Interlog Hym EngineeringBIDDER: Italol -flTr & / 1h temo\
u
SECTION 2
BID DATA FORMS
Nam
BIDDER: lea' 0)44 � U�
BID SCHEDULE
SCHEDULE OF PRICES FOR
SIDEWALK, CURB AND GUTTER REPLACEMENT PROJECT
PROJECT No. 24002
BASE BID SCHEDULE
TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ f ��q
hoed d' Ae AIG1 —
Dollar amount in writMn form
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UNIT OF
EST.
UNIT
ITEM
NO.
ITEM DESCRIPTION
MEASURE
QTY.
PRICE
COST
1
Clearing & Grubbing per plans
and specifications. See technical
LS
1
"00,
��
provisions TP -2, TP -3 & TP -4.
2
Disposal of Waste Materials.
LS
1i
Oo p ij
(ODOR
3
Remove, Dispose and Construct
SF
21,000
4- inches thick PCC Sidewalk per
CIO
�C�
SPPWC Std. Plan 113 -1.
r gdD
4
Remove, Dispose and Construct
SF
500
PCC Driveway Approaches per
JD
ODD,
SPPWC Std. Plan 110 -2.
5
Remove, Dispose and Construct
LF
1,015
8- inches Curb and 24- inches
Gutter per SPPWC Std. Plan
120-2.
6
Remove, Dispose and Construct
LF
100
8- inches PCC Curb Only per
SPPWC Std. Plan 120 -2.
7
Remove, Dispose and Construct
PCC Curb Ramp per SPPWC
EA
1
/
8
Install Survey property and
centerline tie Monument.
EA
10
p0�
TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ f ��q
hoed d' Ae AIG1 —
Dollar amount in writMn form
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BIDDER: :�O
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 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.
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cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and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 he is a certified check, a cashier's check or d bon in 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.
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.
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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.
BIDDER:'jfTtrl0
The undersigned acknowledges receipt, understanding and full consideration of the following
addenda to the Contract Documents.
Addenda Nos. IN bY`r"
R
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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BIDDER:
M
W um� fed . () r) - T?l
Business Street Address
City, State and Zip Code
Telephone Number
Bidder's /Contractor's State of Incorporation: 0 ��
Partners or Joint Venturers: ,-ygclrx 0g,
Bidder's License Number(s): N-g 3 12
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.
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Type or Print Name
Bond No.: INTEN -017
BIDDER: Interlog - Hy m E ngineering JV
Job /Bid No.: 24002
Bidder shall submit its Bid data in accordance with the format shown on each of the following Bid
Data Farms. 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 _Interlo -Hym Engineering JV
Principal, and Aegis Security Insu
as
, as Surety, are held firmly bound unto the
CITY OF ROS%TEAD (hereinafter called the OWNER) in the sum of
Ten Percent a Total Amount Bid
(!11: 107 Of Bid ), 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 Sidewalk, Curb and Gutter Replacement Project as set forth in
the Notice Inviting Bids and accompanying Bid Documents, dated
9 'ate saz .cry NIB -7)
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 vold; otherwise
Ifshali remain In full force and effect. In the edent suit fs brouglit'upon this bohd by
the OWNER and Judgment is recovered, sald,Surety shgil pay.all C45ts Incurred by
the OWNER in such suit, including reasonable attorneys' fees to be fixed by the
court.
SIGNED AND SEALED, this 6th dayof February 20 12
eg s Security
Int - Hym Engineering JV (SEAL) Insurance Company (SEAL)
P rincipal 'j rety
By: By: ��/ " '✓
Sig re Signature Matthew R. Dabyns
Attorney -in -Fact
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Power Certificate No. CA 106
AEGIS SECURITY INSURANCE COMPANY
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, THAT AEGIS SECURITY INSURANCE COMPANY does hereby make, constitute and
appoint: RANDY SPOHN AND MATTHEW R. DOBYNS
its true and lawful Attorney -in -Fact, to make, execute and deliver on its behalf surety bonds, undertaking and other instruments of similar
nature as follows: $2.5 MILLION
This Power of Attorney is granted and sealed under and by the authority of the following Resolution adopted by the Board of Directors of
the Company on the 4th day of February 1993.
"Resolved, That the President, any Vice President, the Secretary and any Assistant Secretary appointed for that purpose by the officer in
charge of surety operations shall each have authority to appoint individuals as Attomey -in -Fact or under other appropriate titles with
authority to execute on behalf of the Company, fidelity and surety bonds and other documents of similar character issued by the Company in
the course of its business. On any instrument making or evidencing such an appointment, the signatures may be affixed by facsimile. On
any instrument conferring such authority or on any bond or undertaking of the Company, the seal or facsimile thereof may by imposed or
fixed or in any other manner reproduced; provided, however, that the seal shall not be necessary to the validity of any such instrument or
undertaking."
"Resolved, That the signature of each of the following officers; President, Vice President, any Assistant Vice President, any Secretary or
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 Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -Fact for the purpose only of executing and attesting
bonds and undertaking and other writings upon the Company and any such power required and certified by such facsimile signature and
facsimile seal shall be valid and binding on the Company in the future with respect to any bond or undertaking to which it is attached."
IN WITNESS WHEREOF, AEGIS SECURITY INSURANCE COMPANY has caused its official seal to be hereunto affixed, and these
presents to be signed by its President this 25` day of January, 2012.
AEGIS SECURITY INSURANCE COMPANY
BY: � `tyINSUk
DARLEEN J. FRITZ
v 197;7
President a Ak,,.„,,,p;
Commonwealth of Pennsylvania }
} s.s.: Harrisburg
County of Dauphin }
On this 25`" day of January, 2012, before me personally came Darleen J. Fritz to me known, who being by me duly sworn, did depose and
say that she is President of AEGIS SECURITY INSURANCE COMPANY, the corporation described herein and which executed the
above instrument; that she (mows the seal of the said corporation, that the seal affixed to the said instrument is such corporate seal; that it
was so affixed by order of the Board of Directors of said corporation and that she signed her name thereto by like order.
Gdkw�
REBECCA LIDDICK
Notary Public
My Commission Expires July 25, 2013
I, the undersigned, Assistant Secretary of AEGIS SECURITY INSURANCE COMPANY, a Pennsylvania corporarion, DO HEREBY
CERTIFY that the foregoing and attached Power of Attorney remains in full force and has not been revoked: and furthermore that the
Resolution of the Board of Directors, set forth in the said Power of Attorney, is now in force.
Signed and sealed at the City of Harrisburg, in the Commonwealth of Pennsylvania, dated thisbth day of February, 2012.
I / n /,,/� �� �/�� \1K 1NSUR
� Z4 ,14- ' '� U oP
DEBORAH A. GOOD N 1977
Secretary
CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT
State of CALIFORNIA
County of ORANGE
On February 6th, 2012 before me ERIKA GUIDO, NOTARY PUBLIC,
personally appeared MATTHEW R. DOBYNS
® who proved to me on the basis of satisfactory evidence to be the persol
whose name(s) is /are subscribed to the within instrument and
acknowledged to me that he/she/" 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 persol
acted, executed the instrument.
ERIKA GUIDO
COMM. # 1843731
NOTARY PUBLIC CALIFORNIA N
J ORANGE COUNTY
J My Comm. eMp ires May 5= 73 t
I certify under PENALTY OF PERJURY under the laws of the State of
California that the foregoing paragraph is true and correct.
WITNESS nW hand and official seal.
Xj
Though the data below is not required by law, it may prove valuable to persons relying on the document and
could prevent fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER
❑ INDIVIDUAL
❑ CORPORATE OFFICER
❑ PARTNER(S) ❑ LIMITED
® ATTORNEY -IN -FACT
❑ TRUSTEE(S)
❑ GUARDIAN /CONSERVATOR
❑ OTHER:
DESCRIPTION OF ATTACHED DOCUMENT
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
BIDDER: 4'1`alln t G
2.8 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 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.
�
2.B LIST OF PROPOSED SUBCONTRACTORS (continued)
["Duplicate Next 2 Pages if needed for listing additional subcontractors. — I
Name and Location
of Subcontractor
Name: 1,11 n� r�W1, U G
Address: (U 1 o Tive5 *6 h
l/kMIRfrOA . (A. d l0b 3O o.
Description of Work
to be Subcontracted
Name and Location
of Subcontractor
Name:
Address:
Description of Work
to be Subcontracted
Name and Location
of Subcontractor
Name:
Address:
Description of Work
to be Subcontracted
Name and Location
of Subcontractor
Name:
Address:
Description of Work
to be Subcontracted
Name and Location
of Subcontractor
Name:
Address:
Description of Work
to be Subcontracted
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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. G
Name and Address of Owner
Name and telephone number of person familiar with project
Contract amount Type of Work
2.
Date Completed
Name and Address of Owner
Name and telephone number of person familiar with proj t
Contract amount Type of Work
3.
Date Completed
Name and Address of Owner /
Name and telephone number of pers n familiar with project
Contract amount // Type of Work
4. /
Date Completed
Name and Address of Owner
Name and telep, one number of person familiar with project
Contract ount Type of Work
Date Completed
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References
1. Name (Firm /Agency): City of La Puente
Contact Person: Barry Knutson Telephone No.: 909 - 957 -0188
Title of Project: Safe Route to School Project
Project Location: La Puente, CA
Date of Completion: Jul 2011 Contract Amount: $450,142.65
2. Name (Firm /Agency): County of Orange
Contact Person: Bruce Poma Telephone No.: 714 -448 -1672
Title of Project: JOC P001 — General Engineering
Project Location: County of Orange
Date of Completion: Dec. 2011 Contract Amount: $125,000.00
3. Name (Firm /Agency): City of La Habra
Contact Person: Chafic Mauradi Telephone No.: 562 - 905 -9720
Title of Project: Annual Sidewalk & Wheelchair Ramp Improvement
Project Location: La Habra, CA
Date of Completion: Feb 2011 Contract Amount: $226,783.61
4. Name (Firm /Agency): City of Santa Ana
Contact Person: Ed Torres Telephone No.: 714- 647 -5680
Title of Project: Santiago Creek Trail
Project Location: Santa Ana, CA
Date of Completion: Aug 2009 Contact Amount: $122,197.34
5. Name (Firm /Agency): New Creation Builders
Contact Person: David Lee Telephone No: 213 - 703 -5266
Title of Project: Site Improvements
Project Location: Lynwood, CA
Date of Completion: Nov 2011 Contract Amount: $187,000.00
I
Current Projects in Progress
6. Name (Firm /Agency): County of Orange
Contact Person: Telephone No.: 714- 448 -1672
Title of Project: JOC 006 — General Engineering
Project Location: County of Orange
Date of Completion: Dec 2012 Contract Amount: $1,000,000.00
7. Name (Firm /Agency): City of La Habra
Contact Person: Chuck Stephan Telephone No.: 562- 905 -9700
Title of Project: Alley Beautification Project Fy11 -12
Project Location: La Habra, CA
Date of Completion: April 2012 Contract Amount: $163,285.00
Note: Project 1 by Interlog HYM Engineering
Project 2 to 5 by HYM Engineering
Project 6 to 7 by Interlog HYM Engineering
t'a
SECTION 3
NON - COLLUSION AFFIDAVIT
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BIDDER: G 1'kPRn
NON - COLLUSION AFFIDAVIT (J
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 We to any corporation,
partnership, company association, organization, bid depository, o any member or agent
thereof to effectuate a collusive or sham bid.
i, .�
Sio(pture
- u J- � 6yJ
Typed or Printed Name
of du*
Title
JN Y�P,t�b � ��XY�� C�,y�1�
Bidder
Subscribed and swom before me
This _may of 20 l Z
Notary P Ic in a4d for
the Stf California
My Commission Expires:
(Seal)
TRACY H. KO
Commission IF 1901612
Lallotary Public - Celilornis Orange County
Comm. Expires AV 27 20141
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