Environmental Construction IncCITY OF ROSEMEAD
GARVEY PARK AQUATIC FACILTY
PROJECT No. P53129
'INSTRUCTION TO BIDDERS
WIM
that they have received any and all Addenda. To this end, each Bidder should contact
the Public Works Department at (626) 569 -2150 or Pat Shea, Construction Project
Manager, at pshea @cityofrosemead.org to verify that he has received all Addenda
issued, if any.
Bidders must acknowledge receipt of all Addenda, if any, in its Bid Letter. Failure to
acknowledge receipt of all Addenda may cause its Bid to be deemed incomplete and
nonresponsive.
6. PREPARATION OF BIDS
Bids shall be prepared only using copies of the Contract Bid Forms provided with the
Bid Documents. The use of substitute bid forms other than clear and correct
photocopies of those provided by the Owner will not be permitted and may result in the
Bid being declared nonresponsive. Bid Letters shall be executed by an authorized
signatory as described in these Instructions to Bidders. In addition, Bidders shall fill in
all blank spaces (including inserting "N /A" where applicable) and initial all interlineations,
alterations, or erasures to the Contract Bid Forms. Bidders shall neither delete, modify,
nor supplement the printed matter on the Contract Bid Forms nor make substitutions
thereon. USE OF INK, INDELIBLE PENCIL OR A TYPEWRITER IS REQUIRED.
7. ALTERNATE BIDS
If alternate bid items are called for in the Bid Documents, the lowest bid will be
determined on the basis of the base bid only, but the Owner may choose to award
the contract on the basis of the base bid alone or the base bid and any alternate
or combination of alternates. Since the time for the alternate bid items has already
been factored into the Contract Time, no additional Contract Time will be awarded for
any of the alternate bid items. Because the Owner may elect to include one or more of
the alternate bid items, or to otherwise remove certain bid items from the Project scope
of work, each Bidder must ensure that each bid item contains a proportionate share of
profit, overhead and other costs or expenses which will be incurred by the Bidder.
Bidders shall not unevenly weight or allocate their overhead and profit to one or more
particular bid items.
8. MODIFICATIONS OF BIDS
Each Bidder shall submit its Bid in strict conformity with the requirements of the Bid
Documents. Each Bid prepared by Bidder shall be complete in itself and shall be
submitted within a sealed envelope in accordance with the instructions herein.
Unauthorized conditions, limitations, exclusions or provisions attached to a Bid may
render it nonresponsive and may cause its rejection. Bidders shall neither delete,
ITB - 5
CITY OF ROSEMEAD
GARVEY PARK AQUATIC FACILITY
PROJECT No. P53129
CONTRACT BID FORMS
TABLE OF CONTENTS
SECTION 1 BID SCHEDULE .......................................................... ............................... 1
SECTION 2 BID DATA FORMS ....................................................... ..............................4
2.A BID BOND .................................................................... ..............................5
2.13 LIST OF PROPOSED SUBCONTRACTORS .............. ............................... 7
SECTION 3 NON - COLLUSION AFFIDAVIT ................................. ............................... 10
SECTION 1 - BID
I3IDDLR:EM ji�IVM(��,J1MLi•
BID FOR
GARVEY PARK AQUATIC FACILITY
PROJECT NO. P53129
BASE BID SCHEDULE
TOTAL BASE BID PRICE: $ �� �r'�s 0-,0 - `'
Dollar amount in written
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
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 4� the amount of
Dollars ($ ) said amount being not less 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 -1
MDDER'G )OL� S W W •�"
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 for the 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 under the 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. I
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 -2
131DDER:&�� C .1LW,
By: �!
ignatur
Type or Print Name
Title
�_ -1FX. ►1 - r
Address Business Street
City, State and Zip ..
(8 1 ' " i.Y r
elephone Number
Bidder' s / Contractor's State of Incorporation: C9..`t2-RA=Ou
Partners or Joint Venturers:
Bidder's License Number(s):
NOTES
1) By its signature on this Bid, the Bidder certifies under penalty of perjury the 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 -3
SECTION 2
BID DATA FORMS
CBF -4
BIDDER- Environmental Construction, 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.
2A BID BOND
KNOW ALL MEN BY THESE PRESENTS:
THAT Environmental Construction, Inc.
as Principal, and Vigilant Insurance Company
, as Surety, are held firmly bound unto
the CITY OF ROSEMEAD (hereinafter called the OWNER) in the sum of
(10 %) Ten Percent of the Attached Bid Amount
DOLLARS
($ 10.0% of Bid Amount ), 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 Garvey Park Aquatic Facility as set forth in the Notice
Inviting Bids and accompanying Bid Documents, dated November 3,2 10
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.
SIGNEDAND SEALED, this 28th day of October ,20 10
' Environmental Construction, Inc. (SEAL) Vi ilapA 'lap Insurance Company (SEAL)
Principal ur ty
BY: BY:
ignature Signatu Ste hanie Pham, Attomey -in -Fact r�
CBF -5
CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT
STATE OF CALIFORNIA
}County of Orange
On aR h before me, Irene Luong, Notary Public
Date Here Insert Name and Title of the Officer
personally appeared Stephanie Pham
Names) of Signer(s)
IRENE LUONG
Commission # 1883838
z =e Notary Public - California z
Z ' Orange County
My Comm. Expires Mar 22, 2014'
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 m hand a fficial sea
Signature
Place Notary Seal Above Signature of Nota y 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
Signer(s) Other Than Named
Capacity(ies) Claimed by Signer(s)
Signer's Name: Stephanie Pham
❑ Individual
❑ Corporate Officer— Title(s):
❑ Partner— ❑ Limited ❑ General
Attorney in Fact
❑ Trustee
❑ Guardian or Conservator Top of thumb here
❑ Other:
Signer Is Representing:
Number of
Signers Name:
❑ Individual
❑ Corporate Officer— Title(s):
❑ Partner ❑ Limited ❑ General
❑ Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
Top of thumb here
02007 Nalional Notary Associalion • 93500e Soto Ave.. P.O. flux 2402 - Chatsvorm. CA 913132402 • mmv.NaticnalNataryorg Item 95907 Reorder'. Call Toll -Free 1- 800 - 876 6827
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 INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE
COMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and
appoint Shawn Blume, Eric Lowey, Stephanie Pham and Mark Richardson of Costa Mesa, California-- --
each as their true and lawful Attcmey- in- Fact to execute under such designation In their names and to affix their corporate seals to and deliver for and on their behalf as surety
thereon or otherwise, bonds and undertakings and other writings obligatory in the nature thereof (other than bail bonds) given or executed In the course of business, and any
Instruments amending or stiOng 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
Mesa presents and affixed their coryamt /teeSeals on this 15th day of January, 2010. y
Norris, Jr., V PWende ssl nt Secretary
STATE OF NEW JERSEY
ss
County of Somerset
On this 15th day of January, 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 Ahomay, and the said Kenneth C. Wendel, being by me duly swum, did depose and my 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 Power of Attorney are such corporate seats and were thereto affixed by authority of the By- Lam of said Companies; and that he signed said Power 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 handwriting of David B. Nerds, Jr., and was thereto subscribed by authority of said By-
Laws and in deponent' s presence.
Notarial Seal
OA10
KATHERINE I ADEL AR NOTARY PUBLIC OF NEW JERSEY No L2�316685 Notary Public
99Rtiaissi ®n LyaUpe July 16, 2011
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 Presitlent, jointy with the Secretary or an Assistant Secretary, under their respective designations. 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
centfcate relating thereto appointing Asslstard Secretaries or Attorneys- in- Fad for purposes only of executing and attesting bonds and undertakings and other
wrings obligatory in the nature Ihereol, and any such power of atu may or certificate bearing such facsimile signature or facsimile seal shall be valid and binding
upon the Company and any such power so executed and cortined by such facsimile signature and facsimile seal shall be valid and binding upon the Company
with respect to any bond a 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
(i) the foregoing extract of the By- Lam of the Companies is true and contact,
(In) the Companies are duty licensed and authorized to transact surety business in all 50 of the United States of America and the DisMct of Columbia and are
aummmoad 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
(Iti) the foregoing Power of Attorney is tie, correct and In full force and effect.
Given under my hand and seals of said Companies at Warren; NJ this OCtober 28, 2010
_ �dM�. n. yYUA.rrE
� '1halAa I-- x• eeMYW -'�
r
Kenneth C. e , Assistant Secretary
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: surety0chubb.com
Form 15 -10- =SB- U (Ed. S- 03) CONSENT
2.13 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 after the 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 Contractor's 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 -6
8ieDra vtn t .11 L6�16�.�11yi
2.6 LIST OF PROPOSED SUBCONTRACTORS (continued)
[* *Duplicate Next 2 Pages if needed for listing additional subcontractors. * *]
Name and Location
of Subcontractor
Name:
Address
;.try -qR j d Fs -/ . 7-
Description of Work
to be Subcontracted
„2cl
Name and Location Description of Work
of Subcontractor to be Subcontracted
Name:
Address:?,; �-
Name and Location Description of Work
of Subcontractor to be Subcontracted
Name:
Address:
Name and Location Description of Work
of Subcontractor to be Subcontracted
Name: �i9�✓7/9t2� %fo ✓ "�'-� jE:,JG
Address:: 14 A4 ✓ U�J �.vl. —. i� '� a
tv. -Iia S I,)) z
Name and Location Description of Work
of Subcontractor to be Subcontracted
I ,�e� ;✓f
Name:
2.0 REFERENCES FOR BIDDER (Duplicate page -ds needed)
UUU CBF -7
N1DI)1 =R:
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:
i
Name and telephone l'@mb&b of public agency person familiar with project
P2.1 Tv4 t >I � 200
Contract amount Type of Woflk Date Completed
e� - •
and t
&fl
Contract amount
Owner 1
of public agency person familiar with project
I r% \ � k . ] _. ..
Type of
Date
Name and Address of Owner '
ame and telephone number of pub 1c agency person familiar with project
4 .a n�4 i�lt 2kDoe
Contract amount Type of Work Date Completed
11/01/2010 11:35 9093941630 CAL COMM POOLS PAGE 06/06
BIDDFR :a,kAl � 1A ?OOL S
2,0 REFERENCES FOR SWIMMING POOL CONTRACTOR fC 53 LICENSEI
(Duplicate page as needed)
All of the work in sections 13151 -13158 (of the Project Manual for City of Rosemead
Project No. P53129 Garvey Aquatic Center) is to bathe 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 5,000 square feet of water surface area with a concrete and ceramic the
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:
1.
,N_ v gG2�l�
and Address of Owner
Name and telephone number of ublic a enc l ✓
P g y person familiar with project
2012 Nsv
Contract amount Project Name S L CsG�
Date Completed
2.
number of public agency person
K �
Contract amount ` Project Name
3.
Name and Address of Owner
Name
wizn protect
Date Completed
:)(0) 22 -13GG
of puli agencyperson fami
Name D te
CBF -9
with project
BIUD[R:
2.13 REFERENCES FOR SWIMMING POOL CONTRACTOR (C -53 LICENSE)
(Duplicate page as needed)
All of the work in sections 13151 -13158 (of the Project Manual for City of Rosemead
Project No. P53129 Garvey 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 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:
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 Date Completed
SECTION 3
NON - COLLUSION AFFIDAVIT
CBF -10
BIDDER:
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 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.
Title ,
Bidder
Subscribed and sworn before (ne iI,
This k of �- ntV&(Y ULX, 2010
Notary Publi I i and for
the State of C ornia
My Commission Expire �2—
(Seal)
BEVERLY PARKS
Commission # 1806841
-o Notary Public - California
- Los Angeles County
My Comm. Expires Jul 19, 2012
I t
Slabs of CaKvomia
t
C40ftp afi t ns Angeles i
Ow �v before me, 'Beverly Pa ary P rbl ;
are Hera maan Name and rm a me ouLCar '
"smna4Vappeared Farid Soroudi
Naax(s) a5igner(s)
BEVERLY PARKS
'* Commission # 1806841
. 4 Notary Public - California �
Los Angeles County
My Comm. Expires Jul 19, 2012
VOWWWWWWK
who Imtved to me on the basis of satisfactory evidence to
be tits pe sn* whose nai is/ara �subwnbed to the
within 'instrument and a ' owledged to me that
ha4%94heV.emcuied the same in h&U9FAheihauthorized
cast; and feat by his eifeignaturgK on the
insh'um mitt Nte par -orge( or the entity upon behalf of
which the persaa�Wcied, anscutc-d the instrument.
1 carkity under PENALTY OF PERJURY under the laws
of fee ate of Caliiurnia ttlat fee foregoing paragraph is
true sand abnect.
WITtE m hand and of ii 'al I.
Place Nauy Seal REOVe Slgrlitfrlre
Si a e of Naary PVi)ilL
OAIPEO kWfi
Though ffs- information below is not required by law, it may Prow valuable to persons relying on the document
and could prevent fraudulent removal and reaffachmeM of this form to another document.
We or Type of, Document:
Silgaeo(s) Other Thm Named Above:
9•.1 e._v..Q l Q-) IMVt�+ppc- ,I, ♦ ±'.y7
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Is Representing:
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Number of Pages:
Signal 'S Name:
❑ hldhliduat '
❑ Corporate Winer - TSte(s) :
❑ Parbwr — 0 Limited Cl General
❑ A0.amey in Fact
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