Mission Paving and Sealing, Inc.1
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BIDDER: "SSIONPAVINO AND SEAUN
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CONTRACT BID FORMS
TABLE OF CONTENTS
SECTION 1 BID SCHEDULE .......................... ...............................
:................. 1
SECTION 2 BID DATA FORMS ................................................................... ............................... 5
2.A BID BOND ................................................................................. ............................... 6
22 LIST OF PROPOSED SUBCONTRACTORS ....................... :................................. 7
SECTION 3 NON - COLLUSION AFFIDAVIT .............................................. ............................... 10
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BIDDEMISSI PAVING AND SEALING, ING
SECTION 1- BID SCHEDULE
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BIDDERM PAVING AND SEALING, INC
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):
213,382.80
Two hundred thirteen thosuand three hundred eighty two dollars and eighty cents
Dollar amount in written form
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UNIT OF
EST.
UNIT
ITEM
NO.
ITEM DESCRIPTION
MEASURE
QTY.
PRICE
COST
1
Clearing & Grubbing per plans and
specifications.
LS
1
$ 7,000.00
$ 7,000.00
2
Disposal of Waste Materials
LS
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250.00
250.00
3
Crack Sealing
LS
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4
Slurry Seal Type II — See Exhibit
"A" on Appendix per street
locations & areas.
ELT
760
217.2E
165,132.80
5
Traffic Striping and Pavement
Markers — See Exhibit "A" on the
15, 000.00
15, 000.00
Appendix per details.
LS
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TOTAL BASE BID PRICE (SCHEDULE BID PRICE):
213,382.80
Two hundred thirteen thosuand three hundred eighty two dollars and eighty cents
Dollar amount in written form
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ALTERNATE BID ITEM No. 1
ALTERNATE BID PRICE: $ 56,010.00
TOTAL BASE BID AND ALTERNATE BID PRICE: $ 269, 392.80
Two hundred sixty nine thousand three hundred ninety two do a e ce nts
Dollar amount in written form
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cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and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
govem.
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 bid bond the amount of
Ri ri w,na 1 ns Dollars ($ of B; a) 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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UNIT OF
EST.
UNIT
ITEM
NO.
ITEM DESCRIPTION
MEASURE
QTY.
PRICE
COST
6
Clearing 88 Grubbing per plans and
specifications.
LS
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$ 2,800.00
2,800.00
7
Disposal of Waste Materials
LS
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250.00
250.00
8
Crack Sealing
LS
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6,600.00
6,600.00
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Slurry Seal Type II — See Exhibit .
"B" on the Appendix per street
locations & areas.
ELT
175
239.20
41,860.00
10
Traffic Striping and Pavement
Markers — See Exhibit "B" on the
4,500.00
4,500.00
Appendix per details.
LS
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ALTERNATE BID PRICE: $ 56,010.00
TOTAL BASE BID AND ALTERNATE BID PRICE: $ 269, 392.80
Two hundred sixty nine thousand three hundred ninety two do a e ce nts
Dollar amount in written form
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
govem.
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 bid bond the amount of
Ri ri w,na 1 ns Dollars ($ of B; a) 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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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 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 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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' By:
President
Title
' 4/30/12
Date
BIDDER: MISSION PAVING AND SEALING, ING
12747 Schabarum Ave.
Business Street Address
_Irwindale, CA. 91706
City, State and Zip Code
(626) 452 -8200
Telephone Number
' Bidder's/Contractor's State of Incorporation: California
Partners or Joint Venturers:
N/A
Bidder's License Number(s): 624257
NOTES:
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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,
partnership or joint venture has the authority to do so.
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Qnia SwpenpV
Type or Print Name
' BIDDER: MISSION PAVING AND SEALIN ING
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' SECTION 2
' BID DATA FORMS
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f Mission Paving &
MAY y pp,n BIDDER: Sealing Tnn
�d LYu
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 Mission Paving & Sealing, Inc, ,as
Principal, and SureTec Tnsurance C mm�a nv
, as Surety, are held firmly bound unto the
CITY OF ROSEMEAD (hereinafter called the OWNER) in the sum of
108 of amount bid
DOLLARS
(g % 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 Annual 2011 -2012 Slurry Seal Project as set forth in the Notice
Inviting Bids and accompanying Bid Documents, dated May 9, 20
NOW, THEREFORE, if said Principal is awarded a Contract for the Work by the
OWNER and, within the time and in the manner required by the above- referenced
Bid Documents, enters into the written form of Contract bound with said Bid
Documents, furnishes the required bonds (one to guarantee faithful performance
and the other to guarantee payment for labor and materials) furnishes the required
insurance certificates and endorsements, and furnishes any other certifications as
may be required by the Contract, then this obligation shall be null and void; otherwise
it shall remain in full force and effect. In the event suit is brought upon this bond by
the OWNER and judgment is recovered, said Surety shall pay all costs incurred by
the OWNER in such suit, including reasonable attorneys' fees to be fixed by the
court.
SIGNED AND SEALED, this 30t
dayof
April
20 12
Mission Pavin &
Sealina. Tnc
/
rSFAII
0
SureTec _mm�nny (SEAL)
Surety
D d/
David 16ddle, Attorney in
in Fact
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CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT
State of California 1
County of LOS ANGELES Jl
On MAY 1, 2012 before me, ALEXANDRA LEE VILLA, NOTARY PUBLIC
Deno Hero Inaon Namo and Tile of the Oincor
personally appeared DOUG SWEENEY PRESIDENT
Name(a) of Signor(s)
who proved to me on the basis of satisfactory
evidence to be the person whose name
subscribed to the within instrument and acknowledged
to me that he /&KAhey executed the same in
his that. authorized capacity(te�), and that by
his/hta tl`* signature(. on the 'instrument the
person or the entity upon behalf of which the
person(R)acted, executed the instrument.
I certify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
_ ALEXANDRA LEE VILLA paragraph is true and correct.
Commission 1 1894494
Notary Public - California z WITNESS my hand and official seal.
= Los Angeles Count s
. 'My Comm. Expires Jul 3, 2014 G,
Signature
Place Notary Seal Above OPTIONAL Signature of ota ubfic
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above: _
Capacity(ies) Claimed by Signer(s)
Signer's Name:
❑ Corporate Officer— Title(s):
❑ Individual
• Partner — ❑Limited ❑General Top of thumb here
• Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
Number of Pages:
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Individual
• Partner — ❑ Limited O General Top of thumb here
• Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
NOTARY (1- 8M0766827) Ilam.5W7
-4=
ACKNOWLEDGMENT
State of California
County of Los Angeles )
On
APR 312012
before me, Christopher John Rizzotti Notary
(insert name and title of the officer)
personally appeared David Noddle
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.
' ,;� CI6 ° ISTp ?4�,R IORi? �I %ZCiTI
U) A1.
WITNESS laand offic ial seal. a� ';; # fc ~` CO MM. 18/`;J43
-c N01kt, fU61.IC GAL{ U?N(A
LUS ANGELES COUNTY
e
My Comm. Expires 18n. 014
... . i
Signature (Seal)
PoAa: 510010
SureTec.Msurance Company
LIMITED POWER OF A'T'TORNEY
Know AU.Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company "), a corporation duly organized and
existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents
make, constitute and appoint
David Noddle
its true and lawful Attorney-in-fact, with full power and authority hereby conferred in its name, place.and stead, to execute, acknowledge
and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of stuetyship to include waivers to the
conditions of contracts and consents of surety for:
Five Million and 00/100 Dollars ($5,000,000.00).
and to bind the Company thcrebv•as;fully and to,the same extent as if,such bond ?�:- •-;,;ig,:.r: -' , theYresident, sealed with the corporate
seal of the Company acid duly attested by its Secretary, hereby ratifying and'confrtming ali that the said Attomey -in -Fact may do in the
premises. Said appointment shall continue in force until: 1013112013, and is made under and by authority of the following,
resolutions of the Board of Directors of the SureTec Insurance Company:,
Be it Resolved, that the President, any Vice - President, any Assistant Vice - President, any Secretary or any Assistant Secretary shall be and is
hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s) -in -Fact to represent and act for and on
behalf of the Company subject to the following provisions:
Attorney -in -Fact may be given full power and authority for and in the time of and of behalf of the Company, to execute, acknowledge and
deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all
notices and documents canceling or teirminating' the Company's liability thereunder, and any such instruments so executed by any such
Attomey- in- Fact 'shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary.
Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or
any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid
and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20 of April,
1999.)
In Witness Whereof, SURETEC INSURANCE COMPANY, has caused these presents to be signed by its President, and its corporate seal
to be hereto affixed this 3rd day of September, A.D. 2010.
e ..e•�- `..�,' SURETEC INSU13A4CE.C9MPANY
By:
State of Texas ss:
County of Harris
John
On this 3rd day of September, A.D. 2010 before me personally came John Knox Jr., to me known, who, being by me duly sworn, did depose and say, that
he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above
instrument;.that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the
Board of Directors of said Company; and that be signed his neat. u'tcreto.btBke order.
JACQUELYN MALDONADO d.
3 ,.,.
Notary Public, State of Texas -
' ;�' = My Commission Expires acq ely alder ado, Notary Public
1,rbf",; °- Moyle, 2013 y comm sion ex it$s May 18, 2013
1, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy
of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set
out in the Power of Attorney are in full force and effect.
Given under my hand and the 'seal of said Company at Houston, Texas this day of AYK 3 U Cu N.D.
M. Brent Beaty,
Any Instrument Issued in excess of the penalty stated above Is totally void and v. any validity.
For verification of the authority of this power you may call (713) 812- 0800.sny business day. between 8:00 am and 5:00 pm CST.;,
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BIDDER: MISSION PAVING AN SEALIN INC
2.6 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
t 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.
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BIDDER: MISSION PAVING AND SEALING, INC
2.8 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: Rubberized Crackfiller Sealant, Inc Crack Filler
Address: ann R Walrnit AvP ' n711Prf - nn .P CA_ 92831
Name and Location Description of Work
of Subcontractor to be Subcontracted
Name: Superior Pavement Markings
Address: 511 9 n raac qt- _ , C4q=ass CA_ 9064 Striping
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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BIDDER: MIS PAVING AND SEALIN ING
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. Please See Attached List
Name and Address of Owner
1 Name and telephone number of person familiar with project
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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 Type Work
amount of
Date Completed
1]
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Owner :Southern California Edison Co.
501 S. Marengo Ave.
Alhambra, CA. 91802
Eddie Lopez
(818) 681 -5126
Owner :Southem California Edison Co.
501 S. Marengo Ave.
Alhambra, CA. 91802
Vito
(626) 302 -6535
Owner :Southern California Edison Co.
501 S. Marengo Ave.
Alhambra, CA. 91802
Bruce Hammer
(626) 302 -6500
Owner :California State Polytechnic
University, Pomona
3801 W. Temple Ave.
Pomona, CA. 91768
Russ Woodruff
(909) 869 -2029
Owner :Simi Valley USD
875 E. Cochran St.
Simi Valley, CA. 93065
Pedro Avila
(805) 306 -4680
Project Rancho Vista Sub Station
124846 1h St. / Etiwanda
Rancho Cucamonga
05/04/09 to 08/27/09
$ 1,618,860.00 (Fixed Price Contract)
Contract # 4500092516
Proiect Mt. View Sub Station
2492 W. San Bernardino Rd.
Redlands, CA. 92374
02/18/09 to 03/03/09
$ 95,410.00 (Fixed Price Contract)
Contract # 4500093782
Project Parking Lot 3
Old Highway 101 Past Lot 4
San Onofre, CA. 92055
03/21/09 to 05/16/09
$ 184,605.23 (Fixed Price Contract)
Contract # 4500017272
Proiect Lot K & Adjacent Service Entry Rd.
Temple Ave. /University
Pomona, CA. 91768
07/13/09 to 07/13/09
$ 23,750.00 (Fixed Price Contract)
Contract # 0000040271
Project Miscellaneous Sites (7)
Big Springs, Hollow Hills, Royal,
Sycamore, Township, Valley View,
Santa Susana
07/11/09 to Present
$ 290,144.00 (Fixed Price Contract)
Contract # P09- 004211
MISSION PAVING AND SEALING, I N C .
PAST PERFORMANCE
12747 Schabamm Ave.. Imindale. California 917065807
Phone (626) 452 -8200 • Fax (626) 452 -9200 • www.missionp:rving.com • St. Lic. No. 624257
SIMILAR PROJECTS
1. SCE - VICTORVILLE SERVICE CENTER 2010 $ 412,990.00
REMOVE & REPLACE, SEAL & STRIPE
2. SCE - VENTURA SERVICE CENTER 2010 $ 462,905.00
REMOVE & REPLACE, SEAL & STRIPE
3. SCE - RANCHO VISTA SUBSTATION 2009 $ 4,200,000.00
GRADE, BASE & PAVE, STREET REHAB
4. KGC, INC. - GKN SANTA ANA BUSINESS CENTER 2009 $ 256,500.00
PULVERIZE, GRADE, PAVE, SEAL & STRIPE
CONTACT: JEFF KINDNESS (714) 636 -4542
5. J.H. SNYDER - LAKEWOOD, PARKING LOT 2009 $ 148,000.00
REMOVE & REPLACE, COLD PLANE & OVERLAY, SEAL & STRIPE
CONTACT: KATHLEEN ARNDT (323) 857 -5546
6. SIMI VALLEY USD -VARIOUS SITES 2009 $ 290,144.00
REMOVE & REPLACE, SLURRY, SEAL COAT & STRIPE
CONTACT: CHARLIE LINGLE (805) 813 -1720
7. DWP- ASPHALT INSTALLATION 2009 $ 145,332.00
CONTACT: MARK VAN ROSMALEN (213) 367 -7814
8. MOUNTAIN VIEW USD -4 SITES 2009 $ 178,800.00
PETROMAT & OVERLAY, SEAL & STRIPE
CONTACT: PETE (909) 947 -2205
9. OXNARD SD -3 SITES 2009 $ 125,330.00
ASPHALT REPAIR, SEAL & STRIPE
CONTACT: JOE RIRIE (PAVEMENT ENGINEERING INC) (805) 801 -4625
10. PROFESSIONAL CONSTRUCTION - LUNDY SUBSTATION 2009 $ 231,000.00
NEW ASPHALT INSTALLATION
CONTACT: JEFF HAGER (909) 581 -1918 EXT. 229
MISSION PAVING AND SEALING, INC.
11. GARDEN GROVE USD - VARIOUS SITES 2008 $ 299,239.00
REMOVE & REPLACE, COLD PANE & OVERLAY SEAL & STRIPE
CONTACT: BOB HOENSTEIN (714) 663 -6136
12. GLENDALE USD - - VARIOUS SITES 2008 $ 825,965.00
REMOVE & REPLACE, SEAL & STRIPE
CONTACT: KEITH JONES (818) 242 -0003
13. SIMI VALLEY USD - MULTIPLE SITES 2008 $ 241,735.00
ASPHALT REPAIR, SLURRY SEAL & STRIPE
CONTACT: CHARLIE LINGLE (805) 813 -1720
14. TILDEN COIL - LAUSD ADULT ED 2008 $ 152,000.00
NEW PARKING LOT
CONTACT: CORELY WILSON (951) 684 -5901
15. DMV -VENTURA 2008 $ 134,675.00
REMOVE & REPLACE PETROMAT W /OVERLAY, SEAL & STRIPE
CONTACT: FRED LAYTON (818) 262 -8344
16. SCE SONGS - ANNUAL CONTRACT ANNUAL $1,500,000.00
ASPHALT REPAIR
CONTACT: MARK CONKLIN (949) 368 -3521
17. SCE - VICTORVILLE SERVICE CENTER 2008 $ 348,713.00
REMOVE & REPLACE, SEAL & STRIPE
18. SCE - GATEWAY CENTER 2007 $ 970,000.00
REMOVE & REPLACE, STRIPE
19. SCE - CHINO SERVICE CENTER 2008 $ 78,487.00
REMOVE & REPLACE, CONCRETE, SEAL & STRIPE
20. SCE - REDLANDS SERVICE CENTER 2008 $ 310,500.00
REMOVE & REPLACE SEAL & STRIPE
21. SCE -ONTARIO 2008 S 282,582.00
REMOVE & REPLACE, SEAL & STRIPE
MISSION PAVING AND SEALING, I N C .
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BIDDER: MISSION PAVING AND SEALIN INC
SECTION 3
NON - COLLUSION AFFIDAVIT
CBF -10
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BIDDEW ISSION PAVING AND SEALING, INC
NON- COLLUSION AFFIDAVIT
In accordance with Public Contract Code Section 7106, the undersigned, being first duly
swom, deposes and says that hewf 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 heQbid 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 depo�itpry, or to any member or agent
thereof to effectuate a collusive or sham bid - - � �� �1
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Typed or
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President
Title
Mission Paving and Sealing, In
Bidder
This 30th day of April 1 20 12
Subscribed and swom before me
(Seal)
Alexandra Lee Villa, Nota Public
Notary Public in and for
the State of California
My Commission Expires: 7 /3/14
4�� LEE VILLA
N 18944gq
Notaryftblic - California
Los Angeles County
M Comm. EX ires Jul 3, 2014
CBF - 11
CALIFORNIA JURAT WITH AFFIANT STATEMENT
0 See Attached Document (Notary to cross out lines 1 -6 below)
❑ See Statement Below (Lines 1 -5 to be completed only by document signer[s], not Notary)
a
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t;
1 Simi of Document Signor No.1
State of California
County of LOS ANGELES
ALEXANDRA LEE VILLA
r Commission O 1894494
•'�. Notary Public •California =
Los Angeles.county s
'Mv Comm. Expires Jul 3, 2014 r
Place Notary Seol anaror Stomp Above
Spnatura of Decumont Signor No. 2 (it any)
Subscribed and sworn to (or affirmed) before me
on this 30th day of APRIL 20 12 ,
b Data Month Year
(1) DOUG SWEENEY, PRESIDENT ,
Name at Signer
proved to me on the basis of satisfactory evidence
to be the person who appeared before me (.) (,)
(and
(2) ,
Name of Signor
proved to me on the basis of satisfactory evidence
to be the poison who appeared before met
of
OPTIONAL
Though the information below is not required by law, it may prove vale•
able to persons relying on the document and could prevent fraudulent
removal and reattachment of this form to another document.
Further Description of Any Attached Document
- Title or Type of Document:
Do,au,ni Date: Number of Pages:
Signers) Other Than Named Above:
RIGHT THUMBPRINT RIGHT THUMBPRINT
OF SIGNER N1 OF SIGNER U2
0 2009 National Notary Association • NotbnatNotery.Or9 • NNA Mention; Only Hotline 1e9e 876 W27 Item 05910