ASR Constuctors IncCITY OF ROSEMEAD
ROSEMEAD PARK AQUATIC FACILITY
PROJECT No. P53251
CONTRACT BID FORMS
TABLE OF CONTE
SECTION 1 BID SCHEDULE .......................................................... ............................... 1
SECTION 2 BID DATA FORMS ..... ..................... ............................... .................... 5
2.A BID BOND .......................... ................................ ..............................6
2.13 LIST OF PROPOSED SUBCONTRACTORS .............. ............................... 7
SECTION 3 NON - COLLUSION AFFIDAVIT ................................. ............................... 11
SECTION I - BID
BIDDER: Na W NS % U lx*;, we .
BID FOR
ROSEMEAD PARK AQUATIC. FACILITY
PROJECT NO. P53129
BASE BID SCHEDULE
00
TOTAL BASE BID PRICE: $ 3. S-,11 % ODO-
-rJ9 /LGiov. 15�v -e -.1 %v�'lt/ L"•l!°,Gzcua
Dollar amount in written
ALTERNATE BID ITEM NO. 1, 2, 3, 8,4
TOTAL ALTERNATE BID ITEMS PRICE: $ % 9 t�00•
All l,( rY
Dollar amount in written form
�o
00
Note: The City of Rosemead reserves the right to reduce or increase the quantities of any
items in the schedule of values above, within the limits define in Section 3 -2.2.1 of the
Standard Specifications, to stay within the budgeted amount of this project.
INCORPORATION BY REFERENCE
Notice Inviting Bids, Instructions to Bidders, General Conditions, Technical Specifications,
Geotechnical Study Report (September 3, 2010) and addenda, Asbestos and Lead Paint
Survey Report (August 5, 2010) and addenda, Bidder's Proposal, Plans, Standard
Specifications for Public Works Construction 2009 Edition ( "Greenbook "), Drawings, Project
Manual, Required Bonds and Forms, Permits, Addenda, and all applicable codes and
regulations are hereby incorporated in and made part of this Contract. The provisions of
CBF -1
ITEM DESCRIPTION
UNIT OF
EST.
UNIT
TOTAL
ITEM
NO.
MEASURE
QTY.
PRICE
COST
1
Shade Structures
SF
20
20'x 20' Module
2
Solar System
LS
1
3
Bleachers
EA
8
S 2sv -
�/ ?, oov,°
4
Entry Marquee
LS
1
Sign /Supports
TOTAL ALTERNATE BID ITEMS PRICE: $ % 9 t�00•
All l,( rY
Dollar amount in written form
�o
00
Note: The City of Rosemead reserves the right to reduce or increase the quantities of any
items in the schedule of values above, within the limits define in Section 3 -2.2.1 of the
Standard Specifications, to stay within the budgeted amount of this project.
INCORPORATION BY REFERENCE
Notice Inviting Bids, Instructions to Bidders, General Conditions, Technical Specifications,
Geotechnical Study Report (September 3, 2010) and addenda, Asbestos and Lead Paint
Survey Report (August 5, 2010) and addenda, Bidder's Proposal, Plans, Standard
Specifications for Public Works Construction 2009 Edition ( "Greenbook "), Drawings, Project
Manual, Required Bonds and Forms, Permits, Addenda, and all applicable codes and
regulations are hereby incorporated in and made part of this Contract. The provisions of
CBF -1
BIDDER: M 1'UluJmagslu'.
the Greenbook shall apply to this Project except as may be modified by other provisions of
the Contract.
The undersigned agrees that these Contract Bid Forms constitute a firm offer to the Owner
which cannot be withdrawn for the number of Working Days indicated in the Notice Inviting
Bids from and after the bid opening date, or until a Contract for the Work is fully executed
by the Owner and a third party, whichever is earlier. The undersigned also agrees that if
there is a discrepancy between the written amount of the Bid Price and the numerical
amount of the Bid Price, the written amount shall govern.
Attached hereto is a certified check, a cashier's check or a bid bond the amount of
Dollars ($ ) said amount b ess than ten percent
(10 %) of the Total Bid Price. The undersigned agrees that said amount shall be retained by
the Owner if, upon award, we fail or refuse to execute the Contract and furnish the required
bonds, certificates and endorsements of insurance and other certifications within the time
provided.
CBF -2
If awarded a Contract, the undersigned agrees to execute the formal Contract, which will be
prepared by the Owner for execution, within five (5) Calendar Days following the Letter of
Award forthe Contract, and will deliver to the Ownerwithin that same period the necessary
original Certificates of Insurance, Endorsements of Insurance, Performance Bond, Payment
Bond and all other documentation and certification required by the Contract.
The undersigned offers and agrees that if this bid is accepted, it will assign to the
purchasing body all rights, title, and interest in and to all causes of action it may have under
Section 4 of the Clayton Act (15 U.S.C. Section 15) or underthe Cartwright Act (Chapter 2
of Part 2 of Division 7 of the Business and Professional Code), arising from purchases of
goods, materials or services by the Bidder for sale to the purchasing body pursuant to the
bid. Such. assignment shall be made and become effective at the time the purchasing body
tenders final payment to he Contractor.
Bidder understands and agrees that, when requested by Owner, he shall provide: (1)
evidence satisfactory to the Owner of Bidder's California contractor's license(s) in good
standing; (2) evidence that the person signing this Bid is authorized to bind Bidder to this
Bid and to a contract resulting therefrom; and (3) any other information and documentation,
financial or otherwise, needed by Owner to award a Contract to the lowest responsible and
responsive bidder.
Bidder understands and agrees that liquidated damages shall apply to this Contract in the
amounts and subject to the terms and conditions described in the Contract Form and the
Contract Documents.
Bidder acknowledges that data submitted with its Contract Bid Forms which it requires to be
incorporated into a Contract arising out of this Submittal has been so identified by Bidder.
Bidder further acknowledges that the Owner may, at its discretion, incorporate any of the
remaining data submitted herewith into a contract arising out of this Bid.
The undersigned acknowledges receipt, understanding and full consideration of the
following addenda to the Contract Documents.
Addenda Nos. #1 Wd lolstpl t�)
The Bidder understands and agrees that the Total Bid Price is inclusive of all labor,
materials, and equipment or supplies necessary to complete the Work as described in the
Bid Documents. If this bid is accepted, the undersigned Bidder agrees to enter into and
execute the Contract with the necessary bonds and accept the Total Bid Price as
compensation in full for all Work under the contract.
CBF -3
I• � � 1 � X11. � � � 1,
oresldim fa aN
Title —I
5230 WIIAN STt��T
Business Street Address
Rev I D I%, ( A 9)2S69
City, State and Zip Code
X151.1-701. uS G
Telephone Number
Bidder' s / Contractor's State of Incorporation: NO r- 6 eN ii
Partners or Joint Venturers: N
Bidder's License Number(s):
NOTES:
1) By its signature on this Bid, the Bidder certifies under penalty of perjurythe accuracy
of the representations made on the Contract Bid Forms.
2) If Bidder is a corporation, enter State of Incorporation in addition to Business
Address
3) If Bidder is a partnership or joint venture, give full names of all partners or
joint venturers.
CBF -4
SECTION 2
BID DATA FORMS
CBF -5
Bond # 8215 10 60 A
b1fDDER: ASR Constructors, Inc.
Bidder shall submit its Bid data in accordance with the format shown on each of the
following Bid Data Forms. Bidders shall prepare and use as many sheets as are necessary
to adequately provide the information required. Bidder shall ensure that every page of its
Bid Data Forms are properly identified with the Bidder's name and page number.
2.A BID BOND
KNOW ALL MEN BY THESE PRESENTS:
THAT ASR Constructors Inc
as Principal, and Federal Insurance Company
, as Surety, are held firmly bound unto
the CITY OF ROSEMEAD (hereinafter called the OWNER) in the sum of
Ten Percent and 00/100 * * * * * * * ** DOLLARS
($ 10% * * * * ** ), being not less than ten percent (10 %) of the
Total Base Bid Price; for the payment of which sum will and truly to be made,
we bind ourselves, our heirs, executors, administrators, successors, and
assigns, jointly and severally, firmly by these presents.
WHEREAS, said Principal has submitted a bid to the OWNER to perform all
Work required for the Rosemead Park Aquatic Facility as set forth in the
Notice Inviting Bids and accompanying Bid Documents, dated November 3,
2010
NOW, THEREFORE, if said Principal is awarded a Contract for the Work by
the OWNER and, within the time and in the manner required by the above -
referenced Bid Documents, enters into the written form of Contract bound
with said Bid Documents, furnishes the required bonds (one to guarantee
faithful performance and the other to guarantee payment for labor and
materials) furnishes the required insurance certificates and endorsements,
and furnishes any other certifications as may be required by the Contract,
then this obligation shall be null and void; otherwise it shall remain in full
force and effect. In the event suit is brought upon this bond by the OWNER
and judgment is recovered, said Surety shall pay all costs incurred by the
OWNER in such suit, including reasonable attorneys' fees to be fixed by the
court.
SIGNED AND SEALED, this 21 st day of October
10
ASR Const c ors, Inc. (SEAL)Federal Insurance (SEAL)
Principal Surety Co y
By:
Signat Si ,ature Yvet e Aceves
Attorney- in -FAct
CBF -6
Chubb POWER Federal Insurance Company Attn: Surety Department
OF Vigilant Insurance Company 15 Mountain View Road
Surety ATTORNEY Pacific Indemnity Company Warren, NJ 07059
Know All by These Presents, That FEDERAL INSUR,
COMPANY, a New York corporation, and PACIFIC INDEMNI
appoint Yvette Aceves and Newton Kellam of Irvine,
4Y, an Indiana corporation, VIGILANT INSURANCE
a Wisconsin corporation, do each hereby constitute and
each as their true and lawful Attorney- N- Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety
thereon or otherwise, bonds and undertakings and other writings obligatory in the nature thereof (other than ball bonds) given or executed in the course of business, and any
instruments amending or altering the same, and consents to the modification or alteration of any instrument referred to in said bonds or obligations.
In witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested
these presents and affixed their corporate seals on this 6th day of October, 2010.
t
'Kenneth C. Wendel. Assistant secretary D . Noms, Jr., Vice Preside
STATE OF NEW JERSEY
m.
County of Somerset
On this 6th day of October, 2010 before me, a Notary Public of New Jersey, personally came Kenneth C. Wendel, to me
known to be Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which
executed the foregoing Power of Attorney, and the said Kenneth C. Wendel, being by me duty swum, did depose and say that he Is Assistant Secretary of FEDERAL
INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof, that the seals affixed to the
foregoing Pourer of Attorney are such corporate seals and were thereto affixed by authority of the By- Laws of said Companies: and that he signed said Pourer of Attorney as
Assistant Secretary of mid Companies by like authority; and that he Is acquainted with David B. Norris, Jr., and knows him to be Vice President of said Companies; and that the
.signature of David B. Norris, Jr., subscribed to said Power of Attorney is in the genuine haMrMtirg of David B. Norris, Jr., and was thereto subscribed by authority of said By-
Laws and in depomnrs presence.
Notarial Seal ci; F. 1(AINERINE J. ADELAAR
NOZW PUBLIC OF NEW JFkSFI
Nr.431d56$ '.a Commission 6rpdrmo 1Ldy 16, 4011
CERTIFICATION
Extract from the By- Laws of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY:
'All powers of attorney for and on behalf of the Company may and shall be executed in the name and on behalf of the Company, either by the Chairman or the
President or a Vice President or an Assistant Vice President, Jointly with the Secretary or an Assistant Secretary, under their respective deslgnadons. The
signature of such officers may be engraved, printed or lithographed. The signature of each of the following officers: Chairman, President, any Vice President, any
Assistant Vice President any Secretary, any Assistant Secretary and the seal of the Company may be affixed by facsimile to any power of attorney or to any
certificate relating thereto appointing Assistant Secretaries or Attorneys. in- Fact for purposes Only of executing and attesting bonds and undertakings and other
writings obligatory in the nature thereof, and any such power of attorney or centificate bearing such facsimile signature or facsimile seal shall be valid and binding
upon the Company and any such power so executed and certified try such facsimile signature and facsimile seal shall be valid and binding upon the Company
with respect to any bond or undertaking to which it is attached."
I, Kenneth C. Wendel, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY
(the "Companies' do hereby certify that
(1) the foregoing extract of the By- Laws of the Companies is true and correct,
(ii) the Companies are duly licensed and authorized to transact surety business in all 50 of the United States of America and the District of Columba and are
authorized by the U.S. Treasury Department further, Federal and Vigilant are licensed In Puerto Rico and the U.S. Virgin Islands. and Federal Is licensed in
American Samoa, Guam, and each of the Provinces of Canada except Prince Edward Island; and
(Iii) the foregoing Power of Attorney is true, correct and In full force and effect.
Given under my hard and seals of mid Companies at Warren, NJ this
-wyna/rr� �yuP.�yeFC
x�
.i
IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM, VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER
MATTER, PLEASE CONTACT US AT ADDRESS LISTED ABOVE, OR BY Telephone (908) 903 - 3493 Fax (908) 903- 3656
e -mail: Surety@chubb.com
Form 15 -10. 02256- U (Ed. 5- 03) CONSENT
CALIFORNIA ALL-PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
State of California
County of Riverside
On lo-Zk-jr) beforeme, Minh Quang Tran, A Notary Public
(Here insert name and tide of the officer)
personally appeared Yvet
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to
the within instrument and acknowledged to me that he /she /they executed the same in his/her /their authorized
capacity(ies), and that by his/her /their signature(s) on the instrument the person(s), or the entity upon behalf of
which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph
is true and correct.
WITNESS my
of Notary
seal.
MINH QUANG TRAN
w COMM. #1741451
NOTARY PUBLIC - CALIFORNIA
RIVERSIDE COUNTY
(Notary Sea]) My Comm. Expires April 24, 2011
ADDITIONAL OPTIONAL INFORMATION
DESCRIPTION OF THE ATTACHED DOCUMENT
Bid Bond
(Title or description of attached document)
(Title or description of attached document continued)
Number of Pages Document Date
(Additional information)
CAPACITY CLAIMED BY THE SIGNER
❑
Individual (s)
❑
Corporate Officer
(Title)
❑
Partner(s)
It
Attorney -in -Fact _
❑
Trustee(s)
❑
Other
2008 Version CAPA vl2.10.07 800- 873 -9865 www.NotaryClasses.com
INSTRUCTIONS FOR COMPLETING THIS FORM
Any acknowledgment completed in California most contain verbiage exactly as
appears above in the notary section or a separate acknowledgment farm must be
properly completed and attached to that document. The only exception is if a
document is to be recorded outside of California. In such instances, any alternative
acknowledgment verbiage as may be printed on such a document so long as the
verbiage does not require the notary to do something that is illegal for a notary in
California (i.e. certifying the authorized capacity of the signer). Please check the
document carefully for proper notarial wording and attach this form ifrequired.
• State and County information must be the State and County where the document
signer(s) personally appeared before the notary public for acknowledgment.
• Date of notarization must be the date that the signer(s) personally appeared which
must also be the same date the acknowledgment is c(mpleted.
• The notary public must print his or her name as it appears within his or her
commission followed by a comma and then your title (notary public).
• Print the names) of document signer(s) who personally appear at the time of
notarization.
• Indicate the correct singular or plum] forms by crossing off incorrect forms (i.e.
he/she /Wey, is /ere ) or circling the correct forms. Failure to correctly indicate this
information may lead to rejection of document recording.
• The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges, re -seal if a
sufficient area permits, otherwise complete a different acknowledgment form.
• Signature of the notary public must match the signature on file with the office of
the county clerk.
Additional information is not required but could help to ensure this
acknowledgment is not misused or attached to a different document.
Indicate title or type of attached document, number of pages and date.
Indicate the capacity claimed by the signer. If the claimed capacity is a
corporate officer, indicate the title (i.e. CEO, CFO, Secretary).
• Securely attach this document to the signed document
[00111.41
Ly
( t
State of California
County of tZIJ�CS'td�
On Nov. '!5I 20t0 before me,
(Here Insert name
personally appeared
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is /are subscribed to
the within instrument and acknowledged to me that he /she /they executed the same in his/her /their authorized
capacity(ies), and that by his/her /their signature(s) on the instrument the person(s), or the entity upon behalf of
which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph
is true and correct.
WITNESS my hand and offs al seal MINH QUANG TRAN
Q COMM. #1741451 a
NOTARY PUBLIC - CALIFORNIA y
(Notary Scal) M RIVERSIDE COUNTY
Signature of Notary PublicY C!n Expires April2q, 2p77
ADDITIONAL OPTIONAL INFORMATION
DESCRIPTION OF THE ATTACHED DOCUMENT
4 `O d
(Title or description of attached document)
(Title or description of attached document
Number of Pages _ Document Date
(Additional information)
CAPACITY CLAIMED BY THE SIGNER
❑
Individual (s)
❑
Corporate Officer
(Title)
❑
Partner(s)
❑
Attomey -in -Fact
❑
Trustee(s)
❑
Other
2008Version CAPAvl2 .10.07800 - 873 -9865 www.NotaryClasses.com
INSTRUCTIONS FOR COMPLETING TI-BS FORM
Any acknowledgment completed in California must contain verbiage exactly as
appears above in the notary section or a separate acknowledgment form must be
properly completed and attached to that document. The only exception is if a
document is to be recorded outside of California. In such instances, any alternative
acknowledgment verbiage as may be printed on such a document so long as the
verbiage does not require the notary to do something that is illegal for a notary in
California (i.e. certifying the authorized capacity of the signer). please check the
document carefully for proper notarial wording and attach this form if required.
• State and County information must be the State and County where the document
signer(s) personally appeared before the notary public for acknowledgment.
• Date of notarization must be the date that the signer(s) personally appeared which
must also be the same date the acknowledgment is completed.
• The notary public must print his or her time as it appears within his or her
commission followed by a comma and then your title (notary public).
• Print the name(s) of document signer(s) who personally appear at the time of
notarization.
• Indicate the correct singular or plural forms by crossing off incorrect forms (i.e.
Wshehhey, is /are) or circling the correct forms. Failure to correctly indicate this
information may lead to rejection of document recording.
• The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges, re -seal if a
sufficient area permits, otherwise complete a different acknowledgment forth.
• Signature of the notary public must match the signature on file with the office of
the county clerk.
Additional information is not required but could help to ensure this
acknowledgment is not misused or attached to a different document.
Indicate title or type of attached document, number of pages and date.
Indicate the capacity claimed by the signer. If the claimed capacity is a
corporate officer, indicate the title (i.e. CEO, CFO, Secretary).
• Securely attach this document to the signed document
2.113 LIST OF PROPOSED SUBCONTRACTORS
In compliance with the "Subletting and Subcontracting Fair Practices Act," Sections
4100 through 4114 of the California Public Contract Code, and any amendments
thereto, each Bidder shall provide the information requested below for each
subcontractor who will perform work, labor or render service to Bidder in or about
the construction of the Work in an amount in excess of one -half of one percent
(greater than 0.5 %) of the Bidder's Total Bid Price, or, in the case of bids or offers
for the construction of streets or highways, including bridges, in excess of one -half
of 1 percent of the Contractor's total bid or ten thousand dollars ($10,000),
whichever is greater, and shall further set forth the portion of the Work which will be
done by each subcontractor. Bidder shall list only one subcontractor for any one
portion of the Work.
Pursuant to Public Contract Code Section 4104, the Owner has determined that it
will allow Bidders twenty -four (24) additional hours afterthe deadline for submission
of bids to submit the information requested by the Owner about each subcontractor,
other than the name and location of each subcontractor and description of work to
be subcontracted.
If the Bidder fails to specify a subcontractor for any portion of the Work to be
performed under the Contract, it shall be deemed to have agreed to perform such
portion itself, and shall not be permitted to subcontract that portion of the Work
except under the conditions hereinafter set forth below.
Subletting or subcontracting of any portion of the Work in excess of one half of one
percent greater than 0.5 %) of the Total Bid Price or, in the case of bids or offers for
the construction of streets or highways, including bridges, in excess of one half of
one percent of the Contractors total bid or ten thousand ($10,000), whichever is
greater, for which no subcontractor was designated in the original bid shall only be
permitted in cases of public emergency or necessity, and then only after Owner
approval.
CBF -7
BIDDER: �'tJh�011"4�1U•`�1� .
2_13 LIST OF PROPOSED SUBCONTRACTORS (continued)
[` *Duplicate Next 2 Pages if needed for listing additional subcontractors. * *]
Name and Location
of Subcontractor
Name: /�S S 7-cig—, c
Address: S'2 3u Ld /c S0"/ S T-
��� /�
Name and Location
of Subcontractor
Description of Work
to be Subcontracted
Description of Work
to be Subcontracted
S,uL- Er �.Crxr
Name: sle"—
Address: c,,c- 72Fr,ic lci4 c
Name and Location Description of Work
of Subcontractor to be Subcontracted
Name: e Ll c
Addrasc- 2 2 J— A— )C'. c2 ✓iv C: ic, mac.
Gc - C41
Name and Location
of Subcontractor
Description of Work
to be Subcontracted
9 / -ci T
Name: S - ✓i
Address: 9 ? 2 G
Name and Location Description of Work
of Subcontractor to be Subcontracted
%G
Name: /!q/,
04, 5zJ-6 �
2.0 REFERENCES FOR BIDDER (Duplicate page as needed)
BIDDER: P y QkSO4MwC .
2_B LIST OF PROPOSED SUBCONTRACTORS (continued)
[ *'Duplicate Next 2 Pages if needed for listing additional subcontractors.**]
Name and Location
of Subcontractor
Name:_
Address:
ST-
C',a C i mvs,o , Gam/ -
Name and Location
of Subcontractor
Name: 6- iS .L r C-CTx i c
Address: SS/ /-,,"C rw cc 1-,7e
Description of Work
to be Subcontracted
14j14 C-
Description of Work
to be Subcontracted
SEC- T.[
Name and Location
of Subcontractor
Description of Work
to be Subcontracted
Name: T/c !-.Si 72o.c/
Address: / S— r3 S T
Name and Location
of Subcontractor
Description of Work
to be Subcontracted
Name: /lL 6.. -
Address: ! 9 J saw Vl s n" 4!d s
�p.4/yl�,� lc c✓
Name and Location Description of Work
of Subcontractor to be Subcontracted
Spta v
Name:
Address:
2.0 REFERENCES FOR BIDDER (Duplicate page as needed)
f1'-3➢1 S,
The following are the names, addresses and telephone numbers for at least three public
agencies for which BIDDER has performed similar work within the past four (4) years:
Name and Address of Owner
kP �la,a�U�s
IAN. a95•1W4
Name and elephone number of public agency person familiar with project
$50, 000 00 -i;� f 12!000 No 00 VariOU5 &h0K ON-Will
Contract amount Type of Work Date Compl ted
2.
3.
and
of Owner
Name and teWphone number of public agency person familiar with project
Contract amount Type of Work
volar 11fI �lIL1 i
Date
fill
M
Name and telephone number of public agency person familiar with project
X50,000.co -110, 000,600.00 VayiDUS SchMl5 ON-60Ino
Contract amount Type of Work Date Compl6ted
CBF -9
INIMS• 1
2.13 REFERENCES FOR SWIMMING POOL CONTRACTOR (C -53 LICENSE)
(Duplicate page as needed)
All of the work in sections 1 31 51 -1 31 58 (of the Project Manual for City of Rosemead
Project No. P53251 Rosemead Aquatic Center) is to be the responsibility of one
experienced swimming pool contractor with a C -53 license, which can be either the bidder
or a subcontractor, primarily engaged in the construction of commercial public -use
swimming pools. A swimming pool contractor shall be considered primarily engaged as
required herein if the swimming pool contractor derived 50% of its annual revenue during
the past five years from public -use swimming pool construction. The swimming pool
contractor must have also, in the last five years, constructed at least three (3) commercially
designed municipal and public -use swimming pools, each of which shall have incorporated
a minimum size of 6,000 square feet of water surface area with a concrete and ceramic tile
perimeter overflow gutter and self - modulating balance tank. The following are the names,
addresses and telephone numbers for at least three completed projects as required:
Name and Address of Owner .
Name and telephone number of public agency person familiar with project
Contract amount Project Name Date Completed
2.
Name and Address of Owner
Name and telephone number of public agency person familiar with project
Contract amount Project Name Date Completed
3.
Name and Address of Owner
Name and telephone number of public agency person familiar with project
Contract amount Project Name I Date Completed
CBF -10
Attachment # 1
11/01/2010 11:14 9093941630 CAL COMM POOLS
BIDDER:���Q�MMC�j�t_
2.D REFERENCES FOR SWIMMING P004 CONTRACTOR C•53 LIB NSE
(Duplicate page as needed)
PAGE 06/06
m_
All of the work in sections 13151 -13158 (of the Project Manual for City of Ro� jjead
Project No. P53129 Garvey Aquatic Center) is to be the responsibility of one experlE{iced
swimming pool contractor with a C -53 license, which can be either the bidde}??- ''�''or a
subcontractor, primarily engaged In the construction of commercial public -use swimming
pools. A swimming pool contractor shall be considered primarily engaged as required
herein if-the swimming pool contractor derived 50% of its annual revenue during the past
five years from public -use swimming pool construction. The swimming pool contractor
must have also, in the last five years, constructed at least three (3) commercially designed
municipal and public -use swimming pools, each of which shall have incorporated a
minimum size of 5,000 square feet of water surface area with a concrete and ceramic tile
perimeter overflow gutter and self- modulating balance tank. The following are the names,
addresses and telephone numbers for at least three completed projects as required:
L
e and Address of Owner
Name and
� 2
9
-v 7>_I .i
�� :� � 1 ►r I i I I_
SECTION 3
NON - COLLUSION AFFIDAVIT
CBF - 11
BIDDER: P69 NO VQ(To&iw.
NON - COLLUSION AFFIDAVIT
In accordance with Public Contract Code Section 7106, the undersigned, being first
duly sworn, deposes and says that he or she holds the position listed below with the
bidder, the party making the foregoing bid, 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 bidderto 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 rf lative thereto, or paid, and will not
pay, any fee to any corporation, partnership, c association, organization, bid
depository, orto any member or agent ther f e uate.a-Cgllysjv "r sham bid.
me
Typed or-Printed Name
TV1Qer+ I sefx�a�u
Title
:.. -
Subscri ed and sworn before me
This AO day of NOVftW 20-Lb
(Seal)
No ublic in and for
the State o lifornia
My Commission Expires:
State of California
County of
Riverside
Jurat
Subscribed and sworn to (or affirmed) before me on this � rd day of Note cnhe r
2010 by Alan Regotti and Patricia Berry --------- - - - - --
proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me.
Signature (Notary sea])
MIN QUANG TRAN
.- COMM. #1741451
- NOTARY PUBLIC - CALIFORNIA to
RIVERSIDE COUNTY
My Comm. Expires Ap6124, 2011
OPTIONAL INFORMATION
DESCRIPTION OF THE ATTACHED DOCUMENT
Non- Collusion Affidavit
(Title or description of attached document)
(Title or description of attached document continued)
Number of Pages _ Document Date
(Additional information)
INSTRUCTIONS FOR COMPLETING THIS FORM
The wording of all Jurars completed in California after January 1, 2008 most
be in the form as sel forth within this Aran.. There are no exceptions. If a Jarat
to be completed does not follow this form, the notary mast correct the
verbiage by using a jural stamp containing the correct wording or anaching a
separate jm'al form such as this one which does contain proper wording. In
addition. the annoy nrasn require an oath or affirmation from the document
signer regarding the tnnlhdness of the contents of the document. The
document must be signed AFTER the oath or affrration. If the document was
previously signed, d mast be re- signed in fm-om of the notary public during the
juralprocess.
• State and County information must be the State and County where the
document signer(s) personally appeared before the notary public.
• Date of notarization must be the date that the signer(s) personally appeared
which must also be the same date the jurat process is completed.
• Print the camels) of document signers) who personally appear at the time of
notarization.
• Signature of the notary public must match the signature on file with the office
of the county clerk.
• The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges, re -seal if a
sufficient area permits, otherwise complete a differentjurat form.
Additional information is not required but could help to ensure this
jurat is not misused or attached to a different document.
Indicate title or type of attached document, number of pages and date.
• Securely attach this document to the signed document
2008 Version CAPA v1.9.07 800 -873-9865 www.NotaryC]asses.com
ASR
INC.
STATE LICENSE NO. 615395
5230 WILSON ST., RIVERSIDE CA 92509
951779-6580 Fax 951779-6588
PR03ECT INFORMATION
ROSEMEAD PARK AQUATIC FACILITY
PROJECT:
OWNER
ARCHITECT
GENERAL CONTRACTOR
ASR 308 #897
ROSEMEAD PARK AQUATIC FACILITY
9155 E. MISSION DRIVE
ROSEMEAD, CA 91770
CITY OF ROSEMEAD
8838 EAST VALLEY BLVD.
ROSEMEAD, CA 91770
PHONE 626 -569 -2150
FAX 626- 307 -9218
PATRICK SHEA -SR. PR03ECT MANAGER
CELL 626- 240 -3136
DAVID MONTGOMERY - PARKS & REC. DIRECTOR
FARID HENTABLI- PUBLIC WORKS MANAGER
CHRIS MARCARELLO -DIR. OF PUBLIC WORKS
RAFAEL FAJARDO- ASSOC. CIVIL ENGINEER
RAY RODRIGUEZ
MICHELLE RAMIREZ- ECONOMIC DEVELOPMENT
ADMINISTRATOR
AQUATIC DESIGN GROUP
2226 FARADAY AVENUE
CARLSBAD, CA 92008
PHONE 760 - 438 -8400
FAX 760 - 438 -5251
ASR CONSTRUCTORS,. INC.
5230 WILSON ST.
RIVERSIDE,CA 92509
PHONE 951 - 7796580
FAX 951- 779 -6588
MICHAEL TRAN- PRO3ECT MANAGER
CELL 951 -634 -2120
TONY PUPPING - SUPERINTENDENT
CELL 951- 538 -S569
MARC W. BERRY PRINCIPAL
ASR CONSTRUCTO
STATE LICENSE NO 615395
5230 Wilson St., Riverside CA 92509
951779-6580 Fax 951779-6588
INC.
SUBCONTRACTOR PHONE /FAX LIST
SECTION
10500 EROSION CONTROL
1500 SURVEY
20560 ASBESTOS REMOVAL
2050 DEMOLITION
2200 EARTHWORK
2441 IRRIGATION SYSTEM
2800 PLANTING
2510 SITE WATER
2530 SANITARY SEWER
2630 STORM DRAIN
2820 METAL FENCES & GATES
3200 CONCRETE REINFORCEMENT
4220 MASONRY REINFORCEMENT
2514 SITE CONCRETE
3300 CAST CONCRETE
3300 CONCRETE SUPPLIER
4220 UNIT MASONRY
SUBCONTRACTOR/SUPPLIER
ASR CONSTRUCTORS, INC.
DGRK
2079 SKY VIEW DR.
COLTON, CA 92324
PHONE 909- 824 -2775
ASBESTOS INSTANT RESPONSE, INC.
3517 WASHINGTON BLVD.
LOS ANGELES, CA 90018
PHONE 323 - 733 -0508
FAX 323 - 732 -3414
ASR CONSTRUCTORS, INC.
ASR CONSTRUCTORS, INC.
ASR CONSTRUCTORS, INC.
ASR CONSTRUCTORS, INC.
ASR CONSTRUCTORS, INC.
TS STEEL
5230 WILSON STREET, SUITE C
RIVERSIDE, CA 92509
PHONE 951 - 682 -2031
FAX 951 -682 -2042
ASR CONSTRUCTORS, INC.
ROBERTSON'S
200 S. MAIN ST. SUITE 200
CORONA, CA 92882
PHONE 951 - 493 -6508
FAX 951 -493 -6462
ASR CONSTRUCTORS, INC.
4220 MASONRY SUPPLIER ORCO BLOCK
4510 RUTILE ST.
RIVERSIDE, CA 92509
PHONE 951- 685 -1521
FAX 951 -685 -4295
5120 STRUCTURAL STEEL ASR CONSTRUCTORS, INC.
5500 MISC. METALS ASR CONSTRUCTORS, INC.
6200 FINISH CARPENTRY DAVID M. BERTINO, MFG., INC.
1696 W. MILL STREET, UNITS 21 -22
COLTON, CA 92324
PHONE 909 - 888 -9122
FAX 909 -381 -5577
7410 SHEET METAL ROOFING
INTERGRITY SHEET METAL, INC.
7620 SHEET METAL
319 MCARTHUR WAY, SUITE 1
10200 LOUVERS
UPLAND, CA 91786
PHONE 909 - 6080449
FAX 909 - 608 -0439
7920 JOINT SEALERS
ASR CONSTRUCTORS, INC.
7620 SKYLIGHTS
ASR CONSTRUCTORS, INC.
8110 HOLLOW METAL
CONSTRUCTION HARDWARE
8710 FINISH HARDWARE
8520 ALUMINUM WINDOWS
HUNTINGTON GLAZING, INC.
8810 GLASS & GLAZING
4800 SOUTH HUNTINGTON DRIVE
LOS ANGELES, CA 90032
PHONE 323 -227 -0305
FAX 323- 222 -2782
7950 INSULATION
ALCAL - ARCADE CONTRACTING, INC.
1232 SIMPSON WAY, SUITE B
ESCONDIDO, CA 92029
PHONE 760 - 233 -2640
FAX 760 -233 -2650
8580 ROLLING SHUTTERS
9220 PLASTER
9250 DRYWALL
CERTIFIED DOOR & DOCK EQUIPMENT
7711 SOMERSET BLVD.
PARAMOUNT, CA 90723
PHONE 562- 377 -1208
FAX 562 -377 -1248
CASTON, INC.
354 SOUTH ALLEN STREET
SAN BERNARDINO, CA 92048
PHONE 909 - 381 -1619
FAX 909 -889 -0726
9310 CERAMIC TILE RDM TILE COMPANY NORTH, INC.
1018 TRAIT STREET
PO BOX 278
OCEANSIDE, CA 92049
PHONE 760 - 722 -0396
FAX 760 - 722 -0489
7175 WATER REPELLANTS STREAMLINE PAINTING, INC,
9900 PAINTING 9726 SUNNYBROOK DRIVE
MORENO VALLEY, CA 92557
PHONE 951 - 581 -2242
FAX 951 -928 -1719
10601 TOILET PARTITIONS SHELCO INDUSTRIES
10800 TOILET ACCESSORIES PO BOX 446
RANCHO CUCAMONGA, CA 91729
PHONE 909 - 204 -9087
FAX 909 -899 -9958
10400 SIGNAGE ASR CONSTRUCTORS, INC.
10500 METAL LOCKERS
RUSCO, INC.
425 S. PINE STREET
SAN GABRIEL, CA 91776
PHONE 626 -285 -2291
FAX 626 -285 -5028
10520 FIRE EXTINGUISHERS
ASR CONSTRUCTORS, INC.
10801 DRINKING FOUNTAIN
ASR CONSTRUCTORS, INC.
13150 SWIMMING POOL
CALIFORNIA COMMERCIAL POOLS
CONSTRUCTION
2255 E. AUTO CENTER DRIVE
GLENDORA, CA 91740
PHONE 909 - 394 -1280
FAX 909 -394 -4579
15400 PLUMBING
DUKE PLUMBING
5230 WILSON STREET, SUITE B
RIVERSIDE, CA 92509
PHONE 951 - 774 -0013
FAX 951- 774 -0019
15850 HVAC
FRANKLIN MECHANICAL SYSTEMS
1090 5T" STREET, SUITE 120
CALIMESA, CA 92320
PHONE 909 - 795 -3900
FAX 909 - 795 -3993
16010 ELECTRICAL
GBI ELECTRIC, INC,
551 HERITAGE PLACE
PALMDALE, CA 93550
'i
16730 SECURITY SYSTEM
16735 VIDEO SYSTEM
16770 DATA
PHONE 661- 947 -0551
FAX 661- 947 -4551
TRI- SIGNAL INTEGRATION, INC.
15835 MONTE STREET, SUITE 101 & 102
SYLMAR, CA 91342
PHONE 818- 566 -8558
FAX 818 - 450 -2585