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CC - Item 5D - Award of Contract High Intensity Act. Crosswalk Proj. at Mission Dr. & Ivar Ave. - Proj. No. 28004TO: 11 If," 1JONORA13[,E MAYOI� AND ITY COUNCIL FROM: (irLORIA MOL11"IDA, CITY MANAGER DATE: SfTTEMBER 25, 2018 SUBJECT: HIGJI INTENSITY ACTIVATED CROSSWALK PROJECT — MISSION DRIVE AND IVAR AVENUE - PROJECT NO. 280 4 — AWARD OF CONTRACT SUMMARY As a part of* (fie City's Fiscal Year 2018-2019 Capital Improvement Program, the City Council approved a project to improve the intersection of Mission Drive and Ivar Avenue. The project consists of the installation ol'a flashing beacon systern, that will work in coordination with the existing in -pavement flashing crosswalk, This is a I'Lderal aid project funded through the I fighway Safety finprovernent Prograni, t,ocal (I ISIPL), with a total approved grant of $241,300. STAFF RECOMMENDATION It is recommended that the City (I I ouncil: 1. Approve the plans and specifications fbr the High Intensity Activated Crosswalk Project - Mission Drive and Ivar Avenue -Project No. 28004;,and 2, Authorize the City, Manager to enter into a contract with f.dectior Belco Electric Inc., in the arnOU111, 01' $106,000. In addition, authorize all arnount of' S10,600 (l0%) as a contingency to cover the cost ofunforeseen COTIStrUction expenses. DISCUSSION A Notice Inviting Bids was published in local newspapers and trade publications on August 16"', 23", and 301', 20:11 8. Scaled bids were received in the Office ofthe City Clerk until I 0.30 a.m. on Wednesda y, September 5t". 2018. At I I :00 a.m. on Septerriber 5"', 2018, the City Clerk pUblicly opened and read two (2) scaled bids with the following result: Rank Bidder Location Bid Amount I Elecno,r Belco Electric Inc, Chino, ('.'A $106,000-00 2 Dynaelectric Los Alan,iitos, CA $126,171.00 City Council Meeting Septembei 25, 2018 flage 2 of 2 Staff has reviewed the bid documents for completeness and investigated the: contractor's background and recent projects for competency. It has been determined that Fleenor Belco Electric Inc. is the lowest responsive hidder and is qualified to complete the work as specified for this project. Elecnor Belco Electric hic, has previously completed public works project,; for the Los Angeles County Department of Public Works, City ofLa Puente, City of Diamond Bar and other municipalities. FINANCIAL REVIEW This prospect was included in the I"iscal Year 2018-2019 Capital Improvement Program as as carryover project f'rorn Fiscal Year 2016-2017, The budget for this protect is $241,300 frorn a federal aid program. ESTIMAT ED PROJECT COST Description Amount Base Bid Amount S 1061 �,000,00 1 Construction Contingencies $ 10,600,00 Total Contract Work $1 !(a ()00.0() Contract Adminisiration 25,000M (inspection and Staff—Firne) Total Project Cost ,L�4 1 600.00 ENVIRONMENTAL REVIEW This project is categorically exempt frorn the California Environmental Quality Act (CI QA) pursuant to Section 15301 (a) of the Cl'"-IQA Implementing Guidelines. PUBLICNOTICE PROCESS This item has been noticed through the regular agenda notification process. Prepared'13 Rafael M. l'a,jardo, P.E. City Engineer Submitted By: Greg 'l"'SU.0UChi Assistant City Manager Aaacfiments; APlans, Specifications, Project Location (Available in the CityC'lerk's Officc,) B. Bic] Analysis C. Proposal FMAYMMIMMM Plans, Specification, Pr(jec�t Location Available in the City Clerk's Office) MENEM CITYOFROSENJE %D - BID ANNLYSIS SEPTEMBER S, 21I18 - 11:110 AM PROJEC' HICH INTENSITYACTIVA I IA) CROSSNNAUK PROJ EIC I'MISSION DRIVE" AND WAR AVENVE PROJECTNO,. 28004 .1parent Low Avnt Low Ridder 2 jWot BIDTABI LATION DYNAELECTRIC .......... --- ........................ Did Item anti Description UNI I 1-4fi1 Priv a Total Price Price I owl Price .................................... . . ..... ......... .............. ... ..... ............ ....................... . ........ CARING AND,GRUBBIN6 ITIR PI ANS I �s 1 $ 1, 00% 00 $1,000J)oi $5, 6 ( 2,00 S5,692,00 AND SPECIFICATI(JNS. ... .... ............ . ..... VIP P(1—. J,.Tq�99� S3,984.00:: $3,984,00 ... . ........ . . - - — INS I'AH, I IKA I INTF,NSI'l Y A(-] IVA HID 3:CROSSWALK PLANS ANS 1,S 1:: S 104, 0170� OW: $104,000,4)W 5116,A95 00 �l 10,495,00 iSPF('IHCA I IONS COMPITTF TOTAL BASE BID AMM'N'TCA LC VLATED BASED ON SHKOW100 S 12-16,171 ]M)l I t,'N'1'1' PRICES IIM Attachment C \« \m \:# 2' UT © l : 12 C>t NTB T DID FORv: B .! UNANIMOUS WRITTEN CONSENT IN LIEU OiF 2016 ANNUAL MEETING OF THE BOARD OF DIRECTORS OF ELEC-NOR BELCO ELECTRIC, INC. The undersigned, being all of the rnembefs of the Board of L)ir tors (the "Board-) of'Eleenor Bekaa Electric, Inc,, a California eorporation (tile 11C and adopt tile following result,tions b 9 a fueetilig of the Board, hereb3'tarke the following actions OmPan)"% in lieu of holdinby unanimous Written consent: WHEREAS, the Board has determined that it is in the Company's best interest!, to, appoint a revised date Of ()fflkers ofthe Company, NOW, THEREFORE,, BE IT RESOLVED, that the foliowing peconsbe, and hereby are, elected to the offices set fOrth opposite their respective rlames, to hold such Offices onfli their respective ,successors are elected and qualified at or before the next annual meefifig of the Board, or until their earlier respective deaths, resignations or rem. oval s. - President and Chief Executive officer Chief Financial Cfficeer Executive Vice presideut John Wong Secretary R,oger Devito Juan Bravo Jerorn Gel -villa Alberto Garcia Vice Ptesidcnt for Construction Pedro Enrile Assistant Secretary FURTHER RESOLVED, that Juan Bravo, Jeroni Gervilla and Alberto Garcia in their respective capacities of President mid CEO, Chief Financial Officer and Fxecutive Vice President subject supervisory powers of the Board to such of Directors, hereby are authorized and directed to Perform all the duties Commonly incident to that office; shall have authority to execute in the name of the Corporation contracts, leases and other written instruments to be executed by the Corporation; and, shall Perform such other duties as the Board of Directors may from time to time detertnifie, A" IT IS FURTHER RESOLVED, that all actions heretofore taken by the officers of the Company on behalf of and in the nante Of the Company, relating to the conduct of the business of the COMPanY, the expenditure of money, the making Of contracts and all other acts taken or omitted in the pedormance of their duties to the Company be, and the same hereby are, in al I respects, approved, ratirled and affirriled, as of the date taken, done or ornitted, respectively. The actions taken by the Board Consent shall have the sarin force and effect as if taken by the undersigned at a meeting of the Board of Directors, duly called and constituted pursuant to the Bylaws of the Cor bora and the laws of the State of California, This Board Consent may be executed in Counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same docurnent, [SIGNATURE PAGE FOLLOWS1 IN WITNESS WHEREOF, the mulersigned, being all of the merriber-, of' the Board of Directors of Eletmor Belco Electric" [11c., [mve executed these actjorL5 by written c,onsent as of the date first written above. Argimiro Rap g'acio f'r4l, 6wetm, JOS,e Migtm6 Fra o, Director AIGH INTENSI Y CTIVATED CROSSWALK PROJECT MISSION DPRI'VE AT IVAR AVENQE t §HSIPL TL599-m ■ Name of 9Wer,-__VQrMv- Woo E\42dv�o , Vnc. The L Indersigred, havrng examined the proposed Contract Documents and haOig Visited the site and examined the condibrx)s affecting the work, hereby proposes and agrees to furnish M labor, materials, equipment, and appliances, and to perforrn operations necessary to compiete the work as required by said proposed Contract Documents, excluding work of Mernates for The undersigned agrees that these Contract Bic] Forms constitufe,,a firm offer to Ihe Oviner which, cannot be withdrawn for the number of Working Days indicated in the Notice Cnviflng Bids frorn and after the bid opening date, or unfil a Contract for the Work is fully executed by the Owner and a third parly:, whichever is earlier. The urdersdgned atso agrees that if there us a discrepancy between the written aniount of t6,,e Bid Pace and the nutner[cai` amount of the Ed Price, the written arriount sj-jaPf gavern, If the Bid Documents sPecify aiternate bid items, the fodowing Alternate Bid af-nounts sha: fl added to or deducted frorn the Total Bid Pirice entered a!bove, The owneir can choose to include o o,r more of the alternates in the Total Bid' Price of the Project. If any of the Alternate Bids are utiliz by the Owner, the resulting amount shall be considered the Tota!l B�id Price, for the Project, Attached hereto is a certified check, a cashier's check or a bid bond in the, amount of Doilars said amount being not less than ten percent a Total Bid Phco, The undersigned agrees that said amount shall be retained by the Owner if, upon award, we fall 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 Conti -act, Which will be prepared by the Owner for execution, within five (5) Calendar Days following the Letter of Award for the Contract, and will deiiver to the Owner within that same period the necessary original Certificates of lrisurance, Endorsements of insurance, Performance Bond, Payment Bond and all other documentation and certification required by file Contract. The undersigned offers and agrees that if this bid is accepted, it will assign to the purchasing body ail 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 Professjona8 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 the Contractor. Bidder understands and agrees that, when requested by Owner, lie shall provide: (1) evidence satisfactory to the Owner of Bidder's California contractor's ircense(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 responsibie and responsive bidder, shall a, I to this Contract in the amounts of five ninety 90 workin Contract T71M_e_will 1 Sorkin s firm the nate of ceofbe in to run ten Proceed' _2subj�ecLlo theterms panditicr�s described inin the Contract Farm and the contract ocuments. aF�d Bidder understands and agrees that liquidated damages shall appiy to this Contract in the amounts and subject to the terms, and conditions described in the, Contract Formi and the Contract Documents, Bidder acknowledges that data submitted wlth its Contract Bid Forms which it requires to be incorporated into a Contract arising out cf 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 fcHoMng addenda to the Contract Documents, Addenda Nos, The Bidder understands and agrees that the Total Bid Price is inclusive of ail labor, materials, tinct equipment or supplies necessary to complete the Work as described in the Ed 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, CC' 'I RAO By", ,ign tu re n Wong Type or Pant Name Vice Presiclent TitIe Mder'sfConfractcr's State Of bn=PCI'at&i, Partners or Joint' Venturers; B,idder's License Nurnber(s)w Department 1ndLJSh`4 Relations Registered No. 114320 Albers Way Busine�ss StreetAddress Chino, CA 91710 City, State and Zip Code 909-993-5470 Telephone NUmber 1000004804 1) By its signature on this Ed, 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 addftion to Business Address 3) If Bidder is a par nership or joint venture, give full names of all partners or joint venturers, C) N T R,6,r N4iF S B F 3 KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the it of ROSEMEAD, California ("City"'), has issued a notice inviting bicisforth ework described as follows: ProiectNo, 28004 Koh Intensi!yActivated Crosswalk Mission Drive at IvarAvenue, WHEREAS Elecnor BFflco Eledk, Inc, 14320,81bers Way, Chino, CA 91710 (Name and address of bidder) ("Principal"), desires to s,ubm;it a bid to City for the work. WHEREAS, bidders are required to fUrniSh a form of bidder's security with their bid. NOW, THEREFORE, we, the undersigned Principal, and that the said Surety's Office is located at: Name Fidelftyand E)eprjM (';,ompany of Maryland Address 1299 zuokli Way, 5th Row Schaumbwfg, IL 60196.1056 Telephone --- ----- ------ . ........ . all (305-60010 and the California Licensed Non -Resident Agent for said Surety is. Narne Insurance Agent's License No. OK95958, Address 10 rpt ata Hou o. Sauwe, Roo� I Hwlk)rd, C1 06103 Telephone �86D) 241-4492 ("Surety") a duly admitted surety insurer under the laws of the State of California, as Surety, are held and firmly bound unto the City in the penal SUM of — Ven Percent of Amount Dd— Dollars (S 109/0 being not less than ten percent (1 011/o) of the total bid price, inClUding alternates, in iaWftll money of the United States of America, for the payment of which sum well and truly to be rnade, we bind ourselves, our heiTs, executors, administrators, SU4rCeSS01'S, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THlS OBLIGATION IS SUCH THAT, if the hereby bounded Principall is, awarded a Contract for thework bythe City and, within the firreand in the manner required bythe bidding spe6ficatiOns, enters into CC)NI RA C H i D F 1!4 N4 S BF 4 the written form of Contract included with bidding specifications, furnishes the required bonds, one toguarantee faithful performance and the other to guarantee payment for labor and materials, and furnishes the required insurance coverage, then this obligation shall become null and void; otherwise, it shall be and remain in full force and effect. In case suites brought upon this bond, Surety further agrees to pay all court costs incurred by the City in the suit and reasonable attorneys' fees in an amount fixed by the court. Int WITH ESSWHEREOF, this instrument has been duly executed by Principal and Surety, on the date set forth below, the name of each corporate party being hereto affixed and these presents duly signed by its undersigned representative(s) pursuant to authority of its governing body. Date: August 21, 2018 '"Principal" Elecrior Belco Electric, Inc. By. By: (Seal) "Surety" Fidelity and Deposit Company of Maryland Its JoshUa Sarford By: `Can i Caneschi Its Winess (Seal) Note: This bond must be dated, all signatures must be notarized, and evidence of the authority of any person signing as attorney-in-fact must be attached. Corporate seal must be impressed hereon in case of corporation, CONTRACT DIDFORMS Elf-- 5 A notary public or other officer completing this certificate verifies only the identity of the individl,lel who signed the document to which this certificate is attached, and not the truthfuHness, accuracy or validlty of that document, ...... +++++*+* ...... ++ ............ State of JA M O11before me, . . ..... G�g Notary Public d I N W, jute WWI - personally app eared AA&h� Name ani C4 Nw"Vs Df SK)"C"(5) Who proved to me on the basis of satisfactory evidence to be the person(s) whose narne(s)*Ire subscribed to the within instrument and acknowledged to me that he/sheA0 executed the same in his/her/authorized oapacity(ies), and that by liic3/lierYtLLe-lbsigiiaturp,(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,ifore oIng paragraph is, taIO and correct. 7a271 Witness my, Signature O�P'TIONAL Mace NcAary Public Gnat Above �J4)Jgtl tfae i1Tf0F7ra1xjn b0ow m ncf rFqum.",,d by law, 4 may pnive vahiable to the persolm, rn,tYM9 0) 0m) 6XUment and (-x-w1dprvveot frail lent removal and reattauhnient Df this form to another dcxtjment, Description of Attached Document Title or Type of Document Document Date Nurriber of Pages: Signer's Name: Individual ED Individual Cl Corporate, Officer - Title(s):-- 13 Corporate Officer - Title(s).__.... Partner - r-1 Limited 11 GeneraJ1flzk 13 Partner - 0 Limited 11 General WNIlyl WN* * .4 11 11"Ro U Guardian or Conservator , O'I, - El Guardian or Conservator RV catMumb Top 01 Ih+arnb EJ Attorney -in -Fact El Attorney -in -Pact El Trustee 0 Trustee Other: EJ Other; Signer is representing Signer is representing 0 + * + * * + * + + * 0 + + + * * * 0 0 * * 0 + + + + * * * * * * * * * * + 0 0 + * + 0 * * * * * * * + 0 * * + * + * * * * 0 + 0 * * OLIVIA DHEA +. u Commission o.21074,74 NOTARY PUBLIC,CALIFORNIA SAN BERNARDINO COUNTY My Comm. ExpreS APRIL 18, 2,019 Mace NcAary Public Gnat Above �J4)Jgtl tfae i1Tf0F7ra1xjn b0ow m ncf rFqum.",,d by law, 4 may pnive vahiable to the persolm, rn,tYM9 0) 0m) 6XUment and (-x-w1dprvveot frail lent removal and reattauhnient Df this form to another dcxtjment, Description of Attached Document Title or Type of Document Document Date Nurriber of Pages: Signer's Name: Individual ED Individual Cl Corporate, Officer - Title(s):-- 13 Corporate Officer - Title(s).__.... Partner - r-1 Limited 11 GeneraJ1flzk 13 Partner - 0 Limited 11 General WNIlyl WN* * .4 11 11"Ro U Guardian or Conservator , O'I, - El Guardian or Conservator RV catMumb Top 01 Ih+arnb EJ Attorney -in -Fact El Attorney -in -Pact El Trustee 0 Trustee Other: EJ Other; Signer is representing Signer is representing 0 + * + * * + * + + * 0 + + + * * * 0 0 * * 0 + + + + * * * * * * * * * * + 0 0 + * + 0 * * * * * * * + 0 * * + * + * * * * 0 + 0 * * 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. Connecticut State of County of Hartford On August 21, 2018 before me, -Aiza Anderson, Notary Public (insert name and title of the officer) personally appeared Joshua Sanford --- ------ 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 signatures) 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. Signature AIZA ANDERSON N07ARYPUBLIC- r--1,153320 (Sea[) Wy Co"'SS10N EXPIRES DEC, 31,2-018 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attorneys -an a " et. The ChicfExecutive Officer, the Presideni, or any Executive Vice President or Vice President may, by written instrument under the attested corporate sea], appoint attomcys-in-flw with authority to execute bonds. policies, recognizances, atifuiations, undertakings, or other like histri.inients on behAfof the Company, and may authorize any officer or any such attorney-in-fact to affix the corporate seal thereto; and may 'With Or Without cause niodily of revoke any such appointment orauthori4y at any tune," CERTIFICATE 1, the undersigned, Vice President of the ZLJRI(.',Ii AMERKAN INSURANCE )MPAN), the COLONIAL AMERICAN S CASUALTY ANI)URk"TY COMPANY, and the 11 DFLITY AND DEPOSITCOMPA�0Y OF MARYLAND, do hereby certify ilialthe foregoing Power of Attorney is still in full force and effect on the date of this, certiricale,- and I do further certify that Article V, Section 8, of the By -Laws ofthe Companies is still in force, This Power of Attorney and Certificate may be signed by Caesimile under and by authority, ofthe fofloxving resolution of the Board of Directors of the ZUIU(JJ AMERICAN INSUIRANCE COMPANY at a rnecting duly ci-illedand field ori the 15th day of December 1999. RLSOLVED: "Thatthe signature ofthe President or as Vice President arid the attesting signature of as Secretary or- an Assistant Secretary, a csimile on any Power ofAttorney...Any such Power or an), certificate thereol'bearing such and the Sea] ofthe Company may be affixed by fi, facsimile signature and seal shall be valid and binding on the Cornpany." 41 ['his Power of Attorney and Certificate may be signed by facsirnile under and by authority of the following resolution ofthe Board of Directors of the COLONIAL ANIDUCAN CASUALTY AND SIIRE I V COMPANY at as meeting duly called and held on the 5th day (if May, 1994, and the following resolution of the Board ol"Directors of the FIDELI I'Y AND DEPOSIT COMPANY OF MARYLAND at a niecting duly called and held on the 10th duly ofNlay, 1990. RESOLVI-J): "That the facsimile or mechanically reproduced seal of the company and inesinifle or mechanically reproduced signature of any Vice -President, Secretary, or Assistant Secretary ofthe Company, whether made heretofore or fiercafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force nand effect US though nianUally affixed, IN TESTIMONY WI IFIREOF, I hdve hereunto subscribed my name and affixed the corporate seals ofthe said Companies, this 1"1t"day of 20^_, 0 t, www EAL Im 'bf David MeVicker, Vice President TO REPORTA CLAIM wrrH REGARD TO A SURETY BOND, PJ.,EASE SUBMIT At,U REQUIRED INFORMATION TO: Zurich American hisurance Co. Attn: Surety Claims 1299 Zurich Way Schaumburg, 11, 60196-1056 The bidder hereby certifies that he/she and his/her subcontractors have inspected the sate and related specifications of work and fully acquainted themselves with all conditions and matters which might in any way affect the work, time of completion or the cost thereof, 4icluding, but not limited to scheduling and disclosed outside Contracts involving this work. The bidder also certifies he/she has observed the designated Contractor work areas and access routes, if disclosed or shown, as Part of work in this Contract, M -MW ffi Persons who inspected sate of the proposed work for your firm: Narre "a hi Antuna Title Superintendent ME Title CO Ij T R AC'"T B I D F ()R!,A S Date of Inspection /28/118 Date of Inspection pnnng��" 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, City of Victorville, 14343 Civic Drive, Victorville, CA 92393 Name and Address of Owner Name and telephone number of person familiar with project $445,220 Traffic January 20 ic Signal and Fiber Optics Ja18 . .......... . Contract amount Type of Work Date Completed 2, County of Losrnqe�[q§ artmi�qt of Public Works, 900 S. Fremont Ave, CA 918iO3 Name and Address of Owner •11 M Name and telephone number of person familiar with project $1,268,430 Traffic Siq,nal Modification M411HIMEEM Type of Work 3, Cily- of La Puente, 15,900 E. Main St, La Puente, CA 91744 Name and Address of Owner Name and telephone number of person familiar with project 1 $849,063 Traffic Signal Installation Contract amount Type of Work 4 .qjty of LMir �, I 1.5 Phoebe Ayt,_�a . rqq_q, CA--PP638 Name and Address of Owner Eric Villag_r u Name and telephone number of person familiar with project December 2017 Date Completed II WON .00, WHU&MMUMM $299,4910 Traffi_paInstall afion September 2017 Contract amount Type of Work Date Completed 5, Cii of Diannond Bar 2,1810 CoP.[9-Y..-Q!1.1rPApqopd Bqf, CA 91765 Name and Address, of Owner Name and telephone number of person familiar with project Se fic Work _p.tember 2016 Contract amount Type of Work Date Completed CON TRACT �11D FOR VS B-! 7 3 7, Name and Address of Owner Name and telephone number of person familiar wth project Contract amount Type of Work Date Completed Name and Address of Owner Name and telephone number of person familiar with project Contract amount Type of Work Date Completed CONTRACI RID FORMS BF- 3 NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) 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 pLiblic 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, Ibid depository, or to any member or agent thereof to effectuate a collusive or sham bid. ure 111 111111111111 OM308MM Title Elecnor Belco, Electric, In a _Bidde_r­___A Subscribed and sworn, before me This_ day day of se at -A?_( 26 N6t5'ry Pubtrc in and for the State of California My Commission Expires: FED -1 I A notary public or Lother officO( c0m�,_ebng rt at ' 4, "' 'm"' this certificate verifies only the Identity of document the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of rne that document, (Seal) OLIVIA CHER ". Jir Commission No, 2107474 � NOTARY PUBLIC -CALIFORNIA 2 SAN BERNARDINO COUNTY My Comm Expires APRIL 18, "ai A notary public or Lother officO( c0m�,_ebng rt at ' 4, "' 'm"' this certificate verifies only the Identity of document the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of rne that document, 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 fads 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 riot be permitted toLsubcontract 1hatpgrtion of the Work except Linder 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 I percent of the Contractor's total bid or ten thousand dollars ($10,000), whichever is greater, for which no subcontractor was designated in the originaI bid shall only be permitted in cases of public emergency or necessity, and then only after Owner approval. Name: Description" Address: cj'�Z "pug s,% city: ­� �j"q Is S.- State: Zip: 0 License No. Department of lndustria4 R6atior Registration No, W000061 -(- Name: --Work Description: Address: City: ­— State: _ Zip, License No. Department of Industrial Relation Registration No. Name: .. ..... ___Work Description: Address:.._.__ ...... City State; Zip: License No, Department of Industrial Relabon Registration No, Name: Descriptlon: Address: City. State: —_ Zip" License No. Department of lndustriM Relation Registration No. A,** tk* *** * * k** *,J: * t **,k **,*A ****�, **** ** **A-* k Narne: .w...___.____.' or Descripfion: Address: city-� Stal& _Z# I.Jcense No, Department of lndustrta& Relation Regrstmtlon No, Name: Work Description, Address: Cfty: State" Zlp License No, Department of lndustnal Relatlon Registration No, Name: Address: Dty: State: —Zip: License No. Department of Industrial Relation Registration No A*** k k** i* P, A,** k** A Name, Work Descriptlon: Address: City: State: Z'p License No, Department of Industrial Relation Registration No. **** 411 * * * * *+ k k * * k* * Narlie: ^Nork Descrlptlon: Address: Dty: State: License Na, Departnient of industrlal Relation Reglstratioil No, F7 -D-1,2 Name: Work Description:. Address: City: State: Zip,: License No., Department of lndustrial Relation Registration No. Narne: Work Descriptiory Address: city: State: ­—ZiP: License No, Department of Industrial Relation Registration No, Name: Work Description; Address: - City: -- State: License No. Department of Industrial Relation Registration No, Name: Work, Description; Address: City: State: License No, Department of Industrial Relation Registration No, Name: --Work Description: Address: city: State: --- License No, Department of Industrial Relation Registration Na. *il****************".k************,Ai''kk,k*.**** Name: --1/Vork Description:. Zip: Address. City:..,.__.___ State_Zip; License No. Department of lndustriai Relation Registration No, F -F -D-1 2 > 'iii lf' ii %iZIM Yj Z E2, X M n uj C 4 LW RAN Jkl ;/ 46 " 101 r 11"� I W LU El EIEJ -T 7D 0 C 0ff (0 C1 0 CL TO Is) V) vo, 0 N _dU) 0 C) 0 C7 C: 0 C-) 0 C- 0 CD 0 C-. M1 0 0 C) E E E E E E .m C"'. E E E E cts-0 LO 0 U, LC) LQ Z;7 (D C14), U11) U') U V') Cj; V) 0.05 v N V V V A V V V V A v El ED . . ............. .... . 0 C,o (-3 Uj ir x >< Q- . .. .... . . .... ............ .. ... cr C) crs C7, cl co v; SJ 0) C-7 4�1 I CL 77 0 2 0 ca- 0 !Gr/ qj �e ON (v"PA, LO r If C,",,7p Ji fill, "o JM el 1-11 a) CL (D 0 0 0 E 0 CL 0 0 V) cz 0 0 0 0 0fn E E E E Ln LO CD LO LO CD LO LO CD C: C7 v v V .0 V .0 A .0 V -0 v v v -0 A 0 V V V �O V 0 A 11 UP =Ell Tff Elj[�fEl�[� 'El a X 0 M = CL CD C> X LT- LT Li - CL 9yi y„E M z NJ E U- N ry �:-- -zi E ............ L ........ ... j i" 0�" "lt er, LJ4"�' gg- QU/ d'i M V ap, 0I i0 E E C-) LO LO - ria64 16q 69 a U), cz Z: IV v cz V 0 A 0 v v v .0 v .0 A �O o Op E [:141. 1:' I Lb C5 (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION' OF THOSE CERTIFICATIONS WHICH ARE A PART OF THIS PROPOSAL) The bidder Elecnor Belco Electric, Inc. Subcontractor proposed hereby certifies that he has , has not _, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, ail reports due Linder the appkable filling requirements, Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1,5. (Generally only contracts, or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO -1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the D�rectcr, Office of Federal Contract CornpJapce, M, Department of Labor. FED PUBLIC CONTRACT CODE SECTION 10285,11 STATEMENT In conformance with Public Contract Code Section 102851 (Chapter 376, Stats, 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has , , , , has riot -X. been convicted within the preceding three years of any offenses referred to iri that section, including any charge of fraud, bribery, COUSiOu1, conspiracy,, or any other act in viciation of any state or Federal antitrust lave in connection with the Mcling upon, award of, or perfcgrnatice of, any public works contract, as defined in PuVc Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, inclu(fing the Regents of the University of California or the Trustees of the CaVornia State University. The term "Mcler" is, understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 102851, Note: The bidder n!LJSt place a checkmark after "has"' or "has not" In one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shaf also constitute signature of this Statement, Bidders are Cautioned that making a false certification may, subject the certifier to criminat prosecution. PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE in conformance wIth Public Contract Code Section 10162, the Elder shall cornp4ete, Under penalty of perjury, the. V"cwifig quesIionraire: Has the bdder, any officer of the bidder, or, any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented frorn bidding or), or cornpleting a federal, state, or Iocai government project because of a violation of law or a safety regulation? Yes No X If the a,ns,w,ver is yes, expiairi the circumstu-,inces in the following space, PUBLIC CONTRACT CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the Naflonal Labor Relations Board Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire, Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. ED -1 8 TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as rioted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: 0 is not currently under suspension, debarment, VOlUntary exclusion, or determination of ineligibility by any Federal agency; I has not been Suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; t does not have a proposed debarment pendingand 0 has not been indicted, convicted, or had a civil judgment..rendered against it by a court of competent jurisdiction in any matter involving fraud or offic4l misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space, Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action, Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposa: on the signature portion thereof shall also constitute signature of this Certification, The prospective participant certifies, by sigNng and submitting this bid cr proposal, to the, br,.,,sf of his, or her knowledge and belief, that, (1) No Federal appropriated funds have been paid or Wil be paid, by or on behalf of the undersigned, to any person for influencing or, attempfing to influence an officer or em,pbyee of any Fede;4 agency, a Member of Congress, an officer- or empioyee of Congress. c,:)r ar employee of a Member of Corgress r I corneclion with the awar&g of any Federal contract, the making of any Federal grant, the rnaklng of any Federal loan, the entering onto of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, Joan, oir cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for infkiencklg or. attempting to influence an officer or employee of any Federal agency, a I'dember of Congress, an officer or er,rrpjoyee of Colr1gress, or an empioyee of a Member of Congress in connection with, this Federal contract, grant, loan, or cooperative agreernen', thE,1 Llfldersgreed shall complete and submit Standard Form -LLL, "Disclosure, of Lobbying Activities," in accordance with its instructions, This certification is a niaterlal represertation of fact upon which r6lance was placed when this transaction was made or entered into, Submission of this certification is a prerequisite for making or entering into this trarsacfion imposed by Section 1352, Title 31, U,S, Code, Any person who fails, to file the re#red certification shall be subject to a civH penalty of not less than $10,000 arid riot inore than $100,000 for each such failure The prospective participant also agrees by submitting his or her bid or proposal that he or she shall requure that the language of this c0ification be included in all lower tier subcontracts, which exceed S100,000 and that all such SLibrecipients shall certify and disclose accordingly. A "I COMFII,ETE THIS FORM TC DISCI OSE 1...GBBYlNG ACTWMES PURSUANT TC 31 S 1352 1.\ Type of Federal Action: 2. Status of Federal Action: 3. Report Type: q hid/r)ffP.r/Anr)F(',,,ifion = a G66;;l I/ / qV b,\grant b, initial award b, i nateriai char c. c operafive agreement c, post -award For MO aterial C"4e nly: 'e' �(Oa,)arantee yex Aart,,er N f loan insutrance date ot)/jst report_ 4. Name and Addre's,� of Reporting Entity Prime Sawardee ltl� Tier if known Congressional District, if known 5, If Reporting Entityffi No, 4 is Subawardee, � Enter Name and Address of Prime: ,Congressional District, if known IMM Number, if appkable, 10, a., Name and ddress of Lobby Entity b. Individuals Performin�, Services (including (If hdjvio�,a�,.last name, first narve, address if different from ' t� 1 Oa) (last narne, first narne, K) (attach ConfiflUation Sheet(s) of necessary) ........... .... 1. Amount of Payment (check all that 13. Type of Payment (check all that apply actual I planned a. nstaner b, cne-time fee 12. Form of Payme6t,(check all that apply): C' corrml�ssion & cash d, contingent fee b. in-kind; specify: "tura e deferred ............ valuef, other, spe 14, Brief Description of Services Performed 6`r"'�, be including "',N officer(s), employee(s), or rnember(s) contacted, (attach Conti 15, Continuation Sheet(s) attached:,,Yies [J 16, Information requested fhrouO this form is authorized by Title 31 U. '. .Section 1352, This disclosure of iobbyfhcj ieliance was placed by the fier al ve when his Z transacfion vva s � ade or entered onto This disclosure is r uire,d pursuant to 31 U.Q.C. 1352 This " iformafion wT, be reported to Congre eserniannuaHy and Ml be availablefor p !c inspection, Any person who fails to e�Zthe required disciosuie sf4he subject a civH penalty of not Tess than, $10,000 and riot more than $10,01,000 for each surri failure. �1 • t Indicated in Item 11: Sheet(s) if necessary) No 11 Signature: Pnnt Name. Inn r .' _�A_ Title: Vice president Teiephono No.: .9,09-9193-5470 Date; 91/4/1' Authorized for Local Reproduction Standard Form LLL Standard Form LLL Rev, 09-12-97 This disclosure form shall be Con1pleted by the reporting entity, whether subawardee or prirnr: Federal recipient, at the initiation or re(,,eipt of covered Federa�i action or a rnaferial change to previous filing pursuant to titre 31 FE01 1r uS.C. Section 1352, The filing of a form is required for such payment or agreenaent to make payrrient to lobbying entity for influencing or atterripting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection wiPi a covered F(-xleral action, Attach a continuation sheet for additional information if the space on the forni is inadequate,. Connplete all iterns that appiy for both the init4filing and material change report. Refer to the implementing guidance published by the Office of Managernent and Budget for addloi4 information, 1 Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence, the OLItCOme of a covered Federal action, 2, Identify the status of the covered Federal action. I identify thp aporopriate classification of this report„ if this is a Vrov�-up report (.',,aused by a material change to the information previously reported, enter the year and (JUarter in which the change occurred, Enter the date of the last, previously submifted report by thJs reporting entity for this covered Federal action 4. Enter the full narne, address, city, State and zip code of the reporting entity. Include Congressional District if known, Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient, Identify the tier of the subawardee, e,g,, the first sublawardee of the prime is the first tier. Subawards rKlUdo but are not lirnniterd to subcontracts, subgrants and contract awards under grants, 5. If the organization filing the report in herrn 4 checks "Subawardee" then enter the full name, address, city; State and zip code of the prime Federal recipient Include Congressional District, if known. 6, Enter the name, of the Federal agency making the award or Iloaan commitment, lncWe at least one organization levcd below agency name, if known. For example, Department of Tmnspertation, United States Coast Guard. T Enter the Federal prograrn narne or descrcption for the covered Federal action (iterri 1), if known, enter the full Catalog of Federal Domestic Assistance SCFDA) number for grants, cooperative agreernents, loans and loan conim�ltrnents, 1 Enter the most appropriate Federal Identifying number available for the Federal act6i idenflfication in itern I (e,g,, Request for Proposal (RFP) number, Invitation for &d (IFB) number, grant announcement Purnber, the contract grant or loan award number, the apphcafion/proposal contronumber assigned by the Federal agency)i. Include prefixes, e.g. "RFP ,SDE: -90 001 ' 2, For a covered Federal action where there has been an award or Doan commitment by the Federal agency, enter, the Federal amOLV)t Of the award/loan con)rnitrnents for, the phn')e ent�ly identified in Item 4 or 5. 3 (a) Enter thea tui name, address, city, State and 71P coda of the labblying enfity enqa�ged by the, rerqx6rg entity identified in Item 4 to infuenced the covered Federal acfio,'I. (b) Enter the full names of the individual(s) performing services and include full acidress if different from I () (a) Enter Last Name, First Name '.Md Middle lnclial (MI) :7E0 as 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10) Indicate whether the payment has (been c -,)@do (actual) or wN be read e (planned). Check all boxes that apply, If this is a rnater4 change repoi�i, enter the cumulative arriount of payment made or planned to be made. 12, Check the appropriate boxp,es). Check all boxes that apply. If payment is made through an ir-kund contribution, specify the nature and value of the, in-kind payment, 13, Check the appropriate box(es). Check a1 boxes that apply, If other, specify nature, 14. Provide a specific and det4lled descriptlon of the services that the lobbyist has perfonmed or Mil be expected to perform and tire date(s,) of any services rendered, lncliude all preparatory and reiated activity not just time spent in actual contact with Federal officials, Identify the Federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted, 15, Check whether or not a continuation sheet(s) is attached. 16, The certifying official shall sugn and date the forni, print his/hor narne title and telephone number. Public reporting burden for this collection of information is estimated to average 30 rninutes, per response, including tirne for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and cornpleting and revi&�ving the Wection of information, Send comments regaiding the 'burden estimate or any other aspect of this collection of information, incudlng suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), V%'ashiington, D.C. 20503,