Bidder: PCI I
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I CITY OF ROSEMEAD
I CITY WIDE STRIPING PROJECT
PROJECT No.25001
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I CONTRACT BID FORMS.
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BIDDER' •VL-�
CONTRACT BID FORMS
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TABLE OF CONTENTS
SECTION 1 BID SCHEDULE 1
SECTION 2 BID DATA FORMS 5
2.A BID BOND 6
2.8 LIST OF PROPOSED SUBCONTRACTORS 7
SECTION 3 NON-COLLUSION AFFIDAVIT 10
BIDDER: 'C.
SECTION 1-BID SCHEDULE
CBF- 1
BIDDER: RL\
BID SCHEDULE
SCHEDULE OF PRICES FOR
CITY WIDE STRIPING PROJECT
PROJECT No. 25001
• Walnut Grove Avenue from Marshall Avenue to Garvey Avenue.
• Valley Boulevard from Easterly City Limit to Westerly City Limit
• Sang Gabriel Boulevard from 110 Freeway to Graves Avenue.
• Lower Azusa from Rosemead Boulevard to Easterly City Limit.
BASE BID SCHEDULE
iUNIT OF EST. UNIT ITEM
NO. ITEM DESCRIPTION MEASURE QTY. PRICE COST
1 Clearing &Grubbing per plans LS 1
and specifications. � , c cx x , ca'. cr-
2 Caltrans Detail 9 with Solid LF 44,425
Segment with RPM's at , I-I- A>Iti (fS�CSe-
Intersections,crosswalks and limit
lines. •
3 Caltrans Detail 22 LF 10420 1. 14 $11,F if-.£-c
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4 Caltrans Detail 29-Double double- LF 1,390 csc- •
stripes with RPM
5 Caltrans Detail 32-two way left 4 LF 8,500
stripes with RPM. $1. IC *9,-35c cc
6 Caltrans Detail 38 LF 7,151
7 Caltrans Detail 40 LF 260 cc. Lc.
8 Caltrans Detail 41 LF 120 ,cc $;;tio cc
9 12 Inches Wide White Crosswalk LF 6,725
Line ,Sc Il��B9-CC
10 12 Inches Wide White Limit Line LF 1,360 iv) cc cc.
11 12 Inches Wide Yellow Crosswalk LF 140 a,Sc. `K3SOIC
C.
Line Markers $
CBF-2
BIDDER: PC\
UNIT OF EST. UNIT ITEM
NO. ITEM DESCRIPTION MEASURE QTY. PRICE COST
I 12 2-12 Inches wide yellow crosswalk LF 1,962
lines with 2 feet wide ladder
I crosshatch- 12 inches width of
crosswalk.
•c� `h5, �'4 �`-
crosswalk.
I 13 4 inches yellow crosshatch area at LF 170
45 degrees 5 feet an center. tz,2,cc ` 3-1c -CC
I14 4 inches white crosshatch area at LF 560 <; •
45 degrees 5 feet on center. is t_�c ` e 1U 'c
15 B inches raised pavement LF 150 ` lc, cc Li 5 C oc
Imarkers.
16 Pavement Legend Marker(Stop, EA 62
I Ahead, Only, Keep Clear, School,
Zone,
Zone, etc.)
I 17 Pavement Legend Marker(Arrows EA 109
right or left) ,c<• t 1(4- pc
I18 Pavement Legend Marker EA 2 Fc(Railroad Crossing) ` 350 . -cc .N-
19 Red Curb LF 13,800 -$Ci.`f,Sh *ll)13G.CC
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20 Green Curb LF 300 1,9_ uocc, ,CC
I 21 Parallel Parking Stalls EA 94 fS ,CC fit,9 tc.CC •
**Thermoplastic shall be used on all striping details,crosswalks, pavement markings,and arrows.
I TOTAL BASE BID PRICE (SCHEDULE BID PRICE): $ \ V S., a.;; • C 1
ICALMEAccR.A ock -„4_I Tloi_ck r. 71,w.Sr,.t,A Tr.•,' t1‘,.1\eXAvKSC 11/4-3.0,nf.1 PCIN.-lv^
Dollar amount in written form t 0 1 .° v j cs. -., c__ v-i c_)f,v)y n) VOL CP.k-C\-5
INote: 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.
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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
I 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.
CBF -3
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BIDDER'
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 herg tod is a certified check, a cashier's check or a bid bond in the amount of
($
Dollars R-.,.�� ) said amount being not less than ten percent (10%)of the Total Bid Price. The
undersigned agrees that said amount shall be retained by the Owner if, upon award, we fail or refuse to
execute the Contract and furnish the required bonds, certificates and endorsements of insurance and other
certifications within the time provided.
If awarded a Contract, the undersigned agrees to execute the formal Contract,which will be prepared by the
Owner for execution, within five (5) Calendar Days following the Letter of Award for the Contract, and will
deliver to the Owner within that same period the necessary original Certificates of Insurance,Endorsements of
Insurance, Performance Bond, Payment Bond and all other documentation and certification required by the
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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 shah 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 proiect 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 subiect 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 1,
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. I (n n__. Wvld fUsET
JJl
CBF-4
BIDDER_ C\ •
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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CBF - 5
BIDDER: TCI
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By /. I cr i-S w 1'11-
Signature
Signature Business Street Address
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\ ( cte„ « `tt c �
ce vvv(� _\e`�`-�'�)
Type or Print NameRycsicccr.-t City, Stale and Zip Code
Mitts"-,i rd--- oSC 4
Title Telephone Number
Bidder's/Contractor's State of Incorporation:
Partners ori— ` \„\ rt ‘ir-)
Bidders License Number(s):
Department Industrial Relations til
Registered No. IC CCP:( 5Ltst_ li
NOTES:
1) By its signature on this Bid, the Bidder certifies under penalty of perjury the accuracy of thea,
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.
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As further discussed in the Instructions to Bidders, Bidder will be required •
to provide evidence that the person signing on behalf of the corporation, •
partnership or joint venture has the authority to do so.
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CBF-6 •
BIDDER: TC1
SECTION 2
BID DATA FORMS
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CBF - 7 I;
BIDDER: l'(-1
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 Bidders
name and page number. ILII
2.A BID BOND
KNOW ALL MEN BY THESE PRESENTS:
THAT P(.l ,asPrincipal,
and Indemnity Compnns'of Calilinma
, as Surety, are held firmly bound unto the CITY OF
ROSEMEAD (hereinafter called the OWNER) in the sum of
1 en Percent of the Total Amount of the Bid
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 CITY WIDE STRIPING PROJECT– PROJECT No. 25001 as set forth in the Notice
Inviting Bids and accompanying Bid Documents,dated Match 7, 201
NOW,THEREFORE,if said Principal is awarded a Contract for the Work by the OWNERand,
within the time and in the manner required by the above-referenced Bid Documents,enters
into the written form of Contract bound with sald 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 famishes any
other certifications as may be required by the Contract,then this obligation shall be null and F
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 gat day of mm,d, . 20 18
Indemnity Compam
PCI (SEAL) nrcol[forma s (SEAL)
Principal Surety/
By. - '$� — - By:
Signature Sig -cure,
u-tlArc vv Gx. ,'u kr: 't imadc. La du. A rncv-In-1-act
R , ri,
CBF-8
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POWER OF ATTORNEY FOR
DEVELOPERS SURETY AND INDEMNITY COMPANY
INDEMNITY COMPANY OF CALIFORNIA
PO Box 19725,IRVINE,CA 92623 (949)263-3300
KNOW ALL BY THESE PRESENTS that except as expressly limited,DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA,do each
hereby make,constitute and appoint.
—"Lisa Saumur,Adriana Valenzuela, Mark Rosskopf, Lourdes Landa.jointly or severally"'
as their true and lawful Atlomey(s)-in-Fad,to make,execute,deliver and acknowledge,for and on behalf of said mrporauans,as sureties,bands,undertakings and contracts of
suretyship giving and granting unto said Atlomey(s-in-Fad full power and authority to do and to perform every act necessary requisite a proper to be done in connection therewith as
each of said corporations could do,but reserving to each of said corporations full power of substitution and revocation,and all of the acts of said Attomey(s)-in-Fad,pursuant to these
presents,are hereby ratified and confirmed.
This Power of Attomey is granted and is signed by facsimile under and by authority of the following resolutions adopted by the respective Boards of Directors of DEVELOPERS SURETY
AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA,effective as of January 1st,2008.
RESOLVED,that a combination of any two of the Chairman of the Board,the President,Executive VloePresient Senior Vice-President or any Vice President of the
corporations be,and that each of them hereby is,authorized to execute this Power of Attorney,qualifying the afiomey(s)named in the Power of Attorney to execute,on behalf of the
corporations,bonds,undertakings and contacts of suretyship:and that the Secretary or any Assistant Secretary of either of the corporabons be,and each of them hereby is,authorized
to attest the execution of any such Power of Attorney,
RESOLVED,FURTHER,that the signatures of such officers may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such
Power of Attorney or certificate bearing such facsimile signatures shall be valid and binding upon the corporations when so affixed and in the Nture with respect to any bond,undertaking
or contract of suretyship to which it is attached.
IN WITNESS WHEREOF,DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA have severally caused these presents to be signed by
their respective officers and attested by their respective Secretary or Assistant Secretary this 6th day of February,2011.
B : . SYwrvn IN�t OB ANYO
Y Dante Young,Senior Vice-President >c,4d,, q.,Fy- A4ppvOgqi.(,
-S - fff w 1936 i;__
�/ _ " - OCTf ``
er 7
B Mark Landon,Vice-President` -',IBp.w ear '<free��a
;, *
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 February 6,2017 before me. Lucille Raymond,Notary Public
ears Insert Nrn°
personally appeared ore Daniel Young and Mark Lansdonfarm.mn.oma,
NM(s)of sge.l+I
who proved to me on the basis of sabslactory 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
rapadty(ies),and that by hisTerr/heir signature(s)on the instrument the person(s),or the entity upon behalf of
LUCILLE RAYMOND which the person(s)acted,executed the instrument.
? ?' . Commission•20!1815
/'y�T-¢¢ a NOtary Public-California Icerty under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is
N} Orange County — true and coned.
j MT Comm.EWru Oct 13,201!;
I - WITNESS my hand and official seal.
Place Notary Seal Above Signature
Luci4 cord Notary Public
CERTIFICATE
The undersigned,as Secretary o Assistant Secretary of DEVELOPERS SURETY AND INDEMNITY COMPANY or INDEMNITY COMPANY OF CALIFORNIA,does hereby
certify that the foregoing Power of Attorney remains in full force and has not been revoked and,furthermore,that the provisions of the resolutions of the respective Boards of Directors of
said corporations set forth in the Power of Attorney are in force as of the date of this Cerarate.
This Certificate is executed in the City oflrvine,California,this �lLr-rn day of VY1Qf LYS o{% <SI
ty AND/a..By `J� CCas J.sNN,Assistant Setory CJ)
ATS-1002(02/17)
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 attachedand not the truthfulness. accuracy.or validity of that document
State of California
County of Orange s.s.
On 03/05/2018 before me. Lisa Mane Saumur. Notary Public
• personally appeared Lourdes Landa
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. USA MARIE SAUMUR
W ITrVESS my hand(Cid official seal. .1.40,51:: COMM. 42146523 zz
/ o yNotary PURik•CatHotnu o
Catnb
r.., Comm .. Mfr.ty 1020
OPTIONAL INFORMATION
Description of Attached Document
The preceding Certificate of Acknowledgment is attached to a Method of Signer Identification
document ttled/for the purpose Of Proved to me on the basis of satisfactory evidence
fermis)of identification credible witnessies I
containing pages, and dated Notarial event is detailed in notary Journal on
The signeris) capacity or authority is/are as Page r. entry=_
I ndmiduallsl Notary contact.
Attorney-in-raft
Corporate OR6ensi Other
Additional Signer Signe.s)Thu mbpn ntsrsl
Guardian Conservator
Patine r.ti mited:Geoerel
T.rustee ISI
Other.
representing:
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 March 6, 2018 before me, Araceli Flores . Notary Public,
Date Insert Name of Notary exactly as it appears on the official seal
personally appeared William G.Jacob
Name(s)of Signer(s)
who proved to me on the basis of satisfactory evidence to
be the person(*whose name* is/ar€subscribed to the
within instrument and acknowledged to me that hei0e/lyefi
executed the same in his/b&//tbcfr authorized capacityLiag),
and that by his/bet/their signature(*on the instrument the
°:It"�''• ARACEU FLORESf person*, or the entity upon behalf of which the person(($
tipticouu.112151763 acted, executed the instrument.
Los Mqels County
1 yccmm.F.�.r yyt a)p I certify under PENALTY PERJURY under the laws of
S
the State of California thatt the foregoing paragraph is true
and correct.
Witness my hand d official s¢ I.
Signature /(up,{y
Place Notary Seal Above Signature of Nolan.Ixubll JJ
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:
E Individual ❑ Individual
❑ Corporate Officer—Title(s): ❑ Corporate Officer —Title(s):
U Partner ❑Limited U General U Partner U Limited O General
❑ Attorney in Fact RIGHT THUMBPRINT ❑ Attorney in Fad RIGHT THUMBPRINT
❑ Trustee OF SIGNER 0 Trustee OF SIGNER
❑ Guardian or Conservator Top of thumb here 0 Guardian or Conservator Top of thumb here
U Other: 0 Other:
Signer is Representing: Signer is Representing:
BIDDER: R C'
2.8 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
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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- 9
BIDDER: k)C-1
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: IC
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. •
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Name and Location Description of Work
of Subcontractor to be Subcontracted
I Name:
Address:
ILicense No.: •
Department of Industrial Relation Registration No.
ICBF- 10
BIDDER: RCI
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. R kacr.A-4 c l\ cC:
Name and Address of Owner
Name and telephone number of person familiar with project
Contract amount Type of Work Date Completed
2.
Name and Address of Owner
Name and telephone number of person familiar with project
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Contract amount Type of Work Date Completed
•
3.
Name and Address of Owner
Name and telephone number of person familiar with project illi
Contract amount Type of Work Date Completed ISI
4.
Name and Address of Owner
Name and telephone number of person familiar with project
Contract amount Type of Work Date Completed
CBF- 11
ammo. Amerimierim
Striping'Sealcoet
.5=r,
A Parking&Highway Improvement Contractor
AGENCY REFERENCE LIST
AGENCY PROJECT VALUE COMPLETED JOBN
City of West Hollywood Traffic and Parking Signs
164650N IN PROGRESS 69380
8300 Santa Monica Blvd (Bike Rack InstalleliOn)
West Hollywood,CA 90069
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818-203-1968 Project 006453
Helen Collins
Los Angeles Unified School District School Playgroung Markings 150 .CV IN PROGRESS 7042C
333 South Beaudry Ave.,22nd Floor R-14045 Poe4S00157U6
Los Mgele,CA 90017
213-241-8714
Xochitl Vargas
City of CalabasasProfessional Service Agreement 112,17200 6/3/2016 6857C
100 Civic Center WaY
Calabasas,CA 91302
818224-1600
B enjamin Chan
ChofWO[Hollywmtl Annual Striping&Marking 913,602.50 4/29/2016 57960
8300 Santa Monica Blvd.
West Hdlywood,CA 90069
818203-1956 Project 900
H elen Collins
los Angeles World Airports Paint Marking of Parking Lots )00.000.100 02/05/2016 6430C
PO Box 92882 elll-169
Los Angeles.CA 90009
4244467954
Richard Morales
City of Santa Monica Traffic Striping Services 218,979.00 07/13/3015 715B0
2500 Michigan Avenue
Santa Monica,CA 90404
310-458-2201
K ori Jones
Nobest Incorporated
Sec 2 Concrete& 366105.008/78/20]0 69230
PO Box 870 sc.Slurry
Westminster,CA 92684 do Manhattan Beach
714-373-0039
Mike Lewis
All American Asphalt San Gabriel Bike Trail 107,880.00 8/1/2013 5993C
PO Box 2229
Cocom,G 92878
951-736-7Project 24182.01
/ 600
/ ak.',ZA Jerry Lebouef
City of Bakersfield Bike Lane Improvements &7ga9N 05/77/1013 6170C 1600Truxtun Avenue 12,(251
`C q� Bakersfield,CA 93301
7]'(
0708-5' 681.3263724
290 Vannda Bllb
School Area Signing&Markings
110.295N 3/15/2013 62650
23920 ClalentlCBI913 Suis 300
Santa 66293-2489
S9G 91355
6618542489 ProleciNMWBR
City of Santa Monica 4th Street at Colorado Ave 11429500 3/9/2012 57900
1685 Main Street
Santa Monica,CA 90401
Hill 18111 Mt 11111 3107100499 PO p325254
lad Flores
INN NS
ri Striping Seelcoat
G �
A Parking&Highway Improvement Contractor
AGENCY REFERENCE LIST
AGENCY PROJECT VALUE COMPLETED JOB
City of Carson City of Carson-Striping and Markings $64500 08/01/3013 6444C
701 E.Carson Street .1.338
Carson,CA 90745
310-952-1700
San Diego Unified Pod Ohtrittaent Marking 35,000.00 3/8/2011 5542C
PO Box1201b &StripingMaintenance
San Diego,CA 92112-23M
619.686-6321
Excel Paving Co. Cast Way Bikeway&Signage 21036150 3/25/2010 4783C
PO Boa 16405
long Beach.CA 90806 Project 86362 146611
562-599-5841
City of Santa[lama Striping Motl0in0on 36.060.00 9/3/2009 4142C
23920 Valencia Blvd.,Suite 300
Santa Clarita•CA 91355 Contracl809-00183
661.2532489
S W�
Fryq( p
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II IFI IIs11 D1111111
BIDDER: RL--,
SECTION 3
NON-COLLUSION AFFIDAVIT
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BIDDER: t L1
NON-COLLUSION AFFIDAVIT
I 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.
I /
Signature
Typed or Printed Name
I N"SS 1 C-\L r\t
Title I
Bidder
I
Subscribed and sworn before me
Thisbth day of C \avCL 201
��./� (Seal)
1 �-
Notary Public in and for QCof
the State of California
My Commission Expires:
CBF - 13
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 March 6,2018 before me, Araceli Flores , Notary Public,
Date Insert Name of Notary exactly as it appears on the official seal
personally appeared William G. Jacob
Name(s)of Signer(s)
who proved to my on the basis of satisfactory evidence to
be the person whose name(6j is/dsubscribed to the
within instrument and acknowledged to me that he/she/t1,
executed the same in hisAl 1'1thetf authorized capacity ',
T ARACEU FLORES I and that by his/Wither'signaturejs'on the instrument the
,Ir>-:E COMM.A 2151763 4
persons or the entity upon behalf of which the person(s'f
g ' xday nmc-C a'"° acted, executed the instrument.
] \ q Los a,n Ecw cwmr p
1 My Com ..wee May 1,20203
I certify under PENALTY OF PERJURY under the laws of
the State of California that the foregoing paragraph is true
and correct.
Witness my hhen(r� d office I al
Signature ( /InA*4 sa,
Place Notary Seal Above SgnaWr of Notary Pu
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 El Limited E General ❑ Partner ❑Limited In General
❑ Attorney in Fact RIGHT THUMBPRINT ❑ Attorney in Fact RIGHT THUMBPRINT
El Trustee Os SIGNER ❑ Trustee OF SIGNER
❑ Guardian or Conservator Top of thumb here ❑ Guardian or Conservator Top of thumb here
❑ Other: 0 Other'.
Signer is Representing: Signer is Representing.
I �', CITY OF ROSEMEAD
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ADDENDUM No. 2
To all prospective bidders under Bid Documents for the
CITY WIDE STRIPING PROJECT
Project No. 21005
Bidders shall be licensed in accordance with the provision of Chapter 9, Division 111 of the
Business and Professions Code of the State of California. Bidder shall have a Class "A" or C 32
license in good standing at the time Bids are received.
The rest of Bid Documents as originally issued shall be used in submitting bids, and an
acknowledgement of receipt of this Addendum Number I shall be entered on the page CBF—4 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 OF ROSEMEAD
Date: March 5,2018.
By
Rafael M. Fajardo P.E.
City Engineer
/M N
CITY OF ROSEMEAD
tryy
ADDENDUM No.1
To all prospective bidders under Bid Documents for the
CITY WIDE STRIPING PROJECT
Project No.21005
1. You are hereby informed that the Bid Opening scheduled for 11:00 a.m. on Wednesday
August 28, 2018 has been changed to March 7, 2018 at 11:00 a.m. The City of Rosemead
will receive sealed bids up to 10:30 a.m. on March 7, 2018 and will follow up with publicly
opening the bids at 11:00 a.m.
The rest of Bid Documents as originally issued shall be used in submitting bids, and an
acknowledgement of receipt of this Addendum Number 1 shall be entered on the page CBF —4
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 OF ROSEMEAD
Date:February 26,2018
By - ..e
'i.afacl M. Fajardo P.E.
City Engineer