In the case of aiSetcpancies in the amotintthid, unit prices shalt govern over extended amounts 14POYPW,0141Li:301MPV,Ot.440$3„ ... • • 3• .3 | � ` | �| ' i <| U} ! . i I f CRY otiKRUNtINOtON BEACH': CENMAAtakAittr LOWEIt LEVEL'.ggsTRoom,ADA IMPROVEMENT ...:10.04.0.ittiiii.t0 [ , f 1 . ,, , : , , ,. r.• Item#' 0,0040100::;0f Work sttuarifitv Unit. i::: .4trit PificAi. Item Total . ,..... 1 iMobiliz4tidtl, ,1 , T 44 ; $i.21,041Liiti $, 104,...,,t0,0 • ••,•• • t . ,.... •, .„„ . .1 ';•-•2 CartIttlidflOil Wstite,A440401•Oii001'. T ' '4 :1,S:4004i 04: 4 4i0W.4.0 .. . 00.s00.6f.. l .: 1:, , L$. ; ':$t.46816.6.',' $i '.';$040.) • . , 4 Demolition , i '."1 LS .$sf,3,$1.0d 4 sissaat),.:. 5 Abciferoeof .1 !;',- 1 L..:5', 100404. -$iff4,00 . .. ,, .. . . . . ..:. , ,..$.. • .011:••prete:10.001:R0iiloro:Orgerlf: :•E'' 1 Ls .', iiszoio. .I;aA8Z,-M.Q' -.. 4,...- 4 , . $ - . :7 ICtise.w.deqtautitatiop 1 'i ,-) , t10, .$1.i t 0140 $1,AV.,:.:419' .'...8. ,410014*,Fitikititibil :.1 1 ', LS, •,$:1,,t4st 66 I'„2,14209 9 -, 'joint Setilitibt,• 'I '',' 1 ' LS 1,44244.,.0„ aM.2400 IQ ',Aluminum Door 1 1:: G25:: :$.,404'1.,i44 $001400 1 j . Wood:0'06M , I , , Ls:. 4:-,10:A;.t..:00, ,,$(.,.1;"$2-k00 - • [ - -, . ; 12, ' Access tIOdet,tittd:Ftitritio's: ' 1. L.,$:,' ?,,S"tt.,;, 01,011 'i$,1g6140. :. . . . „ • „. • •. - •_, ••. 1$:' ',JP:00r H.. t7,-*Ot0' 1 1 ,c LS $:$44;.0.4, •$•:,.$44-00 . . . . .: ...... .. . . . I,41', .01;.0:40g11,0irfOr ; I ,.. .:Ls ;114404 :$... ,i,.;001;00 .. . . :. .. .. , : i;- I5. Gypsum;aiiitd : 1 ' 1.5 $1,044:1 :00- $,:,400,,,40, I Mof.citSfaii,Froittifitt: Hi 1 .• 1,14 ;$,,,16400: '',$A04:00: ...,,, . , , -•,', ft i:Ptstdelettei ti 16 Floor Fiiiit)irig - ' ' . I ,. ;ILS it-1..0140 '$;.0.#:t 0.0,,, ,.. . .,,. „ • . , :•-, „ • , • • . ., .,. .. 183 H.Obit4itifti Tile Wall Finishing ' 1 :, .:LS $,,',., 1,40 60, ••$,,2 .,i4.1t6 • , 1: I% ....',Poieltirog [ , . 1 , ,1:3 ''$:.,e.-,:aio•::Oty, $,:e;87600. .. .. 20 ,istoptige 1 1:i...Is aattm $-;801:',oa . :„ ... ,, _ _ : . , , i • ; •‘..,: 21, .•TOitet Aceest,OnOs '1 4 " .L$ $, ,:,c),$7040.,, :$•,'941:7•got.t -.- _. .-, - . • . i: - ,I •i 21z, : Plumbing : '1 ' LS .$•:, t4-4.04,(" $''.' 3i220,0.0'; • ! tl, ,,..,M6dhtiti.1601 : ‘1'.• ''t,,S :$lit04,0:6 '$•t',i444,01/ ..„.„ . . - • ' ' " - ' --- - ' ", •--, .„ :.. , 24, :',E[0:dfitddlii ii : 1 LS $:44;sitit ditl', r$404404' ..: , .,... . ••„ ,, , . ,, .„ . , . . , • [ Tor0,1 jr.i-,,,Korpej0,0 . $ 11 , ,.' . ,•I , [ . „.02;,1. . Ritd1WW[Oi!dt . „ ,•z.„ tootufit.0.01111%10000110401,10 01000.0.01fittY40•Or' • NO[ft The ettitheOeUtwahtitletliOedih the Proposal .gre,toj* ii„W,otikScompaiisonef bids,Payment fgr wetlt*.•*11:1.groatikPom 010 .iiiedtiuteinsOfs,'Ifthe*t491 gmljties:4hweither.eehtregew40004$01.teththegiogotitio Overl'''kulTiPF WM(010$040,;:fii*gOtrgt pf494t kiittoitipto#16:4411tio paid of tits 1:01-240 pet;gAinlie agtoi**kostuptete4,,Itoiritt(04ditibilathitfpett"alblt Will 13„„e•altovigtil*keirok(6 NYr1104 will ritittel'fitade'torenOte:tr,0410.#40 104.0404:011#* t,t1":400:004#110,16it,4004:ihotontrao#,itfirs includes rejected from veigo14:000;ffi#4tioTt0100 after It has been ii4.400 [N0,0:000,0440-0)))be g4w0 for 0.10004*excess oatolowniot)trreserv ***(ghti**0000 bids to, 1:00***Of 42000$00i*ttiOI40Ot4nr 414atitky,shown on 010:00100.14K0(014.00;,*010 Of a varla,tkitt0.000.01holitikptice ondthe,toatt',4tomtby OWItitddeOht;uhltprice Mit:be - • Cb6106WfdifftWitemsofirorkruitspecifitallser40004ki thgw.01040•44*,014410 alt iiidtetriktooK,i equipment,safetrarqA*07v4 F4pgr*tommt4j0.4v,goppkwAtfg work tgg00,0404:01010:000.444P*0 on the Plans or staked In tooloto,,motstio be no got0010000tfotiN,:0.ktitotts*otItoil#1.170,Pitti3O*.0)0 cost'Of all work the Plans S.#04040000fhtit not Atittifig*Witifte0 as bid rtem eittklOthed Within' MO kohl shall be included itOretaW.14iiitteink.ehttihh4ddittahe1 eiiffi#000000 shall become due the totittottor ,Iitroutotokoli.40**0440, 10000 ,,• • „1 !„1 ,• • ,.„• • • • • . : .„ . .,LIST OF III actor4ogo:,,Ni.:W.i.,,,.0.0011#74..c4 C.o'...4:Sotiot:4104 to'tig4ttor shatt.*.t.fosi-tho to*, and...,hutitioss.i:444..rosofgook$00.40,400,8wq*K perform wortorre04.0oNtootoi:Oioi, .litditor,041§4ii1;-Oblittk#itl-att:4410110t bl-V(000,,,Or004,141,r00.110 percent of the total bit or',.$100.600i **01.4'yg is „greater,.and. the'portion -ot he iw.o.4 to,•iti„o,,tlisilo,.',:by such.: aibtoofra-a4; 1„,.. .II .... ,.....„,. . . . ... . . *one iiii4:44:0:,:esilif IT 4:to,e, : :(740,* - OrAllyc .. ,004,ta ,,, S'e, • , 10.14i$ :' i Otibetiiiitiktop :' fitimo i,!' ., 0**,110444'..,,' Arnogot: :0)*(gfe ., 1..: Number Abatement• 1.:‘bOttOiltiit.00.001 40.14.6: ::.!.ogf,:. moologo. ;stow 6'.0‘, • t .1 :0•40 I . . . • :.; .., geOttiO So Oat : ,,:o:totbg :: ,A (1oi.00.00,4- - 1:14i4'.74$`6 7'. % -1, . ' . • , :CIO : 11 . . . •., ,I • ':,• :I • .. . .., , „ . , . , . .„ . , . . . . - • , .. . . , . : t , . • , „ . . ., , . ,,,.. . ,. : . . , 1 . It4iiibilii§dcimbfthis proposal,the certifies. 1.,:: 'That..heiaobte*Aai011 ogrom...11*totsopt,,a,all work which 101.0.00-yor04. in tho.,abti840*60#40**tiilg, .. .f .. ,,Z, 'T.1:14-t fli. :,AGENCY*441*.;.•Artiistioa,i00$4$oixtt$01506.6itotetiteetta into and 150uth.foitUh:4;:45t:'s4110.::1'.•• otor tor this ,. 4C4 , . 1 . 1 . , - . ,N9NC:9144.VIQN AFFIDAYIT' T.0,litEXECUTEEk:BT1IIDDMAND:SUIIMITEMD. WITH Eli)•. •, .. ,• • : „., , . 1 dokroviderilloodity.ofogpry underiha laws of the State;ofr atiforrnwthat the fiitestkiig i true and correct and drOlatatimts.exeowArcio'00011,014:0.ntogtWO.001, . Date' rio, -$0to :.Eitiiizod 1: i 6oikittitt duly sworn,deposes tIcl,,,$7.4•YO1*-11.g•W _,Rod . he io,,*0*,:y1cp.fesidetit .i of:RIffeitiliti FroWebilarlidtidetr6i* the party;... . _ . . . ... • :. ,':forogoilleathOlh644,io,*to, a40 in the interest of;.0.0 the bob411740.4%odisOtO*gorso.A. o-o;t41ers*1,otivooy,vs'odoott,,:ootlidi64, bf otoott4ti000hot the bid is$040,410 and,tot v.z.414050i7A..4 ,t1:14:titlolii-44OillostOilitootty oriodieottyboo04.1.0t'0tioitottooyp*,fN040, to;lintilt a false sham Okli.**11440,4t400,0104ito4(ofilWA conspired, connived, or - - Vree4**0Y*440•35 foY•cd*O1*'fq:000*§.)141#.bKAIINt.*yo40,4i4Itio.bin,O.00tti Waillt itialiho,b4derhp4;04'WAPY V41111Pr%O*4Ario*P...Oftiooigiltbyogoottx-cot,, 'oittt..titi'atiiiii,, bt. conference 1041 ,4"#yone..to fix the bid strkg,or that of any other bid*,or to.:s0OtitO '4iiy, o.4Noitago against the public body awarding the contract,of anyone'illtgrg04,in the proposed contract, that all oatettioot&,o0Otaittoi in iho.bia,.416 true,. and fufttiekiliatIlig: #4467114s not, directly or.bdirOtlY, submitted his or'to',:iiiit prfoe..ior sii,,fbreakdovn dieted; or ihdtbitlidits 0004 or'4iv:0894!infOnigai11 or data:170146vo thereto, or paid, and will not pay tee to any ations partnership,footTpany odociAttop,.0!poizatiool tii4,dooditto„Ar to any member or as:OitiliOtOtifio0fOtaato,a.c0.4,40*0.011.41014i ,. II . i i lit Atio.mel4t0110 06mituott4o4orporaiCort. 14:#41“itOgIdor • . , . ., . ,. .. .., . ... .. . . , . .. . ., „ . . , ... . ,.,,•• . •• , sikoatorol:4 moot •, - , i . tP111 skitgOgotkt:Ste$.i,Iii.011P-gt0.40ockf04,0k044, , . . . , • Address ofBidder . .• . . . • 1 , . ... . •, .. . . . . ' I . • . ..., [ ..C.:-4- . ., 1 . '1'LIT:ILITYAGRETIVIENT. :., 1 I .0:MOVIVIMI'Vt00$`0**00*HCAM(.0041* ., . . Gentlemen • • Tiwuodosipo*here*protiies and agrees that ittAiootift4tiofeett flievoilt yedieC4the p:9*.r404 Imo*as tie:002tRA4 11/117 VOWMItWIL AO*IMPROVEMENTS, .•OX*V0 .70/.111 employ and 141:i.zP 9:0Y.qualified'17-.MP114''4* hereinafter'.4444 *4',work hi ptainiiv,to, electrical secondary or,titatiliiiiibiti,fatilitiei The' igrat,V44:404.,?.90pjf is .4.0.':%.0-itiii Title%::040*iig Aii#A0.400 0040i, , . . '1*-4104::P00$0* ;',40.06itil0i4 by,Pe4$0*6fopplenoogr* . if btlidt6"--''''itaiiii''''e'''." '"id riii'diver te,!: .,,., , ,, Imo .,: ,, ,th.,1444., -,.v. „,.„ ,. The utxdgrs4ote4:,Atso,'prooiio4,aod agrees aitt all such work shdtilit%tfortoritedift accordance with all m*0 to glo.o °.Oo.:..I°!'.u."b Iitt,j3tio:olpp.3" 1.t.o!'AuClo.:". .ti."-Ill:V°°1:fri:*::::: it°4.k.1' they tuid:Stetei-ergOlfmig c0 q t 4- Slikreuirerniits4 • „... „„.„,,,...„.........., ,„..,..,„..,,..,..._.., .I Thelitlaor*:#4.tattitt prooli*,:miti4growthat the tifitiVistorit herein shall be and are binding upon.any'stibee0t4ew or$tibotoopt4 1*(#10**14t#04'Ag ototoro':':,,:b7"the 20.04.0.04604,, 4047.t.that the •04:0t,*04.shag ice steps.as,are tioo*W to,'assure compliance:,by any said $0$04#4:00.-0.00011:474000With ibOteviivitteim eiti**04•.*.ei*, •, .,:• .. . I.• ,i .... ,.. ...,. ., ,.. ,, !I•RhotreF,',.0010,07,000:fiwOPrP0r49rt 1 cootttotoe 1 .,,• .• . ,..„ • 80•01.4nY990. •-••-••':-•,.. :f.':', ::.:.. ,.. ' .' ',...:: i ;SY ,.. . • ii Senior Vice„. .. .,,.., p9. ptoordot , Titit, ,. . ..,. 1 • ' . ,,00,1*..6402da&L., 1 . • • :,C..»$. •. ,, pr- ou � ~~-- ( l U _-.~ ._ __' ] _-| NOW: ' � COMP,MSA116,411SiglIttliStteERTIFICATE :1**8-40, 00-#011;1401.014*$140.1415r00:44401i010#4010.0.ItIA:044:1Aibli.O.**St-011,0a :11,*beenAvcrat4a4 hall sign th0 f0110.0VO4:004* an aare of *064114 of Section 1100 ,,Of the Labor Code which require 0t emptoyr to be*Owed) itgabl6t114biTty for*Otkees,::e0015e4atteri or to undertake se1f insurance in tceord4tice with the ordvisiatig,offhai code, and t will fconey with such pr,evisiehoberome,kotti,[00$the pettettiande eittlieto&offifit data:a fii:05ti*cuetioh:colootatiati tenti-Aettie Rod Earwcod SetedelljOi:Praidotit Title I . Date:TI.:(1.2V. *023 • .114DD•V,Irsinoitivt•ATicN • 'sjo,pat oft.100,$ihotthOlilito*hig:itti,tith4tiOhis4itit ati4-corrOtt AhattitPiotirw:OottstitiOlitlh:O.04Y0.41.dh Bidder • 19171 m000010: , .„.., . . • Business Address H4011601.Bead CA 9:g040: •• )::11:g6"'2:6•M , 40torinOttiPmeoorottOott00-:4o.ito _ '.rOtophottoi.Nuoihot 8nittit*idtcs . 1640174',A&B • Sta . . , . . Cti:httattoestig0h$ONO:;:i4,,h4.1000 1.•1 I tt ZO-t„q _ , _ Original Pate j tri1A, piratip Doto, • Thdawotic sitewas,:insp4eted'hylreiare6 ttOtacr orourAtA66-04 211 The following are persons,finns,, thdttirpotailititis lt4Viitwa,;„,p.tititip41,.ititerosr itt this proptitat,, Wennte President tibtteaoktkid Senior Viet(President The . . . „. . . fogikr00.04..is-,:prppazOd10,40;i0fYlif0 Council of the Cily M Huntirgton Beaoh ofits:4,:hilh'.ty.; inancialli or otherwise,„ perform.fl*,!contract for 1110 propotOr. work- 404 Improvements in AgordaitoovithAhe:itahs.:anii4eiiticatiohS,..sdtfdt,th, I ;1 ..r;..11t)poto:Profile Optp.0:000.0 otitiatt4 Name 4tor.. I3iddot ..1 13.0q.aktliat I .„Printe,4,0„p17„yriga Sigionto • • Y � | / | � 1-2 1PIP Ito. th O _ ~ � ` = ' ` — --°p��--� Wry persori ndj ` o � U . :o � , � " 8 � \ � U � " 1 / . . , i, 1! ., tidittiot..VtotettlfittiiId '/:-'P$t the purposes of.'''Atiti#144.0 the:6*itt:40tor and:Wi7,PPn1...tract.ornillst have, :in4be last five years, constructed at 1641 0,1W.:,(5)'pt6j:004,':of;$*1*.*to*‘,:$peerneat , referencing 1dlid1 constriction-of 10:01$00be$001fik*Olt and experience necessary for project,for'?example gleconittndidn or rehabilitation of'existing public Iigt,:':tddlid4 . Bidders tr., etiettod to submit tioptertheitai relevant hi:o0-0,:itivwditiiSktixtitt or..*::(4$11404tierdit. . . The following tkof futejettS tniattit:,ift10111-. ten-Wits of above' :1,,i; 10itY-cif ,41414ra . • 11:./001-0*.a1.444.iii:'4A0-,01antti. '144:010:404,1r0100.0.00804'4(0„Mti:ffnOtt4of t4H - 7,131 .' 4o*,*t4lot:opii000xat.Ee.bottt 6,,:a.. ,e.rtas, :. OfOlttpakOkiOc$10 :got2on .. . ,. . .. . • .,... ...,:, Completed. . .. Contract Amount ' Type wok: 4:,.4*P : PrOvIde,,Addittonap#04 dacdpiAtinkt&411aVviginilakwork: _ .eri. ''f.-45, -.e;IgiA4:64:e... nti4, e..:::-.. --,ei Qci,,t1 • •-"'''-' .' ''.- - ' -- - " f).' ' ....., ... ............. .., .. . .....::,. :. .....,: , 2, . a State ticiniuei',Hilts,, ..:14o*Attcl'Adilt .1- oritdr''eterfog . ) . s9,0,o. 1 Teratifimptovertiolintotiok,*iiOn t$01.762i, . ,, , ..„, -,. ...- .. . . . riatO,C00.P1004.: _.,. to-04.0Akiilikitt41 pri*Oilad4tioittdihdiktiiiiii4Waik teclfr-,... .'iW,fiee\i‘o,i8k..,1? if ..1,erci4,-eei eitits04, .:eklail -...,a,s,, 4ittc.i.... 3., .00 POI:Nth..ii*. . . . . ... . .., _ : .14,4111.6*Aildieg4,,tiotend,0 .. :: , „,. .,„,,,, ,. . Natite,andtelephone ii,o,;:lor. Owna', N tixt,.'tA 1,50.2.1Akt.‘k - '011.•'?-;'1'19•‘ -•S511 podi.otio. i -1 ,t4evilltifidittotoristrucfton and sitework Ofig400 , . . . .., . ., . ., 'N'.'r''.‘"sdittif4014.ii-• Oita. , 'Ty&iStWort MitConlp4tcd rraS44.0).4.44404.41 prplooiO.so..i.)00.41olhomr,sitlIllorwoik' .177i!Ap4 uf.,-,.. e4,.. .Ltik4.,c.4 46 , :.e.:-,j4.1.AgOet ' 6411:011'I Afit4 . . , .i. .1 1 • ' Crib . ,. . , . ., . ... ... ...„. _.., . . ..... , .. ..„ . ., .... . .. ., LAe S.OJ\ a.et +tt.5 • 11 I tne,andAdd a s.d Re,t Name artd.,T00.0.ie NoJ of"Ownit "t 4 S )0onoract;Anotri ' a o� fir.'. . *ark Dade C.0xnpl.ele Proutde additional prq.T ath es Optinn tge sbow s a..wor1c 5, .lame end Miess of'Refeiztc0 F lame and Te1eplaono' To of Owne 14,01 , t efteVt-,. Gotati noun TYpgofor ate:Cotxtlted t'rovxde ad0109:01irdjec .de iOx how stxit tlarwork- • • CAI tl Itiddees CrikettiStait Listed hatqw,are:tho,'panutg.ofth6biOdttgropogdd doh-stjitd:iian::Ptojat Manager,and iSt0000fkilt..fot each of these crifi-ciarp001011$t Ple06:tio*A4eaAt three projects brwbi tho.,:erifiW staff has Watt-M*1W ftt1e:***‘,111e:tast fivelrow.,,,Thg4eijr,oigc*.aci nqt have who:.114(10thettirtioalt ort*biacto-britlij ,15-roleot Bidders are encopraged submit OPOOme1:04:0104:4t PEOPOtS$40 ittida011 tP=*elprPjogt$ligaher.010 `1„ NaMe:ferrilier penager B181.44.4,41* Tolophorto No;ofpropogoci,Piojeof ganagor Li:et Lob, stbok. 120, 21(10Nal,ne,c4:0111tra#M40,:10 ttOte,'COMIA:etta, 00 livoteit e2-r.U.V1- :PrOegtNaino,84',OgitraittikplOufit ILtle*Mot* Dat&CoititileW, :::5601-tJa..00,ect reA igsfect I OA 1-Kistt.tWvin- Pitie604'.ait:04ConitkC.Astoluit; 1 .pe ofWoik Pa000:MP1004. :er tAithx,iy,,Na40tiosga.$4.torintet(iieo 'f5V - etoteoloo,* aproposoi superittteniiett 1504. 'gde-.,efaenroti tU.21 vcAgetua.., Zet4.017,0*i .4., DateCotvw°1 .1 .4x.rkztj. ‘cor. 20-22_ Project Name&Cón1ractunoint Typ ceWorle DatoCtimoloto.:1 NameVt9104 . 4•:l00.04.A. Amount type OfVgark 004'.CortnAttd,d sc.-37 • CON:11a0rOjt REGN4RATION WIT]."IMWO100.0.1)EMTIVIZN.T. Or INOV.S.T.VOULATIONSOMR)CERTIFICATE: •• Pursuant to.:41*W(0141#g ESOloit:711J(0), .p.k.4** Senate 04:1010**44.,04bfi4140 4.40:Wp:0110:-*Grito.Cot.1...tri00ilt:0044:00„yog:arn: whiekxquires all contractors and aubeontractors .1)14.440 and 00...,rrotitg on Public WOtk4, Projects to regser on 444.10140 Ito**Oh July 1 through T01.0 state flsca year)with the California • Oppott#te4orWttsfii411;t;eio4oiu(DIR).t:toitaty the annual nonreftiiiiiibtit**-00-*g lbr :gt'k::Witoti*tofttv'viehcal W.P.011PN. 10-,Mitrao-tliahoetit*Atitstill sign the folk?)rtii4:0Orttaaie.: IPAMMSIMTotala )itqjf'tttikto4difi'04!,OY#TX...$.Wf'.,*1100tR...s/SOS.54P.io.isltotifizo•A4,por IXRA:•-.P00#440t:00gtstatioti 040(.$44)$._,2•2034 J**-4/411-zifit04,00W704/***$'091:0040.00#4-014.1V0010114.• DiRts 000400 1ieittAti0hAearo114140 database • hitofileilfogafr4400nlysott,a, 00.3 am aware aildiwilltptmgy with the ottAtieroderseotion 1771•1()•whio'hmtoot contractor stitiointadot shaliriot be41.440f4dA0 liambo listed•;*.litiitbid.pittooso, kif>100 Ig-*.g!:r0qxiiroviOtoorStio:Itto4xifIhe.P4b1i0 Contract Code,or014401**10 P000-trritt00 o 4112t 0040 TO public A$04k,as defined in currently ogijtot:4::.4tto q1althed to perform pubTtc work puranto Section 1725 5 b fo;not a 0614tfoirof044Actio,ti:l'or4-4 uttogiitft,d,otitt4.0t0t a bid ttioC.is 4:01194i0414 $.4ttiok.1003 ofth4: 34416$$ '..404 ;r1Profassiot4;0040 or by Section 10164or 4010,5 „ •:ote N410;;toottst co*;#0.004 the contractor i 1700400.4,sto perform public*0* Pursual*:toste**1114:44:010440I furthermori1t comply by 0 th.0 gomottow.iiiii& Or-. 01407-$10-6?,cirSeStkli AY#1* 4-$0 gitoxootxctatt%, cat.watt§ret ALL 009.014i4410.4Mdtpo sub Atmri.'Prtifi*dni:Wdtkitt-P#000030 11 COtittactot • 1;(0d EaOttdod: . , •matwacoottiovotgit**40,y, SeniorAnce President • , rtt.;0=2. . • • OW,C1000,4,4olvilk#440$20,7g. L.14,1 • •• tjaltikr A titgADv TACK])RTAINESS ittittiOO-t-tO P4104.0.$21 'rifle 2 .6.de ofFedttal RegulAtipm e#0:041.Votraoing wfth niU and Minority Businesses, AtYmpe:s tiitetprfs ,,and:Lal?or$1.10100,Area TtligI401400s3lh'theitetitay-arezincm**4 herein by ibis reference It :is the *toy of The City 1at disadvantaged. business triterrosgs (DoBti), st4 attAtirtii Paf2003217, Titl2 CFR slI be#00,0040d rO.pArtfOpi the performance rf ciltiAtt14. financed iii v‘rh0*Prhxpaftyiithfeitetat fiitie,'ThvCpttta:Ofcor:stO44Sure'::t1*bi3%as defined .0PtottoiftY to participate in t110,performance of this Cottraotarien44'4146au?nece4WIA.,114..:1704$0.Oable ster,a sdt0j.t:thiilg,(2013for flis . assAralt :Tht(COtittadtorilldfliOt 4401P.1114te,010i0-4ifisitatatd 0104r0444p:tiOili, or sex itk,the award and porfatito ot'oibottr4o*:faiiuteito carry Outthe requirements Oft PO4grVii shali;gobstitdte abreach of PO11#44 4041114ytewittit termination of this Contract or other:MO.0Y"thi'Ckrotty dosoittAivt*iat .. °I4dett shall be ItrilifeqPq l'esP06:g7fh6.TOOft-°°1°At of thORgg4,1*M. and are urea tit). ohtati.013:0:portichfatkit hi this Pr41,04111419osh litfigois-novetiftoit for'DBE pg#1914141.0% 44. EXHIBIT DBE INFORMATION—0000 FAITH gf,FOOTS, Federal-aid PrilijeetNo. . Bid Opening Ode The ti4r::111-Hu*ing.t911:13P49/1 0**114*44.1 Disadvantaged Business thtopifst(DBE)goal of VA for this Project. The litteithigiolprovi40440**Oiows that wgoodialthLercirt was-made. Lowest, second and third lowest bidders shall submittho:fOltovirig,i0fOrrngh*fo:400ovot adequate good faith efforts,'IMOder$',should submit the following information even if the "Local Agency Bidder 033 Commitment"rod indicates that the bidder has met the goal.This will .protect the hiddefs-;eggihili*foraward orthe contract if the adininiSteting4agenoy'deteffiitnothat the bidder failed to-s.meet:the g001 for various reasons, *DK firm was not certified at bid opening, or the a ttattiett*tfeatektet, Submittal of only the Agencyl3Wer.033.0,9inmittnent7-fotru14rttot provide Sufficed 404=006%tndedonstniteIhat adequate good faith Wort*were made. The following items are Section entitled of: paFJctotnititege* Special OrolOiosog.: 4. The names;and(14*0'04.011'1J30.04110.,Wilt which a request for DBE participation for project was placed by the bidder 47,104:e3 attach copies: advertisements or proofs of publication): P4tioatio48, Datapf Advertisement , . „ B. Thgtart10s4044.4te„SOf*Tittennotioes sent fOOOrtihaPBEs soliciting bids for this Project and dates and methods used for following up solicitations to Aetetinint,with certainty whether the DIIBs*ereititerested.(pleaseattaaheolijaofsOlicliations,telephone, records, fax confirmations,etc.):. Virno,of0EEi$otititod.. Date ofInitial Follow Up Methods Solicitation and Dates W.! ',Etecitrei,„ 7el ePt7L • , . „ , C. The items work which the bidder made available to DBE firms including, Vigra, VProPrie*'al*break, 111g4oyAiofthg4p4trgo woilcjvim(including those ltoxis.normally Otti6titiOdAY-tht bidderwith its:Owmf9lvq$).103 gPC1419.4494,11,Y7feasible tinits:to facilitate 'Mt pa4eigattOtt It is the bidder's responsibility deindnifiate:that sufficient work facilitate ritt participation was1-nade0411410 to DBE firms. Items of Bidder Normally Breakdown of Amount Percentage' Performs Items of orit, Contract _ . . D. . . „. . . „ The names, addresses And phone numbers-,ofxefeeted DI3E firms, theitaatiiit for the 'bidder's-rejection of 0.1 ,1P..a.Est.ii-P firms 5010zi..ted for ihat copies Of 4OO*51000.t.i'.11g:fitillSfi0Olv044;:'4114*0pAot difference for DBE ir the teleeteli„Athil is not 4'1).ta; Names, addresses and phone numbers of rejected DBEs and the reasons for thebidder's 10001Olii.:Ofthe DBEs: Nalnet,:T4-itate4t-etsJtthaOt:ttjrtetdffi.bet§of fifina,Seleeted.fortg-vgrkockyc: , . E. .Efforts....made to ssioti#vrosto411113rA in obtaining bonding, lines of credit or insurance, and any t9C114#41. '45.4441.1ce.. or information related to the plans, specifications And. itit4titthientifbithe.wotk which waAproyided;'-tottW C-IA; Efroiftpt.#40 to as* t i*t„Otifod MEs in. .atolhOg:i10,:msary equipment uptes materisor related siggkee ør$00slice$,,, excluding supplies and equipment:.thd Oat ,,,pkgoo*ororptirohoOo dtlet§6s,frpArthopti,...*o-,00litraotorotitt-afAltatot• The names of Agen04, organizations orgroops contacted to provide assance In oxifaeff4g, tomititt id usm DBE Outs(please attach copies of requests to vetkies at440$*$1710§tsIcc.:01Y040:0,listt-;iktorin**0,404th.64,6*,X ,N0010401414,0figo: MeiliOdit*64if..060.14 Results ,Atty atttitietazita•fq Oyppptta,.:iAe•t'Tlom.uAtiottotgooiftaith efforts.44wairditiopit$frotts; V11000*-0X NOM lfgEAnnrrrcNAxMgot$OrVAPig.0 AcEssficax, • ,04,7 IF A SOLEA EA Olt SOLE COISITICTOICSION HERE (1)‘,N '!".el. .044410i,Vhich Ijuiine4is conducted(2) . :SigrIature(flien and suniAmo)aprotietot, Placer0f4.144inegs (*cot and-Ninttl56t) Ck?*14 State. (41 Zt.p.,:Ctiad' 'r61,ephon '.(5) IP A PARTNERSHIP.SIGN HEREi (I) ameunderwju busniessis condnet,g4 (,1)SIgnatnre(given and:surname and ch#040, of partner)(IgOtet Signature niust be made by,,a gerferal pie . f3)-Place Otis- ttibtr tfty:Ahitt, tatt (4),-Zip<C0de., TireplitineNo., (5):E44411 • • • 4 _ . SIGN ITER& • , busittes$ei&e.cmducitd Oh q1110'Pio• (e 1typta,.0.0p1,..attb., • . . , . „ . Senio1 Vice i!fosicient.1 _ . -Catif gtidtriholawOfthe SittitOlit orita • " .(.4)ilacoffluditess t$UPgti4Pd..N14.0,00:4):: tiiyttlitSfet 1104 ] .,Teepbone,No (6).,E41thl.,,4000R010,0qcP0144...004401,, . , . :,• NOTARIAL,ACX:11,0:VVLWONMNIC Or',VXM:VTION •ikLt$10-$000,1ts- „. . AZATTACtItti? List bOlgRA81110$11-finsident;vfce Preside0,44dre'tar,tA4stfs:t4.tittftae,t0,iiti.t.biTitotttiiif;It ia.4401Parg114;:p.attTAM a 1::-.0,:rtwoo:r) -e S6AZde .1te . . iobiiiiiiittinutinseioatowkiftta-t000thstaiiiikshiat 0#0.,,:eitfottlio;,tsunicottmiemblifilthooks-****1** cnihs rsm owooto*******4 botokalyogilormokoowilicoio*****:.f:.40ry.,:**4- fotegoolgpows,pkisinteninototted 'AviTi‘q4oiliiirittaad,atodwit, :1 „ . KENNETH.01104, . . „. • t„4.04Fr1.44.'Pliffgrilf,, 'icomini!O gr.7.411P: ort:.1.19,3,414, •,:,,t101,*,,„:41.00710*000f.**fehltAifailie4i:fdit, • ; ; . . gq#44,,•:•prvaii0-4(0:thiiilocum*it. . . . ,1! 'VXittillre• , . . :.. LOCAL.A.GgNOY,0100W:0:St COAII:VirrititENT(CON$11VATOTION7CONTRAOTM :1 '• ' • - . . • '74,01%;•A).EXii,:0,,- gtkOT..0. iNVITOLtellogs ON THE REy,g,:gg.;.;:$117WPF,T/i1$';',F , LOCAL ...,.___, i .AtiuNCY1 ',1 . :WrSitt.0-tri-• . • . PROJECTDESCR)VilOtik, • 1 - • , ..,......... ..... .......-,. .. _, ,• , ,, - .,„. • „., . .. . .„ •., — , '.-Biq:17.A.T.Et 1 .._ :ajlitiEitt.OitifilA.;*). - . . .. . . _ ... • • • „ :.. • .. . . . . .., .. . . ..,.. • CONTRACT Ogg OP WORK-ANWDESIpTloto!44-rg.ZRT.N4, ' tott OF 'ti01", 'Pl.A 0641.0 AMOUNT OR SERVICES i 1 'TO gt..Arsf110PIMTION 'Ortusi'.be 0040-ciii 2,:iii,1 Oic.4,40-...*4 p0.4 o00000.**-ertiti,ot::iiedeitikt;,:s!luit (4*.#000.4,.ip041,400044:400; TO tielitoVIDErk,(4 0.01440#*t(t110 Anct:plIMPPATikb...e#: bi0d6f.U.•1*DBE) 1 ••• .. . ......, , .! , ,. • . .. . ' ,,......,, .. ..,. :, „ .. . ,, 1 . . .. . .. . .. ... ,.:... .. , . .. .. . . •, _ ,„ .. „. . .., . . . • . . , . . .. . .. „ . . . . ,.., . . For.1::moOtAgo:o.cy.:to C000itoto: Tolutlellitiiii&DRE. $01i0X.C6iitidttNinfibal. i I Pdiff0:4)40,#iy, Federal,..fig.070105 X4101M. #0iterittiairdt . ' •.•contita.i040p4to , . . -144d4u*ge04/,:ott44**#-Altr43,0000010,4000s**41100.0.'voi*and irAttioaco*:tomoioto-'alia#0.4irditt.. .„ .. .... : • ' ‘"- §.1il=itAtOrt,i4c,10.f . ' •• '' Date'; ' ' - fA*C410-71.0k192A PiiiieN4i110., SititiA4K. Data; LOW,Ag00 **.ti.vc, • ,Pcii-oliito.tiiiitial !Oroill..*--T$'0#.•:0,fT4#0,0 ., . . : •... • . : 41(*00.40itetiiiii$40Nlitilit,*.'• , '.1 ': . . •:, . ::t6.04t4sF!*_01.04.i.0.0..0,',036*(t.091.4.:(0*40.000.ii-OPAtt4c0 - (t.0:',0.4.000) '1 .. .....„. . . . : 010 •.1! • PLEASE NOTE: This itifoopittion 10040 submitted with blit;ltitis not,and you are the apparent low bidderor oioLlofbidder,it iOtt be submitted and ite.04 as specified in Special PO#414:4*30tkroto4libmittitc tectuireit DBE commitment will hoi-groini*tot:titiiiitigthe bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location,',Project Description, Total Contract Avoto* Bid Date Bidder's Name, and Contract DBE Goal. The ., form has a column for the Contract Item Number and Ttet, Work and 00oriotiolk or S'orYitootO)*S:••:‘#),00•040tTOoriibfolt*Pt04,1itbk•0334,*100:•404014410t.itiAlliiidietite, r , all work to be performed by DBEs including, if the prime is 41.ai*otk•POtfo.0004 by its own forces, if a DBE. The DBE shall provide a certification number the .ttierthe'PO•tOti.:Tite74:44dAtkeeifitadtete:evattifie4iiee mtbetslholorm has a column for the Names of DBE contractors TO performt the work (who itiu.§t be oerixed on the date bids are 00.4fedthidincl.4041g;04BIMPORTANT: Identify all .address and.phone number). u4Eittiliwpartidis.At&ip the projecixeprisest.ofdet*root Ott* , First-Tier DBE Subcontractors and their respective listed should be consistent, where applicable, atdiratt4,-tit*i.. ittt•ttw°00.torStibo.s.otuotot$*001tifit:44•Witlt your bid. There is a • '00411110, for the DBE participation •44100144 Enter the Total Claimed DBE Participation 4011atti444'orcOttageatiouritOkt.trit,of work submitted with your m40:0414,01 to the Special Pre* Iff*HeitpmEio get'S01be,5V,etf4ttiea.l:t•tstizt•ttiAttby,:•-thd DBE,,i;g‘7.cribp exact portion of time to be performed or furnished by the 70004 See Section Business Evorotigt*Magribtthe001dfdt.FibviOcn*K994#1•091tP1Titr.406 to determine how to count the participation of DBE firms. Exhibit I 5-G must be signed and dated by the person bidding. Also list a phone number in the Vace;Prelf44itand print the name of the person to contact. teeat'Agenete*Sheliatolvto.0 the Local Agency CO**Award,Federal-aid Federal Share,Contract Awan$ )ate fields and verify that all 4.: •information before sigrtio044000. I • 041 .::.i'.. 1 : IX-141Aint iookt,1100,...01110 opPoirmITY CtittiiiI0VOON ;..T.I*Iiiidorfoowvitof:Oosq4ortootoof,atto „.... ..:„. ....... „„..., [proposed stibolirgotor 1 ,.,..„ if herby '0000.01:0141x0illiosiLj,it has 4.0t 't Ottikftteddlii.ifkOitiviO4,5,;qqAtgr---4141,10.40:44 subject to the 4*qppw.ittg*'Ptoosi$;,al**4,4-'4 Oaitiliftrif5iiidit lom.11144,9T II244 at4***tei6'rpoirgilibgi*/#bollgaiviitt 414.,Rxint gepertitigtelititiitteei the•., . .,, ,. bireOicirPftWOffloo of Federal COtittooteonitiffailm*$000,41 Government(4,404#4.40:t a4ttiiiii#060t40*.yitir fh0•Ai,*Orli-0*1001trkt.Pitiiiitioe.ott,0011 011otoyblotit Q.00000y, .411 ttpott.ft***404.0,401.10-14,1041:11***4.4itoffi..04$ . ,I *;:to :Tt*.401,00tiftaxiolti is tittiiii0:4 itViho‘Ektlid 81*001104 00,01*IityAegtilittwof The Secretary of Labor(41 CF :604.,1(b):CI)),oi4 Ittlgt•bree$0itittabf bidders andproposed,• - ,. 4:,u1NOtrAqtgv 00ftt prail#000tittNAtli contracts.iiiiit4tibqpritt744TWeh are 0:%btoot to-to,equal opportunity''clause, Contracts*,4;$41/.o.owaots-).wiikh,are exempt from the equal opportunity 414tigd!tit':set forth in 41 cFR .604.,4.,,iteemattl'onir contracts or suboitracts,..oe*itkono.or .1 voiter are totempt4 i ••• cigFeAtlyi,X4AdarfiThtm 10.(Ea.Q.44:$#10,0000pottrequired by the E*-00#i*.eXkildttofith‘rit, #PkivoWOVtktiott$,,, (*00;408?*trd,YOsk,001,1,.,lutvAY.4114.02c-grrtvk • ,, - ., . Proposed prime contractors 04 subcontractors Nibty,have•pattiiiiiitdii ill 4„#6,vious,,contract•or • ot;.tDoot0*Ot*j•OA,..,,t-011t& xegiOw ::()t;40ts.and hoo*o.t.ft104theocilft40:gort4IthotaflotOiNt • 41 cat 60.,•14-7(b)tti prevent '-:tb.:0 award,of epttitketS and$tibetitittAdt unless such contractor Atihttiitt a feted covering the',,S4 elitttmegt period or snob:''01tor:p-oftot specified,'by the Federal Vg*,•41Y ,A4*.iwatiott or by• the lattectOri Office' ,' of Federal Contract •CotrIpliote,, tl,.g..,. .., 1),gp',O.Wiolt.Orlib.m.. — • , , . , . , , ,, . , _ „, , • Signature .•,;....'•::, -:.'',., 1-•,:' .-.:.' •.•'„•:,-,::,::;.,,::,,,.,,, ,,, , 15, t• --0, .,wm• op•••gsa•-•: eg-sef • , Print Name :SO 0*.00:00 Title: .$411friviciAtitolOhi, ] . •I .,•. . . ,. . • . • 0..12 • , A.• • .atittat NONCOMMONOFOUVIT• . critic 113,TJnitedStates Code ff2 and fttioCettitraot,C.04oSO*911,7.140), 00.010.4MOT) To the layOf Puntin4ton 404, 1*000001140.00701:10021,0a01.Stito*C04.0 StotioottZ*tit4Tifettl*Nbli.OcottrAOf Code 1.166AeliiiititititOlatea,,t:hattliolAdlot0t made in theof,Oron.behalf of any unchaclbsed pOtSoikpartnot**OOntpany;*soOlatioNorga#oni OtootpotatiOtgtkattotO not the bidder 1has 40 directly or4i14.4,4t ii144044 or orliOtted any other bioottovoti**41$00t 414#05404fiototOootly or itaitotiyooliti&d .00rtspiroii,totittlit4 OA yotre.eito,to put in.a.shantbid, or' 'that anyone *Oa agreedor bidder , , . , n ,„ bidding; be WOO'has not it anythr1ner, directl or iikAtc.070 sought by agreement, communication,or conference 8*.4.1i-myoto to,;gx the bidder or any otilor;.tttgork otlo tikoyo*tioadprokOr.,cost OtOmotf of gio04*00 or of That of anyoifiertiddoketAti vouto anyadvantage against public body7,awarciinglIm contract pro inforesto&j,0 the propose4.o0t*O0iiatall statOttotnA,Ont*Ottin.thc bid are Irno4ntitrotiltot,that the bidder has 0.0t;;4itOotlyoeit4itt.otiyi,litte41iikor*r)$fgp*o or any thorootorli0000tooti thereof; ordivulged wool**otk44t*toto:fi*o4iooto,.or paid,and will pay,gor fee to:any oovotitionl partnership, company A000t;00*,otvtiigiot,,'bid.,dqt4O$1itory*Ortq any memberor 4:0*ttiOtOotici'eM01411q4;cON*0*A401114, Notet Proposal. By sigumg the Yropo$0,1ho Uiddot14$also signed Affl.,4341, .. , may subject the Bidder criminal • Si y Signature ;RPOIE40404 Tit*, Ve President Senior , . • C4,23J ,:. , . „ tkliffliTE; • oF.OA; .._.wd.,..,....,.. pA:ws.v,srENKQKOkrl.nt,Atiox mit,4%.ittOpwcw.nThauLoomATONsmar29i TiftV.dittoti Allidti,),6n4jY 04,0141714 VOtif.404 Si4:ti 0.IsMi.;0 notebeto4 iko/At'or Atifottieli '..p.00tt 0$00i4tett*Ittittiddet.riiitht fatizteitytirctlyrtm partner,-4: tiot,officer,oallgot. i _.• I'' 'biA.0 currently*Wei::„.......:rfsti%,.4)00416,117 46bdfiti. :,.. dtitl•,Whintd—ft.„exrA- 7 usiogo.7r •ii‘td-fiti•Oticilvorinetigibility14y*yiedertd agency; * 114**tt,*#.$410044 40110W4Itlt**ittY excluded Ot.04000.011g4b40.111.0. by 01(*14041 40.4q*itig*ifig$1*:1iy . „*: l'40.00,:toth*.:*,'410t0P4s4d0b41004venditio and •-•„' .1),0 tot liartitiOddit convicted 0:14,4w04111440:mosonitoraoggiouVitilihT-et bY:A,.V.Vteootn::po.to4ltititititffdttiti any matter iitvolv4i104-1.4:01 pmqtal_4401:1644, viithktivit.,PSt3Iga*1 Ifiliemarg,apr ose,000,0#i Os:6.60E64E04 iii40,14:,•*0.04*ilf-0 Following 404.0* Exceptions will not tpatsitti-liestiii in.4.eoiA;ot.:*otd,i-b.ot..Nilltfd00fdott00 ill.49(00*iiilg V4:40toilsitili0,,VorAt.Y40000iiii3Ot04,4b0*:141ta*.b„010*to whom it applies,ildti4ti#0. agony,0.4•4#0:4644i:oiv Note,, Oiovklittg f".4;0:10.04-fon.lnoy.result iii:tfitikiiiit,prosepution,qr,a4txxi*Wily.g sanctions. The above l' g•tiAggl:PAV:Is: grr'itilf*0•PVOttig4L Sttnitit,this Proposal on.The: 41:40ifid potion ti6i.641ghill alscriogsWg sipae OiliiMtat4ijit. 1 ,:7,,-..••,- :,,r„' :,'•'1' ..• ,,/.:.< SignAltOt .!.. ,,,•:')7'.., , •-' . •:..,...,.: „,,- ,••:-.,, ,:,- tigo;: 040:20.0. 010( NotNitite d Eadmiod '.. Tide; :,00,66001.0:0„r4i4ft . ., , . :.1 il ll •• ! . r.;;...24 , • •. ,,• El • . :•••• bittit8rr0, , . NONLoguYitqttERTIPteNTIONFORIZDFAAtaib CONTRACTg. .1 111C W9RVAWPgtigietna' ,Y 4.11111g7aiiit'Aibititting this S4T179P94.4ktOthOileAta ii.4,Ot hOildic01044,1*Iiggb41 . 1). No Federal appopflateki.:tiiiid§have been paid or will bes•pfid,'bl'or'.on Uttar et the 114dg.4004. :to any person for offloatenig or attempting to influence All 0000 or otoployo#of any Federal.,agency, 4:Member 0,04*w, an officer Or 0#0:101*,of Congt.*.prAtt employee of a Member of',Congress in.connection with thok:otar.4-ig of any P040.4:00titratt,*0%47140.,arty''POiteriltr44 the 41.416406.*'.#0doatlotiliho entering fils of any.-.cooperative agreement, .40i;:t t.b.0,.extension, 0900.1.1.40.0i.vt..4w.gt, oteiid*i*.,pr ra(4.0040440POtterai 001:10004,041*'104-k00:61***V0441,0fi' :4 If any funds etberthan:tefteA1'appropifatea funds twie;been#14 Or,wiltbepard to any :person fOrhitirlitti*,(10 attempting to influence an officer or employee of Federal,„. .4$.0074*.Ketitoot ott*grt*ii8,b.if4"9crl?r,gmcifwg-P of 0)11-.0.poi pria*;01p.toyet,of a Member of Congress firooneOtiOn with this Federal contract,•grant,loan,or'00.0Petniva agreement,the undersigned,shali,eon Were 4#4‘;:anbnOti'$fantWil_Torm444,Userosure pf,tobkilog AOMii.okt litt:04#titAike4fth its instructions ... ._, ..:„„,._ - - ..: . . _ . , i. . This.:.eerttatoo is*materiallepte001#4004 of fact upon whichreliance *40404 when this transaction was made ot7tittottd'itatx StifrithoOottqfft:.00:004.0t4uAproroos#0 ibr*44 or entering into this trowa,a104 iltvdso4:•Ily Sstioh• 10$11 Title,11,414,,,C.-444,Any person whot fails to...ftthe,tOoltahtttM6atibh::d41 h4lahk0.004•041,,porwof hot Iaa*a.h.$,1,0,0614fid ,,. witoliwt4o!.$1000.01.7:ot o44:$ifoh taiiitt. • ,.6„, 44idfittiOdetivetaitiOpant 41§91,4g179g.4*1.401114014111S,car or ovotallh#h&or glie4lall. '1TOVIce.:that the italu040.of 414 certification be nolo4e0 in:40 loot tier$oh-ootittaak which exceed•SIOA,00 40 012,44:04.h,,000.fidift$shall. certify and kfisdo.4e4c,-.010.*.., . . . . . . .... . _ . , .. „..., . ,: ..Signature ,.. . . ...,, : . Date .,41/PVQ2'4,. i• .:: . :• '" , „ Ptint'Nan* 19-04C404act 1 .i ' - , - , •-• -- H• --, - d , " 1 , ,.._.. ,. •1 ,. •1•. „., '..' , . . , ,.. . J •• . •• . ., • .. • .. • , •, , 1 ,.:, .,• , . ..• • .. .. . dr. I! , .„ ... •1 .. VIHIBIT H to, .,,617 r. DISCiOSIlltg QV tottliti4N.akeTWITIES •', ,-,d„'. 4'. • - d ija t...,11 COLIA'atrtlii$PCW-Rati„OrSOWS-$140101140,ACTIVITIESIVRSUANT-TO 3t1 NISC.,145Z li Ii1.04.0444.0801401C.: "-i : ':2:4-;(4tOkt00c0IAO.41on; E.1-*:i,.40:0410i,-!, 1 AI:0101W.4ppliption. . .. „,, , .. 'lignitiat El...,=, ,..,....iT,„ tii.AeatfP .f: 1 - -li:iiiiii40o4 • d'''ti.,..ittiAtetiktigiaitd, .:000ii430,4WVM:Piti 'di 011:44.7,40 4 10 4A ' . :•. : Toimiteditalang0'0' ., ,, gd:.1iNa r via*: r4ntegi f.*:,.10.**1000, ;•• . ,. ., gr, 0 OtOff**9.0-- , 4'.., l'Onioltakititirest tifittoottnitto* gReforntioow*ANAlookowarderi, ... . ,.: .. , ... . „. satofrit*e000.4kesjOtit* .. .,• D...pri. Jo.0 ,Sittiawantee , 110, -Jt1410*P.0.4*-0.0oigkOotootatittiow i ,ongrozsiiottaolthidonioot: 6. geitio.i oepartniwiiiAoito.i 1 't :144keral70***,4**OP:fAriVirOM 'JPF44,NO.00.0ri-Itmirmilite ,..,„. . , ...• ,, & F0d0482.44.41.14,1.114pri. itknomi *i ;Armanunuttiritktiovoitt 44,„ 444*0....400.:14ikoklit,40*Entity ., b„. :404400:**0,,r,-.040g,gemoo 0.404404 040-01.4t4ti#04•0**1110,-;Ml): 0:4iiitssil.afir3iotAiiiili.146;1001 , Vatto00.0400:07,101) . : ,• .1 ':(,#:ttOtiVo— otiiitati Oti.-iir..0.40:iffi.00,s.:404 . :11'-', 400000:f0i1.004*0.0ctiit**0•000) Sd!.: ''''ri 000444deitt(00*„"ii4E#4t.iVISIO . A .6124t il Eloann g4 :b...0twtigildifite .. 714'. }78iiitOtt4i*::6400*00,44pitijt; '-g,i.Mmissiko. Ititistf ' 0.0101,4,4041.7.gg.: k ii141044 slier*tittiO. . t idettitit . , - - , . It.#1iAgi 'NO* 'ix* , .. . • .1* *tot**4.00004„vddlt.orittoimis oKtk.hotoo.eineollotbiget#0.0•61'N?;10.0000d..40-g 6#40(4,04.14044*..i.iiiIii00(4i.‘4oior4.,•tOt'6.iiiiiiiiiiihote0440**; , , . 1 *ith,'ototio*tioishottco.ir,0005-§*tyy . ., . _. . ....„.„. . ,..: 15.,, C.'..0ittiii.110000iiieggheiti,:.1 *a a: lico, ,, .., it& tiikuttaii*IeliqeitaihrbtigliAiS raOli Aaiiitii6044 .-Tftle , . ......, .,.„. • U/rj.,:$0;,$.4cgonfil$1,:llits,litgblo.e.,*0::16401,gt.0)14,4,p24 ::Sionaturc WASI*Oitittlit:ifee'abiii**tieri.,404*00:14,Nas•mo404,r citt6til iiit0'lli1k4ls410**44m9tit164,;,;tit, 1Ptilitl**- tt52 •:Mit: 1070j490 4,4 be },r.opytttii to ..Congress. :004:4614439/*4017c:;.:avaii4ae i'.*Ioilifie inspection Any Vfiqr, ti.0.0iiil NoipAio•hi‘;*1,44diedalseto*opot.***0 . 44.A,4iii penal*'dtiot toss ihiliV00:404.410iMoiP1Nxii teklifibtti.X64, 1*,;:,,, 44.0.0,0170.004.0040.1,14* ••• . Mtfiti60-4-totUtit aci*OdOtiOtt. ..... . ...,. , ...,, th4a41'0#.9i.flyti .. -„•• 414.4400#1*-LIM ... • . .. ... L L:F ai S ,tiiiitdofiiiLI(O0942*7 , .. . ,..„.„ , •.„ w,.,„ , :.: , . 0,46 • ... . . , !I! routo. :Fuxiuttal4, . ...„, DISCLOSURE OP tbritiriergaACTIVITMS: This r($.fig:6„ii ,.00.111 W. ttotitritg. whothersubawardee'.orpritoefederal t04-04117.4 OW 04414004 tittOtiPtaffeovrO 004.gr41 action or 41.440.1:14;6.400141#,:tvinn4 Mint pm444t:to 440 14 it$4. section 1451 The *km s required. for wax:otinteitt or, agreement tø iTake p4r.nent.:.tni1obbtg enty for influenefig or attemptmg t nuetxee an 0000' employee of :VAAPYi a *.nibot f Congress an.officer or employee of congress or an tittoloyet f a mini* ofongress hi 001144.41foll with a covered Federal :agtipt Attach a continuanoil het for additional information ifthe icottooto?.all items That applytbr both the inital filing and 040134. cliange report. Refer to the implementing 0(44104p4.$14.o41*-1h0O*0:9f..104044:0010:404.1$0401:for*WOO ftifootwiok. Titootitr'ittio':4.;p0 of covered Federal,4‘Tnit. for*bioti:lobbying,a06*(tyia and has btoo secured ti ktr40AM.:111:00titcort*:00.*r,:000,0:4F0-406,1 ittiott, 21. 1.40:: *Yi$14,t4,Oft,1*-tOtita,#etteiral 46ti9n4, ditiktoott.If this is a ft)I1.91!,r1,4y.roport googol*a niaterial change to the loptittott,titer itid year and quarter in w1u,li the owge act'ulted-Enter the date of the last pm:y(044y submitted report by•titiaAtpbitiim ,oetrfOfiliia:,:oovaroatedttat action. 4) 'Enter the fall name,, '1414. zip 000 ot the reportutg 004, 140.1ii.4 coiV4.44004f,1)404:if known,:Check appropriate 410400:Atiititt of the17VOttiflg entity 140..:40$444W4ifit 10.Of*pools to be Identify fieieeth:4 .„ , subawatOoo*k.4,-Itiefio.t.,suliavvotteo Offi*00.101$thd,initttiet,Snna**$inotnn,p but are not'imited to subcontracts, 000ttoOtAvat.64044gotts, the:94410 g440n filing the tpoiti fteto,4,ohtka,'10S:tibakratitdio. Mot enter t.tig,T41).,jut__ k,..; 'Adifitti§1 city stateand zip code,of thevirne Eakieral teoVient. Include Congressional Diatiet; itknowni,, Entçr the name orthereaeral agency nuiking theaward or loan wxygignmpt Include at one , •Prg.g.0409T; level totilVif' 0$040Y For example, Department of Transportation,Pyi.to4$,tatoV0.4.al Giiant 7) Enter the Yoiforo. pm**name of description for•‘,-covered'30,00vo 4040#kitoto . enter the fill Catalog of Federal Domestic Assistance (CFDA)'40m1Ot'f01''grants, vo000.400 agreements,loolo41.441001.ootnnttorg*, 8) Enter he',mot.:appropriate Federal identifying number.4-V.0101*- for theircttottal action identification I :RooggCt6tTrf4P66dtAftl Auttitieri:14Y444-0 fr 04 Of" 4) numbergrant 4,110040000ieot: number,, the contrastgrant or loan 4*AniVntnnitik the lo.:PlAig..4tiOniptnp0041 Onttntntinilior toff0t4:11'yilfdTeileial, agency) !"prefixes,. 0)1 For a covere&Federil.40,9q**9 .410.0 A.4$ been anowatti or loan commitment by the P,0147440.titittOtthS,•#04etal amount of AWATOAPAttgovvilittotis for$10piiitIo!ittity identifled in item 4 or5 10)(a)Ent rhefuIl name,adch-es,city,state and zip cocLe ortholoi5boottitity•eogg4)0Ytfid ro.potiorott4iitotti414 in itott.416 1.0146dedaftoogt.44,4o0*.tioni; •• " „ . , , ettOt:60,.441,:mri*,,orthoildiyi4410)tietfoititilitsorviOqo 4tcliittitdo'AM ad4r jf e4„al 40retit from Pitt Naito and Middle .70411: 1.4titer•the amount of compensation paid or rossomhty cltiyoote,d,.lo be paid h5elho ropor*g entity(item 4)to the lobbying ehtitYi(ite#1,1%.littlitatiO4hothot fholotoot(ho,*4,01,44 (actual) or be made(jilsotit4 Cheek afl boxes that apply,:tt this is a material change; report,aiter the otattitatiiieantount Opaytnent:made orpoiieittohiethade. I:40*k the appropriate boxes owl*trpgrotot s made thitukh;40441*4 tottribttim specify the hathie,ancflfgftv,ofthe ilti4444.p4rietit: 14C'heek*e.4pwp,PriAte 70140);/.0heclattlftathdkpOly If spect nature t4rY",P:t484ddfa:4tfddifikA.n-c4etg4Te4 glosgripatot ofiffitlertadeg ittitA4tekbOatlies performed or will be 0.0040.410 perform and the 4ateaofanyleolOgs rendered, Include fnelndeall.preparatory 444441tia activity not jt.0 tune spent in actual contact with Federal offloialo.,10etiote the fOdorar.:Offfcer(*tor:dttip10,040.1 441*:**Or:the Offie0(s)01010000 Pf.Meher.(s) of Congress that were contacted., 15).Cheek.0gthet ornot a continuation S110414*4ttOO404 tO:t 40', 01ttiffyire9fAci0,0a11*.goon-Ct4ate:tlieformpthu hisihet tante&.620 iot.exkoto tgoihot. Public r portngburdenThrth4oetrec$op of iirfuotiot:lestfitateirto 4.1,fcr4p.".30'411intAks per MPQM-41.-inseblakatitod for Oiliviiiilgio*O494vswoli4exg data tonitegatheilmagd, iaifteinllfh,:., tg4:ea, ,iom:: tihgn tr he4l collection of t tteti ioto: or4t4!gt,;:b7totf Or an aspectj001todttcth:of ttn jiotoqimtte7tlt burden, Office of PO . .**R00090 Project(0548,',004,6"),VashfitgfOil,brO,Z05,1; 45(#13.1:4rtattrton 014000541 It?r0fwttaorpenalty of perjury under the laws'of the State California, that the lOrOgOiOg questionnaire and statements of Pub*co444:ct Code Sections )iefor, fi)232 and ittgli are true and correct Atitt„.that the bidder has complied with the requirements of$Cetinn 8103 of.the Fair Employment 007/0111:igssidit Regulations .. Ch4ptet45,,,T#1orto Cji ifrative cadq. •, ,• '048 • • ViX14.141t1 • VEDgAt itiOSAYINGITtESTIIICTIONS .,„Sod0Oit 0.521 tl31i VO.#041$0.04 C040 OtOlkihits,:N4Orit fiol-4,0oto bOitt0.0t4.4* recipient ot any foot tier Wtooloiorix. pf t contract to pay for any person for influencing or Opropligg to influence a Epder41 agency or Congress in connection,with the avearaitga'6#Ptddital4.40itract4 01#4110:citWO:Pa.0:4000411t offorotihoJ,otatilitg,ita of any agreement 07:4AY-4#1000.rOVII.:V4101it*Oli000-0;;Poato.'ttlid.,Wii1.0pArposeslivoogripaigowith,A4. Federal-aid i00400#4,the recipient shall W)114**1(pogipdgct#40.#011,coOf requiredsubmit a 0.00,00.4.4wOsotto, o'rol*,.p*zottlig:fia:dottifitota„ 4otrtiOO.4o.ftfOr.P-,odot.o440#404,!rggilg,'p:4roo:v,or.foAaiifolos,w4#std'ss,Or*FOdwal agency is included id the Proposal Standard.f'ofx# Mfkittop with iligtoption*Tor cmotoototoyTs*dord'•PpitmiolstilitatitedlititittPlitoga String* PrOpail The tOgitittitOiviatirWt4g,'CedikafioMi „, AtpycIof0.*tcootl ortificatiottAtuliiikibtt*catiobt*:#4 activities.shall tfejgOtoM in eab subcontractand any 19,WPI4tir contracts exceeding .'0.06060. AU disclosure rot*, but not ';'00.1004#014410,010470rww404,0044.tcr.40.#0rAlltitive.:4:1thettEigkoot, The Contractor, subcontractors and AttylOft0Mierooiltrattiort ishall ad Ord at the iend of 046:::.01004t, quarter in which there occurs any event that 00i:to disclosure or thai loggriogy .-04,fh-o..a00140y!:0'0*-i00-todioit rotAptolooslyAto4 by the , Contractor, gtibtojiltAttOrgotT4411Y10 ;40 contractors An ooittiti4toatetauyaffectsi Ih.040.0.04-0101*itifatttati*totfdtudiftidu'fades ,A cumulative increase if$MQ:Qvt:more in itte:14Mattit pit&ott.ttfttaliti.be paid for . 41014611440fattdOtitirigVinfiWIM koo,yoml Eodoroboito rq or . „ ,,toiditglit the person()drindoi 661(4 influencingor attempting to influence a covered tAtiOit or phooge,ht g*.:(00040 orpotoyte00eor Moubgr®contacted to influence tir attempt ,to itilliletteid,4000400.4er41 Attift, . . • ,• • • •• •• • • .C4.9 • Citytif Hob-tit:103o BOO Poitliof*tk*000attriient. 1000Vatet'Stroet 'TOL(714 .. 54: : Fax04).17:4-.1$10 ADDENDUM NUMBER ONE Fp,r, CENTRAL VBRARY LOWER LEVEL'RESTROOnt ADA .1.111.1PROVEMENTS August'14440 Notice to AR Bidders Please note the t0.:th*Pf0leaPlanstApecifiteti0w004*,0001 Provisions s, 71). The updated Alimpa-004frootoi4to otttga has been attached herein This replaces the 'wage 4dfer011gOrtfo#0*-,*ppoot.0 of the project T1ft 10.ti),A01,010i410.4ge,reolote ed4074167*of 4.04044.01:1NAmbet Otiei'dateitAx1gtisti54 20234 161, P 'f - '; ' • :- rat r:„..„ Company Name By ilget A.4 NtAr; riaf,6 t.ofutAddejitigittilki.ou, r f U.S. Specialty Insurance Company 601 S.Figueroa St.,Suite 1600,Los Angeles,CA 90017 (310)649-0990 BOND NO. N/A PREMIUM N/A • BID DATE: August 22,2023 BID BOND KNOW ALL MEN BY THESE PRESENTS,That we, RHOME Profile Construction Corp. (hereinafter called Principal),as Principal,and U.S. Specialty Insurance Company ,a corporation, organized and existing under the laws of the State of Texas and authorized to transact a general surety business in the 1 State of California (hereinafter called Surety),as Surety,are held and firmly bound unto City of Huntington Beach (hereinafter called Obligee)in the penal sum of ten percent( 10 %) of amount bid not to exceed Ten percent of amount bid Dollars($ 10% • ) for the payment of which the Principal and the Surety bind themselves,their heirs, executors, administrators, successors and assigns,jointly and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH,That,whereas the Principal has submitted or is about to submit a proposal to the Obligee on a contract for Central Library Lower Level Restrooms ADA Improvements Bid#CC-1658 • NOW, THEREFORE, if the said contract be awarded to the Principal and the Principal shall, within such time as may be specified, enter into the contract in writing, then this obligation shall be void. If the Principal shall fail to do so,then the undersigned shall pay the obligee the damages which the obligee may suffer by reason of such failure up to and not exceeding the penal sum of the bond. SIGNED,SEALED AND DATED THIS 18th DAY OF August , 2023 } RHOME Profile Construction Corp. �•� ., PRINCIPAL 'fiy s : .. By: e " U Specialty In mace mpany Cynth Y u g,Atto -in- act Hccs7moaoano CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California } County of Orange } On 08/22/2023 before me, Kenneth Chiang, Notary Public (Here insert name and title of the officer) personally appeared Rodney Earwood 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. • 4,.r1;!.•. KENNETH CHIANG WITNESS my hand anki official seal. ,'}��; Notary Public Californiau.. 4>P.� Orange County Commission q 2334923 • � `+iir••" My Comm.Expires Oct 6,2024 Notary Public Signature (Notary Public Seal) • • • INSTRUCTIONS FOR COMPLETING THIS FORM ADDITIONAL OPTIONAL INFORMATION This forni 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 slate so long as the hording does not require the California notary to violate California notary U.S. Specialty Insurance Company law. (Title or description of attached document) • State and County information must be the State and County where the document Bid Bond 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. 08/22/2023 • The notary public must print his or her name as it appears within his or her Number of Pages 1 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. lie/she/they,—is/ere)or circling the correct forms.Failure to correctly indicate this ❑ Individual (s) information may lead to rejection of document recording. 0 Corporate Officer • The notary seal impression must be clear and photographically reproducible. Principal Impression must not cover text or lines. If seal impression smudges,re-seal if a (Title) sufficient area permits,otherwise complete a different acknowledgment form. ❑ Partner(s) • Signature of the notary public must match the signature on file with the office of the county clerk. ❑ Attorney-in-Fact Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. Other Indicate title or type of attached document,number 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). ^Y,,w.No?c'rv(;ir. ses.com 800-8%'3-i??nS • Securely attach this document to the signed document with a staple. • • ' CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE 1189 ...�. .....1....r.,. .. .. ....l... .../., ...,....ten.... . ... . ../ . 1... .. .. ...n...::.�........,. ♦l.....:./.,.. ..,....�... ♦... ,..fin. A notary public or other officer completing tlus 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 AUG 1 8 2023 before me, Vanessa Copeland ,Notary Public, personally appeared Cynthia J. Young 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 r VANESSA COPELAND laws of the State of California that the foregoing �w:, Notary Public-California ' 'ifs paragraph is true and correct. z ° fir =; Orange County ,;.+ Commission N 2424393 `1-im" My Comm.Expires Oct 31,2026 WITN S my d and o iial seal. Signature: li Si,.a ire of Notary is Place Notary Seal Above OPTIONAL ----- Though the information below is not required by law,it may prove valuable to persons relying on the document and could present fraudulent and reattachment of this form to another document. - Description of Attached Document Type or Title of Document: - Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Capacity(ies) Claimed by Signer(s) Signer's Name: Cynthia J. Young Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer—Title(s): ❑ Corporate Officer—Title(s): ❑ Partner: ❑Limited ❑ General ❑ Partner: ❑Limited ❑ General ® Attorney in Fact ❑ Attorney in Fact ❑ Trustee ❑ Trustee ❑ Guardian or Conservator ❑ Guardian or Conservator ❑ Other: ❑ Other: Signer Is Representing: Signer Is Representing: • Rev. 1-15 • STATE OF CALIFORNIA - DEPARTMENT OF INSURANCE NQ 07984 SAN FRA.NCISCO Amended Certificate of Authority THIS IS To CERTIFY TEAT;Pursuant to the Insurance Code of the State of California, U.S. Specialty Insurance Company of Houston, Texas • •. ,organized under the laws of Texas ,subject to its Articles of Incorporation or other fundamental organizational documents,is hereby authorized to transact within the State,subject to all provisions of this Certificate,the following classes of insurance: Fire, Marine, Surety, Disability, Liability, Workers' Compensation; Aircreft, and Miscellaneous • as such classes are now or may hereafter be defied in the Insurance taws of the State of California, TF31S 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 requirement jtow are,or may hereafter be changed or amended IN WITNESS WHEREOF,effective as of the 29 th d y of December 2004 ,I have hereunto set my hand and caused my official seal to be affixed this 29 th day of December 2004 • 'oho Ga amendi mil r (//f /eprOIX-Rilgir Y for Ida Zodrow D • put, NOTICE: Qualification with the Secretory of State must be accomplished as required by the niter issuance of this Certificate of Authority.Failure to do so will be a violation of Insurance Code Section 701 and I 1 be grounds for revolhmg this Certificate of Authority pursuant lathe convenors made in the application therefor end the conditions contained herein. • Sai OM'CO rno, I-111 �I�'I 'IIIIIUIII` vw ,I \Plos, lit'' I PIII I �gllll�oll it" UII'I Illll�ul' if miim III�IIIII�IIIIIIII l�lu� sr tor TOKIO MARINt. HCC == - = = = = .OWERFI - ___ _ _ —_ = AN AAAA C S INDEM mo P W-T :BONDING *I _ == _-P _C= — UID EITY COMPANI .SCTNSURANCE CiAAAAAA - KNOW ALL MEN BY THESE PRESENTS:That American Contractors Indemnity Company, a California corporation, Texas Bonding Company, an assumed name of American Contractors Indemnity Company, United States Surety Company, a Maryland corporation an ecialty Insurance Co any corporation (collective) t "C anies"), do by these prese a constitute 11' 4Eii1istina � PPI IIIII�II IIIIIIIII III""II�I ' j44) %Ja��IIIIII ill�lll�'lll '1, istinaMollll.. II Ild :� • III .II,. nzuela o I IIIn l" . �' of San �llll A ' a l , , 4, lullllun,l nl II ,q p, I I IIIIIIIIIIIII IIIII))IIII I I� IIIII11111 IIIIII II III II II lll Imillll�I I III I�' II its true and lawful Attorneys)-in-fact, each in their separate capacity if more than one is named above, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings. or other instruments or contracts of suretyship to include riders, amendments, and consents of surety, rcOd #re bond peral�d_ nc e i _ — E Million****" _ = Dollars= = *' 3 0.00*** ). UsWo r Nhall expire 1, hrdt Of-Wm; is€* anuary 31N22 4= NNW M4ttorney is=_a Via_ er and by a Ity_ fcvesolutions ad- --tth__d_ irectors of than-:_ __ Be it Resolved,that the President,any Vice-President,any Assistant VIc�PresicTint,any Secretary or any Assist Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney-II Fact maybe given full power and autho Vy for and in the name of and on behalf of the Company,to execute,acknowledge and deliver,any nn I�IIIIIIII�P I �inq IIIIII"rl IIIII 10 , I I Ingml II IIIIIIII ,n , ul:�lbi1I`II1�6recognizan s ,i�llrtr.�ll'u��l�lll�g�llle� It 4stimates indemnity r .°°I'hPer' lu���iitl IIIIII li' I� gll,atory undelyN11;',11\Id�,lll g I y� d IIIII conentsI�II II IIII I� I I� VI� I � I I� , � IIQ � i.i��� �11 '� ��� IIII. II��� Ilb . I^ of retained{ e o on e� h� contracts n e ocumentsI I I I.Ihl.IIIII I„III IIPII I� �j g L II VII IIIlrilII I II II III III 111 III II I' ' III' I II I I III I IIIIIIIIll)III n e In ^IIyyI�h��Il erminating the !I i'�� •pa, "pI t I,,;Under,and any 9 i ts;i �ts I��•, led by any suf ne, n- ' a I�I ,l nding upon I IIII I'Ih^'IIIIIIPIll�i 1IIIIII ill mill)I IIIIIill IIIIII II IIIIIIIIII I IIIIIIIIII I. IIIIII Il llu IIIIIII II(IIIIIIIIIII - I I 1llllllllllll III e b resl�le� an Sea ed and effected b � Co 'bate Lcre�a I Ie bm an as rf sI n d II � IIIP Y 9 Y ...I� ��� � ry Illll Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile,and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. WHEREOF _V t0_0aused this it r e r d their corpOat ee h ffxed,this September,2 _ _= — -- =- — — -- — - — IAE1 CITCTORS.INDEM CNfIS BONDING COI�4Nl -UNITED STATES SURETY COMPANY—U.S.SPECIALTY INSURANCE COMPANY 4tP riae�, sfeoN,,.�co*u� .�K45 4+F}`a z��n�"'w"S. State of California F� ' ' '� t�. .fif .p/ +\.gti i y21 sscatmo,f w1 (]/v` 1 �l ,ry,;' v >mli.Y/\� � �E l� f IIIII C nf''llk l es Angeles IIII 1I I 1 III ty s.;\ l'' Ilf By: , .,m1011111hm lllliimlm III IIIII Iilulll,. III II II I II U II'.: ...., t,p? PT �I•.Q I I I a li ,P m q Iilli .�.,Im III�IIU�IIIIIIII Illl11 ,IIIIIIIII IIIIIIIIllllllllh Ill�illllllll ��tt I•I, 11 II r'pF� y iita ll IIIj�N"I,11I1 IIIIIIIII 1,p09�li�I, ; 114111�,�„ „Itosident q III prpll I' IIII II�'" 'III I,Il�r III II�. d I l P' I,I II lu 'III II IVI'' �II W I,IIIIII' IIIIIIIIIIIII , III uIIP III IV IIII"' . IIIII III;III III � .,tl II III III I 'I�IIIIIIIIPI'' Ill IIIII IIIIIII:IIIIIAII bt l l Public or ofhe ice 111 t? '' +nglll$rs certificate vi es o,0,��,,I1IMel�l�.de r)of the indiwd I h�1lll r ,+e ll�f,elll ument to III If I I II I u 11 II III which this certificate is ata shed and not the truthfulness, accuracy, or validity of that document I�I IIII r On this 23rd day of September, 2021, before me, D. Littlefield, a notary public, personally appeared Daniel P. Aguilar, Vice President of American Contractors Indemnity Company,Texas Bonding Company, United States Surety Company and U.S. Specialty nswer .ompany who_proitedel3i1trtatasis of satisfactoryeviwwi ce b person whose name subwi the within - s t d acknowleeeeefge t€ i UM cecuted the as • _ trM `capacity; d fia€ __a re on the A person,o er f which the nteeerthe instrument— I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. �II' •...,, O RTllLE.PGIEsLlD WITNESS my hand and off • I seal. r t- Noury Pt oa r\?110h„, I �, I II I 'I.I fI l ° r .,0#aP � cs i , I ,I i I ° (seal) I' II _1iII�_ I 1 �,� it Ep 'I II � � I � II l d I 1I Iru As b istant Secr ry ��1� an Contractors In ,I. h.ty .P4 nP �, Texas Bondln9 pa d s Surety I Company and U.S.Specialty Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies,which is still in full force and effect;furthermore,the resolutions of the Boards of Directors, set out in the Power of Attorney are in full force and effect. LThtJj$ ItW a c _ sag_ ompaneornia this _ = — =_ "�*ACTO'i�nY� .�,*DINGpk4 p," ,S R4i� �,,, oph,;, i Corporate Seals /� o"a� as yy a ON,._ c s io? Fro h a a /�� c�Q' 'Wo6 a @ Oct 1; 7 ' dY# r� �Co Bond No. I r k t x •1• c �7k 1 4�Qj `?1 '4. .F Qa- A 3501 yfy IIII t. \aS� wr,\ y!q� "' ra Ki0 L 5 ' eta 41, L �muoNouum r`� `w I 1 1 II ...."A p Illhll ryII I� ill � II,,•.�I ��I 1'" "0�0n�4 IIII'll.l �I�'frr: IIIIIfy I!h III II IIII IIIIII III I Illlfl , ll I IIII' Il ;l,,l it ;I�j ,I II,I��II , ,��, .�.. q �I II IIII� II hI II II I ICI IIIIII IIIII IIIIIII ll�loi1 III IIIIIII '111 ii1 ll I �illll,lll�lil;l" I I� IIII lil I I IIIIIII III IIIIIIII I III I I I ,I 1 .filllll I I. I III II I I I I I I csMArvoAo9/2021 lIIII IIII III, I I IIIIIIIIIIIIIII I l IIIIIIIIIII I I IIIIIIIII I I � I I I l (IIIIIIIII. .. Il IIIlllllll Ill) .. IIIII • visit tmhcc.comisurety fnr acre information • Kan't Kopy K1 Kan't Kopy Kt Security Paper Security Paper • Hidden Pantograph • Hidden Pantograph • Color Match • Color Match • Artificial Watermark • Artificial Watermark • Anti-Copy Coin Rub • Anti-Copy Coin Rub • Erasure Protection • Erasure Protection • Security Features Box • Security Features Box • Microprint Protection • Microprint Protection • Acid Free • Acid Free • • • • • Kan't Kopy K1 • Kan't Kopy K1 Security Paper Security Paper • Hidden Pantograph • • Hidden Pantograph • Color Match • Color Match • Artificial Watermark • Artificial Watermark • Anti-Copy Coin Rub • Anti-Copy Coin Rub • Erasure Protection • Erasure Protection • Security Features Box • Security Features Box • Microprint Protection • Microprint Protection • Acid Free • Acid Free OFfb:fA SEC - Do NO OPEN Project- (ko'ra,) Li brc*r1 LL. (&rc7o n ADA L ( w\e► -1-s 1GSv D is 0 pe":01fkAke= A e-si- 22, 2d? 200-. VIOr-vc_ Pro- Cie 12-4Ia d SECTION C PROPOSAL for the construction of CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENTS CC No. 1658 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 60 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications,Instructions to Bidders and all other contract documents.If this proposal is accepted for award,BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses,taxes,royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded,the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the Contract,the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER,the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find bid bond in the amount of_ which said amount is not less than 10%of the aggregate of the total bid price, as required by the Notice Inviting Sealed OR ELECTRONIC Bids,payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder'sBond 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. ; Daggeeeived T z BW a..!;Signature. /zSg . 1-08-15-23 08/15/2023 c&fBwa.dva C-2 CITY OF HUNTINGTON BEACH CENTRAL LIBRARY LOWER LEVEL RESTROOM ADA IMPROVEMENT BID SCHEDULE Item # Description of Work Quantity Unit Unit Price Item Total 1 Mobilization 1 LS $6334.60 $6334.60 2 Construction Waste Management 1 LS $2200.00 $2200.00 3 Closeout 1 LS $3517.30 $3517.30 4 Demolition 1 LS $14,627.20 $14,627.20 5 Abatement 1 LS $N/A $N/A 6 Concrete and Reinforcement 1 LS $5401.00 $5401.00 7 Casework/Countertop 1 LS $3651.00 $3651.00 8 Blanket Insulation 1 LS $2888.04 $2888.04 9 Joint Sealants 1 LS $364.61 $364.61 10 Aluminum Door Frames 1 LS $3811.51 $3811.51 11 Wood Doors 1 LS $2000.00 $2000.00 12 Access Doors and Frames 1 LS $2000.00 $2000.00 13 Door Hardware 1 LS $477.50 $477.50 14 Glazing/Mirror 1 LS $3000.00 $3000.00 15 Gypsum Board 1 LS $3668.18 $3668.18 16 Metal Stud Framing 1 LS $2243.00 $2243.00 17 Porcelain Tile Floor Finishing 1 LS $2209.69 $2209.69 18 Porcelain Tile Wall Finishing 1 LS $21,503.46 $21,503.46 19 Painting 1 LS $2033.83 $2033.83 20 Signage 1 LS $300.00 $300.00 21 Toilet Accessories 1 LS $14,198.00 $14,198.00 22 Plumbing 1 LS $15,974.08 $15,974.08 23 Mechanical 1 LS $3043.00 $3043.00 24 Electrical 1 LS $15,420.00 $15,420.00 Total in Numbers $130,866.00 C-2.1 Total in Words: One hundred thirty thousand eight hundred sixty six dollars and zero cents NOTES: The estimated quantities listed in the Proposal Bid Sheets are approximate and are to be used only as comparison of bids. Payment for quantities will be made from field measurements. If the actual quantities show either an increase or decrease from the quantities given in the Proposal Bid Sheet,the Contract Unit Prices will prevail. Full compensation will be paid at the contract price for the actual work completed,and no additional compensation will be allowed therefor. Payment will not be made for materials wasted or disposed of in a manner not called for under the Contract;this includes rejected material not unloaded from vehicles and material rejected after it has been placed. No compensation will be allowed for disposing of rejected or excess material.The City reserves the right to reject all bids and to increase or decrease the amount of any quantity shown on the Proposal Bid Sheets. In case of a variation between the unit price and the totals shown by the bidder,the unit price will be considered to be the bid. Compensation for items of work not specifically identified in these bid items shall include all labor, materials,tools,equipment,safety measures,and supervision required to complete the work to grades and dimensions shown on the Plans or staked in the field.There shall be no compensation except for the bid items specified in the Proposal.The cost of all work shown in the Plans and Specifications but not specifically identified as a bid item or described within a bid item shall be included in related bid items,and no additional compensation shall become due the Contractor by nature of compliance with the Plans and Specifications. C-2.2 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Brd A NameandAddress , State Class' DIR PVVC Dole 1` %r, item 4 i , ikontractax Licence Amount , attract .Number, % : By submission of this proposal,the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on 8/18/23 , at Huntington Beach _, CA Date City State Rick Brogdon ,being first duly sworn, deposes and says that he or she is President of R&R B Inc the party making the foregoing bid that the bid is not made in the interest of,or on the behalf of,any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid,or that anyone shall refrain from bidding; that the bidder has not in any manner,directly or indirectly,sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation,partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Name of Bidder-Rick Brogdon Aka J`3.w.gdan Signature of Bidder 13885 Redwood Ave. Chino, CA 91710 Address of Bidder C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH,CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the CENTRAL LIBRARY LOWER LEVEL ADA IMPROVEMENTS, (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. R&R B Inc Contractor Rick Broadon By President/Co-Owner Title Date: 08/15/2023 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 fJ No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code,each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. R&R B Inc Contractor Rick Brogdon By President/Co-Owner Title Date: 08/15/2023 C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: R&R B Inc DBA Servpro of Chino/Chino Hills Bidder Name 13885 Redwood Ave. Business Address Chino, CA 91710 City, State Zip ( 909 ) 548-3191 sales@servpro-grie.com Telephone Number Email Address 935856-B ASB C22 C61/D64 State Contractor's License No. and Class 07/27/2009 Original Date Issued 07/31/2025 Expiration Date The work site was inspected by Laura Thomsen of our office on August 08 , 2023 The following are persons,firms, and corporations having a principal interest in this proposal: R&R B Inc DBA Servpro of Chino/Chino Hills The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. R&R B Inc DBA Servpro of Chino/Chino Hills Company Name ✓tic&£t3gdast Signature of Bidder Rick Brogdon Printed or Typed Signature C-8 ET iCA ;Subscribed and swori tor1efpre ?•this �ay of 4 s 202 ' A notary public or of er 0�eer co ipWtng ace cater aeries only the I � Q o .. fttdiv,Is ual he signed, the document; w ch its certificate t a to le 1, and not c trutl:ulness fa urac x or validity&that dueu en : c Geri +r► c: . Count Of l t i ., A. b ... an � ( befr-re i'rle' , , 7l i,c j �o" '.'4 b c `onttt034Y,'xid ear Insert Name e® It e dfNotary er ona�ll eared. r a �ines n: 3 proved =me;cm the haws of$a1€s kory a hence to be,the ersott,use name tar subscribed to the within,insi�ner t:and ack ios fidget to nme t f e/ ey execrated the same irUtWher c�authorized ca cIty es ,-nd' is y`tr4s/herb ae ssi �)onthe strum the ,, person( c the en u o , at a u hie;ae on -a ed 71:-(1,:11.: -t istruii et1r,Z eertify under PENT LT ' OF RJURY ides the lave of fate of C €rrnia that the .:. foregoing pa graph is:,Vie;and oorrec,. I'I' SS m hariainalatficial seal_ aM : - Signat - -, ,1 rrfl °atary . hlic TI—dkG 'N"4 T .5W',A 1 )` - , ., Bidder's Project History For the purposes of this project the contractor and subcontractor must have, in the last five years, constructed at least five (5) projects of similar work specifically referencing the construction of {Describe specific work and experience necessary for project, for example "Reconstruction or rehabilitation of existing public use facilities". Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. The following list of projects meet the requirements of above: 1. Coachella Valley High School-83-800 Airport Blvd.Thermal, CA 92274 Name and Address of Reference Name and Telephone No. of Owner: Leticia Torres 760-848-1843 $134,000 Abatement/Reconstruction 08/14/2023 Contract Amount Type of Work Date Completed Provide additional project description to show similarwork: Rehabilitation of existing public use facilities. We performed asbestos abatement on the windows in the weight room at the high school. 2. Coachella Valley USD-John Kelley Elementary-87163 Center St.Thermal, CA 92274 Name and Address of Reference Name and Telephone No. of Owner:David Baucom 760-925-7167 $113,000 Abatement/Reconstruction 08/18/2023 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Reconstruction and rehabilitation of public use facility-elementary school-We performed asbestos abatement on the windows and replaced them as well. 3. Ontario/Montclair SD-Montera Elementary School-4825 Bandera St. Montclair, CA 91763 Name and Address of Reference Name and Telephone No. of Owner: Rudy Perez 909-917-5261 $18,000 Vandalism Reconstruction 08/14/2023 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Reconstruction and rehabilitation of public use facility-elementary school vandalism C-10 4. University of Redlands-955 N. Grove St. Redlands, CA 92374 Name and Address of Reference Name and Telephone No. of Owner: Rick Quinbar 909-709-6598 $17,155 Mitigation/Reconstruction 05/17/2023 Contract Amount Type of Work Date Completed Provide additional project description to show similarwork: Rehabilitation and reconstruction of public use facility-mitigation, demo and debris removal 5. Chaffey Joint Unified School District-6001 Milliken Ave. Rancho Cucamonga, CA 91737 Name and Address of Reference Name and Telephone No. of Owner: Rory Nevins 909-346-8753 S12,260 Mitigation/Reconstruction 03/07/2023 Contract Amount Type of Work Date Completed Provide additional project description to show similarwork: Rehabilitation and reconstruction of public use facility-mitigation. demo and debris removal C-11 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. Luis Lola Name of proposed Project Manager 909-310-5734 Telephone No. of proposed Project Manager Los Angeles Home Addition $185,000 New garage and home addition 05/2018 Project Name&Contract Amount Type of Work Date Completed Moreno Valley Apartment$895,000 4-plex apartment construction 11/2017 Project Name&Contract Amount Type of Work Date Completed Fontana Commercial Units$235,000 4 commercial units remodeling 04/2020 Project Name&Contract Amount Type of Work Date Completed 2. Curtis Brogdon Name of proposed Superintendent 909-973-0209 Telephone No. of proposed Superintendent, US Merchants-Ontario Warehouse$2,200,000 Fire/Abatement/Restoration 11/2022 Project Name&Contract Amount Type of Work Date Completed Coachella Valley High School $134.000 Abatement/Window Replacement 08/2023 Project Name&Contract Amount Type of Work Date Completed EAH Housing-Reflections@Yosemite$75,000 Mitigation/Reconstruction 08/2023 Project Name&Contract Amount Type of Work Date Completed C-12 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. R&R B Inc Contractor Rick Broedon By rick@servpro-grie.com Email President/Co-Owner Title Date:08/15/2023 PWC Registration#: 1000030258 C-13 EXHIBIT A DISADVANTAGED BUSINESS ENTERPRISE (DBE) This Project is subject to Part 200.321,Title 2, Code of Federal Regulations entitled "Contracting with Small and Minority Businesses, Women's Business Enterprises, and Labor Surplus Area Firms." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in Part 200.321, Title 2 CFR, shall be encouraged to participate in the performance of Contracts financed in whole or in part with federal funds.The Contractor should ensure that DBEs,as defined in Part 200.321, Title 2 CFR, have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps,as set forth in Part 200.321,Title 2 CFR, for this assurance.The Contractor shall not discriminate on the basis of race,color,national origin, or sex in the award and performance of subcontracts. Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project, although there is no specific goal for DBE participation. C-14 EXHIBIT B DBE INFORMATION—GOOD FAITH EFFORTS Federal-aid Project No. N/A Bid Opening Date The City of Huntington Beach established a Disadvantaged Business Enterprise(DBE)goal of 0% for this Project. The information provided herein shows that a good faith effort was made. Lowest,second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder DBE Commitment"form indicates that the bidder has met the DBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE Commitment"form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement N/A B. The names and dates of written notices sent to certified DBEs soliciting bids for this Project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested(please attach copies of solicitations,telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods Solicitation and Dates N/A C-15 C. The items of work which the bidder made available to DBE firms including, where appropriate,any breaking down of the contract work items(including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items ($) of (YIN) Contract N/A D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: N/A Names, addresses and phone numbers of firms selected for the work above: N/A E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: N/A C-16 F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: N/A G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download,etc.): Name of Agency/Organization Method/Date of Contact Results N/A H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): N/A NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. C-17 IF A SOLE OWNER OR SOLE CONTRACTOR SIGN HERE: (1) Name under which business is conducted (2) Signature (given and surname)of proprietor (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail IF A PARTNERSHIP, SIGN HERE: (1) Name under which business is conducted (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail C-18 IF A CORPORATION, SIGN HERE: (1) Name under which business is conducted R&R B Inc DBA Servpro of Chino/Chino Hills (2) Ricf&53wcdan (Signature) President/Co-Owner (Title) Impress Corporate Seal here (3) Incorporated under the laws of the State of California (4) Place of Business 13885 Redwood Ave (Street and Number) City and State Chino, CA (5) Zip Code 91710 Telephone No. 909-548-3191 (6) E-Mail rick@servpro-grie.com NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED List below names of president,vice president,secretary and assistant secretary,if a corporation; if a partnership, list names of all general partners and managing partners: Rick Brogdon-President Rhonda Brogdon-Secretary/Treasurer C-19 EXHIBIT C LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY: LOCATION: PROJECT DESCRIPTION: TOTAL CONTRACT AMOUNT:$ BID DATE: BIDDERS NAME: CONTRACT DBE GOAL: CONTRACT ITEM OF WORK AND DESCRIPTIONDBE CERT NO. NAME OF EACH DBEDOLLAR AMOUNT ITEM NO. OR SERVICES TO BEAND EXPIRATION (Must be certified on the date bidhDBE SUBCONTRACTED OR MATERIALS DATE are opened-include DBE address TO BE PROVIDED(or contracted if the and phone number) bidder is a DBE) For Local Agency to Complete: Total Claimed DBE Local Agency Contract Number: Participation Federal-aid Project Number: Federal Share: Contract Award Date: Local Agency certifies that all DBE certifications have been verified and information is complete and accurate. Signature of Bidder Date (Area Code)Tel.No. Print Name Signature Date Local Agency Representative Person to Contact (Please Type or Print) (Area Code)Telephone Number: Local Agency Bidder DBE Commitment(Construction Contracts) (Rev 6/26/09) C-20 PLEASE NOTE: This information may be submitted with your bid.If it is not,and you are the apparent low bidder or the second or third low bidder,it must be submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs.Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date.Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier.Names of the First-Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable,with the names and items of work in the"List of Subcontractors"submitted with your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100%of item is not to be performed or furnished by the DBE,describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE),"of the Special Provisions (construction contracts),to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award,Federal-aid Project Number, Federal Share,Contract Award Date fields and verify that all information is complete and accurate before signing and filing. C-21 EXHIBIT D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder R&R B Inc DBA Servpro of Chino/Chino Hills [proposed subcontractor ,] hereby certifies that he/she/it has ,has not X ,participated in a previous contract or subcontract subject to the Equal Opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that,where required,he/she/it has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently, Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. (eeoc.gov/employers/eeolsurvey/index.cfm) Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Signature: `.l ic&gulgdon. Date: 08/22/23 Print Name: Rick Brogdon Title: President/Co-Owner C-22 EXHIBIT E NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) Central Library Lower Level Restroom ADA Improvements To the City of Huntington Beach In conformance with Title 23 United States Code Section 112 and California Public Contract Code 7106 the bidder declares that the bid is not made in the interest of,or on behalf of,any undisclosed person,partnership,company,association,organization,or corporation;that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid,and has not directly or indirectly colluded,conspired,connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead,profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true;and,further,that the bidder has not,directly or indirectly, submitted his or her bid price or any breakdown thereof,or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation,partnership, company association, organization,bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. By signing the Proposal,the Bidder has also signed this Noncollusion Affidavit. Bidders are cautioned that making a false Certification may subject the Bidder to criminal prosecution. Signature: R c&atootion Date: 08/15/2023 Print Name: Rick Brogdon Title: President/Co-Owner C-23 EXHIBIT F DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS,PART 29 The Bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated with Bidder in the capacity of owner,partner, director, officer,manager: • is not currently under suspension, debarment,voluntary exclusion, or determination of ineligibility by any Federal agency; • has not been suspended, debarred,voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted, convicted, or had a civil judgment rendered against him/her by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility.For any exception noted above, indicate below to whom it applies,initiating agency, and dates of action. Note: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Signature: 214gdwi Date: 08/15/2023 Print Name: Rick Brogdon Title: President/Co-Owner • C-24 EXHIBIT G NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies,by signing and submitting this bid or proposal,to the best of his or her knowledge and belief,that: I) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan,the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment,or modification of any Federal contract,grant,loan,or cooperative agreement. 2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed$100,000 and that all such subrecipients shall certify and disclose accordingly. Signature: 2ici 24"id" Date: 08/15/2023 Print Name: Rick Brogdon Title: President/Co-Owner C-25 EXHIBIT H 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: Ela.contract ❑a.bid/offer/application El a.initial b.grant b.initial award b.material change c.cooperative agreement c.post-award d.loan For Material Change Only: e.loan guarantee year quarter f.loan insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No.4 is Subawardee, Enter Name and Address of Prime: ❑Prime ❑Subawardee Tier ,if known Congressional District,if known Congressional District,if known 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number,if applicable 8. Federal Action Number,if known: 9. Award Amount,if known: 10. a.Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual,last name,first name,MI) address if different from No.10a) (last name,first name,MI) (attach Continuation Sheet(s)if necessary) 11. Amount of Payment(check all that apply) 13. Type of Payment(check all that apply) $ ❑ Actual planned a.retainer b.one-time fee 12. Form of Payment(check all that apply): c.commission ea.cash d.contingent fee b.in-kind; specify: nature e deferred value f.other,specify 14. Brief Description of Services Performed or to be performed and Date(s)of Service,including officer(s),employee(s),or member(s)contacted,for Payment Indicated in Item 11: ' (attach Continuation Sheet(s)if necessary) 15. Continuation Sheet(s)attached: Yes ❑ No El 16. Information requested through this form is authorized by Title - 31 U.S.C.Section 1352.This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into.This disclosure is required pursuant to 31 U.S.C. Print Name: 1352. This information will be reported to Congress semiannually and will be available for public inspection.Any Title: person who fails to file the required disclosure shall be subject to a civil penalty of not less than$10,000 and not more than Telephone No.: Date: $100,000 for each such failure. Authorized for Local Reproduction Federal Use Only: Standard Form-LLL Standard Form ILL Rev.09-12-97 C-26 INSTRUCTIONS FOR COMPLETION OF EXHIBIT H., DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1) Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered Federal action. 2) Identify the status of the covered Federal action. 3) Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last,previously submitted report by this reporting entity for this covered Federal action. 4) Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5) If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address,city,state and zip code of the prime Federal recipient.Include Congressional District, if known. 6) Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation,United States Coast Guard. 7) Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8) Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9) For a covered Federal action where there has been an award or loan commitment by the Federal agency,enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10)(a)Enter the full name,address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. C-27 (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name,First Name and Middle Initial(Ml). 11)Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4)to the lobbying entity(item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12)Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13)Check the appropriate box(es). Check all boxes that apply. If other, specify nature. 14)Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15)Check whether or not a continuation sheet(s) is attached. 16)The certifying official shall sign and date the form,print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project(0348-0046), Washington,D.C. 20503. By my signature on this proposal I certify, under penalty of perjury under the laws of the State of California, that the foregoing questionnaire and statements of Public Contract Code Sections 10162, 10232 and 10285.1 are true and correct and that the bidder has complied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5, Title 2 of the California Administrative Code). C-28 EXHIBIT I FEDERAL LOBBYING RESTRICTIONS Section 1352, Title 31, United States Code prohibits Federal funds from being expended by the recipient or any lower tier subrecipient of a Federal-aid contract to pay for any person for influencing or attempting to influence a Federal agency or Congress in connection with the awarding of any Federal-aid contract,the making of any Federal grant or loan,or the entering into of any cooperative agreement. If any funds other than Federal funds have been paid for the same purposes in connection with this Federal-aid contract,the recipient shall submit an executed certification and, if required, submit a completed disclosure form as part of the bid documents. A certification for Federal-aid contracts regarding payment of funds to lobby Congress or a Federal agency is included in the Proposal. Standard Form - LLL, "Disclosure of Lobbying Activities," with instructions for completion of the Standard Form is also included in the Proposal. Signing the Proposal shall constitute signature of the Certification. The above referenced certification and disclosure of lobbying activities shall be included in each subcontract and any lower-tier contracts exceeding $100,000. All disclosure forms, but not certifications, shall be forwarded from tier to tier until received by the Engineer. The Contractor, subcontractors and any lower-tier contractors shall file a disclosure form at the end of each calendar quarter in which there occurs any event that requires disclosure or that materially affects the accuracy of the information contained in any disclosure form previously filed by the Contractor, subcontractors and any lower-tier contractors. An event that materially affects the accuracy of the information reported includes: 1) A cumulative increase if$25,000 or more in the amount paid or expected to be paid for influencing or attempting to influence a covered Federal action; or 2) A change in the person(s)or individual(s)influencing or attempting to influence a covered Federal action; or 3) A change in the officer(s), employees(s), or Member(s) contacted to influence or attempt to influence a covered Federal Action. C-29 111,11,1 1$10IR D` itrovipigt,,Mtrtif t I ESE PRESENTS,total we &R B Inc DBA Servoro of. iitp: I:t H111, ,s pnrncrpai, here►rtafter called the Pnnapa(,"and SUREFEC INSCIt1RANCE COMPANY,incorporated in Texas,as:sureet #, hereinafter called t�'te"Surety,"are held and firmly i ad nt City of Huntington Beach as obl►gees hereinafter called the Obh a am the such of teti Pe>'cemlt` i)df ti e A mount Bui by Pnncrpal for ' payment of htrch sum r cell and truly to be made,the sa►d Pnncrpal,and the said Surety,bind ourselves, our :heirs,,executors,..ad ministrators.succ acid asstg is,jointly and severalty,firmly b y these presents. . `WHEREAS 'the prrncipal.has,submitted;a b►dE'for 'ntrat-Libr e�rel ary',Lowerl ° .-,.1;!®rrt-AUK improvemen .ts N6w, tiEt1 EPOtiE,rf the o400 be t melyr o at tit the Ptinapal end a Prmtpal.shaf w thutnsuch time as spaeified�in hie bad,enter'into a ontr�ac . wrthrig or the;-event':a`i"th'e•fa►lure.:of the Principal to; enter:into:such(ortra of et, th ,P e rincipal shall pay to the Oblrgeeeto the difference not t, exceed the penal hereof between the amount specified tmt said bid and such larger ai nount fOr which thke }bllgee may in work faith cont�xact with another pa► .jr to perlormrr the wcirk covered,by said bid,then this obligation shall be 400 acid vokl,otherwise to remain lit fUtl`face a f € PROVIDED,HC WEVEI _neither Principal'ftor Suret 'shall be bound hereunder unless Obligee pflor td ' :execut►on *the. onit raa ract s. all furnish eur±€kenoe of financing to a marry r any,)form acceptable to.?rrncipal, 'and,Surety tktac financing has been firmly committed:to c ove te.ent►re cost.ef..tl proaect... ,SIGNS'?,sealed.and;dated this 2tst,day of August 24� , l Principal R&RB>Inc DBA Bery ►rrr`.otr Bye _ �-' , , ,,, ,, C hin�al+ li rra,Hills- .„. „. " . :: Si7-0, - ,gnature - - .:: „., . „ • -1),,.,.„,, ,,,,,, 6,,,,,,,..6,i,,i . ' ''''''' - ' --,5e---m,,,-, r_ ., , .:. . ,, ,.„,,: ,. „ ,„..,. , . ..,:„„.„ .„...„ .:•..,..., .... .. : , , , , ,,:,,,.::,, . ,., -..: . .. , . .. .,, ,. ,„ „,,,,, . „:: , Title 3V , fi "'SureTec rsuana 0401pany > t r SiGnati .aloe. David Me ii art y =c Aatrtey Irt fact �` -. The Ride, bred Neret4.f�tre Inc orporated Itt tie ao and Corzta-*.00partnt`:.Car 'aav I:ar lZdri g • sly atii Uri tipped t Pa9 =1 of I .r.. Po A#'519680 JOiNT LI M:ITE©-POWER-D:F-ATTORN E` Kl 0% 11 MEN BY-THESE PRESENTS`:ThatSureTec'incurance Company;"a Carpor,anon,duty.organized andexisting under the laws of the State of Tekas.and having its prindpaf°offfce in the County.:of H san arrls,`fexed Market Insurance Company(the'"Company"'),,a corporation duly`organized and.existing under,the laws of the state ofIltIndis:'and having its:prindjial admihistrativeroffice In,Glen Allen,.Virginia;_doesby these•presentsinatie;constitute and'appoint Glpria:.S.,eecerra;Dave a.Realkvain ,,David'Ntefirnan,.Ranh,Alonso, anda-Harvey;Evan M.DeBew, • Eric Taylor.,.Maria,Melendez,Rene Brand4.Deanna-Fonseca,-Albert Esping Their-trueandla wfutagent(syand attorney(s)-itt=fad;each in,theirseparatecapacityif more than orre`ls named.above,to:rrwke execute,sealand;dellver for and rip, their,own t ehalf,"Individually,ass surety oriorritly asca-sureties,and as their act and'deed,anyand.ali`bonds and other undertaking.ln surety ship provided:however; tattle le penal-silm.of any one Stich instrumentexecutetf hereunder strait.not exceed,the.. sure of: Fifty;Million'and 00/100 Dollars($ 0 0Do,00(L00). . This PowerofAttortrey:is granted,-anri signed`,and`sealed'underand'hy:the;authority ofthe fah:iming Resalutions:adopted'by the Board of Directors of SureTec insurance Company and Marital Insurance Company ^RESOLVED;Thatthe President„any Senior Vice President;Vice President,Assistant trite President,Sec etary=;,AssistantSecretaryi,Treasurer or�AssistantTreastirer and eadt,of them'liereby isauthoraed to,execu e.powers of attorney,,antsudl.authority can beexecuted by,useof facsimile signature;which may be attested or` 'acknowledged byanyt officer.or attorney,of the eompanjr,..qualifying the atterney:or✓attorneys named'inthe given-power of'attorney;to execute in,behalf of,.and adsnowledgdas;the.actarid deed of theSureTec lnsurante,Company and Market Insurance Company;asthe-casemay bet allbond>undertakings-and contracts of seietyship,;and to affix the Corporate seal thereto," IN WITNESS WHEREOF„Markel Insurance:Company and SureTec Insurance Company,havercaused their official Sealto•be hereunto affixed and'these present;to be. signed by their duly:authorized effieer's On the 28tsi day of Opel ,2023.. SureTeclmurarsce Cam an. Htarke` surance • party p W ufANCo ,geolrt{ttc",0 By,htichaetC:iCeirrtig�,R'relide �,j, e ,y '•¢t , e'. ndey lent{�fgsy Vice'resident. S.tate?of:Taq,S M f .r rrjyttl *,� L"ounty:of ilartisc: , i4. On this 28th day of April , '2025 A.D before me,a'Notary Publk:'of the:State of Texas,in-and for the County of.Harris,duly conrmrssioned and.quailfied, -Came:THE ABOVE OFFiCERs.oFTHBCOMPANIES,to me personally known to be-the iridividuais;aridofftcers descrbedin;who.executed the preceding instrument;and 'they„,acknowledged"the°execution of same,and:beingby!tne duly'sworn,disposed"and said,that they are the-officersor the;sakftompanies,aforesaid;and the sealsaffixed to tt a proceeding Instrumentare*Corporate Sealsaf`said Companies;;and"the said Corporate SeaLiand their signaturesAsofficersweeduiyafftxed '.and.subscribed to the said instrument by,the authority,and direction of the,said:companies,,and that<Resalutons-adopted:bythe Boerd.ofOirectors of said,Companies referred toin:theprece'ding instrument`isnow.iieforce. IN O t e. M OftirVI fiEitEO,f,I.have hereunto set my,hand;and affixed myOffldiffSealatthe County dfHarak,the,dayartdyearfrstat'royewritten.. igS0Y� XENIA RIVAS S f�,. _ Notary Public State:ofTexas r By: t; - .r-,3 Chmmissicn'#'129147659 +, x as, ry.Public - -.w,•°i 0ommissIon EiTires 9tt0/24 d My' mission expires W1012t z4 We,the undersigned Oftieers'efsureTecInsurance Company.and Marken nsuranceCompany sio herby,certtfyrthetithe original‘POWEfk OF ATTOBNEif;ofwhich-the foregdingis-a fuli'true and'correct.copy.is.sttl'irn'fuilforceand effect rand'has not been-revoked. IN WITNESS WHEREOF,wehave lereunto setour hands,and affixed-tile Sealsaf'said Companies;_on ttie 21St'.day of,., At igiiAt , 207,3 S eIec lnsu nce Corn y Na el In ance Company By:. Br tBeaty,A StantSecre ry drew, arquis,Assista ectetar Any Instrument inflxcess of the peialty,stated.at ve is tptaity.void and,wthoutanyvaltdity. Forverification of`.theautharity of,this.Poweryou,inaycaU:(x131$12-0$Q0.op any busihes day tte[veen;830 AM and 51Xt PM fS'T, CALIFORNIA, UR Qom: C NOWL.gI . IYIEN' ` r A notar riu1 hclirother,;officer omp14iigg.thi,,' xerti ate viti tes ti rite idetfrtt r t t1ie: . aidhaiiduai•Who:signe4tlt da¢ument;to whitttthis" certificate is attached,acl nottlietruthfulness accuracy,.gr-uali`dit ofth�atdocument ,_ MateoCal ifornia ,County o "-San Diego :Ott t ugust21„2025 l nle, R- Brandt k Nora Publ e v. nall a ared . bavc'-$.Roalicyarr`3 Pam; 7�..L1 ..,..,. who proed tc me§n*0'wtt �s rf iartsf� tdence to bete persgn whose ua n044;is{ ersuhscdhed to_lie hm instrum ent and acknowledged to lame that Biel a ey ebuted the same• to hu - au.tlWt zed ' eapacrt;40 ;'end that ly i liner srgnatut$ on.the instrument the peraop(s, or the.entity pots.behalf'•of Much the"peronsacted,,executed the inisirume eel antler P. TX PERJURY uncle th s the-..Mateo " foima th t the.forego-int.g para&caph is: ?tru .and cast. : A., t .�uiui r+ 1.04F000 W T Smyhand andoffciaLsea satwoiE9v—,,,. fYt.: ' z mute ofNot` `` 'hour l tb*data Ebel`o' is,not regutred Icy law, nia pro valuabi o, reasr lying,aii 's occron anc could prevent fraaitd ent repattachment of this l rrn ' :I '':CL� 31tIED,BU 'JJ:+( R DtSo TiO T . M at . ,DQC>fJMENT ❑ INDIVIDUAL Q cogyoult OFFICER `Title or Type;dtp;0 uumett , Q Pt1IZTLNERCS _ . lumbe of Pae , • Q 1 of'LLC • _ t4 NFACT=Q T u ,TEE5 , Q GUARD CONS 1i VATOR bat occurnemt ?OT)=IER;; SIG1 ZR IS PRE BNtiXO. ; t�s)other:than natty d al ove NAME tF PERSON(S)( R E IT E" ,SurtTecTiisiirance:.;Compativ ACKNOWLEDGMENT' A notary public orot!ier officer compietmg this ' °certificate veanlies atly the.dentrtof to tr�iiividutal ^ uho sid the gne document to which this ce r ate rs. attached, nc not the tru h alt? ss, cc wad,o . vairdr :ot that documentri B� I � " of .. n I UGUST 20-3 before n1e fARWA Ir[3TCK, N�TA 1� PUBLIC ittsrbr� ame acre�e c# re rawer personal yr appeared RA.K YE B N Whta prove* ecn a basis o satissactory evidence to be the ersan( whos"e Iid ( )is al , ""` ark, rt, dge to rite;that /sheltl a execute• d,, .s•ame Ins subscn'bed to the,,it ill ttf trrlment d a,cic c� h� ktrs/herlt( eirauthonzed capacrtyr(i0s),and that bj sfils/her/tl rgnat tte(J on the ns niarl,ti_"t , ` . persoigiO or the etitit upon:behalf ofWhtch the persons acfec#,x ex�ecxttec the:lrrstrume t. tc ert►ty und er 1 EC t -F PERi1LIR`�,iiild rtttt;faws of tlie.Stata:_ f California ghat theffore0oing pa hr ii tr :and cornre ; . , WITNESS rny,hand acid official sea[H, " h - W ., z$fgnatur`e _ ,