Sully MIllerCITY OF ROSEMEAD
MISSION DRIVE STREET RESURFACING PROJECT
FROM ROSEMEAD BOULEVARD TO VALLEY BOULEVARD
PROJECT No. 21015
CONTRACT BIDtFORMS
BIDDER: Sully - Miller Contracting Comp
CONTRACT BID FORMS
TABLE OF CONTENTS
SECTION 1 BID
SCHEDULE.............................................. ...........................CBF1 - CBF6
SECTION 2 BID DATA FORMS ................................. ..... ........................... CBF7
2.A BID BOND ........ .................................................................... CBF8
23 LIST OF PROPOSED SUBCONTRACTORS ..................... CBF9 -CBF11
SECTION 3 NON - COLLUSION AFFIDAVIT ............... . .................... CBF12 -CBF13
BIDDER: Sully - Miller Contracting Company
SECTION 1- BID SCHEDULE
CBF -1
BIDDER: Sully - Miller Contracting Comp
BID SCHEDULE
SCHEDULE OF PRICES FOR
MISSION DRIVE STREET RESURFACING PROJECT
FROM ROSEMEAD BOULEVARD TO VALLEY BOULEVARD
_...... .. ....._ ...... ...... _.
BASE BID SCHEDULE
CBF -2
UNIT OF
EST.
UNIT
ITEM
NO.
ITEM DESCRIPTION
MEASURE
QTY.
PRICE
COST
1
Clearing& Grubbing per plans
LS
1
ct c—
q%-ko
and specifications. See technical
i
provisions TP -2, TP -3 & TP-4.
2
Disposal of Waste Materials.
LS
1
rj OpO—
S ODO
3
Cold mill 2.0- inches thick existing
SF
183,700
0 `�
1-2j O t{L( —
pavement.
4
Construct 1.5 inches thick
TONS
1,653
pavement overlay ARHM -GG -C
OS
—
r {O� SOS
(PG 64 -16) as indicated on the
plans.
5
Construct 1.0 inches thick
TONS
NI NO
Asphaltic Leveling course D1
1,102`
(PG 64 -10) as indicated on the
`Per Add
7(o
plans.
#1.
6
Remove 6- inches of existing
SF
500
pavement and replace it with 3.5-
y� 5c) O
inches of AC B -PG 64 -10 Base
Course over compacted native.
7
Remove, Dispose and Construct
SF
7778
4- inches thick PCC Sidewalk per
p0 ( —
SPPWC Std. Plan 113 -1.
8
Remove, Dispose and Construct
SF
2270
PCC Driveway Approaches per
SPPWC Std, Plan 110 -2.
9
Remove, Dispose and Construct
LF
592
8- inches Curb and 24- inches
Gutter per SPPWC Std. Plan
120 -2.
q
CBF -2
BIDDER: Sully - Miller Contracting C ompany
1 4 19, loo —
TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ — C%
22 5.J
Z-1 YFc; I - - �) 4 E .'r/ +� a ['Y IRS[cDC ®�00 \1b-C �i w+ 2C.t -a
Dollar amount in written form
�o�� 4,.,..,a,re.d N, rlc.'f'cc�n - F�.o�sw� -� lac h�� -�ccc) dotl�cs o.•�` r. «r ce,ti�Cs
CBF -3
UNIT OF
EST.
UNIT
ITEM
NO,
ITEM DESCRIPTION
MEASURE
QTY.
PRICE
COST
10
Remove, Dispose and Construct
PCC Curb Ramps per SPPWC
EA
5
_
2 1
J �/ rj O o
Std. Plan 111-4.
11
Adjust Sewer Manhole to Grade
EA
29
_
per APWAStd. Plan 205 -1 and
(oQp
1 RC30
206 -1.
12
Adjust Water Valve /Gas Valve to
EA
32
I oo
3� Zpp
Grade.
13
Install Survey Well Monument
EA
5
per City of Rosemead Std. Plan
S08 -001. See Section 2 -9
Surveying of the General
(� C 06 _
Provision -7 per details (Cover,
Sleeve & Dome will be provided
by the City at no cost).
14
Install Traffic Striping, Traffic
LS
1
Lj� SOO
! { S�—
Signal Loops, and Pavement
l
i
Markers ( Including 8" Raised
-
pavement markers) per the
i
Striping Plans and Specifications
Complete.
15
Prepare a Storm Water Pollution
LS
1
3700
�i 70d
Prevention Plan (SWPPP)
16
Remove, Salvage and Install
EA
6
Street Name Signs on Existing
_
(o
q
Poles; City will .provide the Signs.
17
Remove, Salvage and Install
EA
2
Street Name Signs on new
_
Poles; City will provide the Signs.
1 4 19, loo —
TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ — C%
22 5.J
Z-1 YFc; I - - �) 4 E .'r/ +� a ['Y IRS[cDC ®�00 \1b-C �i w+ 2C.t -a
Dollar amount in written form
�o�� 4,.,..,a,re.d N, rlc.'f'cc�n - F�.o�sw� -� lac h�� -�ccc) dotl�cs o.•�` r. «r ce,ti�Cs
CBF -3
BIDDER: Sully - Miller Contracting Company
TOTAL ALTERNATE BID PRICE No. 1 (SCHEDULE BID PRICE):$ 30 woo
in written form
I4Lk Soo
TOTAL BASE & ALTERNATE BID PRICE
t. o _ c r. r . n
Dollar amount in written form
Four 4LU"'At- c). '( = oma y- N�Kc 't�o.s• -�-c� Fr�C 4ra...��ccc�. ao�t�cS ..�,..� "L�n� cc�. fS
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
afterthe 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.
Attached hereto is a a bid bond in the amount of
Te Percent of Bid Dollars ($ of B psaid 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,
CBF -4
-UNIT OF _
MEASURE
_._ EST.
QTY.
NO.
ITEM DESCRIPTION
PRICE
COST
1 B
Install Wrought Iron Fence 6
LF
320
feet, 1 1/2" rails and 314" pickets,
S
-2 -Z ) / 4 00
all tubing 100% galvanized inside
and out and powder coated and
2" post per Kingmetals or
approved equal.
TOTAL ALTERNATE BID PRICE No. 1 (SCHEDULE BID PRICE):$ 30 woo
in written form
I4Lk Soo
TOTAL BASE & ALTERNATE BID PRICE
t. o _ c r. r . n
Dollar amount in written form
Four 4LU"'At- c). '( = oma y- N�Kc 't�o.s• -�-c� Fr�C 4ra...��ccc�. ao�t�cS ..�,..� "L�n� cc�. fS
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
afterthe 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.
Attached hereto is a a bid bond in the amount of
Te Percent of Bid Dollars ($ of B psaid 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,
CBF -4
MAYOR:
POLLY Low
MAYOR PRO TEM:
WW. ALARCON
COUNCIL MEMBERS:
SA RAARMENTA
MARGARET CLARK
STEwNLY
May 13, 2013
ity ®f Wpsem
8838 E. VALLEY BOULEVARD P.O BOX 399
ROSEMEAD, CALIFORNIA 91770.
TELEPHONE. (626) 569 -2100
FAX (626) 307 -9218
CITY OF ROSEMEAD
ROSEMEAD, CALIFORNIA
ADDENDUM NUMBER 2
To all prospective bidders under Bid Documents for the
MISSION DRIVE STREET RESURFACING PROJECT
Project No. 21015
f
1 - .
I' V
1. You hereby informed that Alternate No. 2 shall be added to the Contract Bid
Schedule of Items:
Alternate No. 2
Storm Drain Construction
NO
UNIT OF
EST
UNIT
ITEM
2
ITEM DESCRIPTION
MEASURE
QTY
PRICE
COST
19
Install Storm Drain System as
LS
1
indicated on the attached Plans
22 1 000 —
22, o00
Complete.
TOTAL ALTERNATE B ID PRICE No.2 (SCHEDULE BID PRICE):$ 22 oop
T W�tN��r -Two �'t77U9e.� d0 \1oC� ,,..�� 'LC�O levtG.
Dollar amount in written form
2. The rest of Bid Documents as originally issued shall be used in submitting bids, and
an acknowledgement of receipt of this Addendum Number 2 shall be entered on the
page CBF — 5 of the Contract Bid Forms. Failure to provide such acknowledgement
shall render the bid as non - responsive and subject to rejection.
BY ORDER OF THE CITY �ROSEMEAD
By
/Rafael Fajardo
Associate Civil Engineer
Page I
BIDDER: Sully - Miller Contracting Comp
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 Ownerfor execution, within five (5) Calendar Days following the Letter of Award for
the Contract, and will deliverto the Owner within that same period the necessary original Certificates
of Insurance, Endorsements of Insurance, Performance Bon Payment Bond and all other
_ -- documentation- and�certification= required =by -the= Contract.
The undersigned offers and agrees that if this bid is accepted, itwill 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 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. 41 Dated 05/07/13, #2 Dated 05/13/13
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 -5
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.
(Alm dll08 /20,1.3. 1.4::18 FAX
Ian®
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MAYOR:
FOLLY Low
MAYOR PRO TFNI:
891111 ANI ALARCGN
COUNCIL NAEMUER,S!
SANDRA ARAIENTA
MARGARET CLARK
STEVEN LY
:;•:r�j0o3.iooI
City of 1psemead
8838 E. VALLEY OOULEVARD P.0 BOX 399
ROSEMEAD. CALIFORNIA 91770
TELEPHONE (626) 569 -2100
FAX (626) 307 -9218
In
�5
CITY OF ROSEMEAD
ROSEMEAD, CALIFORNIA +
l
ADDENDUM NUMBER 1 y j
1
To all prospective bidders under Did Documents for the
MISSION DRIVE STREET RESURFACING PROJECT
Project No. 21015 j
1. Bid Item No Base Bid Schedule on CBF — 2 EST. QTY. (Estimates
Cluantity) 1,1102 Tons shall be replaced by 1,102.00 Tons.
I
i
2. The rest of Bid Documents as originally issued shall be used in submitting
an acknowledgement of receipt of this Addendum Number 1 shall be ente
the page CBF — 5 of the Contract Bid Forms. Failure to provide such
acknowledgement shall render the bid as non - responsive and subject to re
BY ORDER OF THE CITY OF
Date: May 7, 2013.
1
B y
�� R ani el Fajardo
Associate Civil Engineer
I
I
I
I
I
i
i
i
,'and
on
By: L
Signkurej
BIDDER: Sully-Miller Contracting Company
135 S. State College Blvd., Ste. 400
Business Street Address
Raymond, Sanchez,. Brea, CA 92821
Typeof Print Name City, State and Zip Code
Title Telephone Number
Bidders/Co ntr a ctor's - Stat e �
Partners or Joint Venturers:
Delaware
NN
Bidder's License Number(s): 747612 C
NOTES:
1\ Bv its signature on this Bid, the Bidder certifies under penalty of perjury the accuracy cfthe
representations made on the Contract Bid Fonns.
2) If Bidder is a corporation, enter State of Incorporation in addition to Business Address
3) If Bidder is a partnership or j oint venture, give full names of all partners or j oint
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,
C8F'0
CERTIFICATE OF INCUMBENCY AND RESOLUTION
I, Anthony L. Martino, 11, do hereby certify that I am the Secretary of Sully- Miller Contracting
Company, a Delaware corporation, and that as such I have access to and custody of the corporate
records and minute books of said corporation.
And I do hereby further certify that the following persons are duly elected officers of said
corporation.
TITLE NAME
Chairman of the Board
Gordon R. Crawley
President
David Martinez
Vice President, Chief Financial Officer and Treasurer
Timothy P. Orchard
Vice President and Assistant Secretary
Michael Edwards
Vice President
Scott Bottomley
Secretary
Anthony L. Martino It
Assistant Secretary
George Aldrich
Assistant Secretary
Raymond Sanchez
Assistant Secretary
Dennis Gansen
I further certify that the following is a true and correct copy of a resolution duly adopted by the
Board of Directors. of said Company at a meeting held on February 15, 2012, and that this
resolution has not been in any way rescinded, annulled, or revoked but the same is still in full
force and effect:
" BID.TENDERS: GENERAL
RESOLVED, that any officer of the Corporation be and they hereby are
authorized in the name and on behalf of the Corporation, under its corporate seal
or otherwise (i) to prepare proposals and bids for the supplying of construction
materials and the performance by itself or in joint venture, of work of whatsoever
nature in connection with the construction or paving of highways, roads and
airports and in connection with earthworks and civil engineering projects of all
kinds, together with all work incidental thereto, (ii) to execute and submit any and
all such proposals and bids to any governmental authority, instrumentality, or
agency of the United States, its several states, territories and possessions,
including without limitation, any municipality or other political or corporate
subdivision thereof, and to any corporation, partnership, sole proprietorship, or
other business entity, (iii) in connection with any such submission, to deliver bid
deposits or bonds as may be required and (iv) to execute and deliver definitive
agreements binding the Corporation to perform work in accordance with any
proposals and bids authorized hereby."
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the corporate seal this 23rd
day of April 2012.
(SEAL) Anthony
Secretary
Sully- Miller Contracting Company
135 S. State College Blvd., Ste. 400
Brea, CA 92821
STATE OF CALIFORNIA
COUNTY OF ORANGE
On May 17, 2013 before me, J. Daniels, Notary Public personally appeared Raymond Sanchez
Description of Attached Document
Title or Type of Document: Bid Proposal- Signature Page
Document Date: May 17, 2013
Signer(s) Other Than Named Above:
❑ Individual
Capacity(ies) Claimed by Signer(s):
Signer's Name Raymond Sanchez Signers Name
❑ Individual
FX Corporate Officer — Title(s)
❑ Partner — Limited /General
7 Attorney In Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other
Signer is Representing
Assistant Secretary ❑ Corporate Officer — Title(s)
Right Thumbprint
of Signer
Number of Pages:
1
❑ Partner — Limited /General
Attorney In Fact
Trustee
Guardian or Conservator
Other
Right Thumbprint
of Signer
SULLY - MILLER CONTRACTING COMPANY
who proved to me on the basis of satisfactory evidence to
be the person(s) whose name 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
FS� ., J. DAN1ELS
r Y
instrument the person(s), or the entity upon behalf of
1 4 989 a
- COMM tt 54
m (a'2. r� Notary Publl >
a S
which the persons) acted, executed the instrument.
,, myc mm 24,mtb
).......r: _ ._
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 jficial seal
Signature
J. Da
iels, Notary Public
Notary Seal
OPTIONAL
Description of Attached Document
Title or Type of Document: Bid Proposal- Signature Page
Document Date: May 17, 2013
Signer(s) Other Than Named Above:
❑ Individual
Capacity(ies) Claimed by Signer(s):
Signer's Name Raymond Sanchez Signers Name
❑ Individual
FX Corporate Officer — Title(s)
❑ Partner — Limited /General
7 Attorney In Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other
Signer is Representing
Assistant Secretary ❑ Corporate Officer — Title(s)
Right Thumbprint
of Signer
Number of Pages:
1
❑ Partner — Limited /General
Attorney In Fact
Trustee
Guardian or Conservator
Other
Right Thumbprint
of Signer
SULLY - MILLER CONTRACTING COMPANY
BIDDER: Sully - Miller Contracting Com pany
SECTION 2
BID DATA FORMS
CBF -7
From Rosemead Boulevard to Valley Boulevard, Project No. 21015
BIDDER: Sully- Miller Contracting Company
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 Sully - Miller Contracting Company as
Principal, and Liberty Mutual Insurance Company
, as Surety, are held firmly bound unto the
CITY OF ROSEMEAD (hereinafter called the OWNER) in the sum of
TenPercent of the Amount Bid -------------------------------------------------------------------- --- ---- ------ ----- --- - - - ---
($ 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 forthe Mission Drive Street Resurfacing Project as setforth in the Notice
Inviting Bids and accompanying Bid Documents, dated May 22, 2013
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 15th day of May , 2013
Sully-Miller Con a tin Coln (SEAL)
Principal
By: By:
Signature
RAYMOND SANCHEZ, ASSISTANT SECRETARY
Liberty Mutual Insurance Company (SEAL)
Surety
Signature Victoria M. Camobell, Atto y - in -Fact ;
CBF - 8
STATE OF CALIFORNIA l
COUNTY OF ORANGE J
On May 17, 2013 before me, J. Daniels, Notary Public personally appeared Raymond Sanchez
Description of Attached Document
Title or Type of Document:
, oli
Document Date: May 15 2013 Number of Pages:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s):
Signer's Name Raymond Sanchez Signers Name
Individual
corporate Officer — Title(s)
Partner — Limited /General
E] Attorney In Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other
Signer is Representing
Individual
1
Assistant Secretary F corporate Officer — Title(s)
Right Thumbprint
of Signer
Partner — Limited /General
Attorney In Fact
❑ Trustee
Guardian or Conservator
Other
Right Thumbprint
M
SULLY - MILLER CONTRACTING COMPANY
who proved to me on the basis of satisfactory evidence to
be the person(s) whose name 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
�ti;h JJ DANIELS
which the person(s) acted, executed the instrument.
COMM # 1989544 a
Notary Public z
I certify under PENALTY OF PERJURY under the laws of
ORANGE COUNTY
tea, A7y Commiuron BWlres Sept.14, 201fi
the State of California that the foregoing paragraph is true
.«
and correct.
WITNESS my hand and fficial Seal
Signature
J. Mniels, Notary Public
Notary Seal
OPTIONAL
Description of Attached Document
Title or Type of Document:
, oli
Document Date: May 15 2013 Number of Pages:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s):
Signer's Name Raymond Sanchez Signers Name
Individual
corporate Officer — Title(s)
Partner — Limited /General
E] Attorney In Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other
Signer is Representing
Individual
1
Assistant Secretary F corporate Officer — Title(s)
Right Thumbprint
of Signer
Partner — Limited /General
Attorney In Fact
❑ Trustee
Guardian or Conservator
Other
Right Thumbprint
M
SULLY - MILLER CONTRACTING COMPANY
CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT
State of California
County of Orange
MAY 15 2013
On before me, Julia Hien Nguyen Notary Public
DATE NAME, TITLE OF OFFICER - E.G., "JANE DOE, NOTARY PUBLIC"
personally appeared Victoria M Campbell , who
proved to me on the basis of satisfactory evidence to be the person(s) whose names (s) is /are
subscribed to the within instrument and acknowledged to me that tae /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.
JULIA HIEN NGUYEN
Commission a 2006350 WITNESS my hand and official seal.
i -: Notary Public • California i
= Orange County
M Comm. Ex Tres Feb 3. 2017 + ` Z �'
SIGNATURE OF NOTARY
OPTIONAL
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
TITLE(S)
❑ PARTNER(S) ❑ LIMITED
❑ GENERAL
® ATTORNEY -IN -FACT
❑ TRUSTEE(S)
❑ GUARDIAN /CONSERVATOR
❑ OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
DESCRIPTION OF ATTACHED DOCUMENT
TITLE OR TYPE OF DOCUMENT
NUMBER OF PAGES
MAY 15 2013
DATE OF DOCUMENT
SIGNER(S) OTHER THAN NAMED ABOVE
Liberty Mutual Insurance Company
BIDDER: Sully - Miller Contracting Comp
2.13 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 %) o €-the - Bidder's Total -Bid
Price, or, in the case of bids or offers for the construction of treets or highways, including
bridges, in excess of one -half of 1 percent of the Contractors 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 itwill 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
(greaterthan 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 -9
BIDDER: Sully - Miller Contracting Company
2.13 LIST OF PROPOSED SUBCONTRACTORS (continued)
Fouplicate Next 2 Pages if needed for listing additional subcontractors.
Name and Location Description of Work
of Subcontractor to be Subcontracted
C. I c) PIQ..e
Name:
Name and Location
of Subcontractor
Name: PC 1
Address: Lois R - Ck
Name and Location
of Subcontractor
Description of Work
to be Subcontracted
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Name: Cade I ,n �Ufucy r c�
Address: Qr9� Y C n
Name and Location
of Subcontractor
"
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Address:
Gtlobal �oa� Sea1�� -`�
Cx orcr5e_v. Gt ro.rC. , Gl�
Name and Location
of Subcontractor
Name:
Address: Co�ana_ GA�
Description of Work
to I& be Subcontracted
- rorx P r k
Description of Work
to be Subcontracted
(-00 �PS
Description of Work
to be Subcontracted
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CBF -10
BI DDER: Sully-Miller Contracting Company
2.0 REFERENCES
The following are the names, addresses and telephone numbers forthree public agencies for which BIDDER
has performed similar work Within the past two (2) years�
- "- --- * *Please See Attached List of Project References ** -- --
1.
Name and Address of Owner
Name and telephone number of person familiar with project
I
Contract amount Type of Work Date Completed
2.
Name and Address of Owner
Name and telephone number of person familiar with project
Contract amount
Date Completed
3.
Name and Address of Owner
Name and telephone number of person familiar with project
till
Contract amount Type of Work Date Completed
Address of Owner
Name and telephone number of person familiar with project
Contract amount Type of Work Date Completed
CBF - 11
SIJLiY- MILLER
CONTRACf[N<i CO.
BIDDER'S EXPERIENCE AND QUALIFICATIIONdS
Project Name /Number: Medford Street/ 10030C & 10128814
Year of Project. 11/2011 — 5/2012
Project Description: AC — CONCRETE — STRIPING - SIGNALS
Agency Name: LOS ANGELES COUNTY DEPARTMENT OF PUBLIC WORKS
Contact Person: FAHIM RAHIMI Telephone: 626- 458 -3112
Fax: 626- 458 -2197
Original Contract Amount: $1,961,576 Final Contract Amount: $1,893,032
Change in original contract amount is due to extra work and /or contract change orders adding work.
Project Name /Number: 2010/2011 ANNUAL WATERLINE & SLURRY SEAL JOB/ 11090C & 10128866
Start and Finish Dates: 5/2011 — 3/2012
Project Description: WATER LINE AND STREET IMPROVEMENTS
Agency Name: CITY OF LA HABRA
Contact Person: CHUCK STEPHAN Telephone: 562- 905 -7200
Original Contract Amount: $1,507,833 Final Contract Amount. $1,443,408
Change in contract amount is due to items of work being deleted by the agency.
Project Name /Number: TORRANCE BOULEVARD / 28791C
Year of Project: 10/2008 — 05/2010
Project Description: STREET RECONSTRUCTION & ARHM OVERLAY
Agency Name: CITY OF TORRANCE
Contact Person: BETH OVERSTREET Telephone: 310 - 618 -3074
Fax: 310 - 781 -6802
Original Contract Amount: $5,904,267 Final ContractAmount: $6,133,068
Change in original contract amount is due to extra work and /or contract change orders adding work.
Project Name /Number: LONG BEACH ANNUAL 2009 / 28810C
Year of Project: 01/2009 — 05 -2010
Project Description: AC /ARHM — CONCRETE — BASE — SIGNALS — SURVEY — STRIPING - LANDSCAPE
Agency Name: CITY OF LONG BEACH
Contact Person: CHARLES RAMEY Telephone: 562 -570 -5170
Fax: 562 -570 -5176
Original Contract Amount: $5,000,000 Final ContractAmount: $4,290,000
Annual Contract — work was done on an as needed basis.
Project Name/Number: LACMA PHASE II PAVILION PROJECT 28006 / 29820C
Year of Project:
Project Description:
Agency Name:
Contact Pcrson:
02/2009 — 04/2010
B PERMIT
MATT CONSTRUCTION CORPORATION
GREG WADE
Telephone: 562- 903 -2277
Fax: 562 -903 -2290
Updated August 2010
MUM
StJLLY-MILLER
CONTRACTING CO.
-- - -
--.-------BIDDER'S EXPERIENCE AND QUALIFICATIONS
Original Contract Amount: $92,507 Final Contract Amount: $420,000
Change in original contract amount is due to extra work and /or contract change orders adding work.
Project Name /Number: LA SOUTHWEST COLLEGE — PARKING LOT 3 / 28795C
Year of Project: 09/2008 — 01/2010
Project Description: AC — BASE — CONCRETE — STRIPING
Agency Name: CHEVRON ENERGY SOLUTIONS.
Contact Person: STEVE'PELASYED Telephone: 714 -577 -1374
Fax: 714 -577 -1330
Original Contract Amount: $1,120,315 Final Contract Amount:
Change in original contract amount is due to extra work and /or contract change orders adding work.
Project Name /Number: 2007 -2008 PAVEMENT REHABILITATION- 28750C
Start and Finish Dates: 6/2008 TO 7/2008
Project Description: AC /ARHM — MANHOLES — SURVEY — STRIPING — COLD MILL
Agency Name: CITY OF HAWAIIAN GARDENS
Contact Person: STEVE STEINBRECHER Telephone: 562- 908-6200
Fax: 562- 695 -2120
Original Contract Amount: $451,112 Final Contract Amount: $456,287
Change in original contract amount is due to extra work and /or contract change orders adding work.
Project Name/Numb&: ' STREET PAVING PROGRAM- 28735C
Start and Finish Dates: 3/2008 TO 5/2008
Project Description: ARHM — MANHOLES — MONUMENTS — STRIPING — SWPPP- COLD MILL
Agency Name: CITY OF WEST HOLLYWOOD
Contact Person: MILA SOLOGUB Telephone: 323 - 848 -6338
Fax: 323 - 848 -6564
Original Contract Amount: $340,986 Final Contract Amount: $315,916
Change in contract amount is due to items of work being deleted by the agency.
Project Name /Number: THE LACMA TRANSFORMATION PROJECT- 27662C
Start and Finish Dates: 6/2007 TO 4/2008
Project Description: B PERMIT
Agency Name: MATT CONSTRUCTION CORPORATION
Contact Person: GREG WADE Telephone: 562- 903 -2277
Fax: 562- 903 -2290
Original Contract Amount: $912,402 Final Contract Amount: $1,363,596
Change in original contract amount is due to extra work and /or contract change orders adding work.
Project Name /Number:
Start and Finish Dates:
Project Description:
CA T ALINA MEDIA / THE POINTE- 27732C
1/2008 TO 3/2008
SEWER MAIN INSTALLATION
Updated August 2010
SULLY- MILLER
CONTRAC CO-
BIDDER'S EXPERIENCE AND QUALIFICATIONS
Agency Name: KRISMAR CONSTRUCTION COMPANY, INC.
Contact Person: GARY MORRISON Telephone: 310 - 458 -3170
ax: - - - - --
Original Contract Amount: $315,955 Final Contract Amount: $411,955
Change in original contract amount is due to extra work and /or contract change orders adding work.
Project Name /Number: PACIFIC ELECTRIC INLAND TRAIL PHASES 2 & 3 if 27653C
Start and Finish Dates: 3/07 TO 1/08
Project Description:
R/R CONCRETE /AC - LANDSCAPE /IRRIGATION - SIGNALS
- STRIPE - UTILITIES
Agency Name:
CITY OF RANCHO CUCAMONGA
GEORGE CASTILLO Telephone: 562- 682 -3620
Contact Person:
WALTER STICKNEY Telephone:
909 - 477 -2740
$135,000 Final Contract Amount: $167,074
Fax:
909- 477 -2746
Original Contract Amount:
$3,424,781 Final Contract Amount:
$3,424,780
Change in original contract amount is due to extra work and /or contract change orders adding work.
Project Name /Number:
MARQUARDT AVENUE / 27689C
CITY OF LA MIRADA
Start and Finish Dates:
7/2007 TO 9/2007
Project Description:
R/R CONCRETE - AC ON FABRIC - ADJUST UTILITIES
$2,164,089 Final Contract Amount: $2,575,166
Agency Name:
LOS ANGELES COUNTY DEPT. OF PUBLIC WORKS
CSULB PARKING LOT 13 REPAIR - REPAVE / 27694C
Contact Person:
EMILKURLYAND Telephone:
626 -458 -3166
AC GRIND / OVERLAY - ASPHALT REPAIR - MINOR CONCRET E REPAIR
Fax:
626- 458 -2197
Original Contract Amount:
$183,915 Final Contract Amount:
$183,915
Project Name /Number: ALPACA STREET IMPROVEMENT PROJECT / 27699C
Start and Finish Dates: 8/2007 TO 11/2007
Project Description:
R/R CONCRETE & ASPHALT - STRIPING - ADJUST UTILITIES
Agency Name:
CITY OF SOUTH EL MONTE
Contact Person:
GEORGE CASTILLO Telephone: 562- 682 -3620
Fax: 562- 684 -0130
Original Contract Amount:
$135,000 Final Contract Amount: $167,074
Change in original contract amount is due to extra work and /or contract change orders adding work.
Project Name /Number:
REHABILITATION OF LA MIRADA BLVD. if 27664C
Start and Finish Dates:
5/2007 TO 9/2007
Project Description:
ARHM / AC PAVING, CONCRETE WORK - LOOP DETECTORS / SIGNALS
Agency Name:
CITY OF LA MIRADA
Contact Person:
GARY SANUI Telephone: 562- 943 -2385
Fax: 714 -522 -5800
Original Contract Amount:
$2,164,089 Final Contract Amount: $2,575,166
Change in original contract amount is due to extra work and /or contract change orders adding work.
Project Name /Number:
CSULB PARKING LOT 13 REPAIR - REPAVE / 27694C
Start and Finish Dates:
7/2007 TO 8/2007
Project Description:
AC GRIND / OVERLAY - ASPHALT REPAIR - MINOR CONCRET E REPAIR
Updated August 2010
SULLY- MIIA,FR
CON1"RA(7 TINC: CO.
BIDDER'S EXPERIENCE AND QUALIFICATIONS
Agency Name: CALIFORNIA STATE UNIVERSITY, LONG BEACH
! nnfart Persnn• FNRTTnIIF RnRI FS TelenhnnP- 562 -9R5 -4175
Fax: 562- 985 -2308
Original Contract Amount: $375,823 Final Contract Amount: $380,572
Change in original contract amount is due to extra work and /or contract change orders adding work.
Project Name /Number: ORANGE LINE — CANOGA STATION PARK AND RIDE / 25568C
Start and Finish Dates: 3/2006 TO 1/2007
Project Description: NEW TRANSPORTATION STATION INCLUDING AC PAVING &CONCRETE WORK
Agency Name: METROPOLITAN TRANSPORATION AUTHORITY
Contact Person: GHULAM SHAIKH Telephone: 818- 262 -6300
Fax: 213- 922 -7384
Original Contract Amount: 13,732,500 Final Contract Amount. $12,415,392
Change in Contract amount is due to items of work being deleted by the agency.
Project Name /Number: SOUTH COAST PLAZA PARKING LOT/26608C
Start and Finish Dates: 7/2006 TO 10/2006
Project Description: COMPLETE REMOVE AND REPLACE OF PARKING LOT, CONCRETE CURB &
GUTTER, LOOP DETECTORS, AND STRIPING
Agency Name: SOUTH COAST PLAZA
Contact Person: ROBERTTHOMAS Telephone: 714 -546 -0110
Fax: 714 -546 -9835
Original Contract Amount: $3,100,009 Final ContractAmount: $3,932,226
Change in original contract amount is due to extra work and /or contract change orders adding work.
Project Name /Number: RESIDENTIAL STREET REHABILITATION WORK / 26573C
Start and Finish Dates: 2/2006 to 8/2006
Project Description: ASPHALT CONCRETE OVERLAY AT VARIOUS LOCATIONS CITYWIDE
Agency Name: CITY OF WEST COVINA
Contact Person: OSCAR CAPLIN Telephone: 626- 939 -8445
Fax: 626- 939 -8660
Original Contract Amount: $1,430,888 Final Contract Amount: $1,512,463
Change in original contract amount is due to extra work and /or contract change orders adding work.
Project Name /Number: BERTH 401 -406 BACKLAND IMPROVEMENTS / 25567C
Start and Finish Dates: 1/2006 to 4/2006
Project Description: ASPHALT AND CONCRETE PAVING / SITE IMPROVEMENT PROJECT
Agency Name: PORT OF LOS ANGELES
Contact Person: KEN HARBOR Telephone: 310- 831 -5389
Fax: 310 - 831 -5389
Original Contract Amount: $3,286,800 Final Contract Amount: $3,386,333
Change in original contract amount is due to extra work and /or contract change orders adding work.
Project Name /Number: 195 STREET IMPROVEMENT / 25506C
Updated August 2010
STJLIY- MILLER
CONTRAC, TINC: C(->.
BIDDER'S EXPERIENCE AND QUALIFICATIONS
Start and Finish Dates: 5/2005 to 11/2005
Project Description:
MEDIAN ISLAN and S TREET REPAIRS
Agency Name:
CITY OF CERRITOS
Contact' Person:
VIC MASAYA Telephone: 562- 916 -1231
Fax: 562- 916 -1371
Original Contract Amount:
$862,370 Final Contract Amount: $742,488
Project Name /Number:
MALL PARKING LOT IMPROVEMENTS / 25492C
Start and Finish Dates:
3/2005 to 10/2005
Project Description:
REPAIR and PLACE NEW AC PAVING and STRIPE PARKING STALLS
Agency Name:
CITY OF TEMPLE CITY
Contact Person:
JANICE STROUD Telephone: 626 -285 -2171
Fax: 909 - 594 -2858
Original Contract Amount:
$828,837 Final Contract Amount: $894,012
Change in original contract amount is due to extra work and /or contract change orders adding work.
Change in contract amount
is due to items of work being deleted by the agency.
Project Name /Number:
HELLMAN AVENUE STREET IMPROVEMENTS / 24477C
Start and Finish Dates:
6/2004 to 11/2005
Project Description:
STREET RECONSTRUCTION PROJECT
Agency Name:
CITY OF ROSEMEAD
Contact Person:
KEN RUKABINE Telephone: 562- 908 -6262
Fax: 562- 695 -2120
Original Contract Amount:
$1,051,667 Final Contract Amount: $1,067,429
Change in original contract amount is due to extra work and /or contract change orders adding work.
Project Name /Number:
HOLGATE AREA STREET REHABILITATION AND WATER MAIN / 24446C
Start and Finish Dates:
3/2004 to 6/2005
Project Description:
STREET REHABLITATION AND WATER MAIN REPLACEMENT
Agency Name:
CITY OF LA HABRA
Contact Person:
CHUCK STEPHAN Telephone: 562- 905 -9720
Fax: 562- 905 -9643
Original Contract Amount:
$2,996,461 Final Contract Amount: $3,566,942
Change in original contract amount is due to extra work and /or contract change orders adding work.
Project Name /Number:
PIER 400 BACKLANDS PHASE 2 / 23301C
Start and Finish Dates:
4/2003 to 8/2004
Project Description:
TRANSTAINER FACILITY, GRADING, PAVING, UNDERGROUND, CONCRETE.
PROJECT FINISHED ON TIME — EXTRA DAYS FOR EXTRA WORK ONLY
Agency Name:
PORT OF LOS ANGELES
Contact Person:
MAHMOUD IRSHEID Telephone: 310- 732 -3525
Fax: 310- 831 -5389
Original Contract Amount:
$30,618,798 Final Contract Amount: $30,030,429
Change in contract amount'
is due to items of work being deleted by agency.
Project Name/Number:
PHANTOM WEST STREET IMPROVEMENT / 82803C
Updated August 2010
5
SULLY- MILLER
C0NTRAC "1'ING CO.
BIDDER'S EXPERIENCE AND QUALIFICATIONS
Start and Finish Dates: 12/ 2002 to 8/ 2003
Agency Name:
CITY OF VICTORVILLE
Contact Person:
MARK MILLER Telephone: 760 - 955 -9158
Fax: 760 - 955 -5159
Original Contract Amount:
$4,771,477 Final Contract Amount: $4,994,840
Project Name /Number:
ARROW HIGHWAY - LIVE OAK AVENUE PHASE II / 22273C
Start and Finish Dates:
11/ 2002 to 8/ 2003
Project Description:
AC GRIND OVERLAY — NEW MEDIANS & DECORATIVE CONCRETE
Agency Name:
CITY OF IRWINDALE
Contact Person:
KWOK TAM Telephone: 626 - 430 -2212
Fax: 626- 962 -2018
Original Contract Amount:
$4,289,147 Final Contract Amount: $4,654,815
Change in original contract
amount is due to extra work and /or contract change orders adding work.
Change in original contract
amount is due to extra work and /or contract change orders adding work.
Project Name /Number:
PIER 400 CONTAINER TERMINAL / 21130C
Start and Finish Dates:
1/ 2001 to 9/ 2002
Project Description:
BACKLAND IMPROVEMENTS, PHASE I
Agency Name:
PORT OF LOS ANGELES
Contact Person:
MAHMOUDISHEID Telephone: 310 -732 -3525
Fax: 310 - 831 -5389
Original Contract Amount:
$78,134,500 Final Contract Amount: $74,226,254
Change in contract amount
is due to items of work being deleted by agency.
Updated August 2010 6
BIDDER: Sully - Miller Contracting Comp
SECTION 3
NON- COLLUSION AFFIDAVIT
CBF -12
BIDDER: Sully - Miller Contracting Company
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 genu ine and not collusive or sham; that the bidder has not directly or indirectly induced
- " or solicited any other bidderfo putiira false or §hani bid, and has hilt directly orihdlrectly'
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 tg any member or agent
thereof to effectuate a collusive or sham bid. n h A
Raymond Sanchez
Typed or Printed Name
Assistant Secretary
Title
Su - Miller Contracting Company =' }
Bidder
Subscribed and sworn before me
This _day of 20_
(Seal)
Notary Public in and for
the State of California
My Commission Expires:
Please see attached loose certificate
with proper California Notary wording.
CBF -13
STATE OF CALIFORNIA
COUNTY OF ORANGE
Subscribed and sworn to (or affirmed) before me on this 17 day of May 2013, by Raymond
Sanchez proved to me on the basis of satisfactory evidence to be the person who appeared
before me.
.. » N1
COMM ri 7989544 a
Notary Public - Californian WITNESS my hand and official seal
a Vn+rw, ORANGE COUNTY
.....�:..r My Commm=Expkes5ept.14, 1076 W
I Signature Qf/ y�
J. 136niels, Notary Public
Notary Seal
OPTIONAL
Description of Attached Document
Title or Type of Document: Non - Collusion Affidavit
Document Date: May 17, 2013
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s):
Signer's Name Raymond Sanchez Signer's Name
❑ Individual ❑ Individual
[X Corporate Officer — Title(s)
Partner — Limited /General
Attorney In Fact
Trustee
❑ Guardian or Conservator
❑ Other
Assistant Secretary ❑ Corporate Officer— Title(s)
Right Thumbprint
Number of Pages:
I
Partner — Limited /General
Attorney In Fad
Trustee
Guardian or Conservator
❑ Other
Right Thumbprint
of Signer
Signer is Representing: SULLY - MILLER CONTRACTING COMPANY