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Ian Thomas GroupOil 0 n w 0 BIDDER: CONTRACT BID FORMS TABLE OF CONTENTS SECTION 1 BID SCHEDULE.... SECTION 2 BID DATA FORMS ............................... ............................... 2.A BID BOND ............................................. ............................... 2.13 LIST OF PROPOSED SUBCONTRACTORS ..................... SECTION 3 NON - COLLUSION AFFIDAVIT ..... ............................... ....................... 1 .. ............................... 5 .. ............................... 6 .. ............................... 7 .................. 10 CBF -15 1 BIDDER: CBF -1 BIDDER: _1 cyl �ti C , cat;6S BID SCHEDULE SCHEDULE OF PRICES FOR ROSEMEAD COMMUNITY RECREATION CENTER AND LIBRARY PARKING LOT PROJECT PROJECT No. P83529 BASE BID SCHEDULE CBF -2 UNIT OF EST. UNIT ITEM NO. ITEM DESCRIPTION MEASURE QTY. PRICE COST 1 Clearing & Grubbing per plans and LS 1 specifications. See technical C -- provisions TP -2, TP -3 & TP -4. 2 Removal, Haulaway & Disposal of LS 1 Waste Materials. 3 Earthwork, Roadway, Excavation CY 1,877 y_ l" 1F� F7 ` 1 - and Export. 4 Compacted Selected Fill LS 1 5 Demolition Per Plans and Specifications Complete. LS 1� t �� 6 Construct 1 -inch Thick AC Tons 325 Pavement "D1 -PG 64 -10" as ( r ` ^ indicated on the plans. 7 Construct 3 -inch Thick Pavement Tons 950 "C2 -PG 64 -10" as indicated on the plans. 8 Remove, Dispose Existing and Tons 1,800 Construct 4 -inch Thick Crushed L t< c Z2 Miscellaneous Base (CMB) 95% t Relative Compaction Over 95% Compacted Native per Plans and Specifications. 9 Construct 6 -Inch Thick PCC Pavement "520 -A- 2500" per Plans SF 7,385 / r ` _ (o and Specifications 10 Construct 8 -Inch Thick PCC Pavement "520 2500" Plans SF 15,100 `� (� C) -A- per . C and Specifications 11 Construct 4 -Inch Thick PCC Sidewalk "520 SF 6,750 / C 7 S -C -2500" per i SPPWC Std. Plan 113 -2. CBF -2 BIDDER: CBF -3 UNIT OF EST. UNIT ITEM NO. ITEM DESCRIPTION MEASURE QTY. PRICE COST 12 Construct 4 -Feet Wide PCC Swale Plans Specifications. LF 770 per and 13 Construct PCC Alley Intersection SF 800 J L , tC tr G per SPPWC Std. Plan 130 -2. 14 Construct PCC Curb Ramps per EA 6� C SPPWC Std. Plan 111 -4. 15 Construct 6 -Inch PCC Curb and 6- LF 260 Inch PCC Gutter per SPPWC Std. Plan 120 -2. 16 Construct 6 -Inch PCC Curb Only LF 2,540 . c`-`" S t per SPPWC Std. Plan 120 -2. I 17 Construct 8 -Inch PCC Curb and LF 400 24 -Inch Gutter per SPPWC Std. _2 C1 j Plan 120 -2. r 18 Construct 6 -Inch Thick PCC SF 450 Driveway Approach per SPPWC °c= - Std. Plan 110 -2; Type C. 6 / $ , - 19 Construct 6 -Inch PCC Curb and LF 285 24 -Inch PCC Gutter er SPPWC p '4 Std. Plan 120 -2. 20 Construct Cross and Longitudinal Gutter SPPWC SF 445 per Std. Plan 122 -2. 21 Adjust Sewer Manhole to Grade per EA 2 SPPWC Std. Plan 205 -2. 22 Construct 4 -Inch PVC (SDR 35) LS 1 Perforated Pipe over Crushed Rock, 10 Feet Wide x 20 Feet Long C" - x 4 Feet Deep per Plans and f Specifications Complete. 23 Install Sewer Cleanout per SPPWC LS 1 Std Plans 204 -1. 24 Construct Drain Inlet W/Traffic EA 3 Grate, with Flo -Guard Plus Insert Filter) fZ 'S a) (Fossil per Plans and — Specifications Complete. 25 Construct 4 -Inch Diameter PVC LF 150 Schedule 40 per Plans and Specifications Complete. CBF -3 BIDDER: TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ f Dollar amount in written form CBF -4 UNIT OF EST. UNIT ITEM NO. ITEM DESCRIPTION MEASURE QTY. PRICE COST 26 Construct 6 -Inch Diameter VCP LS 1 Sewer Lateral including 12 -Inch x 12 -Inch unfiltere d Area Drain, 1 ,S C L }U. - Saddle Connection, Wye, LACDPW Fee, Bedding and Pavement Complete per Plans and Specifications. 27 Construct New Masonry Trash LS 1 Enclosure including Gates per Plans and Specifications Complete. 28 Install Book Return Container per EA 2 Contempra 60 Series Book Return t 6 6 Model # 00 -0860 Complete. 29 Install Pavement Markers and LS 1 Striping per Plans and Specifications Complete. 30 Install Irrigation and Landscape per LS 1 7C Plans and Specifications Complete. �Z c' C22t- e 31 Install Parking Lighting and LS 1 Electrical System per Plans and t CZ'"3"' Specifications Complete, 32 Install Erosion Control per Plans LS 1 and Specifications Complete. t -- 33 Install Tree Well per SPPWC Std. Plan 519 EA 4 /U`C?.. -3. 34 Install Survey Well Monument per EA 9 City of Rosemead Std. Plan S08- 001. See Section 2 -9 Surveying of C the General Provision -7 per details (Cover, Sleeve & Dome will be provided by the City at no cost). TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ f Dollar amount in written form CBF -4 BIDDER: ALTERNATE BID ITEM No. 1 ALTERNATE BID ITEM No. 1 BID Dollar amount in written form TOTAL PRICE INCLUDING BASE AND ALTERNATE Dollar amount in written form Note: The City of Rosemead reserves the right to reduce or increase the quantities of any items in the schedule of bid items above, within the limits define in Section 3 -2.2.1 of the Standard Specifications, to stay within the budgeted amount of this project. If the bid documents specify alternate bid items, the City has the option to award the contract to the lowest bidder based on the base bid only, or based on the base bid combined with any combination of alternate bid items. If any of the alternate bid item(s) is considered by the City, the resulting amount shall be considered the total bid price for the Project. Since the time for the alternate bid items has already been factored into the contracttime, no additional contract time will be awarded for any of the alternate bid items. Because the City 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. 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 CBF -5 UNIT OF EST. UNIT ITEM NCB ITEM DESCRIPTION MEASURE QTY. PRICE COST 35 Con t 6 -Inch Thick PCC SF 57,385 Paveme t� 0 -A- 3250" Plans and Specifications lete. ALTERNATE BID ITEM No. 1 BID Dollar amount in written form TOTAL PRICE INCLUDING BASE AND ALTERNATE Dollar amount in written form Note: The City of Rosemead reserves the right to reduce or increase the quantities of any items in the schedule of bid items above, within the limits define in Section 3 -2.2.1 of the Standard Specifications, to stay within the budgeted amount of this project. If the bid documents specify alternate bid items, the City has the option to award the contract to the lowest bidder based on the base bid only, or based on the base bid combined with any combination of alternate bid items. If any of the alternate bid item(s) is considered by the City, the resulting amount shall be considered the total bid price for the Project. Since the time for the alternate bid items has already been factored into the contracttime, no additional contract time will be awarded for any of the alternate bid items. Because the City 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. 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 CBF -5 MAYOR: GARY TAYLOR MAYOR PRO TEM: STEVEN LY COUNCIL MEMBERS: SANDRA ARMENTA MARGARET CLARK POLLY LOW June 28. 2011 Ro sc m c ad 8836 E. VALLEY 13OULFVARD a P.O. BOX 399 ROSEMEAD, CALIFORNIA 91770 TELEPHONE (626) 569 -2100 FAX (626) 307 -9218 PR OJECT ' 2*. )� 'I (Bid Opening Date: July 6 2011) To All Prospective Bidders: Please note the following revisions on the specifications for the above project: 1. Dollar amount in written form o r, Dollar amount in written form Page 1 of 2 UNIT OF EST. UNIT ITEM NO. ITEM DESCRIPTION MEASURE QTY. PRICE COST 35 Construc -Inch Thick PCC Pavement "520 -A- SF 57,385 3250" Plans a Specifications Complete. 36 Earthwork, Roadway, cavation and Export. CY 360 Dollar amount in written form o r, Dollar amount in written form Page 1 of 2 If Alternate Bid Item No. 1 is considered by the City, Bid Item 6 & 7 shall be deleted. Credit shall be the same for Bid Items 6 & 7 as indicated on the Base Bid Schedule. TOTAL CREDIT AMOUNT $ LzZ - �.. Dollar amount in written form 2. Construction Note No. 15 on sheet Al of Al shall read as follows: "Construct 4- inches Dia PVC Schedule 40 including elbow connections." The addendum No. 1 forms a part of the Contract Documents for the above described project and shall supplement or supersede referenced sections of original plans and specifications. This Addendum No. 1 must be signed by the Bidder and submitted along with the Bidder's Proposal. Failure to acknowledge receipt of addendum will disqualify the Bidder. Very trua��urs 'Rafael Fajardo Associate Civil Engineer Acknowledgement: Bidder. Zh Date: ��P1�C>ti Title: Page 2 of 2 UNIT OF EST. UNIT NO. ITEM DESCRIPTION MEASURE QTY, PRICE CREDIT 6 Construct 1 -inch Thick AC Pavement "D1- Tons 325 PG 64 -10" as indicated on the plans. Er 7 Construct 3 -inch Thick Pavement "C2 -PG Tons 950 64 -10" as indicated on the plans. _ 3 C`r 6m, TOTAL CREDIT AMOUNT $ LzZ - �.. Dollar amount in written form 2. Construction Note No. 15 on sheet Al of Al shall read as follows: "Construct 4- inches Dia PVC Schedule 40 including elbow connections." The addendum No. 1 forms a part of the Contract Documents for the above described project and shall supplement or supersede referenced sections of original plans and specifications. This Addendum No. 1 must be signed by the Bidder and submitted along with the Bidder's Proposal. Failure to acknowledge receipt of addendum will disqualify the Bidder. Very trua��urs 'Rafael Fajardo Associate Civil Engineer Acknowledgement: Bidder. Zh Date: ��P1�C>ti Title: Page 2 of 2 MAYOR: GARY TAYLOR MAYOR PRO REM: STEVEN LY COUNCIL MEMBERS: SANDRA ARMENTA MARGARET CLARK POLLY LOW June 30, 2011 8838 E. VALLEY BOULEVARD • P.O. BOX 399 ROSEMEAD, CALIFORNIA 91770 TELEPHONE (626) 569 -2100 FAX (626) 307 -9218 PRO PROJECT No. P83529 (Bid Opening Date: July 6 2011) To All Prospective Bidders: Please note the following revisions on the specifications for the above project: 1. s � � Dollar amount in written form $ T ( . TOTAL PRICE INCLUDING BASE AND ALTERNATE $ CJ Dollar amount in written form Page 1 of 2 UNIT OF EST. UNIT ITEM NO. ITEM DESCRIPTION MEASURE QTY. PRICE COST 35 Construct 6 -Inch Thick PCC Pavement "520 -A- SF 57,385 3250" Plans and Specifications Complete.' 36 Earthwork, Roadway, Excavation and Export. CY 360 L 37 Construct 6 -inch Thick Pavement "C2 -PG 64- Tons 100 10" as indicated on the plans. s � � Dollar amount in written form $ T ( . TOTAL PRICE INCLUDING BASE AND ALTERNATE $ CJ Dollar amount in written form Page 1 of 2 R Bid Item No. 9 estimated quantity shall read 7,385 (seven thousands three hundred eighty five) square feet. The addendum No. 2 forms a part of the Contract Documents for the above described project and shall supplement or supersede referenced sections of original plans and specifications. This Addendum No. 2 must be signed by the Bidder and submitted along with the Bidder's Proposal. Failure to acknowledge receipt of addendum will disqualify the Bidder. Very tru [ly urs,' --°" Associate Civil Engineer Acknowledgement: Bidder: Date: `t Title: Page 2 of 2 BIDDER: 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 in the amount of Dollars ($ "9 id being not less than ten percent (10 %) of the Total Bid Price. The undersigned a ree 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. 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 applyto 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 SIXTY (60) 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. � ,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. t C ` 5 �.r c;; X1 Business Street Address RUM BIDDER: Type or Print Name Title r- : 19 -0I', Date City, State and Zip Code L\.(�; - -)- �1 1. -) a-) Telephone Number ., JUL�f 3 "I, 2008 1FC)''' Bidder's /Contractor's State of Incorporation: Partners or Joint Venturers: Bidder's License Number(s): NOTES: 1) 2) 3) By its signature on this Bid, the Bidder certifies under penalty of perjury the accuracy of the representations made on the Contract Bid Forms. If Bidder is a corporation, enter State of Incorporation in addition to Business Address If Bidder is a partnership or joint venture, give full names of all partners or joint venturers. 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. BIDDER: • BIDDER: Ian Thomas Group 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 Ian Thomas Group 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 DOLLARS ($ 10% Y , being not less than ten percent (10 %) of the Total Bid Price; forthe 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 Community Center and Library Lot Project as set forth in the Notice Inviting Bids and accompanying Bid Documents, dated �3 3c)� otl 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 if shalfremain 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 attomeyW fees to be fixed by the court. SIGNED AND SEALED, this 29th day of June 20 11 Ian Thomas Group Inc. (SEAL) Principal " Ullico Casualty Company (SEAL) Sure f Signature. Linda D. Coats, Attorney in Fact By: JUO' 31 M CBF -9 CALIFORNIA State of California County of Orange On JUN 2 9 ?011 before me, Adelaide C. Hunter, Notary Public (insert name and title of the officer) personally appeared Linda D. Coats 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 official seal. Signature A I" ADELAIDE C BUNTER r ..... Commission # 1808193 MLaglj lifornia n 8,.2012 ULLICO Casualty Company vullico 1625 Eye Street, N.W. Washington D.C. 20006 Power of Attorney KNOW ALL PERSONS BY THESE PRESENTS: That ULLICO CASUALTY COMPANY (the Company), acoiporation organized and existing under the laws of the State of Delaware; does hereby constitute and appoint. Linda D. Coats, Matthew J. Coats, Douglas A- Rapp <&. Timothy D. Rapp of Coats: Surely Insurance Services, Inc. Its foie and lawful Attorney (s). in fact with full authority to execute on its behalf bonds, undertakings, recognizances and other contracts of indemnity and writings- obligatory in the nature thereof, issued in the course of its business and to bind the Company thereby, in an amount not to exceed $5,000,000.00. This Power of Attorney is granted and is signed and seated by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of ULLICO Casualty Company at a meeting . duly called. the 15th day. of July, 2009. RESOLVED: That the Board of Directors hereby authorizes the President or any Vice President of the Company to: (1) Appoint Attorney(s) in Fact and authorize the Attomey(s)'in - Fact to execute on behalf of they Company bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof and to attach the seal of the Company thereto; and (2) to remove, at any time, my such Attorney -in -Fact and revoke the authority given. Andbeit FURTHER RESOLVED:. That the signatures of such officers and the seal of the Company may be affixed to any such Power of Attorney or certificate relating thereto by facsimile, and my such Power of Attorney so . executed and certified by facsimile signatures and facsimile.. seal shall be valid and biding upon the Company in the future with the respect to any bond orundertaking to which it is attached. N TESTIMONY WHEREOF, ULLICO CASUALTY COMPANY has caused this instrument to be signed and its corporate seal to be affixed by its authorized office this 16th day of July, 2009. i SIpENT Daniel Aronowitz President ULLICO Casualty Company, a Delaware Corporation. On this 16th day of July 2009, before me came the individual who executed the preceding instrument to me personally known, and tieing by me duly mom said that he is the therein described and authorized office of the ULLICO CASUALTY COMPANY; that the seal affixed to said instniment is the Corporate seat of said Company; that the said Corporate Seal and his signamrewere duly affixed.. Notary Public CATHERINE M. OBRIEN NOTARY PUBLIC STATE OF MARYLAND MONTGOMERY COUNTY MY COMMISSION EXPIRES JANUARY 21, 2012 CERTIFICATE. I, Teresa E. Valentine, Senior Vice President, GeneralCounsel and Secretary of ULLICO Casualty Company, do herby certify that the foregoing resolution of the Board of Directors and this Power of Attomeyissuedpunsuantthereto on this 29th day of June 20 11 are two and corrected are still in full force and effect. I do further certify that that Daniel. Aronowitz, who executed the Power of Attorney as President; was on the date of execution of the attached Power of Attorney the duly elected President of ULLICO Casualty Company, In Testimony Whereof I have subscribed my name and affixed the facsimile seal of each Comp // any this 29th day of June 20 11 Teresa E. Valentine Senior Vice. President Counsel & Secretary ULLICO Casualty Company BIDDER: _ - S 2.121 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, otherthan 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 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, 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 -10 BIDDER: _ l C 2.B LIST OF PROPOSED SUBCONTRACTORS (continued) ["Duplicate Next 2 Pages if needed for listing additional subcontractors.`"] Name and Location Description of Work of Subcontractor to be Subcontracted Name: ms's e —fie V�G �eL F6�C� Address 8rs V-1, E� C � b Cgg12U3 Name and Location of Subcontractor Description of Work to be Subcontracted " � Name: � Address 777 pro. c�i�t �e,CQ9®7Y4 L,c gol (074 Name and Location of Subcontractor Description of Work 11 to be Subcontracted C Name: � (26\4S cA:U\N Address _�S'29 �av '\ \J� L COL�IZt`i Name and Location Description of Work of Subcontractor to be Subcontracted \\ Name: LG AZ U IC���iP�Cc�,.f;3{uc�.Q. a= ?�(Je[�e Address: q "k\2lV t Name and Location Description of Work of Subcontractor to be Subcontracted Name: PVVe Address: GC- '� S 2d 73T CBF -11 BIDDER: LS� 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. 7(2 3 r1 �� J(�u6 kex , � ��T56ca' Name and Address of Owner (9((r 37(o - I(, -'�0 Name and telephone number of person familiar with project t )) 500 - 6 - 0 �.`;r�tHC ��l��k: e �ct �V C� 6� �� � � 1 l 1'1 oo Contract amount pp Type of W ork Date Completed 2. (' - J and 1s`� \4? is I C D A, and Address of OwneP p q / E I \:Xk l C'�' C Ca (l 1' Name and telephone number of person familiar with project \ 1� ��ll`� �iIL)• Srrct�'�cailrorA CQ%n L�k�j\V ca�lzat �1 G11 Contract amount IJ Type of Worlk Date Completed 3. and c. 4. CBF -12 GC Cl liav- � c l " -- 6 V 05 yP Name and telephone numb r of person familiar with project / J_2 tf Contract amount JType of Wo ` Date Completed Iv - � - IlSlitct �/r� A \{ -I 1 D f-.) Name and telephone number of person familiar with project BIDDER: • raM CBF -13 BIDDER: S C_L \ 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. e Typed or Printed Name Title Bidder Subscribed and sworn before me This y ` day of iri. lv; 20J_ C Notary Public in and for the State of California My Commission Expires: (Seal) NADA•K t70N K. AWWAD Commission 1951433 Notary Publlo • California Los Angeles county M Comm. Ex ires Ma 29, 2913 e CBF -14