VasilJ Inc.BIDDER: VA IL J 14
SECTION 9 - BID SCHEDULE
CBF -1
BIDDER: �' `�) u ) ` I(-
BID SCHEDULE
SCHEDULE OF PRICES FOR
GARVEY AVENUE SEWER RELIEF LINE PROJECT
PROJECT No. 21845
BASE BID SCHEDULE
CBF -2
EST.
UNIT
ITEM
NO.
ITEM DESCRIPTION
UNIT
QTY.
PRICE
COST
1
Clearing & Grubbing per Plans and
Specifications. See Technical Provisions
LS
1
Pages TP -2 & TP -3 per Details.
2
Disposal of Waste Materials.
LS
1
r ji37517
3
Prepare a Storm Water Pollution
LS
1
--
Prevention Plan (SWPPP).
4
Traffic Control Plans prepared by a
LS
1
Registered Traffic Engineer.
5
Unclassified Excavation.
Cy
100
6
Remove and Dispose existing manhole
EA
3
including bedding, backfilling and Paving
per Plans and Specifications Complete.
7
Construct Extra Strength 15 -Inch
diameter Vitrified Clay Pipe (VCP)
LF
2,600
0
!
including bedding, backfilling and Paving
per Plans and Specifications Complete.
8
Construct 15 -Inch diameter Ductile Iron
LF
81
(DI) Sewer Pipe including pipe structure4"
support per SPPWC Std. Plan 224 -2,
bedding, backfilling and paving per Plans
and Specifications Complete
9
Remove and Dispose existing 8" Vitrified
Clay Pipe (VCP) sewer including pipe
LF
330
5 a
�d
4®
plugs, bedding, backfilling and Paving
per Plans and Specifications Complete.
10
Construct extra strength 8 -Inch diameter
Vitrified Clay Pipe (VCP) including
LF
176
bedding, backfilling and Paving per
Plans and Specifications Complete.
11
Construct Reinforced Precast Concrete
Manhole LACDPW Std. Plan 2003
EA
11
(O
f
per -2.
CBF -2
BIDDER: V " '�' � I
TOTAL BASE BID PRICE $ ter a
Dollar amount in written form
CBF -3
EST.
UNIT
ITEM
NO.
ITEM DESCRIPTION
UNIT
QTY.
PRICE
COST
12
Construct Drop Manhole per CSD Std.
EA
1
---
Plan S -a -205.
13
Install House Connection Remodeling
EA
41
J Z
1 � 9 ) Z
including pavement per SPPWC Std.
Plan 223 -2
14
House Lateral Replacement per SPPWC
*(approx.
EA
10
6
Std. Plan 222 -2. 25% of
existing laterals)
15
Construct Wye per LACDPW Std. Plan
EA
50
° �� b
2
S l
2024 -1.
16
Construct 72" Manhole Type "E" (case II)
LS
1
l
1 SUM
per CSD Std. Plan S -a -205. And detail
on sheet D1
17
Remodel and plug existing sewer
"A"
LS
1
manhole per detail on sheet D1
18
Remove existing and Construct
diameter RCP (2000 -D), including
LS
1
Z/
i
I�
concrete collars per SPPWC Std. Plan.
380-4, complete as shown on the plans
19
Sewer Flow Bypassing at all locations as
LS
1
��
7
shown on the plans.
20
Construct Terminal Cleanout Structure
EA
1
d
per SPPWC Std. Plan 204 -2
21
Abandon Existing Sewer. Fill with low
density cellular concrete (LDCC) or
LF
830
—
—
controlled low strength material (CLSM)
I
with min. compressive strength of
3000PSI @ 28day and plug ends
22
Provide temporary and permanent
EA
1
-°°�
�UL"
support for the 36" RCP Sewer per CSD
G_
Std. Plan S -a -222 and S -a -217.
Complete in place.
TOTAL BASE BID PRICE $ ter a
Dollar amount in written form
CBF -3
ALTERNATE BID ITEM 1
BARLETT AVENUE STREET RESURFACING
TOTAL ALTERNATE BID PRICE
Dollar amount in written form
TOTAL BASE & ALTERNATE BID PRICE
Ykt`W,Vrt1 Vwt v&e�
sr amount in written form
-0&v-e' d
$ v 1v1 4 L- I r .
$ 1 pp 2 L t�� - L
3.knlf AVV 11 LY4 Ll `vl SG h
UNIT
EST.
UNIT
ITEM
NO.
ITEM DESCRIPTION
CITY.
PRICE
COST
1
Cold mill 2.0- inches thick existing
SF
91,562
d ,
22, 0�c)
pavement.
2
Construct 2.0 inches thick pavement
TONS
1,170
overlay ARHM -GG -C (PG 64 -16) as
indicated on the plans.
3
Remove Existing, Dispose and
SF
1,200
t� r
6
Construct 4- inches thick PCC Sidewalk
per SPPWC Std. Plan 113 -1.
4
Remove Existing, Dispose and
EA
4
�j
G
Construct PCC Curb Ramps per
SPPWC Std. Plan 1114.
5
Remove Existing and Construct 6-
SF
200
Inches Thick Driveway Approach per
}
b
SPPWC Std. Plan 110 -2
6
Adjust Sewer Manhole to Grade per
EA
13
bbL)
SPPWC Std. Plan 205 -1 and 206 -1.
7
Install Survey Well Monument per City
EA
8
of Rosemead Std. Plan S08 -001. See
Section 2 -9 Surveying of the General
Provision -7 per details (Cover, Sleeve
& Dome will be provided by the City at
no cost).
8
Install Traffic Striping, Traffic Signal
LS
1
Loops and Pavement Markers per the
Striping Plans and Specifications
Complete.
9
Install 36 -Inch Box Parkway Tree Crape
"Muskogee"
EA
20�
Myrtle including 90 -days
maintenance period and tree wells per
SPPWC Std. Plan 520-4.
TOTAL ALTERNATE BID PRICE
Dollar amount in written form
TOTAL BASE & ALTERNATE BID PRICE
Ykt`W,Vrt1 Vwt v&e�
sr amount in written form
-0&v-e' d
$ v 1v1 4 L- I r .
$ 1 pp 2 L t�� - L
3.knlf AVV 11 LY4 Ll `vl SG h
BIDDER: VA(, i L, 3 `
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 bid bond 'n the amount of
i D ° ! o Dollars ($ said amount being not less than en 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 Ownerfor 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.
CBF -5
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.
l 9
By: ( C
Signature
BIDDER: VAS B L tk�(
Ag(1G%3
Business Street Address —�
Type or Print Name City, State and Zi Code
Telephone Number
Bidder's /Contractor's State of Incorporation: 61 f A
Partners or Joint Venturers:
Bidder's License Number(s): - 71 ) b
Department Industrial Relations a�}
Registered No.
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,
oartnershia or ioint venture has the authority to do so.
CBF -7
California All - purpose Certificate of 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
' ss.
County of
On :2 > - 15 before me,
personally appeared
P;rrae ^ ::iec_r ;u
who proved to me on the basis of satisfactory evidence to be the personXwhose name(o)
is /a4 subscribed to the within instrument and acknowledged to me that K//she/thoy executed
the same in 4/her /thXir authorized capacity(�s), and that by 0 /her /thleilir signature on the
instrument thb person(s1, or the entity upon behalf of which the person acted, executed the
instrument.
I certify under PENALTY OF PERJURY under the laws JONATHAN A. UROUIDI
of the State of California that the foregoing paragraph is Cnmmisslon # 2088426
true and correct. f( Notary Public - California n
z a ' Los Angeles County
WITNESS my hand and official seal. 4 My Comm. Expires Nov 1, 2018
OPTIONAL INFORMATION
Description of Attached Document
The preceding Certificate of Acknowledgment is attached to a
document titled /for the purpose oil
containing pages, and dated
The signer(s) capacity or authority is /are as:
D Individual(s)
=1 Attorney -In -fact
Corporate Officer(s)
Proved to me on the basis of satisfactory evidence:
[, form(s) of identification ❑ credible witness(es)
Notarial event is detailed in notary journal on:
Page #_ Entry#_
Notary contact:
_i Additional Signer Signer(s)Thumbprints(s)
DJ
Guardian /Conservator
Partner - Limited /General
Trustee(s)
Other;
representing:
V,
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS:
Iva Vasilj, President of Vasilj, Inc., a California corporation, hereinafter referred to as
PRINCIPAL, in the County of Los Angeles, State of California, does hereby appoint Tanja
Raspudie as her true and lawful attorney, in principal's name, and for principal's use and benefit,
said attorney is authorized hereby, on behalf of Principal and Vasiij, Inc., to do the following:
(1) To demand, sue for, collect, and receive all money, debts, accounts,
legacies, bequests, interest, dividends, annuities, and demands as are
now or shall hereafter become due, payable, or belonging to principal,
and take all lawful means, for the recovery thereof and to compromise the
some and give discharges for the same;
(2) To execute contracts, bids, and any other written instrument in the ordinary course of
business operations, any interest therein or the possession thereof, and to take possession and
exercise control over the use thereof;
(3) To buy, sell, mortgage, hypothecate, assign, transfer, and in any
manner deal with goods, wares and merchandise, chores in action,
certificates or shares of capital stock, and other property in possession
or in action, and to make, do, and transabt all and every kind of
business of whatever nature;
(4) To execute, acknowledge, and deliver contracts of sale, escrow
instructions, deeds, leases including leases for minerals and hydrocarbon
substances and assignments of leases, covenants, agreements and
assignments of agreements, mortgages and assignments of mortgages,
conveyances in trust, to secure indebtedness or other obligations, and
assign the beneficial interest thereunder, subordination of liens or
encumbrances, bills of lading, receipts, evidences of debt, releases,
bonds, notes, bills, requests to reconvey deeds of trust, partial or full
judgments, satisfactions of mortgages, and other debts, and other written
instruments of whatever kind and nature, all upon such terms and
condition as said attorney shall approve.
Giving and granting to said attorney full power and authority to do all
and every act and thing whatsoever requisite and necessary to be done
relative to any of the foregoing as fully to all intents and purposes as
principal might or could do if personally present.
All that said at(arney shall lawfully do or cause to be done under the
authority of this power of attorney is expressly approved.
Dated: August 3, 2012
Iva Vasilj
STATE OF CALIFORNIA
COUNTY OF LOS ANGELES
On August �0 2012, before me, _ Notary Public,
personally appeared Iva Vasilj, 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/then
signatures) on the instrument the person(s), or entity upon behalf of which the person($) acted,
executed the instrument.
certify under penalty of perjury under the laws of the State of California that the foregoing
paragraph is true and correct,
it/itness my hand and official seal.
Signature:
KENT W. VERCRUSE
COMM.# 1888167
NOTA P OBLIC -01 A
Baxx. EXa. AIA. tet4
ACTION WITHOUT A MEETING
BY UNANIMOUS WRITTEN CONSENT
OF THE BOARD OF DIRECTORS OF
VASILd, INC.
The undersigned, being all of the Directors of VASILJ, INC., a California
corporation, pursuant to the authority granted by the bylaws of this corporation
and by the laws of the State of California, do hereby unanimously consent in
writing to and hereby adopt the following resolutions:
ADOPTION OF STANDING RE50LUTION — CC, tNTRACTS
RESOLVED, that Iva Vasilj and Ivan Vasilj, President and Secretary of the
Corporation, respectively, hereby appoint Tanja Raspudic as their attorney if fact
and agent of the Corporation, to execute and deliver on behalf of this corporation
contracts, agreements and other written instruments entered into in the ordinary
course of business of the Corporation; and
RESOLVED FURTHER, that the President, or any Vice President, either
acting alone or together with the Secretary or any Assistant Secretary of this
Corporation be and they hereby are, authorized and empowered to delegate in
wring to any employee or agent of the Corporation authorization and power to
execute and deliver on behalf of this Corporation purchase orders, contracts,
agreements and other written instruments entered Into in the ordinary course of
business. of the Corporation.
ADOPTION OF STANDING. RESOLUTION — REAL PROPERTY
RESOLVED, that Iva Vasilj and Ivan Vasilj, President and Secretary of the
Corporation, respectively, hereby appoint Tanja Raspudic as their attorney if fact
and agent of the Corporation to make, execute and deliver deeds, mortgages,
trust deeds, conveyances, releases of mortgages, requests for reconveyance of
trust deeds, contracts for the sale of real property, assignments or other
instruments relating to any real property at any time owned by this Corporation.
ADOPTION OF STANDING RESOLUTION : SECURIT[ES
RESOLVED, that Iva Vasilj and Ivan Vasilj „President and Secretary of the
Corporation, respectively, hereby appoint Tanja Raspudic as their attorney If fact
and agent of the Corporation to purchase shares of stock, bonds, debentures,
notes evidences of indebtedness or other securities and to sell, assign, transfer,
set over, endorse and deliver any and all such securities at any time standing in
the name of or owned by this Corporation or its officers or its directors and to
make, execute and deliver any and all :written instruments necessary or proper to
effectuate the authority hereby conferred.
IN WITNESS WHEREOF, the undersigned Directors have executed this
written consent as of August 3, 2012,
Iva Vasilj
Ivan Vasilj
State of Califomia .
County of..�
On (D 7-before me,
personally. appeared
KENT W. VERCRUSE
CoMM. # 1885187 - N
NOTARY MMISCOUM
108 AtlBaF8000NTY. -
MY C011M. Et(r. M� � t�F .
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/herhheir -authorized capacity(ies), and that by
his/her/their signature(s) on .the instrument the
person(s),. or the entity upon behalf of. 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 coyli ct. ' I
VVfTNESS my
Signature:
v
PleceNomry Seat amYor Stomp Above .. Stj¢reft
OPTIONAL
Though the information below is not required bylaw, It may prove ve uabte to persons
and could prevent fraudulent removal and reattachment of this form to anod
Description of Attached Docume
Titla or Type of Document:
Document Date: 0 t�l o � f - X 6 1 -Z-- Numberc
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
• Corporate Officer — Tltle(S):
• Individual
❑ Partner — ❑ Limited ❑ General 'Top of thumb here
❑ Attorney in Fact
❑ Trustee
• Guardian or Co_ nservator
• Other.
Signer Is Representing:
on the document
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:
De Soto Ave.,P.O.Sox2402•ChetswN6CA 01379 +1A112•www.Natiw�eiNOlaiyorg�� Remi50o7 R..r&rWTO&Fr 1-W08M-6M7
BIDDER: Vh i Lj t N�c
SECTION 2
BID DATA FORMS
BIDDER: Vasili Inc.
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 Vasilj, Inc. as
Principal, and Fidelity & deposit Company of Maryland
' as Surety, are held firmly bound unto the
CITY OF ROSEMEAD (hereinafter called the OWNER) in the sum of
Ten Percent of Amount Bid UUL L.AKb
($ of amount 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 forthe GARVEY AVENUE SEWER RELIEF LINE PROJECT as set forth in
the Notice Inviting Bids and accompanying Bid Documents, dated
July 8 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 1st day of July , 2015 .
Vasilj Inc. (SEAL)
Principal n
Signature �-
ia
Fi delity & Deposit Company of Maryland (SEAL)
Surety
Signature Frank Morones, Attorney- in-Fact
r0
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New
York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY
AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies "), by
THOMAS O. MCCLELLAN, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said
Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby
nominate, constitute, and appoint Frank MORONES, of Brea, California, its true and lawful agent and Attorney -in -Fact, to make,
execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of
such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and
purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE
COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND
SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT
COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons.
The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of
the By -Laws of said Companies, and is now in force.
IN WITNESS WHEREOF, the said Vice - President has hereunto subscribed his/her names and affixed the Corporate Seals of the said
ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and
FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 16th day of July, A.D. 2013.
ATTEST:
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
H�+[ 'wy 8Va3 .G` R
a �o \ma
SEAL as ea —•_ to
% �� t low Di
Assistant Secretary
Gerald F. Haley
�M/ V I a`.
Vice President
Thomas O. McClellan
State of Maryland
City of Baltimore
On this 16th day of July, A.D. 2013, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, THOMAS O.
MCCLELLAN, Vice President, and GERALD F. HALEY, Assistant Secretary, of the Companies, to me personally known to be the individuals and
officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly swum, deposeth and saith,
that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and
that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said
Corporations.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written.
,"M oo, .
Constance A. Dunn, Notary Public
My Commission Expires: July 14, 2015
POA -F 012 -01148
CIVIL. CODE § 118-9
A notary public ur other officer completing this Certificate verifles only the Identity of t individual who signed the
document to which this certificato is attached, and not the truthfulness, accuracy, or validity of that docurnent.
Statre of California
COmEfty Orange )
On / be���� LC|m�
Date Here Insert Name and Title of the Officer
Personally appeared Frank
who proved to me on the basis of satisfactory evidence Wbethe person(s) whose rarno(e.) is/aie
subscribed to the within lnrArurnent and acknowledged to rne that ho,rshellihp executed thecame in
or the ontity opon behalf of which the pGrson(4 acted, eyocuted the instrument.
L. CLARK
Commission # 1996834
Notary Public - California i5
Los Angeles County �
My Expires Nov 28
Place Notary, Above
| certify under PENALTY {}F PERJURY under the laws
of the State ui California that the foregoing paragraph
ioin/o and correct,
WITNESS my hand and offidal seal.
Si
Signature of Notary Public
OPTIONAL
Thouqh this section is optloral, COMI)leting this information can deteralteration of the docurnent or
fmiudo/ontnaMooh/nenfof this /hnnhy -in un/oA/*dhddpour/nnnt
Descriptio oy Attached Document
Title or Type ofDocument: U$conoontDnte�
Numloer of Pages� .___ Signer(s) Other Than Named Above: __
Claimed bySiSeer(s)
Signer's Name:
[] {orpor
ate Officer -
Partner --- OU*itod OGenmra|
[]{m.vidum/ X; Attorney inFact
L;Tnntwe [J Guardian orCunupnxat*r
[]Cther_____________________________
Signer/nRepnesmU0ng:
tPartn/ — OUmited iDGenem|
L] Individual []Attorney inFact
[|Tn/stee []GumrdinnnrCmnoen/otnr
Signor |nRepresenting:
02814 Nat Notary Association "vvww.Nabnnallot^ty.vrg^1`8OO-U8 NOTARY (1'8D0'876^$827) Item #5g87
California Ail - Purpose Certificate of 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 / _S. �weS s.s.
L�
On — 2'7 ' / before me,
personally appeared
who proved to me on the basis of satisfactory evidence to be the person whose names}
is /� e subscribed to the within instrument and acknowledged to me that %she /they executed
the same in h�s/her /t[Air authorized capacity(Ks), and that by " /her /th�`r slgnatureo) on the
instrument the person lsj, or the entity upon behalf of which the person ) acted, executed the
instrument.
I certify under PENALTY OF PERJURY under the laws JONATHAN A. - - - - i
of the State of California that the foregoing paragraph is Cimmission # 2088426
true and correct. Notary Public - California z
Z `' m Los Angeles County n
WITNESS my hand and official seal. My Comm. Expires Nov t, 2018
n
OPTIONAL INFORMATION
Description of Attached Document
The preceding Certificate of Acknowledgment is attached to a
document titled /for the purpose of 6
containing pages, and dated
The signer(s) capacity or authority is /are as:
Ci Individual(s)
D Attomey -in -fact
Corporate Officers)
_, Guardian /Conservator
[i Partner - Limited /General
D Trustee(s)
Other:
Proved to me on the basis of satisfactory evidence:
D. form(s) of identification ❑ credible vdtness(es)
Notarial event is detailed in notary journal on:
Page # Entry #
Notary contact:
_I Additional Signer Signer(s) Thumbprints(s)
representing:
BIDDER: " p L " 1 N c
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
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 -10
BIDDER: \ `�' - i
23 LIST OF PROPOSED SUBCONTRACTORS (continued)
[•`Duplicate Next 2 Pages if needed for listing additional subcontractors `"1
Name and Location Description of Work
of Subcontractor to be Subcontracted
i I M/ , c rrtnir.-S
License No.: 9 k5
Department of Industrial
Name and Location
of Subcontractor
Description of Work
to be Subcontracted
Name: _ dcsca. "yt ✓.�bt� CAt�. ��
Address: 0 &a
License No.: 2 - k6"I
Department of Industrial Relation Registration No. I boDW 6 IDS(
M
Name and Location
of Subcontractor
Description of Work
to be Subcontracted
Name:
Address: rrio (OV 591 LozbN(y to
License No.: — i3 -a ®1 e
Department of Industrial Relation Registration No. 0o®00'
Name and Location
of Subcontractor
Description of Work
to be Subcontracted
Name: v/.-7v t/a rcaycc `rPhS C/i. 7�
Address: IFM- V>v50Mti0 Foausa•w ✓b f
License No.: 8o1a t22--
Department of Industrial Relation Registration No. (0
Name and Location
of Subcontractor
Description of Work
to be Subcontracted
Name: Cirk+m Q &NVA n in '�Vj l
Address: IS?. 'FOL t '51. 6waN 6<- JJ
License No.: `lop o v 5
Department of Industrial Relation Registration No. 1 LQ - 7
CBF -11
BIDDER: "' ' ° I L
2.0 REFERENCES
The following are the names, addresses and telephone numbers for three public agencies for which BIDDER
has performed similar work within the past two (2) years:
1. G rVr c%v- WS D4FcLv S Z L) e St. LA c4 -)aoa-
2.
C'4J2 IZ 510 `M' 8
Name and telephone number of person familiar with project
1, 12) 6),ocx) vea- i"4,,,� iZi�-rLke -
Contract amount Type of Work
3. C I i H ?C7n'1 `ZL- -( Awo
Name and Address of Owner
E l mSPIL>'3 9C) - 2—
Name and telephone number of person familiar with project
�Co� �t�viS`�• r� � t:Z
Contract amount Type of Work
4.
Name and Address of Owner
- 764 a- j
Name and telephone number of person fam ar with project
M
Contract amount Type of Work
Name and Address of Owner
!,.'1 NPJ Stn •`732 • yCr�J3
Name and telephone number of person familiar with project
2 YV R n.vScti1 VPS17 Z D9C�
Contract amount Type of Work Date Completed
6rr'( R u 'J't CA
Date Completed
,L
CBF -12
BIDDER: VS� L l ti
SECTION 3
NON - COLLUSION AFFIDAVIT
CBF -13
BIDDER: VA 'l �'j 1 t'Lc
NON- COLLUSIQN AFFIDAVIT
In accordance with Public Contract Code Section 7106, the undersigned, being first duly
sworn, deposes and says that he or she holds the position listed below with the bidder, the
party making the foregoing bid, that the bid is not made in the interest of, or on behalf of, any
undisclosed person, partnership, company, association, organization, or corporation; that the
bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced
or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly
colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham
bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly
or indirectly, sought by agreement, communication, or conference with anyone to fix the bid
price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the
bid price, or of that of any other bidder, or to secure any advantage against the public body
awarding the contract of anyone interested in the proposed contract; that all statements
contained in the bid are true; and, further, that the bidder has not, directly or indirectly,
submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged
information or data relative thereto, or paid, and will not pay, any fee to any corporation,
partnership, company association, organization, bid depository, or to any member or agent
thereof to effectuate a collusive or sham bid.
Signature
Typed or Printed Name
/.tS . 7c -n-tr-
Title
Bidder
Subscribed and sworn before me
This _ day of
20_
(Seal)
Notary Public in and for
the State of California
My Commission Expires:
I ve
CBF -14
California Jur°af Certificat
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 '
Subscribed and sworn to (or affirmed) before me on this day of
20 by
proved to me on the basis of
satisfactory evidence to be the person who appeared before me.
Y
OPTIONAL INFORMATION
JONATHAN A. URDUIDI
Cnmmisslon # 2088426
= -ro Notary Public - California n
z ' Los Angeles County
4 Comm. Ez Ires Nov 1, 2018
Description of Attached Document - . 7 T—
The certificate is attached to a document titled /for the purpose of Method of Affiant Identification
containing pages, and dated
Proved to me on the basis of satisfactory evidence:
C form(s) of Identification C credible witness(es)
Notarial event is detailed in notary journal on:
Page #_ Entry#_
Notary contact:
Other
ri Af lant(s) Thumbprint(s) F . - I Describe: _