Loading...
American Asphalt South, Inc.-- BIDDER: J1ye1%(G � lv�i z oo 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 1........... 10 BIDDER: /I/��L171417 ffiK /� `3� l�� SECTION 1 - BID SCHEDULE BIDDER: rJJ// V* //J �i // �v/�7i' BID SCHEDULE SCHEDULE OF PRICES FOR ANNUAL 2011 -2012 SLURRY SEAL PROJECT PROJECT No. 21002 BASE BID SCHEDULE TOTAL BASE BID PRICE (SCHEDULE BID PRICE): rS CBF -1 UNIT OF EST. UNIT ITEM NO. ITEM DESCRIPTION MEASURE CITY. PRICE COST 1 Clearing & Grubbing per plans and ! %�c�. �B�O specifications. LS 1 ✓� 2 Disposal of Waste Materials LS 1 SpD. 0 V S • iw 3 Crack Sealing LS 1 2 $y'�w,CD Z SOD. -rp 4 Slurry Seal Type II — See Exhibit "A" on Appendix per street d3 /• ; /74 locations & areas. ELT 760 5 Traffic Striping and Pavement Markers — See Exhibit "A" on the /X j2 y'. "v 3 2 tD Appendix per details. LS 1 TOTAL BASE BID PRICE (SCHEDULE BID PRICE): rS CBF -1 BIDDER: eyiff 1 OfX� / / '!X W, - - t ALTERNATE BID ITEM No. 1 ALTERNATE BID PRICE: 80 TOTAL BASE BID AND ALTERNATE BID PRICE: So, 2.5:;" 2 -S' e'P -4 amount The undersigned agrees that these Contract Bid Forms constitute a firm offer to the Owner which cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and after the bid opening date, or until a Contract for the Work is fully executed by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 parry, 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. {{ttach hereto is a certified check, a cashiers check or a bid bond in the amount of /0 , d 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. CBF -2 UNIT OF EST. UNIT ITEM NO. ITEM DESCRIPTION MEASURE CITY. PRICE COST 6 Clearing & Grubbing per plans and specifications. LS 1 �D(JD•°D �Ud�,� 7 Disposal of Waste Materials LS 1 SP �hO•�D 8 Crack Sealing LS 1 3 oi .oa 30/9 07> 9 Slurry Seal Type II - See Exhibit 'B" on the Appendix per street 3/. > yo SSG• 2 > locations & areas. ELT 175 10 Traffic Striping and Pavement Markers - See Exhibit 'B' on the G �7ZS OP 7 Z Appendix per details. LS 1 ALTERNATE BID PRICE: 80 TOTAL BASE BID AND ALTERNATE BID PRICE: So, 2.5:;" 2 -S' e'P -4 amount 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 parry, 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. {{ttach hereto is a certified check, a cashiers check or a bid bond in the amount of /0 , d 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. CBF -2 BIDDER: In /flvl 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 satisfactoryto the Owner of Bidder's California contractors 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 thirty (30) 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 Rs 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. CBF -3 BIDDER: By: llyy3z 5444'.4, 14M Business Street Address {�rl�tixl- c� 9,339 City, State and Zip Code �9a9 w;. 1 4 X;Y Telephone Number Bidder's /Contractor's State of Incorporation: 61' ;q1 Partners or Joint Venturers: Bidder's License Number(s): �ofi/v & w 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. As further discussed in the Instructions to Bidders, Bidder will be required to provide evidence that the person signing on behalf of the corporation, CBF -4 ` ,5�r Title A / f -goa - Date MINUTES OF THE 2012 ANNUAL MEETING OF THE BOARD OF DIRECTORS OF AMERICAN ASPHALT SOUTH, INC. The 2012 annual meeting of the Board of Directors of American Asphalt South, Inc., a California corporation (hereinafter referred to as the "Corporation "), was held in Fontana, California, on January 20, 2012, commencing immediately after the 2011 annual meeting of the shareholders of the Corporation. Said 2012 annual meeting of the Board of Directors was held for the purpose of electing officers of the Corporation, considering reports of the affairs of the Corporation, and transacting other business within the powers of the Board of Directors. 1. CALL TO ORDER - CHAIRMAN AND SECRETARY The meeting was called to order by Allan A. Henderson, Chairman of the Board of Directors of the Corporation. Lyle Stone, the Corporate Secretary, acted as secretary of the meeting and recorded the minutes. Mr. Henderson then noted that at the 2011 annual meeting of the shareholders of the Corporation, which annual meeting had just concluded, that Allan A. Henderson, Kimberly L. Henderson and Jeffery R. Petty had been re- elected as members of the Corporation's Board of Directors, all to serve as such until the 2013 annual meeting of the shareholders of this Corporation. 2. VALIDITY OF MEETING Notice of the date of this meeting is stated in the By -laws of this Corporation, specifically Section 3.6. All Directors present agreed that this is a valid meeting of the Board of Directors. 3. DIRECTORS PRESENT The following Directors were present: Allan A. Henderson, Kimberly L. Henderson and Jeffrey R. Petty. The following Director(s) were absent: None. 4. ELECTION OF CHAIRMAN Allan A. Henderson was then unanimously re- elected to serve as the Chairman of the Board of Directors until the 2013 annual meeting. 5. APPROVAL OF PRIOR MINUTES The Chairman then presented to the meeting the minutes of the January 20, 2011 annual meeting of the Board of Directors of this Corporation, which are in the form of a written action. Said minutes were unanimously approved and all actions taken therein unanimously ratified. 6. NOMINATION AND ELECTION OF OFFICERS Page 1 The Chairman then called for nominations for the officers of the Corporation to serve for one year until the next annual Board of Directors meeting and until their successors are elected and qualified. The following persons were nominated for the offices designated beside his or her name: Allan A. Henderson Jeff Petty Lyle Stone Allan A. Henderson - President - Vice President - Secretary - Chief Executive Officer The Chairman called for further nominations but none was made. The above persons were unanimously elected to the offices to which he had been nominated. Furthermore, all elected officers are duly authorized to sign documents on behalf of the corporation. 6. ADJOURNMENT There being no further business, the meeting was adjourned. f� Lyle one C r ate Secretary Page 2 BIDDER: 11-me- i ✓) ��W, T✓�C SECTION 2 BID DATA FORMS CBF -5 1 BIDDER, American Asphalt South, Inc. Bidder shall submit its Bid data in accordance with the format shown on each of the following Bid Date 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 property Identified with the Bidder's name and page number. 2A BID BOND KNOW ALL MEN BY THESE PRESENTS: THAT American Asphalt South, Inc. . as Surety, are held firmly bound unto the CfrY OF ROSEMEAD (hereinafter called the OWNER) in the sum of Ten Percent of Total Bid - -- as ($ 10 % - -- ) , 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 2 11 -2012 Slum Seal Proiect as set forth in the Notice Inviting Bids and accompanying Bid Documents, dated April 19th & 2bth, 2012 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 ft 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 foxed by the coup. SIGNED AND SEALED, this 30th day of April 2012,, '_ American Asphalt South, Inc. The Guarantee Company P (SEAL) of North America USA (SEAL) Principal Surety By; ✓ By. Aa-vAa_U' S' Lure J Signature Ba bars 7 y, ttomey -in- a !f/ .544 7 rte: CALIFORNIA ALL - PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Butte On April 30, 2012 before me, Jennifer Lelouarn, Notary Public (Here insert name and title of the officer) personally appeared Barbara Beeny 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. ---------------- --------- ...... J. LELOUARtI I[ COMM. 0 1973758 WITNESS my hand and official seal. NOTARY W� �F ° �I Comm. Expires MAR 30, 2016 I� (Notary Seal) of Signatur of , ota ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT Bid Bond (Title or description of attached document) American Asphalt South, Inc. (Title or description of attached document continued) Number of Pages 1 Document Date 4130/2012 The Guarantee Company of North America USA (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) - ❑ Corporate Officer (Title) ❑ Partner(s) . ❑� Attorney -in -Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly as appears above in the notary section or a separate acknowledgment form must he properly completed and attached to that document. The only exception is if document is to be recorded outside of California In such instances, any alternative acknowledgment verbiage as may be printed on such a document so long as the verbiage does not require the notary to do something that is illegal far a notary in California ti. e. certifying the authorized capacin of the signer). Please check the document carefully for proper notarial hording and attach this forest ifrequtred State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). Print the name(s) of document signer(s) who personally appear at the time of notarization. Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. helshe /they, is /are-) or circling the correct forms. Failure to currently indicate this information may lead to rejection of document recording. The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form. Signature of the notary public must match the signature on file with the office of the count clerk. .- Additional information is not required but could help to ensure this acknowledgment is not misused or attached to u different document. *._ Indicate title or type of attached document, number of pages and date. '.- Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title fix, CEO, CFO, Secretary). Securely match this document to the signed document 2008 Version CAPA 02.10.07 800 - 873 -9865 www.NouryClasses.com THE GUARANTEE COMPANY OF NORTH AMERICA USA Southfield, Michigan POWER OF ATTORNEY KNOW ALL BY THESE PRESENTS: That THE GUARANTEE COMPANY OF NORTH AMERICA USA, a corporation organized and existing under the laws of the Slate of Michigan, having its principal office in Southfield, Michigan, does hereby constitute and appoint Barbara Midstokke, Renee Ramsey, Richard W. Pratt, John Hopkins, Elizabeth Collodi, Susan Lee, Barbara Beeny, Nancy Luttenbacher, Phillip O. Watkins, Keith T, Schuler Interwest Insurance Services, Inc. its true and lawful attorney(s) -in -fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, statute, rule, regulation, contract or otherwise. The execution of such instrument(s) in pursuance of these presents, shall be as binding upon THE GUARANTEE COMPANY OF NORTH AMERICA USA as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at the principal office. The Power of Attorney is executed and may be certified so, and may be revoked, pursuant to and by authority of Article IX, Section 9.03 of the By -Laws adopted by the Board of Directors of THE GUARANTEE COMPANY OF NORTH AMERICA USA at a meeting held on the 31" day of December, 2003. The President, or any Vice President, acting with any Secretary or Assistant Secretary, shall have power and authority: 1. To appoint Attorneys) -in -fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof; and 2. To revoke, at any time, any such Attorney -in -fact and revoke the authority given, except as provided below 3. In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and authority hereby given to the Attomey -in -Fact includes any and all consents for the release of retained percentages and /or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the Stale of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. 4. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner — Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation. Further, this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of the Company adopted at a meeting duly called and held on the 6th day of December 2011, of which the following is a true excerpt:- RESOLVED that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, contracts of indemnity and other writings obligatory in the nature thereof, and such signature and seal when so used shall have the same force and effect as though manually affixed. *rr IN WITNESS WHEREOF, THE GUARANTEE COMPANY OF NORTH AMERICA USA has caused this instrument to be signed and its corporate seal to be affixed by its authorized officer, this 23rd day of February, 2012. THE GUARANTEE COMPANY OF NORTH AMERICA USA STATE OF MICHIGAN Stephen C. Ruschak, Vice President Randall Musselman, Secretary County of Oakland On this 23rd day of February, 2012 before me came the individuals who executed the preceding instrument, to me personally known, and being by me duly sworn, said that each is the herein described and authorized officer of The Guarantee Company of North America USA; that the seal affixed to said instrument is the Corporate Seal of said Company; that the Corporate Seal and each signature were duly affixed by order of the Board of Directors of Cynthia A. Takai IN WITNESS WHEREOF, I have hereunto set my hand at The Guarantee Notary Public, State of Michigan Company of North America USA offices the day and year above written. ' pi,P'• " -. County of Oakland Fnicefo = My Commission Expires February 27, 2018 V Acting in Oakland County _ I, Randall Musselman, Secretary of THE GUARANTEE COMPANY OF NORTH AMERICA USA, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney executed by THE GUARANTEE COMPANY OF NORTH AMERICA USA; which is still in full force and effect. rrr IN WITNESS WHEREOF, I have thereunto set my hand and attached the seal of said Company this 30th day of April, 2012 CM G s Randall Musselman, Secretary BIDDER: / l /� /�•�N/�� Td f, 2.113 LIST OF PROPOSED SUBCONTRACTORS In compliance with the "Subletting and Subcontracting Fair Practices Act," Sections 4100 through 4114 of the California Public Contract Code, and any amendments thereto, each Bidder shall provide the information requested below for each subcontractor who will perform work, labor or render service to Bidder in or about the construction of the Work in an amount in excess of one -half of one percent (greater than 0.5 %) of the Bidder's Total Bid Price, or, in the case of bids or offers for the construction of streets or highways, including bridges, in excess of one -half of 1 percent of the Contractor's total bid or ten thousand dollars ($10,000), whichever is greater, and shall further set forth the portion of the Work which will be done by each subcontractor. Bidder shall list only one subcontractor for any one portion of the Work. Pursuant to Public Contract Code Section 4104, the Owner has determined that it will allow Bidders twenty -four (24) additional hours 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 (greaterthan 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 ($10,000), whichever is greater, for which no subcontractor was designated in the original bid shall only be permitted in cases of public emergency or necessity, and then only after Owner approval. CBF -7 BIDDER: .1 QN? 2.8 LIST OF PROPOSED SUBCONTRACTORS (continued) ["Dupllnete Next 2 Pages if needed for Ilsgng addltlonal sueconvactors. — I Name and Location Description of Work of Subcontractor to be Sub ke Name: Sy!xr��! IQ vf Address V, G`n�,r,s* S Name and Location of Subcontractor Name: Address Description of Work to be Subcontracted Name and Location of Subcontractor Name: Address Description of Work to be Subcontracted Name and Location of Subcontractor Name: Address Description of Work to be Subcontracted Name and Location of Subcontractor Name: Address: Description of Work to be Subcontracted CBF -8 BIDDER: 2.0 REFERENCES The following are the names, addresses and telephone numbers for three public agencies for which BIDDER has performed similar work within the past two (2) years: 1. Name and Name and telephone number of person familiar with project Contract amount. Type of Work Date Completed 2. Name and Address of Owner Name and telephone number of person familiar with project Contract amount Type of Work Date Completed 3. Name and Address of Owner Name and telephone number of person familiar with project Contract amount Type of Work Date Completed 4. Name and Address Name and telephone number of person familiar with project Contract amount Type of Work Date Completed CBF -9 � w U z w LL ■ k < ) k G § S U) ) § G ) © e ) § \ § ) / I & EL § § < G § } j ( § k 2 2 n 2 <u m <- } m G / ° /® »._ LL 3 I S = / § § ) 2E &k k »k ~ Ga 9 22W §$ �� k §E / k ) »z) U) != n$ < I3 2 < G§ °0 � �� go )k � it W 2§ �k �\ o= @0 a.< \) \} (} )§ \} \ )§ %2 Ic ( o W k k IL) 2 } ] \ ) ± \ K ± y e� < e o ;u z y y oz zen� « j ,P2 oA= �zr oo° § w- Z- o ,r n- oo= =o° om W�- ° E$§ 2±) >3= �$` §op oe »_; o< <�7 ®LL u� z a � «a W� W A CO > - n & =G &b& Kn§ &§� &>§ b0: &ƒk & «^ ,($ƒ ([y (§_ &$& (S/ (,� 4fE (2£ &3\ «oca ate - 50t oos o�� 5ss ous o <s ate& § } � LLI ) < ) < \ \ k \ « - - cri W - - OCL - CD . � w U z w LL ■ k < ) k G § S U) ) § G ) © e ) § \ § ) / I & EL § § < G § } j ( § k 2 2 n 2 <u m <- } m G / ° /® »._ LL 3 I S = / § § ) 2E &k k »k ~ Ga 9 22W §$ �� k §E / k ) »z) U) != n$ < I3 2 < G§ °0 � �� go )k � it W 2§ �k �\ o= @0 a.< \) \} (} )§ \} \ )§ %2 Ic ( o W k k IL) 2 } ] \ ) ± \ K ± y e� < e o ;u z y y oz zen� « j ,P2 oA= �zr oo° § w- Z- o ,r n- oo= =o° om W�- ° E$§ 2±) >3= �$` §op oe »_; o< <�7 ®LL u� z a � «a W� W A CO > - n & =G &b& Kn§ &§� &>§ b0: &ƒk & «^ ,($ƒ ([y (§_ &$& (S/ (,� 4fE (2£ &3\ «oca ate - 50t oos o�� 5ss ous o <s ate& } � « - - cri - - - OCL - CD . ® 60 69> 69 - - k � w U z w LL ■ k < ) k G § S U) ) § G ) © e ) § \ § ) / I & EL § § < G § } j ( § k 2 2 n 2 <u m <- } m G / ° /® »._ LL 3 I S = / § § ) 2E &k k »k ~ Ga 9 22W §$ �� k §E / k ) »z) U) != n$ < I3 2 < G§ °0 � �� go )k � it W 2§ �k �\ o= @0 a.< \) \} (} )§ \} \ )§ %2 Ic ( o W k k IL) 2 } ] \ ) ± \ K ± y e� < e o ;u z y y oz zen� « j ,P2 oA= �zr oo° § w- Z- o ,r n- oo= =o° om W�- ° E$§ 2±) >3= �$` §op oe »_; o< <�7 ®LL u� z a � «a W� W A CO > - n & =G &b& Kn§ &§� &>§ b0: &ƒk & «^ ,($ƒ ([y (§_ &$& (S/ (,� 4fE (2£ &3\ «oca ate - 50t oos o�� 5ss ous o <s ate& e � w U z w LU LL ■ 8 co 0 C14 06 oi <s _ _ LU \ \ \ Cl) tl� S ) k § z z z \ ) \ b ( LLI U) + ) E § k a E < F- Cl) < \ ƒ < j\ co 0 C14 06 oi <s _ _ % } \ \ \ Cl) tl� S E \ ) \ b ( LLI U) + ) E § j a E < F- Cl) < \ ƒ < �G � u m § uj 2 n w ) I >- ( \ $ ] / } � = j njn (� ° < ��( ■�§ ( / 2� S §5 »5y .6 ) 2ES 0>- < ± \@ ` §\m LUX o CD 3$J = §]& S { %) })) z z w < §L �§ _ [ o b e \ o k § 2 = o 0 W00 \w ((k § §§ §k( =o© # <2 0 �� z =w W #§ §2$ 0co »S §G� Ey (%0 (0 <o$# ci (.)ZS §We o2W o =e / ] ] )/ \( j § §}} @AE ) z <5< =8W w/\ w 9R )(§ ) § / Cl) \ >g }( (% ) § \ D }� \6 mI \L -j}\ b$f [�\ § \_2 e } }\ e2s § a 7jk /\\ 02¥ 06 oi co m tl� C4 )/ \( j § §}} @AE ) z <5< =8W w/\ w 9R )(§ ) § / Cl) \ >g }( (% ) § \ D }� \6 mI \L -j}\ b$f [�\ § \_2 e } }\ e2s § a 7jk /\\ 02¥ BIDDER: / r4 {7 SECTION 3 NON - COLLUSION AFFIDAVIT CBF -10 BIDDER: �I�eI(Yl� 4�J�[y�� �!`f�S� Z, 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. Signaty �4le 140e Type or Printed Name Title e l e he?7h zoAo /f Ste! tom, Bidder Subscribed and sworn before me This L day of /' . 1 (Seal) Notary Public in and for A RICHARD ENTRIKIN the State of California COMM. *1854481 19 NOTARY PUBLIC- CALWORNN BAN BERNARORIO COUNfY My Commission Expires: My Cm . Ear JUL. 13.7013 r- CBF -11