Roy Allan Slurry Seal Inc.0
CITY OF ROSEMEAD
ANNUAL 2010 -2011 SLURRY SEAL PROJECT
CONTRACT :BID FORMS
'
BIDDER:
'
CONTRACT BID FORMS
TABLE OF CONTENTS
SECTION 1
BID SCHEDULE ....................................................................... .........:..................... 1
SECTION 2
BID DATA FORMS ................................................................... ............................... 5
2 .A
BID BOND ......... .. .......... :......................................................................... ................. 6
2.6
LIST OF PROPOSED SUBCONTRACTORS... ...................................................... 7
'
SECTION 3
NON - COLLUSION AFFIDAVIT .............................................. ............................... 10
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BIDDER: 1�40, , Y t \ \C ti SL 3 zc�
SECTION 1 - BID SCHEDULE
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BIDDER: 1 AA .V. J WV7nf I�(i
BID SCHEDULE
SCHEDULE OF PRICES FOR
ANNUAL 2010 -2011 SLURRY SEAL PROJECT
CDBG PROJECT No. P84129
BASE BID SCHEDULE
TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ L0%,1G 0 0
Dollar amount in written form—J
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A,0 ((�,c w� 2 eAlc1 J
UNIT OF
EST.
UNIT
ITEM
NO.
ITEM DESCRIPTION
MEASURE
QTY.
PRICE
COST
1
Clearing & Grubbing per plans and
$� 21�V Uc7
/ L00 OO
specifications.
LS
1
/
2
Disposal of Waste Materials
LS
1
¢ 2, gj.CAj
0- 2 -cO0
3
Crack Sealing
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1
027oco- oo
a-? 000.Oa
4
Slurry Seal Type II — See exhibit
"A" & "B" per street locations &
176 C19
C O
jdC
OJ J
areas.
ELT
1,050
/ Z16
5
Traffic Striping and Pavement
Markers — See exhibit "C per
4 � (JO
��/ waw
details.
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6
Paint Home Addresses (Curb
Numbering)
s I S •�O
( q22 .00
EA
1,980
1
TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ L0%,1G 0 0
Dollar amount in written form—J
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ALTERNATE BID ITEM 1
NO.
ITEM DESCRIPTION
UNIT OF
MEASURE
EST.
QTY.
UNIT
PRICE
ITEM
COST
7
Furnish and Install Street and
Regulatory Signs, See Exhibit D
on Appendix A per Quantities and
Types. Contact Erick Gustafson at
213 - 798 -7024 from Zumar or
4
q *10
q2, (),() )
approved equal.
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TOTAL ALTERNATE BID # 1 PRICE (SCHEDULE BID PRICE): $ y 2 S 7 0,0 0
' 17.�r�r„ J I V�UiMI l�,it r.,�.�- eJ�.t�� 1� Jl�,,v� Gc
D Ilar aunt in written form �( %�
' TOTAL AMOUNT INCLUDING BASE PRICE AND ALTERNATE: $ i , X15 - 1
r� J O
Dollar amount in written form 401-A
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' 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.
' If the Bid Documents specify alternate bid items, the following Alternate Bid amounts shall
be added to or deducted from the Total Bid Price entered above. The owner can choose to
include one or more of the alternates in the Total Bid Price of the Project. If any of the
Alternate Bids are utilized by the Owner, the resulting amount shall be considered the Total
Bid Price for the Project.
Attached hereto is a certified check, a cashier's check or a bid bond in the amount of
l c�6a FQ�n& Dollars ($ 1 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.
' 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 Owner within 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.
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BIDDER: SGT cW�u1v
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 amount of
$500.00 per calendar day and subject to the terms and conditions described in the Contract Form
and the Contract Documents if project is not completed in 45 calendar days.
' 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.
' 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.
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1 BIDDER: 1z-
1 By: �—
S Business Street Address
1 V—QWT vcs-- �1�„� S�,rka. ��trte„ clu. g0
Type or Print Name City, State and Zip Cod
Ti le Telephone Number
Date ((��
1 Bidder's /Contractor's State of Incorporation: `_6\. % 4fT4 Y \ C& _11
Partners or Joint Venturers: JOP v� eC,� g W +- hnlYcw
' Bidder's License Number(s):
1 NOTES:
1 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.
1 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.
1
' As further discussed in the Instructions to Bidders, Bidder will be required
to provide evidence that the person signing on behalf of the corporation,
partnership or joint venture has the authority to do so.
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' BIDDER: ZA VV`Cw 12; u`
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SECTION 2
' BID DATA FORMS
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BIDDER: Roy Allan S lurry Seal, 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 Roy Allan Slurry Seal, Inc. as
Principal, and Ullico Casualty Company_ _
, as Surety, are held firmly bound unto the
CITY OF ROSEMEAD (hereinafter called the OWNER) in the sum of
Ten percent of the total amount of the bid
($ 10% 1 , being not less than ten percent (10%) of the Total
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 annual 2010.2011 Slur Seal Pro ect as set forth in the Notice
Inviting Bids and accompanying Bid Documents, dated March 16, 2011
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 attomeys' fees to be fixed by the
court.
SIGNED AND SEALED, this 10th day of March 20 11
Roy Allan Slurry Seal, Inc. (SEAL) Ullico Casualty Company (SEAL)
Principal Surety
By: _ - By
Signature Signature thew J. Coats.,_ At`orrfe0.`in Fact
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CALIFORNIA
ALL - PURPOSE ACKNOWLEDGEMENT
State of California
County of Orange
On MAR 10 2011 before me, Adelaide C. Hunter, Notary Public
(insert name and title of the officer)
personally appeared Matthew J. Coats
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(i) is /arc
subscribed to the within instrument and acknowledged to me that heA4=4they executed the
same in his/herAheir authorized capacity0es), and that by his/her/their signature(s) on' the
instrument the person(s), or the entity upon behalf ofwhich the persons) acted, executed the
instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the
foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Signature `1 . Vt v "v
r ADELAIDE C, HUNTER
Commission # 18o8793
• Notary Public -- California
Orange County £
M Comm. Explras Au 8, 2012
V ULLICO Casualty Company
1625 Eye Stmct N W' Washington D CJ20006
Power of Attorney
KNOW ALL PERSONS BY THESE PRESENTS That ULLICO, CASUALTY, COMPANY (the Company) . a corporation oiganiicd and ciirriuig under tfie laws
of the State of Delaware,:does hereby constitute and appoint:.Irrtda`.D'Coats , Matthew J.;Coais , Dottglas'A. Rapp , &..Timothy D ,Rapp'of. Coats
Surety'lnsurancie Services,, Inc.,
obligatory in the nature thereof, issued in the course'of its business soil to bind the Company thereby, in an amount not to exceed SS,000,(J)U.UU.
This Power of Attorney is granted and is signed and sealed byfacsimile under and by the authority of the following Resolution adopted by the Boardof Direct ors
of ULLICO CasualtyCd ipany et a irmting duly celled the I5tfi July, 2009:
_. _ .:
rn['
RESOLVED: Thai the Board of Daeci orshaebyanthorizes the President orany: Vice PresiAof
the'Company to (1)SAppoinf Atiomcy(s),in Fact and authorize the Attomey(s). in
Fact to�:execute on behalf,of thr.Company bonds_ and undertaking m
s;'etracts of`
mdemnityand othc writings obligatory in the nature thereof and to attach the seal$f
the Company thereto, amd (2) to remove; al anytime „anysuch`Attomey- in and,
revoke the, authority given. And be it;
FURTHER' .
RESOLVED_ i 'That the signatures of,`sucM1,officerranB the sral;`of the Company mag,6e affixed [o
any such',Power of Auomey or certificate relating thereto by facsimile,,md any,such
Power ofAdomey'so_o¢cuted and certified,by facsimile signaiures:and- facsimile
seal shall be valid andbiding upm'.the Company the future with the respect to any
bond or undertaking to Which it is attached..-
IN TESTIMONY WHEREOF, 1ULLIC0 CA SUALTVCOMPANY,fim , causcd this inshummt to'be signed and its corporate seaLto.be affixed its
authorized office this 16th dayofduly, 2009;
Sit,”
DahiebeVonowiizl.
Presiami ULLICO'CasualtyCompany, a Dclaware_Corporation.
rt
Wary Public
:CATHERINE M.,OBRIEN
NOTARY PUBLIC STATE'OF MARYLAND
,MONTGOMERY COUNTY
MY COMMISSION EXPIRESJANUARY. 21, 2012:
... _
CERTIFICATE( -
1, Teresa E. Valcnline Senior Vice President Gen" Counsel add Seaemry, ofULLICO Casualty Company; do baby cell
Boardof Directors andthis PowerofAttomeyissuedpursuantth eretoon this fifth day'of March
ere Gill m full force andeffect I do furtheycenrfy thmfhai Daniel Aronowitz, who executul the Power.of Attorney as Presil
of the
In.Teslimony WhercrofI have subscribed my narneand afftzeci thcfacsimile seal' of eaclf Company .this
10th ' day;oE . March ,20.. II
Ter esa E. Valentine
Senior Vicc Presiden4-0e+ieral.Counsel A: Sccrctai -
ULLICO Casualty' Company
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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.
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 forthe 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, 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.
' BIDDER: Ax `U C♦ �I (l
' 2.13 LIST OF PROPOSED SUBCONTRACTORS (continued)
[ Next 2 Pages if needed for listing additional subcontractors."]
Name and Location Description of Work
' of Subcontractor / p 1 I C e 4 to be Subcontracted
�
Name: yioe-rz l_`Z�c}'CWLe,-S, -�C. Chic,' c1�l�t
Address: WO C. a 1 t htn F o . J
t,,,11k,d�ti CA. ok -B31
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Name and Location
of Subcontractor
Name:
Address:
•Co • 232.6
Description of Work
to be Subcontracted
�aM� 1�.,,� ►�,4a -1 Sep
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Name and Location
of Subcontractor
Name:
Address
Description of Work
to be Subcontracted
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
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BIDDER:
2.0 REFERENCES
The following are the names, addresses and telephone numbers for three public agencies for which BIDDER
has performed similar work within the past two (2) years:
1.
Name and Address of Owner
Name and telephone number of person familiar with project
Contract amount Type of Work Date Completed
2.
Name and Address of Owner
Name and telephone number of person familiar with project
Contract amount Type of Work Date Completed
3.
Name and Address of Owner
Name and telephone number of person familiar with project
Contract amount Type of Work Date Completed
4.
Name and Address of Owner
Name and telephone number of person familiar with project
Contract amount Type of Work Date Completed
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BIDDER:
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SECTION 3
NON - COLLUSION AFFIDAVIT
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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, orthe 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.
Signature
Typed or Printed Name
Title
o Lt
Subscribed and sworn before me
This _ day of
r�
(Seal)
Notary Public i and for
the State of Oalifornia
My Corpfnission Expires:
'� a ( W\ U V,d 'Vk�
CBF -12
State of California
County of Orange
Subscribed and sworn to (or affirmed) before me on this 0 day
of March , 20 \� , by Lawrence Allan ,
proved to me on the basis of satisfactory evidence to be the person(s) who
appeared before me.
ANN -MARIE ALLAN
N CoMM.H 1755275 '
NOTARY PUBLIC- CALIFORNIA V1
ORANGE COUNTY
MY Coo. EzP. JULY J, 2011 "
(Seal) Signature