California Professional Engineering Inc. CITY OF ROSEMEAD
TRAFFIC SIGNAL IMPROVEMENTS PROJECT
MISSION DRIVE AND WALNUT GROVE AVENUE
CONTRACT BID FORMS
BIDDER: `. ` `. .•
ngineering, Inc.
CONTRACT BID FORMS
TABLE OF CONTENTS
SECTION 1 BID SCHEDULE 1
SECTION 2 BID DATA FORMS 5
2.A BID BOND 6
2.B LIST OF PROPOSED SUBCONTRACTORS 7
SECTION 3 NON-COLLUSION AFFIDAVIT 10
CBF - 12
California Professional Engineering, Inc,
\1.N
BIDDER:
SECTION 1 - BID SCHEDULE
CBF - 1
BIDCif® �' ' r nc,
BID SCHEDULE
SCHEDULE OF PRICES FOR
TRAFFIC SIGNAL IMPROVEMENTS PROJECT
MISSION DRIVE AND WALNUT GROVE AVENUE
BASE BID SCHEDULE
UNIT OF EST. UNIT ITEM
NO. ITEM DESCRIPTION MEASURE QTY. PRICE COST
1 Clearing & Grubbing per plans LS 1 1
and specifications. 11- coo
2 Disposal of Waste Materials. LS 1 �VtJ� $. IUD
3 Construct Traffic Signal LS 1
Improvements at Mission Drive UU�aqq g7,60
and Walnut Grove Project per
Plans and Specifications
Complete.
TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ � , 1O1 `19
A;AJ-- I ' 4(5 n; .� k? fed & . i sew dDuos avid ✓ /LP-
Dollar a ount in written form
Note: The City of Rosemead reserves the right to reduce or increase the quantities of any items in
the schedule of bid items above, within the limits define in Section 3-2.2.1 of the Standard
Specifications, to stay within the budgeted amount of this project.
If the Bid Documents specify alternate bid items, the following Alternate Bid amounts shall
be added to or deducted from the Total Bid Price entered above. The owner can choose to
include one or more of the alternates in the Total Bid Price of the Project. If any of the
Alternate Bids are utilized by the Owner,the resulting amount shall be considered the Total
Bid Price for the Project.
The undersigned agrees that these Contract Bid Forms constitute a firm offer to the Owner which
cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and
after the bid opening date, or until a Contract for the Work is fully executed by the Owner and a third
party, whichever is earlier. The undersigned also agrees that if there is a discrepancy between the
written amount of the Bid Price and the numerical amount of the Bid Price, the written amount shall
govern.
Attached hereto is a certified check, a cashier's check or a id bond in the amount of
c. Dollars ($ ) said amount being not less than t rce t(10%) of the Total
Bid rice. 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.
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BIDDF�f I• -; _• eering, Inc.
If awarded a Contract, the undersigned agrees to execute the formal Contract, which will be
prepared by the Owner for execution,within five(5)Calendar Days following the Letter of Award for
the Contract, and will deliver to the Owner within that same period the necessary original Certificates
of Insurance, Endorsements of Insurance, Performance Bond, Payment Bond and all other
documentation and certification required by the Contract.
The undersigned offers and agrees that if this bid is accepted, it will assign to the purchasing body
all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton
Act (15 U.S.C. Section 15) or under the Cartwright Act (Chapter 2 of Part 2 of Division 7 of the
Business and Professional Code), arising from purchases of goods, materials or services by the
Bidder for sale to the purchasing body pursuant to the bid. Such assignment shall be made and
become effective at the time the purchasing body tenders final payment to he Contractor.
Bidder understands and agrees that, when requested by Owner, he shall provide: (1) evidence
satisfactory to the Owner of Bidder's California contractor's license(s)in good standing; (2)evidence
that the person signing this Bid is authorized to bind Bidder to this Bid and to a contract resulting
therefrom; and (3) any other information and documentation, financial or otherwise, needed by
Owner to award a Contract to the lowest responsible and responsive bidder.
Bidder understands and agrees that liquidated damages shall apply to this Contract in the amounts
of five hundred dollars ($500.00) if project is not completed in THIRTY (30) calendar days. The
Contract Time will begin to run ten (10) Working Days from the date of the Notice of Proceed and
subject to the terms and conditions described in the Contract Form and the Contract Documents.
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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BlpbEfifornia Professional Engineering, Inc.
By: ct9 O Y 7 ale LAM e'
Signature 1 Business Street Address
Van Nguyen 1,01 ente t
Type or Print Name City, State and Zip Code
President C(p94)C0110-13b
Title Telephone Number
Bidder's/Contractor's State of Incorporation: ebb-C-0'1 i\
Partners or Joint Venturers:
Bidder's License Number(s): 7_`( 7
Department Industrial Relations
Registered No. _ I 000W\ COO
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,
partnership or joint venture has the authority to do so.
CBF -4
•
•
California Professional Engineering, Inc.
( ucthtp oepand C.-1..xpectalians
MEETING OF BOARD OF DIRECTORS
OF
CALIFORNIA PROFESSIONAL ENGINEERING, INC.
A meeting of the Board of Directors of California Professional Engineering, Inc. was
held on May 13,2015 whereby a resolution was passed authorizing
Van Nguyen to sign on behalf of the Corporation,by his signature,to enter into any and
all contractual obligations on behalf of this corporation.
Presi•ent
See attached jurat.
9316 Mabel Avenue South El Monte,CA 91733 0 Ph: (626)452-8658 0 Fax: (626)448-0470 0 Email: van*cpengineeringinc.com
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate
is attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Los Angeles
Subscribed and sworn to (or affirmed) before me on this 13th
day of May , 20 15 , by Van Nguyen
proved to me on the basis of satisfactory evidence to be the
person(s) who appeared before me.
,:f" ;; DIEM CHU
41r,tf:r?i"i OMM,# 204213 rn N NOARY PUBUG CALIORNIA (n v I k LOS ANOtLE8 COUNTY
MY CPO EXR 8EP 21,2011"6 S,- `
(Seal) Signature - l.: v\
WAIVER OF NOTICE AND CONSENT
TO HOLDING OF FIRST MEETING OF
INCORPORATORS AND DIRECTORS OF
CALIFORNIA PROFESSIONAL ENGINEERING INC.
A California Corporation
•
We, the undersigned, being all of the incorporators, first
directors and/or the directors named in the Articles of
Incorporation of the above-named California corporation duly
foirned by the filing of said Articles of Incorporation in the
office of the California Secretary of State on August 18, 2000,
and desiring to hold the first meeting of the Incorporators and
Directors of said corporation for the purpose of completing the
organization of its affairs, DO HEREBY WAIVE NOTICE of said
meeting, and CONSENT to the holding thereof at 9316 Mabel
Avenue, South El Monte, California 91733, on October 1, 2000, at
10: 00 a.m. of said day, for the purpose of adopting Bylaws,
electing directors and officers, adopting a form of corporate
seal and share certificate, authorizing a notice of the
California Commissioner of Corporations that stock has been
issued in compliance with all the terms and conditions of
. Section 25102. of the California Corporations Code, or the filing
of an application for a permit, as the case may be, with said
office, and transacting such other business as may be brought
before said meeting; and do hereby further agree that any
business transacted at said meeting shall be as valid and legal
and of the same force and effect as though said meeting were
held after notice duly given.
WITNESS our signatures this day, October 1, 2000.
Van Nguyen, �Ircorporator
•
MINUTES
- 1 -
•
MINUTES OF FIRST ORGANIZATIONAL MEETING
OF INCORPORATORS AND DIRECTORS OF
CALIFORNIA PROFESSIONAL ENGINEERING INC.
A California Corporation
. The undersigned, being the Incorporator named in the
Articles of Incorporation of the above-named California
corporation, duly formed by the filing of said Articles of
Incorporation in the office of the California Secretary of State
on August 18, 2000, and desiring to hold the first
organizational meeting for the purpose of completing the
organization of its affairs, in accordance with the powers
conferred upon Incorporators by Section 210 of the General
Corporation Law, held such meeting at 9316 Mabel Avenue, South
El Monte, California 91733, on October 1, 200.0, at 10: 00 a.m. of
said day.
Present at this session of the meeting: Van Nguyen, being
the Incorporator of said corporation named in its Articles of
Incorporation.
On motion and by unanimous vote, Van Nguyen was elected
temporary Chairperson and temporary Secretary of the meeting.
ARTICLES OF INCORPORATION FILED
The Temporary Chairperson stated that the originai Articles
of Incorporation of the corporation had been filed in the office
of the California Secretary of State, and had been assigned the
following filing date and State Corporation filing number:
Filing Date: August 18, 2000
Official Filing Number: 2196373
The Temporary Chairperson then presented to the meeting a
certified copy of said Articles of Incorporation, showing
filings as stated and the Temporary Secretary was directed to
insert said copy in the Book of Minutes of the corporation.
MINUTES
- 2 -
BYLAWS
•
The matter of the adoption of Bylaws for the regulation of
the affairs of the corporation was next considered. The
temporary secretary presented to the meeting a form of Bylaws
which were duly considered and discussed. On motion duly made
and unanimously carried, the following resolutions were adopted:
RESOLVED: That the Bylaws presented to this meeting
and discussed thereat be, and the same hereby are,
adopted as and for Bylaws of this corporation.
RESOLVED FURTHER: That the temporary secretary of '-}!is
corporation be and hereby is authorized and directed
to execute a certificate of the adoption of said
Bylaws and to insert said Bylaws as so certified in
the Book of Minutes of this corporation, and to see
that a copy of said Bylaws, similarly certified, is
kept at the principal office for the transaction of
business of this corporation, in accordance with
Section 213 of the California Corporations Code_
ELECTION OF DIRECTORS
The temporary Chairperson stated that the Bylaws adopted by
the Corporation provide that the number of Directors shall be
one (1) .
The temporary Chairperson advised that the Inco orator, on
motion and by unanimous vote, had elected the following person
as the first Directors of the Corporation to serve until
successors are duly elected pursuant to the Bylaws, or until
resignation or removal, as the case may be, and effective upon
their acceptance of their position, to exercise the powers of
further organization and direction of the Corporation. Each of
the newly elected Directors signified acceptance:
DIRECTOR'S NAME AND ADDRESS SIGNATURE =;'u
Van Nguyen
2574 S. Pepperdale Drive \ � 4 i
2z7i)
Rowland Heights, CA 91748 €�
•
MINUTES
- 3 -
RESIGNATION OF INCORPORATOR
The meeting continued. Present at this session of said
meeting, in addition to the Incorporator were Van Nguyen, the
Director duly elected herein. In the interests of maintaining
continuity of action, the Director waived notice of said
organizational meeting, took his place and the meeting then
proceeded further.
The temporary. Chairperson advised that the Incorporator,
having completed the necessary steps in organizing the
Corporation and having elected the appropriate number of
Directors to carry forward the management of the Corporation,
now wished to submit his resignation:
The undersigned Incorporator herewith resigns:
•
f 1 Van Nguyen
1r
The temporary Chairperson stated that thei` Incorporator' s
tasks had now been accomplished and upon motion duly made and
recorded, said resignation. was accepted.
WAIVER
•
The temporary. Chairperson announced that the meeting was
` ;. held pursuant to written Waiver of Notice and Consent thereto
and was signed by all of the participants and upon motion made
and unanimously carried, was made a part of the records of the
meeting, and now precedes the minutes of this meeting in the
Book of Minutes of the corporation.
ELECTION OF OFFICERS
The meeting then proceeded to the election of officers.
The following were duly elected to the offices indicated after
the names of each:
Van Nguyen, President
•
Van Nguyen, Secretary
Van Nguyen, Chief Financial Officer
•
Each officer so elected being present accepted his office,
and thereafter, the president presided at the meeting as
Chairperson, and the secretary acted as secretary of the
meeting.
CORPORATE SEAL
The secretary presented for approval of the meeting a
MINUTES
- 4 -
proposed seal of the corporation, consisting of two concentric
circles with the name of the corporation in one circle and the
words and figures in the form as follows :
(SEAL)
On motion duly made and unanimously carried, the following
resolution was adopted:
RESOLVED: That the corporate seal, in the forth, words
and figures presented to this meeting be, and the same
hereby is, adopted as the seal. of this corporation.
SHARE CERTIFICATE
The secretary presented to the meeting a proposed form of
share certificate for use by the corporation. On ?notion duly
made and unanimously carried, said form of share certificate was
approved and adopted, and the secretary was instructed to insert
a copy thereof in the Book of Minutes immediately following the
minutes of the meeting.
ORGANIZATIONAL EXPENSES
In order to provide for the payment of menses of
incorporation and organization of the corporation, on motion
duly made and unanimously carried, the following resolution was
adopted:
RESOLVED: That the President or Vice President and
the Chief Financial Officer of this corporation be,
and they hereby are authorized and directed to pay the
expenses of incorporation and organization of this
corporation.
ACCOUNTING YEAR
The Chairperson suggested that the meeting consider the
adoption of an accounting year, either fiscal or calendar, so
that the Franchise Tax Board could be notified thereof. On
motion duly made, seconded and unanimously carried, the
following resolution was adopted:
RESOLVED: That this corporation adopt an accounting
year as follows:
DATE ACCOUNTING YEAR BEGINS: November 1
DATE ACCOUNTING YEAR ENDS: October 31
MINUTES
- 5 -
PRINCIPAL OFFICE LOCATION
After some discussion, the location of the principal office
• of the corporation for the transaction of the business of the
corporation was fixed pursuant to the following resolution,
adopted, on motion duly made, seconded and unanimously carried:
RESOLVED: That 9316 Mabel Avenue, South El Monte,
California 91733 be and. the same hereby is designated
and fixed as the principal office for the transaction
of the business of this corporation in the State of •
California.
OFFICERS AUTHORIZED TO CONTRACT
To authorize the officers to contract and obligate the
corporation, in the ordinary course of business, the following
resolution was, upon motion duly made, seconded and carried,
adopted:
RESOLVED: That the following officers be, and the
same hereby are authorized to sign contracts and
obligations on behalf of the corporation:
Van Nguyen, President
•
MINUTES
- 6 -
BID .fornia Prnfpccinnpl Engineering, Inc.
SECTION 2
BID DATA FORMS
CBF - 5
California Professional Engineering, Inc. dba
BIDDER: California Professional Electrical Engineering
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:
THATCalifornia Professional Engineering, Inc. dba California Professional Electrical Engineeringas
Principal, and The Hanover Insurance Company
, as Surety, are held firmly bound unto the
CITY OF ROSEMEAD (hereinafter called the OWNER) in the sum of
Ten Percent of Bid Amount
DOLLARS
($ 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 TRAFFIC SIGNAL IMPROVEMENTS PROJECT AT MISSION
DRIVE AND WALNUT GROVE AVENUE as set forth in the Notice Inviting Bids and
accompanying Bid Documents, dated May 13,2015
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 6• day of May , 20 15 .
California Professional Engineeri •, c. dba
... . .I i.;.•.. - • • -- -i. (SEAL) The Hanover Insurance Company(S • if
Principal Farr Sure
/
By: By:
Signature 'I Sign. Ire Yung T. Mulli ,Attorney-in-Fact
CBF -6
CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the individual who signed
the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that
document.
STATE OF CALIFORNIA
COUNTY OF Los Angeles
On May 13,2015 before me, Diem Chu Notary
Public,
Date (here insert name and title of the officer)
personally appeared Van Nguyen
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same
in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument
the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the
foregoing paragraph is true and correct.
WITNESS my hand and official seal.
_ DIEM CHU l<
'n - +��+ C0MM. 2042313 rn
Y! ZnO NOTARYPUBLIC-CALIFORNIA (n
� V� � LOS ANGELES COUNTY
MY COMM EXP,BEP 21,2017
Signahird: � r
OPTIONAL
Description of Attached Document
Title or Type of Document: Number of Pages:
Document Date: Other:
2015 Apostille Service.707-992-5551 www.CaliforniaApostille.us California Mobile Notary Network www.CAMNN.com
•
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
STATE OF CALIFORNIA
County of Orange
On May 6, 2015 before me, Christine T. Hoang , Notary Public,
Date Insert Name of Notary exactly as it appears on the official seal
personally appeared Yung T. Mullick
Name(s)of Signer(s)
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
CHRISTINE T.HOANG person(s), or the entity upon behalf of which the person(s)
`�5 `1`;a COMM.#2008757 :a acted, executed the instrument.
N
� o
.� >.�..• NOTARY PUBLIC•CALIFORNIA� I certify under PENALTY OF PERJURY under the laws of
. ORANGE COUNTY N the State of California that the foregoing paragraph is true
V MY COMM.EXP.FEB 25,2017 and correct. g g p g ra p
Witness my hand anz o icial seal.
Signature
Place Notary Seal Above Sign. ure of Nota Public Christine T. Hoang
OPTIONAL —
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 the form to another document.
Description of Attached Document
Title or Type of Document:
Document Date: Number of Pages:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
❑ Individual ❑ Individual
❑ Corporate Officer—Title(s): ❑ Corporate Officer —Title(s):
❑ Partner ❑Limited ❑General ❑ Partner ❑Limited❑General
❑ Attorney in Fact RIGHT THUMBPRINT ❑ Attorney in Fact RIGHT THUMBPRINT
❑ Trustee OF SIGNER ❑ Trustee OF SIGNER
❑ Guardian or Conservator Top of thumb here ❑ Guardian or Conservator Top of thumb here
❑ Other: ❑ Other:
Signer is Representing: Signer is Representing:
THE HANOVER INSURANCE COMPANY
MASSACHUSETTS BAY INSURANCE COMPANY
CITIZENS INSURANCE COMPANY OF AMERICA
POWERS OF ATTORNEY
CERTIFIED COPY
KNOW ALL MEN BY THESE PRESENTS: That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY,both
being corporations organized and existing under the laws of the State of New Hampshire, and CITIZENS INSURANCE COMPANY OF AMERICA, a
corporation organized and existing under the laws of the State of Michigan,do hereby constitute and appoint
James W.Moilanen,Yung T.Mullick,and/or Jennifer C.Anaya
of Mission Viejo,CA and each is a true and lawful Attorney(s)-in-fact to sign,execute,seal,acknowledge and deliver for,and on its behalf,and as its act and
deed any place within the United States, or, if the following line be filled in, only within the area therein designated any and all bonds, recognizances,
undertakings,contracts of indemnity or other writings obligatory in the nature thereof,as follows:
Any such obligations in the United States,not to exceed Ten Million and No/100($10,000,000)in any single instance
and said companies hereby ratify and confirm all and whatsoever said Attorney(s)-in-fact may lawfully do in the premises by virtue of these presents.
These appointments are made under and by authority of the following Resolution passed by the Board of Directors of said Companies which resolutions
are still in effect:
"RESOLVED,That the President or any Vice President,in conjunction with any Vice President,be and they are hereby authorized and empowered to appoint
Attorneys-in-fact of the Company,in its name and as its acts,to execute and acknowledge for and on its behalf as Surety any and all bonds,recognizances,
contracts of indemnity,waivers of citation and all other writings obligatory in the nature thereof,with power to attach thereto the seal of the Company. Any
such writings so executed by such Attorneys-in-fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the
regularly elected officers of the Company in their own proper persons."(Adopted October 7,1981-The Hanover Insurance Company;Adopted April 14,1982
-Massachusetts Bay Insurance Company;Adopted September 7,2001-Citizens Insurance Company of America)
IN WITNESS WHEREOF,THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS INSURANCE
COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals,duly attested by two Vice Presidents,
this 3rd day of January 2012.
THE HANOVER INSURANCE COMPANY
MASSACHUSETTS BAY INSURANCE COMPANY
CITIZENS S RANCE COMPANY OF AMERICA
✓
tora t ; ) toga
Robert Thomas.Vice President
THE COMMONWEALTH OF MASSACHUSETTS )
COUNTY OF WORCESTER )ss. Joe$ri nstram. iY ce President
On this 3rd day of January 2012 before me came the above named Vice Presidents of The Hanover Insurance Company,Massachusetts Bay Insurance
Company and Citizens Insurance Company of America,to me personally known to be the individuals and officers described herein,and acknowledged that
the seals affixed to the preceding instrument are the corporate seals of The Hanover Insurance Company,Massachusetts Bay Insurance Company and
Citizens Insurance Company of America,respectively,and that the said corporate seals and their signatures as officers were duly affixed and subscribed to
said instrument by the authority and direction of said Corporations.
oT BARBARA A.GARLICK
Notary Pubke
1e, CemmxlweaM+ofMassachusMs •� `.h� ��cr.!t�
fN Comvn,sson Weis Sept.21,2cta
Barbara A.Garlick,Notary Public
My Commission Expires September 21,2018
I,the undersigned Vice President of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America,
hereby certify that the above and foregoing is a full,true and correct copy of the Original Power of Attorney issued by said Companies,and do hereby further
certify that the said Powers of Attorney are still in force and effect.
This Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of The Hanover Insurance Company,
Massachusetts Bay Insurance Company and Citizens Insurance Company of America.
"RESOLVED,That any and all Powers of Attorney and Certified Copies of such Powers of Attorney and certification in respect thereto,granted and executed
by the President or any Vice President in conjunction with any Vice President of the Company,shall be binding on the Company to the same extent as if all
signatures therein were manually affixed,even though one or more of any such signatures thereon may be facsimile." (Adopted October 7,1981-The
Hanover Insurance Company;Adopted April 14,1982-Massachusetts Bay Insurance Company;Adopted September 7,2001-Citizens Insurance Company
of America)
GIVEN under my hand and the seals of said Companies,at Worcester,Massachusetts,this 6TH day of MAY 20 15
THE HANOVER INSURANCE COMPANY
MASSACHUSETTS BAY INSURANCE COMPANY
CITIZENS INSURANCE COMPANY OF AMERICA
AtAr;txt.....
I n Margosian,Vice President
BID .forniaProfessional P.ngjneering, Inc.
2.B LIST OF PROPOSED SUBCONTRACTORS
In compliance with the "Subletting and Subcontracting Fair Practices Act," Sections 4100
through 4114 of the California Public Contract Code, and any amendments thereto, each
Bidder shall provide the information requested below for each subcontractor who will
perform work, labor or render service to Bidder in or about the construction of the Work in an
amount in excess of one-half of one percent (greater than 0.5 %) of the Bidder's Total Bid
Price, or, in the case of bids or offers for the construction of streets or highways, including
bridges, in excess of one-half of 1 percent of the Contractor's total bid or ten thousand
dollars ($10,000), whichever is greater, and shall further set forth the portion of the Work
which will be done by each subcontractor. Bidder shall list only one subcontractor for any
one portion of the Work.
Pursuant to Public Contract Code Section 4104, the Owner has determined that it will allow
Bidders twenty-four(24) additional hours after the deadline for submission of bids to submit
the information requested by the Owner about each subcontractor, other than the name and
location of each subcontractor.
If the Bidder fails to specify a subcontractor for any portion of the Work to be performed
under the Contract, it shall be deemed to have agreed to perform such portion itself, and
shall not be permitted to subcontract that portion of the Work except under the conditions
hereinafter set forth below.
Subletting or subcontracting of any portion of the Work in excess of one half of one percent
(greater than 0.5%)of the Total Bid Price or, in the case of bids or offers for the construction
of streets or highways, including bridges, in excess of one-half of 1 percent of the
Contractor's total bid or ten thousand dollars ($10,000), whichever is greater, for which no
subcontractor was designated in the original bid shall only be permitted in cases of public
emergency or necessity, and then only after Owner approval.
CBF - 7
a
BID
fornia Professional Engineering, Inc.
2.B LIST OF PROPOSED SUBCONTRACTORS (continued)
["Duplicate Next 2 Pages if needed for listing additional subcontractors."]
Name and Location Description of Work
of Subcontractor to be Subcontracted
Name: iCi RQ1'lT
Address: „„ '��re' =.MITlir '' I •, �,anOn IWe Dntwna V
License No.: i el 3.p fir 011107-
Department of Industrial Relation Registration No.1(0QO( (pli
Name and Location Description of Work
of Subcontractor to be Subcontracted
Name:
Address:
License No.:
Department of Industrial Relation Registration No.
Name and Location Description of Work
of Subcontractor to be Subcontracted
Name:
Address:
License No.:
Department of Industrial Relation Registration No.
Name and Location Description of Work
of Subcontractor to be Subcontracted
Name:
Address:
License No.:
Department of Industrial Relation Registration No.
Name and Location Description of Work
of Subcontractor to be Subcontracted
Name:
Address:
License No.:
Department of Industrial Relation Registration No.
CBF - 8
BI €prnia Professional Pngineering, Inc.
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. ctO1/4-1 oi-145 MICFARS omitt ore-Ric vo-v (ii- 6401100/4 1l-wi• !mac{W i A -,
Name and Address of Owner 09-,61110p
17Op
AM\ I. r1,0 re S � �-') 5-Name and telephone number of p on familiar with project
T. l 14(o31 453 . 9-92 YGafiC s)oii&A D1),30) 2D1 y-
Contrdct amount Type of Work ate Completed
2. ra OF braYll ye 3(30 , chaprYIc41) i-VP., orav o , CA .1'2b fo(o
Naille and Address of Owner
Model Unntc (1)'-1-)191-1 --.57535
Name and telephone numbbr of person familiar with project
412 I 7'1, 5d1. OD Muc1il-1 TYaffic c ii L 01130 .'W f
Contract amount Type of Work Date Com leted
3. Nil Ut 1)=N44 DI 11 L' 0(0o sit 1 re irve b.)vv 'Q.J, cal D2 Li)
Name and Address of Owner
2 tgi (i ) (DP's_5SP6
Name and telephone number of person familiar with project JA)
#' Imo, IL6'1. Tv v{ ✓Yad e -marine s'i krak �)3 c 2)3 vxi
Contract amount Type of Work Date Completed
1
4. Gil of lot tent2 1 7000 r rA4 f1 SA-. Lk WIL012. , CA .1 ) LH
i
Name and Address of Owner
Ilis)n !XOW 1 ,i,J,U c,n G(t - 102.2.2
Name and telephone number of rson familiar with project
P P 1
f6-0l,43 LI0 ,-7a) '1 J teal.; wop petecA--or 03 30)2)13
Contract amount Type of Work Dat Completed
I
i
I
CBF-9
I
i
BIDDEtWornia Professional Engineering, Inc.
SECTION 3
NON-COLLUSION AFFIDAVIT
CBF - 10
California Professional Engineering, Inc.
BIDDER:
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 deposito , or to any member or agent
thereof to effectuate a collusive or sham bid.
Signature
Van Nguye
Typed or Printed Name
President
Title
California Professional Engincuring9 Inc.
Bidder
Subscribed and sworn before me
This day of , 20
t (Seal)
Notary Public in and for
the State of California „52l
My Commission Expires:
CBF - 11
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate
is attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Los Angeles
Subscribed and sworn to (or affirmed) before me on this 13th
day of May , 20 15 , by Van Nguyen
proved to me on the basis of satisfactory evidence to be the
person(s) who appeared before me.
DIEM CHU
rA. CoMM.# 2042313 1n VI NOTARY PUBLIC-CALIFORNIA U1
All
LOS ANGELES COUNTY
�., MY COMM EXP SEP 21,2017
(Seal) Signature,