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CC - Item 4E - Garvey Park Cooling System Project No. 31019 - Rejection of All BidsROSEMEAD CITY COUNCIL STAFF REPORT TO: THE HONORABLE MAYOR AND CITY COUNCIL FROM: GLORIA MOLLEDA, CITY MANAGER APRIL 14 " DATE: ,2020 SUBJECT: GARVEY PARK GYM COOLING SYSTEM PROJECT NO. 31019 - REJECTION OF ALL BIDS SUMMARY As part of the City's Fiscal Year 2019-2020 Capital Improvement Program and the City's Annual Action Plan for CDBG activities, the City Council approved the Garvey Park Gym cooling project. On March 18, 2020, bids were received and reviewed for the project. DISCUSSION On March 18, 2020, the City Clerk received two (2) sealed bid with the following result: Contractor Location Base Bid Amount Add Alt. 1 Add Alt.2 F.M. Thomas Air Conditioning Brea, CA $317,714 $27,762 $18,534 Renewage Construction El Segundo, CA $399,500 $60,000 $45,000 Base Bid — Gym Cooling Add Alt. — Office Cooling Add Alt. —Bathroom Cooling F.M. Thomas Air Conditioning proposal includes a subconsultant (Scott Manfredi Construction, inc.) that is not registered with the Department of Industrial Relations (DIR) and is therefore rejected as not responsive. Staff believes that by rebidding the project and reaching out to several other contractors, additional bids will be received ensuring the most competitive pricing. STAFF RECOMMENDATION It is recommended that the City Council: Reject all bids received for this project and direct staff to readvertise the project for new bids; and 2. Take such additional, related action that may be desirable. AGENDA ITEM 4.E City Council Meeting April 14, 2020 Page 2 of 2 FINANCIAL IMPACT CDBG funding for this project is included in the Fiscal Year 2019-20 Capital Improvement Program (CIP). Additional funding will be included in the Fiscal Year 2020-21 CIP budget to total approximately $338,000 in CDBG funds. Rejecting all bids and readvertising the project would ensure that the City receives the most competitive bid for the project. STRATEGIC PLAN IMPACT Rejection of all bids and readvertising the project is consistent with the Strategic Plan's guiding principal for fiduciary responsibility of providing for transparency in financial management of City's finances. PUBLIC NOTICE PROCESS This item has been noticed through the regular agenda notification process. Submitted by: Ben Kim Assista rty Manager Attachment A: Bid Opening Results Attachment B: F.M. Thomas Air Conditioning, Inc. Bid Proposal Attachment C: Renewage Construction Bid Proposal Attachment A Bid Opening Results MINUTES OF THE BID OPENING REQUEST FOR NIB NO. 2020-03 PROJECT NO. 31019 — GARVEY PARK GYM COOLING ADDITION Due Wednesday, March 18, 2020 at 10:30 a.m. A total of 2 bids were received. Submitted By: flLi /OM-. Natalie Haworth, Deputy City Clerk Contractor City Date/Time Received Bid Amount Base, Alt #1 and #2 1• F.M. Thomas Air Conditioning, Inc. March 18, 2020 Base: $317,714 Brea, CA @ 9:38 a.m. Alt #1: $27,762 Alt #2: $18,534 2• Renewage Construction March 18, 2020 Base: $399,500 EI Segundo, CA @ 10.30 a.m. Alt #1: $60,000 Alt #2: $45,000 Submitted By: flLi /OM-. Natalie Haworth, Deputy City Clerk Attachment B F.M. Thomas Air Conditioning, Inc. Bid Proposal City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 15 of 630 Bidder's representative. 28. BIDDER'S RESPONSIVENESS CHECKLIST The Owner's initial responsiveness evaluation will consider the following: A. Completed and properly executed Bid Letter (Including a completed Total Bid Price, completed Bid Bond amount, acknowledged addenda, completed state of incorporation or partner/joint venturer information (if applicable), completed license number, and signature by authorized company officer); B. Completed Bid Data Fortes (including valid and properly executed Bid Bond for 10% of the Total Bid Price and a completed List of Proposed Subcontractors); C. Properly executed Non -Collusion Affidavit; and D. Completed and properly executed Bidder Information Forms. If the Bidder is a joint venture, each joint venturer shall prepare and submit a separate form. Extra forms, if needed, can be obtained from the Owner, or photocopied by the Bidder, if necessary. 29. CONTRACT BID FORMS; LISTS OF SUBCONTRACTORS A. Contract Bid Forms. The Bid Letter and Forms must be completed as set forth below. (1) The Contract Bid Forms and Letter must be prepared using ink, indelible pencil or a typewriter. (2) The Bid Letter must be signed by the Bidder or on its behalf by the person or persons having the authority to do so. Proof of the authority to act on behalf of the firm must be submitted when requested. The proof shall be in the form of a certified copy of an appropriate corporate resolution, certificate of partnership or joint venture, or other appropriate document. If Bidder is an entity made up of multiple parties and no person or persons are designated to act on its behalf, all parties shall execute the Bid. (3) Addenda - Receipt of addenda must be acknowledged in the space provided in the Bid Letter. (4) The Bidder shall not delete, modify, supplement or make substitutions thereof, on the printed matter of the Contract Bid Forms or Bid Letter. (5) Corrections shall be initialed by the person who signs the Bid Letter. (6) Exceptions or qualifications to the Bid Documents are strictly forbidden. Any comment by the Bidder which the Owner determines can be construed as altering the requirements of the specifications or the terms and conditions of the Contract will render the Bid nonresponsive and disqualify the Bidder from consideration for award. B. List of Proposed Subcontractors (Forms). State law prohibits substitution of subcontractors listed in the original Bid except as otherwise provided in Sections 4107 and 4107.5 of the California Public Contract Code. Bidders are required ITB -8 City of Rosemead, Califomia Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 3 of 630 CITY OF ROSEMEAD GARVEY PARK GYM COOLING ADDITION PROJECT No. 31019 NOTICE INVITING SIDS i City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No. 31019 Document Control Page 4 of 630 CITY OF ROSEMEAD NOTICE INVITING BIDS NIB No. 2020-03 NOTICE IS HEREBY GIVEN that the CITY OF ROSEMEAD, California, will receive sealed bids up to 10:30 o'clock a.m. on Wednesday, the 18th day of March and they will be publicly opened at 11:00 a.m. for Ty`p(} taxi 'pjr: r,r GARVEY PARK GYM COOLING ADDITION PROJECT No. 31019 The project consists of the installation of cooling addition of the existing Garvey Park Gym building located at 7933 Emerson Place, Rosemead, CA 91770 and consists of new cooling system, electrical, fixtures, framing, and landscaping as indicated in the appendix and other related work as described in the Plans, Specifications, and Contract Documents, by this reference, made a part hereof. The engineer's estimate for this project is $240,000. The successful bidder shall have SIXTY (60) working days to complete the work. Liquidated damages shall be $500.00 per working day. Plans, Specifications, and Contract Documents may be obtained at the office of the City Clerk of the CITY OF ROSEMEAD, 8838 E. Valley Boulevard, Rosemead, California 91770, (626) 569- 2177, for a non-refundable charge of $25.00 and $40.00 if mailing is requested. All prospective bidders must register with the office of the City Clerk's in order for your bid to be considered responsive. SB 854 Requirements: This project is subject to the requirements of SB 854. No prime contractor or subcontractor may } be listed on a bidproposal for a public works project unless registered and qualified with the Department of Industrial Relations pursuant to Labor Code section 1725.5. No prime contractor or subcontractor may be awarded a contract for public work on a public works project unless registered and qualified with the Department of Industrial Relations pursuant to Labor Code section 1725.5. This project is subject to compliance monitoring and enforcement by the Department of Industrial Relations. The bid proposal must include a print out from the DIR registration website showing that the prime contractor and each subcontractor is currently t . registered and qualified. No bid proposals will be accepted nor any contract entered into with a prime contractor without proof of registration as required above. [Unless within the limited exceptions from this requirement for bid proposals only under Labor Code Section 1771.1(a)] t. Each bid must be accompanied by a bidder's security in an amount not less than 10% of the amount of the bid, as a guarantee that the bidder will, if awarded the Conti -act, enter into a satisfactory agreement and provide a Performance Bond and a Payment Bond, each not less than 100% of the total amount of the bid price. NIB -1 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addilion, Project No; 31019 Document Control Page 7 of 630 CITY OF ROSEMEAD GARVEY PARK GYM COOLING ADDITION PROJECT No. 31019 INSTRUCTION TO BIDDERS City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 16 of 630 BIDDER: F.M. Thomas Air Conditioning, Inc. i CITY OF ROSEMEAD GARVEY PARK GYM COOLING ADDITION PROJECT No. 31019 i.. i SECTION I - BID SCHEDULE J t CONTRACT .BID. FORMS i CBF -1 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No; 31019 Document Control Page 19 of 630 BIDDER: DDD== F.M. Thomas Air Conditioning, Inc. BASE BID SCHEDULE SCHEDULE OF PRICES FOR GARVEY PARK GYM COOLING ADDITION PROJECT No. 31017 NO. ITEM DESCRIPTION UNIT EST. UNIT ITEM 1 Install a Split System to Serve the Private Office LS QTY. PRICE COST Install a Packaged DX Rooftop Unit to $ 7-74 7 C 1 Serve the Gymnasium, and the Installation of a 480 Panel to Facilitate LS 1 $r 1� u c� the Newly Added Equipment TOTAL BASE BID AMOUNT IN NUMBERS $ '3 V71 1 ,cam TOTAL BASE BID AMOUNT IN WORDS:" Note: The City ofRosemead 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. ALTERNATE 1 BID SCHEDULE SCHEDULE OF PRICES FOR GARVEY PARK GYM COOLING ADDITION PROJECT No. 31017 NO. ITEM DESCRIPTION UNIT EST. QTY. UNIT PRICE ITEM COST 1 Install a Split System to Serve the Private Office LS 1Do TOTAL ALTERNATE 1 BID AMOUNT IN NUMBERS $ 7-74 7 C CBF -2 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 20 of 630 BIDDER: ❑oDDD DDoc:cooD0[]L=[M F.M. Thomas Air Conditioning, Inc. TOTAL ALTERNATE 1 BID AMOUNT IN WORDS: `i Q -&-A e- iA4 ALTERNATE 2 BID SCHEDULE SCHEDULE OF PRICES FOR j GARVEY PARK GYM COOLING ADDITION PROJECT No. 31017 I i NO. ITEM DESCRIPTION UNIT EST. QTY. UNIT PRICE ITEM COST 1 Install Exhaust Fan to Serve Both the Men's Women's Restrooms LS 1 $ $ and TOTAL ALTERNATE 2 BID AMOUNT IN NUMBERS $ TOTAL ALTERNATE 2 `BID AMOUNT IN WORDS: �� 4 �L-�_- wn f�ovscavt The undersigned agrees that these Contract Bid Forms constitute a firm offer to the Owner which cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and after the bid opening date, or until a Contract for the Work is fully executed by the Owner and a third party, whichever is earlier. The undersigned also agrees that if there is a discrepancy between the written amount of the Bid Price and the numerical amount of the Bid Price, the written amount shall govern. Attached hereto is a certified check, a cashier's check or a bid bond in the amount of Dollars ($ ) 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 i 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 salve period the necessary original Certificates of Insurance, Endorsements of Insurance, Performance Bond, Payment Bond and all other 4 documentation and certification required by the Contract. t The undersigned offers and agrees that ifthis 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 ofthe 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 CBF -3 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No; 31019 Document Control Page 21 of 630 ThomasBIDDER: F.M. • • • • , In,J 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, he shall provide: (1) evidence satisfactory to the Owner of Bidder's California contractor's license(s) in good standing; (2) evidence that the person signing this Bid is authorized to bind Bidder to this Bid and to a contract resulting therefrom; and (3) any other information and documentation, financial or otherwise, needed by Owner to award a Contract to the lowest responsible and responsive bidder. Bidder understands and agrees that liquidated damages shall apply to this Contract in the amounts of five hundred dollars ($500.00) if project is not completed in SIXTY (60) working days. The Contract Time will begin to run ten (10) Working Days from the date ofthe Notice to Proceed and subject to the terms and conditions described in the Contract Form and the Contract Documents. Bidder acknowledges that data submitted with its Contract Bid Forms which it requires to be incorporated into a Contract arising out of this Submittal has been so identified by Bidder. Bidder further acknowledges that the Owner may, at its discretion, incorporate any of the remaining data submitted herewith into a contract arising out of this Bid. The undersigned acknowledges receipt, understanding and full consideration of the following addenda to the Contract Documents. Addenda Nos. none The Bidder understands and agrees that the Total Bid Price is inclusive of all labor, materials, and equipment or supplies necessary to complete the Work as described in the Bid Documents. If this bid is accepted, the undersigned Bidder agrees to enter into and execute the Contract with the necessary bonds and accept the Total Bid Price as compensation in full for all Work under the contract. CBF -4 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition Protect No: 31019 Dacumenono t C h I P 22 coon age o BIDDER: =D❑❑❑ i iD i F.M. Thomas Air Conditioning, Inc. By: 231 Gemini Ave, Brea, Ca 92821 Signature Business Street Address Thomas Feyka Type or Print Name City, State and Zip Code President 714-738-1062 Title Telephone Number Bidder's/Contractor's State of Incorporation: California Partners or Joint Venturers: Bidder's License Number(s): 313574 Department Industrial Relations 1000003383 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, partnership or joint venture has the authority to do so. CBF -5 UNANIMOUS CONSENT OF DIRECTORS IN LIEU OF A REGULARLY SCHEDULED ANNUAL MEETING F.M. THOMAS AIR CONDITIONING, INC. A California Corporation The action set forth below are taken by unanimous written consent of the Directors of F.M. Thomas Air Conditioning, Inc. ("Corporation"), a California corporation, without a meeting, in accordance with California Corporations Code section 307 and the Bylaws of the Corporation. In reaching their decision, the Directors have reviewed and considered the various actions taken by the Officers and Agents of the Corporation, have considered the activities of the Corporation during the past year and its plans for the future, and have discussed the Corporation's financial condition. Based on these considerations and on the Board's evaluation of the Corporation's financial condition, the Directors give their unanimous written consent to the adoption of the following resolution: 1. COMPANY ISSUES DELAYED HOLDING OF 2014 ANNUAL MEETING. Due to company issues, the Corporation did not have time to hold the Annual Meeting of Shareholders for the 2014 year. Thus, this written consent action in lieu of the Annual Meeting of Directors for the 2015 year shall serve to update the corporate books from the 2013 meeting. 2. RATIFICATION. The actions of this Corporation's officers that were taken in the conduct of the Corporation's business for, and on its behalf, since the last annual meeting of this Board are adopted, ratified, and approved in all respects as of the dates taken. 3. APPOINTMENT OF OFFICERS. The following persons are hereby appointed to the indicated offices, to serve at the pleasure of the board of directors: Title Name President Thomas M. Feyka Vice President Michael Feyka Secretary Carolyn K. Feyka Chief Financial Officer Carolyn K. Feyka 4. NECESSARY AUTHORITY. The Officers of this Corporation are authorized and directed to take such action and to execute such documents as they may deem necessary or proper to carry out the purpose and intent of the foregoing resolutions. [Signature Page to Follow] Dated: MayI `�, 2015 Carolyn eyka, IRE TOR Thomas M. Feyka, DI COR City of Rosemead, California Bid Package, Garvey Park Gym Carling Addition, Project No: 31019 Document Control Page 23 of 630 BIDDER: 11=0000 F.M. Thomas Air Conditioning, Inc. SECTION2 BID DATA FORMS M -MME -1 Bond No. CSBA-13130 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 24 of 630 BIDDER: F.M. Thomas Air Conditioning, 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 F.M. Thomas Air Conditioning, Inc. as Principal, and Merchants Bonding Company (Mutual) , as Surety, are held firmly bound unto the CITY OF ROSEMEAD (hereinafter called the OWNER) in the sum of Ten Percent of Amount Bid DOLLARS ($10% ), being not less than ten percent (10%) ofthe 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 GARVEY PARK GYM COLLING ADDITION PROJECT —as set forth in the Notice Inviting Bids and accompanying Bid Documents, dated March 18, 2020 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, ;his 116th day of March , 2020 . F.M. Thomas AI ndltio ing, Inc. (SEAL) Merchants Bonding Company (Mutuat)(SEAL) Principal Surety By: By: Signature Aignature Arturo Attorney -in -Fact CBF -7 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange ) On 3/16/2020 before me, Melissa Ann Vaccaro, Notary Public (insert name and title of the officer) personally appeared Arturo Ayala 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. ••"`, ..'�, MELISSA ANN VACCARO WITNESS my hand and official seal. COMM.#2241394 M Notary Public -California ORANGE COUNTY a ( Seal) °a`,o,,• My Comm. Expires May 12, 2022 Signature(\`_�_ Melissa Ann Vaccaro M.ERCHANTSNk Bond No. CSBA-13130 BONDING COMPANY,. POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of Iowa (herein collectively called the "Companies") do hereby make, constitute and appoint, individually, Arturo Ayala; Ben Stong; Daniel Huckabay; Dwight Reilly; Frank Morones; Michael D Stang; R Nappi; Shaunna Rozelle Ostrom their true and lawful Attorney(s)-In-Fact, to sign its name as surety(les) and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted In any actions or proceedings allowed by law. This Power -of -Attorney is granted and is signed and sealed by facsimile under and by authority of the following By -Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors of Merchants National Bonding, Inc., on October 16, 2015. "The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof." "The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually fixed." In connection with obligations In favor of the Florida Department of Transportation only, it Is agreed that the power and aut hority hereby given to the Attorney -In -Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such Intent has been given to the Commissioner - Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation. In Witness Whereof, the Companies have caused this Instrument to be signed and sealed this 11th day of February 2020 •' P�. ... ••. ••k G C U,y• .•` ItPO/� eo . �O '4i`'. ..... : pi' ''�P 0 Ay •• �; S,Q '9.4�;.�� MERCHANTS BONDING COMPANY (MUTUAL) ly: y • ; MERCHANTS NATIONAL BONDING, INC. :i 2003 y 1933 c: By yvd•• : �� ••.v1�(/ ��`' ; fid;. ,gip`;• •., �1••• President STATE OF IOWA ''•'f°"" °"•• COUNTY OF DALLAS ss. On this 11th day of February 2020 , before me appeared Larry did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) ani seals affixed to the foregoing instrument are the Corporate Seals of the Companies; of the Companies by authority of their respective Boards of Directors. 4PFLIA� s POLLY MASON o q Commission Number 750576- _Z 50576z My Commission Expires January 07, 2023 (Expiration of notary's commission does not invalidate this instrument) Taylor, to me personally known, who being by me duly sworn I MERCHANTS NATIONAL BONDING, INC.; and that the and that the said instrument was signed and sealed In behalf Notary Public I, William Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby certify that the above and foregoing Is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies, which is still in full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and ,•�yo�PoR may: 2003 i o POA 0018 (1/26) •••"""" affixed the seal of the Companies on this 16th day of . March 12020 . • p�N� Cq •. 4;p 1. .q . • ,:'e 1933 .s Secretary CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE c�C�C_wS�C�Y'C.w�C!G�C.w..wC.w•.wS.wC�S�S.w�'.wC.w .w .wC C� .w�•.w .c�C.w��•.w� .wC.w .wC�C.wC�C.wC�C.w�C.:�� .w 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 a.(1,/-VU0,Q ) On '' � I before me, Cc.kli cC /u,k Yiu. , Date Here Insert Name and Title of e Officer personally appeared Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose namefs) is/_aw subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/leer/their authorized capacity(isss), and that by his/ber/their signature(s) on the instrument the person(sr or the entity upon behalf of which the persons) 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. 00 r RENEE RITCHIE NotaryPublic- California Z Signature u orange County > Signature of Nota Public Commission q 2201353 9' Notary My Comm. Expires Jun 16, 2021 Pq Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Number of Pages: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: � •✓4"•✓4"✓�'✓.1'�G'd4`.B�✓.4�. '� '</ 'r/4�y '✓4\�AY.'J 'Pi 't14�,.'d '�/4'� '�4�. '✓4�, - e�G'U 'N4'b4'N4� 'n/.'•✓ 't/4'c/ 'd 'e!4'ei '✓ 'L '� City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 25 of 630 BIDDER: fYJCf7�CflCiO❑CfJ❑m❑❑Ct7❑C0D 2.B LIST OF PROPOSED SUBCONTRACTORS In compliance with the "Subletting and Subcontracting Fair Practices Act," Sections 4100 through 4114 of the California Public Contract Code, and any amendments thereto, each Bidder shall provide the information requested below for each subcontractor who will perform work, labor or render service to Bidder in or about the construction of the Work in an amount in excess of one-half of one percent (greater than 0.5 %) of the Bidder's Total Bid Price, or, in the case of bids or offers for the construction of streets or highways, including bridges, in excess of one-half of 1 percent of the Contractor's total bid or ten thousand dollars ($10,000), whichever is greater, and shall further set forth the portion of the Work which will be done by each subcontractor. Bidder shall list only one subcontractor for any one portion of the Work. Pursuant to Public Contract Code Section 4104, the Owner has determined that it will allow Bidders twenty-four (24) additional hours after the deadline for submission of bids to submit the information requested by the Owner about each subcontractor, other than the name and location of each subcontractor. If the Bidder fails to specify a subcontractor for any portion of the Work to be performed under the Contract, it shall be deemed to have agreed to perform such portion itself, and shall not be permitted to subcontract that portion of the Work except under the conditions hereinafter set forth below. Subletting or subcontracting of any portion of the Work in excess of one half of one percent (greater than 0.5%) ofthe 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 - 8 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No. 31019 Document Control Page 26 of 630 BIDDER: E00a=D=DiJ—=—M0 F.M. Thomas Air Conditioning, Inc. 2.B LIST OF PROPOSED SUBCONTRACTORS (continued) ["Duplicate Next 2 Pages if needed for listing additional subcontractors."] I Name and Location Description of Work of Subcontractor to be Subcontracted r r i Name: Scott Manfredi Construction ceiling, roofing, footings, drywell Address: 8941 Atlantic Ave. #131 Huntington Bch, Ca 92646 License No.: 444234 Department of Industrial Relation Registration No. 1000028706 Name and Location of Subcontractor Description of Work to be Subcontracted Name: Michael Lawrence Electric Electrical L4eeme-No.: 3409 SANDOVAL AVENUE PICO RIVERA, CA 90660 Department of Industrial Relation Registration No. 1000046014 Name and Location of Subcontractor Description of Work to be Subcontracted Name: PRECISION IRON WORKS Structual steel Address: 14342 CERECITA DR. WHITTIER CA 90604 License No.: 1000647 Department of Industrial Relation Registration No. _1000039907 Name and Location of Subcontractor Description of Work to be Subcontracted Name: The Crane Guys Crane Address: 14480 Alondra Blvd. La Mirada. Ca 90638 License No.: tic 967520 Department of Industrial Relation Registration No. 1000008224 s Name and Location of Subcontractor Description of Work to be Subcontracted Name: inland air balance Address:_ 482 W. arrow hwy #C San Dimas, Ca 91773 License No.: 837772 Department of Industrial Relation Registration No. 1000013848 CBF - 9 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 27 of 630 BIDDER: (DCiI❑COD F.M. Thomas Air Conditioning, Inc. 2.0 REFERENCES The following are the names, addresses and telephone numbers for three public agencies for which BIDDER has performed similar work within the past two (2) years: 1' City of Los Angeles Cesar Lopez Salazar 14832 Raymer St Van Nuys, Ca 91405 Name and Address of Owner City of Los Angeles Cesar Lopez Salazar, HVAC Supervisor 213-978-7606 Name and telephone number of person familiar with project NTE $13M / year Task order contract to include HVAC retrofit, design, replacement 6/2005 - Present Contract amount Type of Work Date Completed 2 Orange Country Sheriffs Dept. Sa N. Flower AnCa 2703 Name and Address of Owner Remon Tadrous 714-935-7472 Orange County Men's Jail phase 1 Name and telephone number of person familiar with project $1.7M HVAC Retrofit air handlers 12/2017 Contract amount Type of Work Date Completed 3' Orange Count Sheriffs Dept. 550 N. Flower 9 g Country p Santa Ana, Ca 92703 Name and Address of Owner Remon Tadrous 714-935-7472 Orange County Men's Jail phase 2 Name and telephone number of person familiar with project $1.4M Orange County Men's Jail phase 2 Contract amount Type of Work Date Completed CBF -10 1 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 28 of 630 BIDDER: ❑❑❑ = F.M. Thomas Air Conditioning, Inc. 4. Glendale UHSD 1440 E. Broadway, Glendale, Ca 91205 Name and Address of Owner Raymond Mikaily 818-507-0201 Name and telephone number of person familiar with project $791,000 Replace 60 Ductless Split systems 8/2018 Contract amount Type of Work Date Completed CBF - 11 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 29 of 630 BIDDER: ❑DD❑❑0 =--OD[]== F.M. Thomas Air Conditioning, Inc. SECTION3 NON- LOLL USION AFFIDA VIT CBF -12 City of Rosemead, California Bid Package, Garvey Perk Gym Cooling Addition, Project No: 31019 Document Control Page 30 of 630 BIDDER: '10== 0000 F.M. Thomas Air Conditioning, Inc. 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, j 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 fe to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. �1 /j // Thomas Feyka Typed or Printed Name President Title F.M. Thomas Air Conditioning, Inc. Bidder Subscribed and sworn before me This ('10` day of /%1/t� fit` .(<L , 20 ,�O (Seal) ICU RENEE RITCHIE ! Notary Public in and for Notary Public -California Z z Orange County the State of California a Commission # 2201353 1 My Comm. Expires Jun 16, 2021 My Commission Expires: ��'� Z¢ l� CBF -13 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 31 of 630 BIDDER: ❑0❑p❑C�p❑❑d�mrrra�nn❑❑�D F.M. Thomas Air Conditioning, Inc. SECTION 4 REQUIRED FEDERAL FORMS CBF -1.4 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 32 of 630 CONTRACTOR INFORMATION 1 Company Name F.M. Thomas Air Conditioning, Inc. i Address 231 Gemini Ave, Brea, Ca 92821 Telephone 714-738-1062 Fax 714-738-0886 E-mail mfeyka@fmthomas.com Type of Firm: Individual © Partnership © Corporation Corporation organized under the laws of the State of California 313574B, C-41 C-20, C-38 Contractors License Number State Ca Classification Expiration Date 2/28/21 DIR Registration Number 1000003383 Expiration Date 6/30/20 Names and titles of all officers of the firm Thomas Feyka, President Carolyn Feyka Secretary/Treasurer Michael Feyka, Vice President CBF - 15 C) O 0 O z a 3 CD M n. z N 3 rn v C CL C 0CCD c' 0. CD � O O co N Q N =r a' CD CD CD 6 7 � O O CD CD m co a ❑ 05' J "m O m =� T. a co "0 �'v o 3. c o'Z 7 (i N pj C c CG) CD O N 7 � O fD =r o. N A mCo N Co v CD �. fD 0 O =' Cr O -n N S o m �Q N ti, c m � a CL Uy CD c 0 CD 3 a N 9.0 D0 a.0) o' � CDtr Qo o N O G N G: CD z = m 0 p T n zco a c o• (Do Q. a� ao N 'Y O � N 0 z4 3 � a �o 0 0 1 a rt 3 O C a v M al7 3 c� n 0 �3 3 m v a n 0 tr ID n C lD Q(D z = m 0 p T n EOUoaTCfTl�liio0iyl hent Bid Package,rfrgy WWA1g�¢�iggOftlNo: 31019 ud1 CfTI and Urban Development Opportunity Certification Office of Housing Excerpt From 41 CFR §60-1.4(b) Federal Housing Commissioner The applicant hereby agrees that it will incorporate or cause to be incorporated into any contract for construction work, or modifi- cation thereof, as defined in the regulations of the Secretary of Labor at 41 CFR Chapter 60, which is paid for in whole or in part with funds obtained from the Federal Government or borrowed on the credit of the Federal Government pursuant to a grant, contract, loan insurance, or guarantee, or undertaken pursuant to any Federal program involving such grant, contract, loan, insur- ance, or guarantee, the following equal opportunity clause: During the performance of this contract, the contractor agrees as follows: (1) The contractor will not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. The contractor will take affirmative action to ensure that applicants are employed, and that em- ployees are treated during employment without regard to their race, color, religion, sex, or national origin, such action shall include, but not be limited to the following: Employ- ment, upgrading, demotion, or transfer; recruitment or re- cruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. (2) The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive considerations for em- ployment without regard to race, color, religion, sex, or national origin. (3) The contractor will send to each labor union or representative of workers with which it has a collective bargaining agree- ment or other contract or understanding, a notice to be provided advising the said labor union or workers' represen- tatives of the contractor's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. (4) The contractor will comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regu- lations and relevant orders of the Secretary of Labor. (5) The contractor will furnish all information and reports re- quired by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to its books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation to ascertain compli- ance with such rules, regulations, and orders. Firm Name and Address F.M. Thomas Air Conditioning, Inc. 231 Gemini Ave, Brea, Ca 92821 DepartA49f4 W*f&i'WWA*s OMB Control No. 2502-0029 (exp. 7/31/2009) (6) In the event of the contractor's noncompliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, this contract may be can- celed, terminated, or suspended in whole or in part and the contractor may be declared ineligible for further Govern- ment contracts or federally assisted construction contracts in accordance with procedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, oras otherwise provided by law. (7) The contractor will include the portion of the sentence imme- diately preceding paragraph (1) and the provisions of para- graphs (1) through (7) in every subcontractor purchase order unless exempted by rules, regulations, or orders of the Sec- retary of Labor issued pursuant to section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontractor or vendor. The contractor will take such action with respect to any subcon- tract or purchase order as the administering agency may direct as a means of enforcing such provisions, including sanctions for noncompliance: Provided, however, That in the event a contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency the contractor may request the United States to enter into such litigation to protect the interests of the United States. The applicant further agrees that it will be bound by the above equal opportunity clause with respect to its own employment practices when it participates in federally assisted construction work: Provided, That if the applicant so participating is a State or local government, the above equal opportunity clause is not applicable to any agency, instrumentality or subdivision of such government which does not participate in work on or under the contract. The applicant agrees that it will assist and cooperate activelywith the administering agency and the Secretary of Labor in obtaining the compliance of contractors and subcontractors with the equal opportunity clause and the rules, regulations, and relevant orders of the Secretary of Labor, that it will furnish the administering agency and the Secretary of Labor such information as they may require for the supervision of such compliance, and that it will otherwise assist the administering agency in the discharge of the agency's primary responsibility for securing compliance. The applicant further agrees that it will refrain from entering into any contract or contract modification subject to Executive Order 11246 of September 24, 1965, with a contractor debarred from, or who has not demonstrated ell ibility for, Government contracts and Federally -assisted const uction contracts pursuant to the Executive order and wi}}1 car y out such sanctions and penalties for violatio"f the egytal o ortunity clause as may be imposed Tllle + Thomas Feyka, iresident CBF - 17 form HUD -92010 (3/2006) VA form 26-421 upon contractors and subcontractors by the administering agency or the Secretary of Labor pursuant to Part II, Subpart D of the Executive order. In addition, the applicant agrees that if it fails or refuses to comply with these undertakings, the administering agency may take any or all of the following actions: Cancel, terminate, or suspend in whole or in part this grant (contract, loan, insurance, guarantee); refrain from extending any further assis- tance to the applicant under the program with respect to which the failure or refund occurred until satisfactory assurance of future compliance has been received from such applicant; and refer the case to the Department of Justice for appropriate legal proceedings. Excerpt from HUD Regulations 200.410Definition of term "applicant". (a) In multifamily housing transactions where controls over the mortgagor are exercised by the Commissioner either through the ownership of corporate stock or under the provisions of a regulatory agreement, the term "applicant" as used in this subpart shall mean the mortgagor. (b) In transactions other than those specified in paragraph(a) of this section, the term "applicant" as used in this subpart shall mean the builder, dealer or contractor performing the con- struction, repair or rehabilitation work for the mortgagor or other borrower. 200.420Equal Opportunity Clause to be included in contracts and subcontracts. (a) The following equal opportunity clause shall be included in each contract and subcontract which is not exempt: During theperformance of this contract, the contractor agrees as follows: (1) The contractor will not discriminate against any em- ployee or applicant for employment because of race, creed, color, or national origin. The contractor will take affirmative action to ensured that applicants are employed, and that employees are treated during employment without regard to their race, creed, color, or national origin. Such action shall include, but not be limited to the following: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates ofpay or other forms of compensation; and selection for training, including ap- prenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employ- ment, notices to be provided setting forth the provisions of the nondiscrimination clause. (2)The contractor will in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard race, creed, color, or national origin. (3) The contractor will send to each labor union or repre- sentative of workers with which he has a collective bargain- ing agreement or other contract or understanding, a notice, to be provided, advising the said labor union or workers' repre- sentative of the contractor's commitments under this section, and shall post copies of the notices in conspicuous places available to employees and applicants for employment. (4) The contractor will comply with all provisions of Ex- ecutive Order 10925 of March 61961, as amended, and of the regulations, and relevant orders of the President's Commit- tee on Equal Employment Opportunity created thereby. (5) The contractor will furnish all information and reports required by Executive Order 10925 of March 6, 1961, as amended, and by the regulations, and orders of the said Committee, orpursuant thereto, and will permit access to his books, records, and accounts by HUD and the Committee for purposes of investigation to ascertain compliance with such regulations, and orders. (6) In the event of the contractor's non-compliance with the nondiscrimination clause of this contract or with any of the said regulations, or orders, this contract may be can- celled, terminated or suspended in whole or in part and the contractor may be declared ineligible for further Govern- ment contracts or Federally -assisted construction contracts in accordance with procedures authorized in Executive Order 10925 of March 6,1961, as amende, and such other sanctions may be imposed and remedies invoke s provided in the said Executive Order or by regulations, or order of the President's Committee on Equal Employment Opportunity, or as other- wise provided by law. (7) The contractor will include the provisions of Para- graphs(1) through (7) in every subcontract or purchase order unless exempted by regulations, or orders of the President's Committee on Equal Employment Opportunity issued pursu- ant to Section 303 of Executive Order 10925 of March 6, 1961, as amended, so that such provisions will be binding upon each subcontractor or vender. The contractor will take such action with respect to any subcontract or purchase orders as HUD may direct as a means of enforcing such provisions, including sanctions for noncompliance: Provided, however, that in the event the contractor becomes involved in, or is threatened with, litigation with a subcontractor or vender as a result of such direction by HUD, the contractor may request the United States to enter into such litigation to protect the interests of the United States. (b) Except in subcontracts for the performance of construction work at the site of construction, the clause is not required to be inserted in subcontracts below the second tier. Subcontracts may incorporate by referenced to the equal opportunity clause. 200.425 Modification in and exemptions from the regulations in this subpart. (a) The following transactions and contracts are exempt from the regulations in this subpart: (1) Loans, mortgages, contracts and subcontracts not ex- ceeding $10,000. (2) Contract and subcontracts not exceeding $100,000 for standard commercial supplies or raw material; (3)Contracts and subcontracts under which work is to be or has been performed outside the United States and where no recruit- ment of workers within the United States in involved. To the extent that work pursuant to such contracts is done within the Untied States, the equal opportunity clause shall be applicable; (4) Contracts for the sale of Government property where no appreciable amount of work is involved; and (5) Contracts and subcontracts for an indefinite quantity which are not to extend for ore than one year if the purchaser determines that the amounts to be ordered under any such contract or subcontract are not reasonably expected to exceed $100,000 in the case of contracts or subcontracts for standard commercial supplies and raw materials, or $10,000 in the case of all other contracts and subcontracts. CBF - 18 form HUD -92010 (3/06) VA form 26-421 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 36 of 630 CERTIFICATION WITH REGARD TO THE PERFORMANCE OF PREVIOUS CONTRACTS OR SUBCONTRACTS SUBJECT TO THE EQUAL OPPORTUNITY CLAUSE AND THE FILING OF REQUIRED REPORTS Theo bidder, ❑proposed sub -contractor; hereby certifies that he/she ❑has, ®has not, participated in a previous contract or subcontract subject: to the Equal Opportunity Clause, .as required by Executive Orders 10925, 111.14,, or 11246, and that he/she ❑has, ®has not, filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting :or administeringagency, o.r the former President's .Committee on Equal Employment Opportunity, all .reports. due uhder the applicable filing requirements. r Date: F'roject'Number:.. ContractAward: $. i Awarding Agency: -----. — — t, Contractor Name: -- TotaI Number of Employees Affiliate Company -- — i Title: t NOTE: The above certificatlon is required by the Equal Employment Opportunitq.Regulations of the S.ecretaryof Labor .(41 CFR, 60-1.7(b)(1), and must be submitted by bidders and proposed 6t4bcontractors only in connection with contracts ' and subcontracts which are subject to the..equaf opportunity clause. Contracts and subcontracts which are exempt from the equal opp6rtunity clause are set forth (n:41 CFR.60A.5 (Generally only contracts or subcontracts of $10,000 or under are exempt). I Proposed prime contractors and subcontractors who have participated in a previouscontract'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 t. contracts and subcontracts. uniess such contractor submits a report covering'the.delfnquent period or such other period specified. by the U.S, Department of (he :Interior or by the Director, Office :of Federal Contract Compliance, U.S. Department of Labor. l ' SF -100 (EEO -1) must.be filed bv; (A) All private employers.who are: 1 (1) Subject to Title VII of the Civil Rights Act of 1964. (as amended) with 100 or more employees. + (2) Subject to Title VII who has fewer than 100 employees, if the company is owned or affiliated with another company, or there is centralized ownership, :control or management so that the group legally constitutes a'single enterprise, and the entire' enterprise employs a total of 100 or more employees. i (B) All federal contractors (private employers), who: (1) Are not exempt as provided for by 41 CFR 60-1.5 (2) Have 50 or more employees, and f a. Are prime contractors or first-tier subcontractors, and have a contract, subcontract, or purchase order amounting to $50,000 or more; or {_ b. Serve as a.depository of Government funds in any amount, or c. Is a financial institution, which is an Issuing, and paying agent for U.S. Savings Bonds and Notes. CBF - 19 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 37 of 630 1.xhibl.1; 13 County Lobbyist Certification Los Angeles County Compllanee Form ^ 7o be submltled w1th Bid COUNTY LOBBYIST COW CHAPTER 2.160 couN7Y ORDINANCE NO, 93-0031 Name of Firm: F.M. Thomas Air Conditioning, Inc. Address: 231 Gemini Ave, Brea., Ca 92821 state: -Ca zip Code: 92821 Telephone Number: ( ) 714-738-1062 Acting on behalf of the above named firm, as Its Authorized Official, I make the following Certification to the County of Los Angeles and the Community Development Commission, County of Los Angeles: 1) It is understood that each person/entity/firm who applies for a Community Development Commission contract, and as part of that process, shall certify that they are familiar with the requirements of the Los Angeles County Code, Chapter 2.160 (Los Angeles County Ordinance 93-0031)and; 2) That all persons/entities/firms acting on behalf of the above named firm have and will comply with the County Code, and; 3) That any person/entitylfirm who seeks a contract with the Community Development Commission shall be disqualified therefrom and denied the oontraot and, shall be liable in civil aotion, If any lobbyist, lobbying firm, lobbyist employer or any other person or entity acting on behalf of the named firm falls to comply wlth the provisions of the County Code, This certification Is a material representation of fact upon which reliance was placed when this transaction was made or entered into, Submission of this certifioati is a prerequisite for making or entering into contract with the Los Angeles County and, the ommu)><Ity Development Commission, County of Los Angeles, / Authorized Official: F.M. Thomas Air Conditioning, InC.By: (rantr0ct0r18dbconpaofor) 03/17/20 Thomas Feyka, President (Dale) (11110) CBF -20 w I City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addillon, Project No: 31019 Document Control Page 38 of 630 NON -SEGREGATED FACILITES CERTIFICATION Federally -Assisted Construction Projects The federally -assisted construction contractor certifies that he/she DOES NOT and WILL NOT: 1. Maintain or provide, for his/her employees, any segregated facilities at any of his/her establishments. 2. Permit his/her employees to perform their services at any location, under his/her control, where segregated facilities are maintained. The federally -assisted contractor agrees that a breach of this certification is a violation of the Equal Opportunity Clause in this contract. As used in this certification, the term segregated facilities means any waiting room, work areas, restrooms and washrooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees -which are segregated by explicit directive or are in fact segregated on the basis of race, creed, color or national origin, because of habit, local custom, or otherwise. The federally -assisted contractor agrees that (except where he/she has obtained identical certifications from proposed subcontractors for specific time periods) he/she will obtain identical certifications from proposed subcontractors prior to the award of subcontractors exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity Clause, and that he/she will retain such certifications in his/her files. NOTE: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001 Date: 03/17/20 Project Number: 31019 Compan .M. ho//s Air Conditioning, Inc. By: Title: T Feyka, President CBF -21 City of Rosemead, California laid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 39 of 630 NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of Rosemead / LA County DEPARTMENT OF PUBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares 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. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. CBF - 22 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 40 of 630 COMPLIANCE WITH CLEAN AIR AND WATER ACTS (Applicable to federally assisted construction contracts and related subcontracts exceeding $100,000) During the performance of this contract, the contractor and all subcontractors shall comply with the requirements of the Clean Air Act, as amended, 42 USC 1857, et seq., the Fetleral Water Pollution Control I Act, as.amended, 33 USC 1251, at seq., and the regulations of the Environmental Protection Agency with respect thereto, at 40 CFR Part 15, as amended. In addition to the foregoing requirements, all nonexempt contractors and subcontractors shall furnish to the S.. owner the following: I 1._ A stipulation by the contractor or subcontractors that any facility to be utilized in the. performance of any nonexempt contract or subcontract Is not listed on the List of Violating Facilities Issued by the Environmental Protectlon Agency (EPA) pursuant to 40 CFR 15.20. { 2. Agreement by the contractor to comply with all the requirements of Section 114 of the Clean Air Act, as amended.(42 USC 1857c-13) and Section 308 of the Federal Water Pollution Control Act, as amended (33 USC 1318) relating to inspection, monitoring, entry, reports, and information, as well -as all other requirements specified in said Section 114 and Section 308, and all regulations and.guidellnes issued s' thereunder. s 3. A stipulation that as a.condition for the award of the contract,_ prompt notice will be given of any notification received from the Director, Office. of. FederaLAcUvities, EPA, indicating that afacility utilited.or jto be utilized for the contract is under consideration to be listed on the EPA List of Violating. Facilities. 4. Agreement by the contractor that he will include, or cause to be Included, thecriteria and requirements In paragraph (1) through (4) of this section in every nonexempt subcontract and requiring that the contractor will take such action as the Government may direct as a means of entorcing such provisions. CBF - 23 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 41 of 630 WORKER'S COMPENSATION CERTIFICATION I certify, by signature below. that I am aware of the provisions of Section 3700 of the California Labor Code which require every employer to be insured against liability for worker's compensation orto undertake seif insurance.in accordance with. the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date:. 03/17/20 Project Number: 31019 Project Name: Garvey Park Gym Cooling Addition Company Name: F.M. Thomas Air Conditioning, Inc. Address: _ Print Name: 231 Gemini A Thomas FeA Title: Pr i ent Signature: CBF - 24 Ca 92821 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 42 of 630 NOTICE OF SECTION 3 COMMITMENT To: UA Local 250 [Name of labor Union or Workers' Representative] 8355 S. Figueroa, Gardena, Ca 310-660-0035 (Address) Awarding Authority, City of Rosemead s ProjectNarne and Ndrribei Garvey Park Gym Cooling Addition 31019 The undersigned NA currently, holds a contract with Involving Community :Development Block Grant (CDBG) funds from the U.S. Department.of Housing and Urban Development(HUD) or is subcontract with a prime contractor holding such contract. i You are advised that under the.provislons, of the above contract or subcontract, and in accordance with f Section 3 ofthe Housing and Urban DevelopmentActof 1968,.the undersigned is obligated, to the greatest extent feasible, to. give opportunities for training and employment to lower -Income residents of the project area and to award contracts for work on the project to business concerns that are located In or are owned. in subsiantial'part by project -area residents. } Regarding employment opportunities for this project, the minimum number and job titles are: i 6 Regarding job referrals, request that consideration be given, to the greatest extent feasible, to assignment of persons residing In the service area or neighborhood in which the project Is located. The anticipated date the work will begin is. MAY 2020 For additional information, contact:. Ron Outhier 714-738-1062 Ilf This notice Is furnished to you pursuant to the provisions of the above.cont c or sub act and Section 3 of the Housing and Urban Development Act of 1988.. Copies of t s otice II a posted by the undersigned in conspicuous places available to employees or applica fo empi I. F.M. Thomas Air Conditioning, Inc. [contreotorlsubcontredor] [Signature] 03/17/20 Pr silent (Date] [Title] Y I City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 43 of 630 Section 3 Economic Opportunity Plan 1. Name and Address of Reporting Entity 2. Federal Idenli0callon (Contracl/Award No.):. a. Douai Amount of Award: (Recipient, Sub,redpienl, Contractor, Subcontractor): NA NA F.M. Thomas Air Conditioning, Inc. 4• Contact Parson: Ron Outhier 714-738-1062 S. Phone (Include Area Code): S. Reporting Period: 7. Date Report Submitted: NA NA s. Program Code: (Use a separate shoal for each Program Code) Program Codes 1, Flexible Subsidy 2: Section 2021011 3. Publicllndlen Housing Development. Operation, and Modernization 4, Horbe.lessAssistance .S. HOME 6, HOME-61aleAdminislered 7. CDBG-EntNement 6. CDSG- State.Administered S. Other CD Programs 10. OtherHousing Programs Dar+ i- 1=mninumanf and Traininn Cnmmifmanf TOTAL SECTION '%OFAGGREGATE CODE(S) NEW 3 NEW HIRES WHOARE JOB CLASSIFICATION HIRES HIRES SECTION 3 HIRES RACIAL ETHNIC Professionals Technicians omcelCledcal Trade; Trade: TOTAL: 17nrf ti- Cnnfrarf Award Cinmmifrnanlfn Rarflnn 3 Rueinaasae ice--M-r<r.<H,..< a -<gun.< rrone„r<.-.c—i—o—in<-<r SPECIFY CONSTRUCTION OR CODE(S) NONCONSTRUCTION CONTRACT NAME OF SECTION 3 BUSINESS CONCERN CONTRACT AMOUNT RACIAL ETHNIC RACIAL BACKGROUND: SINGLE CATEGORIES DOUBLE CATEGORIES 1. American Indian/Alaska Native 6. American Indian or Alaska Native AND White 2. Asian 7. AsionAND White 3. BlacklAfrican American 8. Black or African American AND White 4. Native Hawaiien101her Padrie Islander 9. American Indian orAlaska Native AND Black or African American 5. White 10. Other- for individuals not idenlllled above. I A. Hispanic/Latino B. Not Hispanic/Latino CBF - 26 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 44 of 630 Section 3 Business Certification Form i ! Business Name: F.M. Thomas Air Conditioning, Inc. Business Address: 231 Gemini Ave, Brea, Ca 92821 t Telephone Number: 714-738-1062 Contract Amount: 5 NA The above-mentioned business firm is a Section 3 business concern based on the following qualification: i 1. ❑ 51 percent owned by Section 3 residents forms) (attach Sec)ion:3 ResidentCertification OR 2. 3 Permanent, full-time employees. include at least 30 percent Section 3 residents (attach Section 3 Resident Certification forms) OR 3: ❑ Written commitment to subcontract at least 25 percent of contract amount to business concerns that meet Section 3 qualification stated In paragraph 1 or 2 above (attach Section 3 Economic Opportunity Plan, Section 3 Business Certification form for subcontractor, and.Section 3 Resident Certification forms)' ` OR 4. ® Written commitment that Section 3 qualified new hires will comprise at least 30 i percent of total new hires (attach Section 3 Economic Opportunity Plan) r Specify ethnicily.of business ownerships IR] White American Black American G] Native American ❑ Hispanic American El Asian Pacific ❑ .Hasidic Jewls The undersigned by his/her signature affixed hereto declares under penally of pf�ury th the above information is complete and correct, 03/17/20- D ate 3/17/20Date 0 CBF - 27 President Title City of Rosemead, California Bid Package, Garvey Park Gym Coding Addition, Project No: 31019 Document Control Page 45 of 630 CERTIFICATION OF UNDERSTANDING AND AUTHORIZATION CoolingGarvey Park Gym .. . - ■■■■■■r [],D■■ ■■■ ■ ■ 1t■■■ ■■>t ■■■ ■=■■■ ■ ■■■ ■■■■■■■. • Pro[e-ct Number DDDDD=DDD=ii=a]ODDDEOMDOI]EIEID=DEIE)IICIEODDD=11211 This is to certify that the principles and the authoriC]zd payroll officer have read and understand the Minutes of the Preconstruction Conference and the labor standards clauses pertaining to the subject pro❑ect. The following personMois designated as the payroll officer for the undersigned and is authorio3d to sign the Statement of Compliance, which will accompany our weedy certified payroll reports for this project. Carolyn Feyka Secretary/Treasurer Designated Payroll Officer [Name❑❑❑❑Cx]❑❑00=D❑❑❑❑❑❑❑❑❑❑❑❑Cx]❑❑m❑❑❑❑❑❑❑❑❑❑❑❑= Designated Payroll Officer [Signature ❑❑❑❑C77 ❑❑C ❑❑❑❑Ca Cl7 ❑❑D❑❑❑❑DD❑❑❑ F.M. Thomas Air Conditioning, Inc. Authori[33d by [Contractor/Subcontractor❑❑=❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑ CDEI❑❑❑❑❑❑❑C EIDDEID7❑ re Secretary / Treasurer Title ll _ a-1 7 ;2-. R, E�l 03/17/20 [ERS❑Employer Identification Number Date CBF - 28 c--tt—- CONTRACTORS' STATE LICENSE BOARD` ACTIVE LICENSE x wtm.t.~ 313574 «. CORP W- W... F M THOMAS AIR CONDITIONING INC •:elnitY,�el C-4 CGO Cob ^p 'em�mtaf. 02/28/2021 "'F" WvvW.cslb.ca.gov kp..a 1/31/2020 Sunoller Profile Printed on: 1/31/2020 7:32:41 AM To verify most current certification status go to: https://www.caleprocure.ca.gov. I im LJ tz C A I.IFURNIA DSPARThIe NT OR GENE'Rrif_ sf".k:l:u•1Es Office of Small Business & DVBE Services Certification ID: 29235 Legal Business Name: F M THOMAS AIR CONDITIONING INC Doing Business As (DBA) Name 1: F M THOMAS AIR CONDITIONING INC Doing Business As (DBA) Name 2: Address: 231 GEMINI AVE BREA CA 92821 Certification Type Status SB Approved Email Address: mfeyka@fmthomas.com Business Web Page; http://Www.fmthomas.com Business Phone Number: 800/660-0891 Business Fax Number: 7141738-0886 Business Types: Construction , Service From 10/04/2018 To 10/31/2020 Stay informedl KEEP YOUR CERTIFICATION PROFILE UPDATEDI -LOG IN at CaleProcure.CA.GOV Questions? Email: OSDSHELP@DGS.CA.GOV Call OSDS Main Number: 916-375-4940 707 3rd Street, 1-400, West Sacramento, CA 95605 hMnc•/lraLamm��rnnd......i......—..�c...__��_r__..._._.. .. _ ... Business Search - Business Entities - Business programs Page ( of X Business Rn,ti-1--Y Detail ,Data is updated to mornings. the California Business Search on Wednesda g Results reflect' refer bo processin work processed throw Y and Saturday processed. The data Times for the received through Friday, August 26, 2016. please provided is not dates of filings currently being a complete or certified recordofan entity. Entity Name: 'Entity E. NI- THOMAS AIR CONDITIONING Y Number ; r INC. DateE'.iled: C0755790 Status: 09/30/1975 J'uriscUotion: ACTIVE Entity Address: CAIIroRNIA Entit 231 GEMINI AVE Y City, State, Zip: Agent for Agent BREA CA 92821 Service of process: THOMAS FEYKA Address: Agent 231 GEMINI 9' city, State, Zips AVE BREA CA 92821 Indicates the information is not contained Status database. in the California Secretary of If the status of the corporation is "Surrender," the Code automatically revoked, please refer to agent for service of section 2114 for information relatin have surrendered. California Corporations • For information . checkingg to service upon corporations that For information on orderincertificates eserving a name reports or to refer to Name Avallabili.t . • For hel request a more extensive sr refer o€ documents and/otsta tus p'with searching an entity name , refer to • For descriptions , refer to Information Requests. Descri Prions of the various fields and sr to Starc-- c tions and Status Definitions. ypes, refer to Sly Privacy SCatemeltt Eree DocWnent Peaders Copyright ® 2016 California Secretary of state Registrations State of California chap 'Ir,ca,gGVDepartment of Industrial Relations RENEE RITCHIE — Department of Industrial Relations (DIR) (haps://www.dir.ca.gov/dlse/dfse.html) E My Registrations My Dashboard Select One... New Instructions: Link Existing Registration Page 1 of 2 Back to DIR» (hllp9•1knvW.dfr.ca.g0v4 Invoices@knthomas.com • To transfer an active registration from the old system, click Link Existing Registration. • To start a new application, select from the dropdown menu above and dick New. • To revise the existing registration, click Update. • To edit a saved application, click on the registration number. You cannot edit once the application status is "Submitted","Payment Pending", "In Review", "Expired" or "Renewed". • To renew an application, click Renew (link will be available 90,days before the license expiration date, until the expire date). • TO pay registration fees, click the Pay Now link in the Registration # column. • Car Wash: To complete the registration process, you must print the submitted application or a copy of your email staling your application has been submitted and send it wllh the .IBS Form 8821 fhtlo•!/www dir ca aov/dise/IRS8821 Fonn M. Upon receipt of the IRS response, please return to attach the IRS Clearance letter to your application. IRS form 6821 Instndons (http://www dir ca aov/disc/IRSet321 Ins ructions dfl. Actions Business Nome Rogistration 0 Roglatrrtion Submitted Slstus Erfaetive Expiration Payment Type Data Data Data Wks FM THOMAS 1000003303 AIR Update CONOn10NING(rroglstroOonsfVlPFomt_VIP_FmmWaoMp Public Works PeCENo INC id-a1R(000o0027yosFAA) Active 07/01119 00430120 Babra Oue FM THOMAS 1000003303 AIR Update CONDITIONING umglsballonsMPFaam VIP FoamWxard7 Public Works Active 00425/10 INC Id-a1R10000001R2gIEAC) Oan(VTO About DIR Who we are (haps://www.dirca.gov/abouldir.html) DIR Divisions, Boards & Commissions(hftps.,/Avww.dlr.co.gov/divlsfons—and_pmgrams.html) Contact DiR (https://w /w.dir.ca.gov/Contactus.htmQ Work With Us Jobs at DIR (haps:/MWww,dlr.ca.gov/didobstdlgobr..htm) Licensing, registrations, certifications & permits (https:/Avww.dir.ca,gov/permlts-licenses-cerURcatlans.himl) Required Notifications (hUpa://www.dir ca.gov/dosh/Required-NoUffcaUons.htmf) Public Records Requests (haps://www,dir.ca.gov/pra_requesLhtmQ Learn More Acceso at idloma (http9/www.dlr.ca.gov//Bllingual-Servlces-AcVdafaulth(mQ Frequently Asked Questions(https://www,dirca.gov/fagslisthtml) Site Map (https://www,dir.ce.gov/sitemap/sltemgp,htfnl) Back to Top Conditions of Use (hHps:f www,dir ca.gov/od-tub/conditlons.htmQ Disclalmer (htlps:fAvww.dlcca.gov/od_pub/disciatmer.hbW) Registrations Page 1 of 2 State of California Department of industrial Relations Back toDIR>>(hllps'//svww.dir.ca.govn (hftptk-1t1.or-ca,goV4 . Public Works Contractor Registration Search Enter at least one criteria to display registered public works contractor(s) matching your selections. Note: Search results Will display all of the public works contractor registrations, both current and expired. Make sure a proper registration fiscal year is selected when performing a search, input Label r..__..._....._..—__-,_.-_.,......._..._...,.....,.._..._ _._..__----._ ,,_.._._. From Date:(mm/dd/yyyy)^ To Date:(mm/rid/yyyy) hn thoma1 air condltlonln Countyj. . ..... City __... Search Reset Crafts (Select all that apply) ❑ Asbestos ❑ Boilermaker - Blacksmith ❑ Bricklayer/Brick Tender ❑ Carpenter ❑ Carpet, unaleum, Reslllent'llle Layer ❑ Cement Mason ❑ Consultant ❑ Driver(On/Off Hauling) ❑ Drywall Registrations Search Results: l found PrintPDF6 Export.+. Detail: Registration Number. 1000003383 Status: Active CSLB Number. 313574 Legal Entity Type: Corporation Mailing Address: 231 GEMINI AVE BREA CA 92821 County: Orange Craft: Plumbar;Sheet Metal Worker Email: Invo IcesOfmlhomas.com ❑ Electrical utility ❑ Electrician DBA ❑ Elevator Constructor -- ❑ Field Surveyor ` FM THOMAS AiR CONOITiONING INC ~~ -. ❑ General Building ❑ General Engineering ❑ Glazier ❑ Inspector/Field Solls, Material Tester ❑ iron Worker ❑ Laborer ❑ Landscape ❑ Marble Mason/Finlsher ❑ Operating Engineer ❑ Painter ❑ Parking/Highway/Improvement ❑ Plasterer/Tender ❑ Plumber ❑ Roofing ❑ Sheet Metal Worker ❑ Stator Rewinder ❑ Teamster ❑ Terrazzo Worker/Flnlsher MI)SWemtfir cPr•s,rA f^— f.-r___� .. . -- Showing Page 1 of 1pravisus Next Add all to my Ilst MyUst(1)• View Details I t Remove from My Ust ,,051ratlon Hlstory rEfrectiveDate M1EuplratlonDsle 7/1/2019 6/30/2020 6/25/2013 6/30/2019 6/23/2017 6/30/2018 6/24/2016 6/30/2017 6/9/2015 6/30/2016 12/26/2014 6130/2015 'OR'�7® CERTIFICATE OF LIABILITY INSURANCE OATE(MM/DOrYYYY) 12/30/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement('s). PRODUCER CONTACT Bowermaster & Associates NAME: Melissa Alter ott P.O. BOX 61)26 PHONE AIc No t : 714-733-6200 No ; 10805 Holder St Suite 350 AnnRESS: matte ott bowermaster.com Cypress CA 90630 INSURED FM Thomas Air Conditioning, Inc. 231 Gemini Ave. Brea CA 92821 of COVERAGES CERTIFICATE NUMBER: 203295303 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. /LTR TYPEOFINSURANCE AOD BR POUCYEFF POUCYEXP POLICYNUMBER MMlDD MMDD Y LIMITS A X COMMERCIALGENERALLIABILITY 6057223216 4/1/2019 4/112020 CLAIMS MADE a OCCUR ut: To EACH OCCURRENCE $ 1,000,000 PRE ISES Ea occ urem $100,000 MED EXP (Any one arson) S15,000 PERSONAL &ADV INJURY 91,000,000 OEN'LAGGREGATE LIMIT APPLIES PER- GENERAL AGGREGATE $2,000,000 POLICY � jER F LOC PRODUCTS-COMPlOPAGO $ 2,000,000 OTHER: a 8 AUTOMOBILE uAaILITY 6057258063 4/1/2019 4/1/2020 COMBINED SINGLE LIMIT S 1,000,000 X ANYAUTO Eeaeddent OWNED SCHEDULED BODILY INJURY (Parperam) S AUTOS ONLY AUTOS X HIRED NON -OWNED X BODILY INJURY (Per sodded) $ AUTOS ONLY AUTOS ONLY PROP RTYOAMAOE 9 Per aecldent C X UMBRELLA LIAB X OCCUR 6057258077 EXCESS LIAR S 411/2019 411/2020 EACH OCCURRENCE S 4,000,000 CLAIMS -MADE DED X I RETENTION s AGGREGATE s4,000,000 D WORKERS COMPENSATION $ AND EMPLOYERS' LIABILITY WSD506258300 YIN TEE' 1/112020 1/1/2021 X ST TOTE EOR OFFICERIMEMBEREXCLUDED? NIA E.L. EACH ACCIDENT $1,000,000 (Mandatory In NH) If yyea describe under DESGtRIPrIONOFOPERATION3belaw E.L. DISEASE -EA EMPLOYEE S 1,000,000 E.L.OISEASE-POLICYLIMIT $1,000,000 DESCRIPTION OF OPERATIONS! LOCATIONS I VEHICLES (ACORD tot, Additional Remarks Schedule, maybe attached If more apace Is required) Evidence of insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN FM Thomas Air Conditioning, Inc. ACCORDANCE WITH THE POLICY PROVISIONS. 231 Gemini Ave Brea CA 92821 A/LITH RIZED REPRESENTATIVE Attachment C Renewage Construction Bid Proposal City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 18 of 630 BIDDERAnewc� t"rc1c'no ) CITY OF ROSEMEAD GARVEY PARK GYM COOLING ADDITION PROJECT No. 31019 SECTION I - BID SCHEDULE CONTRACT BID FORMS CBF -1 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 19 of 630 BIDDER: Ccn47nl(tvm BASE BID SCHEDULE SCHEDULE OF PRICES FOR GARVEY PARK GYM COOLING ADDITION PROJECT No. 31017 NO. ITEM DESCRIPTION UNIT EST. UNIT ITEM 1 Install a Split System to Serve the LS QTY. PRICE COST Install a Packaged DX Rooftop Unit to��qq��AA lrA's to he ke- br6e ; 1 Serve the Gymnasium, and the LS 1 $ y $ 3gQ 1500 Installation of a 480 Panel to Facilitate the Newly Added Equipment TOTAL BASE BID AMOUNT IN NUMBERS $ 39 q _ ,t; rD 0 TOTAL BASE BID AMOUNT IN WORDS: 0 I hire"'— Note: iram 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. ALTERNATE 1 BID, SCHEDULE SCHEDULE OF PRICES FOR GARVEY PARK GYM COOLING ADDITION PROJECT No. 31017 NO. ITEM DESCRIPTION UNIT EST. QTY. UNIT PRICE ITEM COST 1 Install a Split System to Serve the LS 1 $Eo_ Private Office lrA's to he ke- br6e ; TOTAL ALTERNATE 1 BID AMOUNT IN NUMBERS $ b n/©DO CBF -2 A 0"J) City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 20 of 630 BIDDER: ,Pn r,oaQ air n TOTAL ALTERNATE 1 BID AMOUNT IN WORDS: g lxty Aeu. Izd &,-9/G"r5 ALTERNATE 2 BID SCHEDULE SCHEDULE OF PRICES FOR GARVEY PARK GYM COOLING ADDITION PROJECT No. 31017 NO. ITEM DESCRIPTION UNIT EST. UNIT ITEM QTY. PRICE COST 1 Install Exhaust Fan to Serve Both the LS 1 y� $ K• "�v Men's and Women's Restrooms 7- f- '6/L` 1 F TOTAL ALTERNATE 2 BID AMOUNT IN NUMBERS $: TOTAL ALTERNATE 2 BID AMOUNT IN WORDS: The undersigned agrees that these Contract Bid Forms constitute a firm offer to the Owner which cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and after the bid opening date, or until a Contract for the Work is fully executed by the Owner and a third party, whichever is earlier. The undersigned also agrees that if there is a discrepancy between the written amount of the Bid Price and the numerical amount of the Bid Price, the written amount shall govern. mq&" , Attached hereto is a certified check, a cashier's check or a bid bon in the amount of Dollars ($ ) 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 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 CBF -3 e&A City of Rosemead, California Bid Package, Garvey Part( Gym Cooling Addition, Project No: 31019 Document Control Page 21 of 630 BIDDER: �p �� clop (knS�(C m 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, he shall provide: (1) evidence satisfactory to the Owner of Bidder's California contractor's license(s) in good standing; (2) evidence that the person signing this Bid is authorized to bind Bidder to this Bid and to a contract resulting therefrom; and (3) any other information and documentation, financial or otherwise, needed by Owner to award a Contract to the lowest responsible and responsive bidder. Bidder understands and agrees that liquidated damages shall apply to this Contract in the amounts of five hundred dollars ($500.00) if project is not completed in SIXTY (60) working days. The Contract Time will begin to run ten (10) Working Days from the date of the Notice to Proceed and subject to the terms and conditions described in the Contract Form and the Contract Documents. Bidder acknowledges that data submitted with its Contract Bid Forms which it requires to be incorporated into a Contract arising out of this Submittal has been so identified by Bidder. Bidder further acknowledges that the Owner may, at its discretion, incorporate any of the remaining data submitted herewith into a contract arising out of this Bid. The undersigned acknowledges receipt, understanding and full consideration of the following addenda to the Contract Documents. Addenda Nos. Al The Bidder understands and agrees that the Total Bid Price is inclusive of all labor, materials, and equipment or supplies necessary to complete the Work as described in the Bid Documents. If this bid is accepted, the undersigned Bidder agrees to enter into and execute the Contract with the necessary bonds and accept the Total Bid Price as compensation in full for all Work under the contract. CBF -4 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 22 of 6630 BIDDER: /Pp o r nc� N&Amz t n By: � 1 (� t?aalcy _ y �cs Signature Business Street Address .ryAstiiN eOL00sw,r CA Type or Print Name EL Seg a . cA °►a2 City, State and Zip Code 6341291- G5hh j Telephone Number Bidder's/Contractor's State of Incorporation: CA Partners or Joint Venturers: Bidder's License Number(s): . L '�7�1C�k(it d , r-_— (C) . G-14 Department Industrial Relations Registered No. t bOcY� j s 3 NOTES: 1) By its signature on this Bid, the Bidder certifies under penalty of perjury the accuracy of the representations made on the Contract Bid Forms. 2) If Bidder is a corporation, enter State of Incorporation in addition to Business Address 3) If Bidder is a partnership or joint venture, give full names of all partners or joint venturers. As further discussed in the Instructions to Bidders, Bidder will be required to provide evidence that the person signing on behalf of the corporation, partnership or joint venture has the authority to do so. CBF -5 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 1Document Controls Page 23 of 30 BIDDER: e�h o! SECTION 2 BID DATA FORMS CBF -6 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control P ge 24 of 630 BIDDER: Ln C, (44— r1 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 Principal, and as , as Surety, are held firmly bound unto the CITY OF ROSEMEAD (hereinafter called the OWNER) in the sum of DOLLARS ($ ), 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 GARVEY PARK GYM COLLING ADDITION PROJECT —as set forth in the Notice Inviting Bids and accompanying Bid Documents, dated 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 5E Djthe 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 day of 20 (SEAL) (SEAL) Principal Surety am Signature LIN CBF -7 Signature �ALPHA SURETY & INSURANcE BROKERAGE Surety Solutions. Fast. Simple. To: Renewage Energy Solutions, Inc. dba Renewage Construction From: Chris Eley Date: 3/6/2020 Re: Bid Bond for the City of Rosemead We are pleased to provide the bid bond you requested from our agency for the City of Rosemead. The bond is written with Lexon Insurance Company. This is an excellent company rated A or better by A. M. Best, the third party company that evaluates all surety and insurance companies. Please sign and complete the original bid bond form as indicated by the instruction flags. Once completed, please send it to the appropriate party at the City of Rosemead. We have also provided a copy for your records. If you have any questions about the servicing of the bond, please call our Little Rock office at (501) 537-4568. Thank you for your business and the opportunity to serve you! Your Alpha Surety Service Team 650 South Shackleford Road, Suite 325 Little Rock, Arkansas 72211-3546 501-537-4568 501-537-7778 fax service@alphasurety.com Please visit our new website at www.alphasurety.com where you now have a complete bond management tool accessible 24/7 from anywhere in the world. You can view and update your existing bonds, order new bonds, view your payment history, receive reminders about your renewals and more ... all at the click of a mouse. Our new tool helps streamline our services so that you don't experience the confusion you may have at other agencies with problems like lost paperwork and runaround on the phone looking for answers to simple questions about your bond. All you need is an email address to access your information online! Please email or call your Alpha Surety Service Team to get started today! National Service Center: Phone 800-901-3099 One Financial Center Licensed in all US states, Pax 501-537-7778 650 S. Shackleford Road, Sulte 325 Puerto Rico, & USVI Ercall service@alphasurety.com Little Rack, Arkansas 72211-3546 Website alphasuretycom City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No 31019 Document Control Page 24 of 630 BIDDER: Renewage Energy Solutions, Inc. dba Renewage Construction BOND NUMBER: BidB1006 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 Qi�e�p..... gy ��% SEp,� c �:GtD, ,IIIFOa�\� KNOW ALL MEN BY THESE PRESENTS: THAT Renewage Energy Solutions, Inc. dba Renewage Construction as Principal, and Lexon Insurance Company , as Surety, are held firmly bound unto the CITY OF ROSEMEAD (hereinafter called the OWNER) in the sum of Ten Percent of the contract bid DOLLARS ($10% ), being notless 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 GARVEY PARK GYM COLLING ADDITION PROJECT —as set forth in the Notice Inviting Bids and accompanying Bid Documents, dated 3/6/2020 NOW, THEREFORE, if said Principal is awarded a Contract for the Work by the OWNER and, within the time and in the manner required by the above- referenced Bid Documents, enters into the written form of Contract bound with said Bid Documents, furnishes the required bonds (one to guarantee faithful performance and the other to guarantee payment for labor and materials) furnishes the required insurance certificates and endorsements, and furnishes any other certifications as may be required by the Contract, then this obligation shall be null and void; otherwise it shall remain in full force and effect. In the event suit is brought upon this bond by the OWNER and judgment is recovered, said Surety shall pay all costs incurred by the OWNER in such suit, including reasonable attorneys' fees to be fixed by the court. SIGNED AND SEALED, this 6 day of March 2020 Renewage Energy Solutions, Inc. dba Renewage Construction(SEAL) Principal By: By: Signature CBF -7 Lexon Insurance Company (SEAL) Surety oh, is Eley, Attomey-In-Fact Sienature� SOMPO INTERNATIONAL " -INSURANCE POWER OF ATTORNEY 10974 KNOW ALL BY THESE PRESENTS, that Endurance Assurance Corporation, a Delaware corporation, Endurance American Insurance Company, a Delaware corporation, Lexon Insurance Company, a Texas corporation, and/or Bond Safeguard Insurance Company, a South Dakota corporation, each, a "Company" and collectively, "Sompo International," do hereby constitute and appoint: Jason Jenkins, Chris Eley, Amelia McShane as true and lawful Attorney(s)-In-Fact to make, execute, seal, and deliver for, and on its behalf as surety or co -surety; bonds and undertakings given for any and all purposes, also to execute and deliver on Its behalf as aforesaid renewals, extensions, agreements, waivers, consents or stipulations relating to such bonds or undertakings provided, however, that no single bond or undertaking so made, executed and delivered shall obligate the Company for any portion of the penal sum thereof in excess of the sum of TEN MILLION Dollars ($10,000,000.00). Such bonds and undertakings for said purposes, when duly executed by said attorney(s)-in-fact, shall be binding upon the Company as fully and to the same extent as if signed by the President of the Company under its corporate seal attested by its Corporate Secretary. This appointment Is made under and by authority of certain resolutions adopted by the sole shareholder of each Company by unanimous written consent effective the 15th day of June, 2019, a copy of which appears below under the heading entitled "Certificate". This Power of Attorney Is signed and sealed by facsimile under and by authority of the following resolution adopted by the sole shareholder of each Company by unanimous written consent effective the 15th day of June, 2019 and said resolution has not since been revoked, amended or repealed: RESOLVED, that the signature of an individual named above and the seal of the Company may be affixed to any such power of attorney or any certificate relating thereto by facsimile, and any such power of attorney or certificate bearing such facsimile signature or seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. IN WITNESS WHEREOF, each Company has caused this instrument to be signed by the following officers, and its corporate seal to be affixed this 151h day of June, 2019. Endurance Assurance u 1 By: ,A Richard Aouel: sHAL 2002 Endurance American By"In ura c? t }�pIP f r Richard Appel�,SWA&�,Penlor Counsel , °tic an fn .. _ _ Sa 4 v SEAL Co. coot 1996 0' DELAWARE 'a _ Lexon Insurance Company Ric and Appel; SyWJLSenil "'••nnu 1100 ACKNOWLEDGEMENT Bond Safeguard A SOUTH '. n DAKOTA 0 INSURANCE 'b COMPANY On this 15th day of June, 2019, before me, personally came the above signatories known to me, who being duly sworn, did depose and say that he/tO9101.h loffjcer of each of the Companies; and that he executed said instrument on behalf of each Company by authority of his offic under thVbycos ofeach Company,` N••••••°?EG1E WBy. rgr LlIIAmy Taylor, Noblic My Commissit)n Expires 5/y/23Z CERTIFICATE '.,Qr "...... �.• I, the undersigned Officer of each Company, DO HEREBY CERTIFY that: 1. That the original power of attorney of which the foregoing is a copy was duly executed on behalf of each Company and has not since been revoked amended or modified; that the undersigned has compared the foregoing copy thereof with the original power of attorney, and that the same is a true and correct copy of the original power of attorney and of the whole thereof; 2. The following are resolutions which were adopted by the sole shareholder of each Company by unanimous written consent effective June 15, 2019 and said resolutions have not since been revoked, amended or modified: "RESOLVED, that each of the individuals named below is authorized to make, execute, seal and deliver for and on behalf of the Company any and all bonds, undertakings or obligations in surety or co -surety with others: RICHARD M. APPEL, BRIAN J. BEGGS, CHRISTOPHER DONELAN, SHARON L. SIMS, CHRISTOPHER L. SPARRO, MARIANNE L. WILBERT ; and be it further RESOLVED, that each of the Individuals named above is authorized to appoint attorneys -in -fact for the purpose of making, executing, sealing and delis--ing bonds, undertakings or obligations in surety or co -surety for and on behalf of the Company." 3. The undersigned further certifies that the above resolutions are true and correct copies of the resolutions as so recorded and of the whole thereof. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the corporate seal this 6 day of March 2020 By: Dame S. ne, a retary NOTICE: U. S. TREASURY DEPARTMENT'S OFFICE OF FOREIGN ASSETS CONTROL (OFAC) No coverage is provided by this Notice nor can it be construed to replace any provisions of any surety bond or other surety coverage provided. This Notice provides information concerning possible impact on your surely coverage due to directives issued by OFAC. Please read this Notice carefully. The Office of Foreign Assets Control (OFAC) administers and enforces sanctions policy, based on Presidential declarations of "national emergency". OFAC has Identified and listed numerous foreign agents, front organizations, terrorists, terrorist organizations, and narcotics traffickers as "Specially Designated Nationals and Blocked Persons". This list can be located on the United States Treasury's website — https://www.treasury.cov/resource-center/sanctions/SDN-List. In accordance with OFAC regulations, if It is determined that you or any other person or entity claiming the benefits of any coverage has violated U.S, sanctions law or is a Specially Designated National and Blocked Person, as identified by OFAC, any coverage will be considered a blocked or frozen contract and all provisions of any coverage provided are Immediately subject to OFAC. When a surety bond or other form of surety coverage is considered to be such a blocked or frozen contract, no payments nor premium refunds may be made without authorization from OFAC. Other limitations on the premiums and payments may also apply. Any reproductions are void. Surety Claims Submission: LexonClaimAdministrationtWsomoo-Intl.com Telephone: 615-553.9500 Mailing Address: Sompo International; 12890 Lebanon Road; Mount Juliet, TN 37122.2870 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No 31019 COPY Document Control Page 24 of 630 BIDDER: Renewage Energy Solutions, Inc. dba Renewage Construction BOND NUMBER: BidB1006 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 Renewage Energy Solutions, Inc. dba Renewage Construction as Principal, and Lexon Insurance Company , as Surety, are held firmly bound unto the CITY OF ROSEMEAD (hereinafter called the OWNER) in the sum of Ten Percent of the contract 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 GARVEY PARK GYM COLLING ADDITION PROJECT —as set forth in the Notice Inviting Bids and accompanying Bid Documents, dated 3/6/2020 NOW, THEREFORE, if said Principal is awarded a Contract for the Work by the OWNER and, within the time and in the manner required by the above- referenced Bid Documents, enters into the written form of Contract bound with said Bid Documents, furnishes the required bonds (one to guarantee faithful performance and the other to guarantee payment for labor and materials) furnishes the required insurance certificates and endorsements, and furnishes any other certifications as may be required by the Contract, then this obligation shall be null and void; otherwise it shall remain in full force and effect. In the event suit is brought upon this bond by the OWNER and judgment is recovered, said Surety shall pay all costs incurred by the OWNER in such suit, including reasonable attorneys' fees to be fixed by the court. SIGNED AND SEALED, this 6 day of March 2020 Renewage Energy Solutions, Inc. dba Renewage Construction(SEAL) Principal By: Signature CBF -7 Lexon Insurance Company (SEAL) Chris Eley, Attorney -In -Fact Signature City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 25 of 630 BIDDER: (inSfruchri\ 2.B LIST OF PROPOSED SUBCONTRACTORS In compliance with the "Subletting and Subcontracting Fair Practices Act," Sections 4100 through 4114 of the California Public Contract Code, and any amendments thereto, each Bidder shall provide the information requested below for each subcontractor who will perform work, labor or render service to Bidder in or about the construction of the Work in an amount in excess of one-half of one percent (greater than 0.5 %) of the Bidder's Total Bid Price, or, in the case of bids or offers for the construction of streets or highways, including bridges, in excess of one-half of 1 percent of the Contractor's total bid or ten thousand dollars ($10,000), whichever is greater, and shall further set forth the portion of the Work which will be done by each subcontractor. Bidder shall list only one subcontractor for any one portion of the Work. Pursuant to Public Contract Code Section 4104, the Owner has determined that it will allow Bidders twenty-four (24) additional hours after the deadline for submission of bids to submit the information requested by the Owner about each subcontractor, other than the name and location of each subcontractor. If the Bidder fails to specify a subcontractor for any portion of the Work to be performed under the Contract, it shall be deemed to have agreed to perform such portion itself, and shall not be perntitted 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. City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 26 of 630 BIDDER:�enec�ogeS�rutV1 2.B LIST OF PROPOSED SUBCONTRACTORS (continued) [**Duplicate Next 2 Pages if needed for listing additional subcontractors.**] Name and Location of Subcontractor Name: /V Address: License No.: Department of Industrial Relation Registration N Description of Work to be Subcontracted Name and Location Description of Work of Subcontractor to be Subcontracted Name: (�! Address: License No.: Department of Industrial Relation Registration No. Name and Location of Subcontractor Description of Work to be Subcontracted Name: I Address: License No.: Department of Industrial Relation Registration No. Name and Location of Subcontractor Name: A w h Address: License No.: Description of Work to be Subcontracted Department of Industrial Relation Registration No. Name and Location of Subcontractor Description of Work to be Subcontracted Name: I Address: License No.: Department of Industrial Relation Registration No. CBF -9 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 27 of 630 BIDDER: A'-rnpLY! CMS't�uC�tQ'1 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. L of /�c� Itt (nwiwt ) 54 — L5k "'r, It's (i TCC N,qmi-.,qncf Address of OwnerssN5 dM 1 r� ° l �' (51�) is ollt Name and telephone number of person familiar with project ItCV11-2 879 �i/Ir�CLI �JrJ Contract amount Type of Work Date Completed (17 L--�J Naive and Address of Owne ol -76 Name and telephone number of person familiar with project $)) 5 3 q 10 L / cc�J Contract amount Type of Work 3. C, Name C. -J -L k -v I Ae Address of Owner -. Ez-.-T-�a work dx)1q- Date Completed q l { A-4----55 Lov--�n, ( jam,) �j-'-( 606 Name. and telephone number of person familiar with project Contract amount Type of Work Date Completed CBF -10 City of Rosemead, California 4. L_oS Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 28 of 630 BIDDER:, ne&lM� b Mrd �r Cps Name and Address of Owner oz�) C�r;,V-N i47wdA 0 - GSS�- Name and telephone number of person familiar with project Contract Type of Work Date Completed CBF - 11 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 29 of 630 BIDDER: inec--OWA e Sfin it [X1 SECTION 3 NON- COLL USION AFFIDA VI T CBF -12 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 30 of 630 BIDDER: /CT P-LQ0.re. C'criS�fU,L 1 NON -COLLUSION AFFIDAVIT In accordance with Public Contract Code Section 7106, the undersigned, being first duly sworn, deposes and says that he or she holds the position listed below with the bidder, the party making the foregoing bid, that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refs ain 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 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 nStin CQyat'c ,-V- , Typed or Printed Name Title - \ Bidder Subscribed and sworn before me X*IJ-r,9AlF.s Vr-CI<ER-S I Vo -roe -V R.'eL-sc This day of t -t+ -PCC: -t , 20 �o (Seal) °• IAN JAMES VICKERS Notary Pu and for n NOTA ' ' RY PUBLIC. CALIFORNIA COMMISSION # 2198600 the State of California ° LOS ANGELES COUNTY My Comm. Exp. May 22.'2021 ` My Commission Expires: CBF -13 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 31 of 630 BIDDER: 4eAO-L 3Q Cmstiru� ri SECTION 4 REQUIRED FEDERAL FORMS CBF -14 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 32 of 630 CONTRACTOR INFORMATION Company Name ?I�A;aqe. CMA -A -A&M. Address 141 0- _.5r4a 0&, CA 9o2 -4,S_— Telephone C9 1.9�2ci1— GS'o V Fax J to 6'1O — 65T1 E-mail ALLS'he�,Q �enec �as� ^s yn Type of Firm: Individual[] Partnership© Corporation Corporation organized under the laws of the State of CA c-34 Contractor's License Number Sgt State C&ClassificationR.(=jZ_Expiration Date DIR Registration Number l oc), K:KC S3 Expiration Date es4p I"No 1- n,) Q Names and titles of all officers of the firm �. ... ■c- .-� CBF - 15 O m 0 CO d a 0 0 U C E 0 E U E U W Q O 0 W ul U 2 d a) 9 O V � .Q O Y m D � . O E � W G� air W �a D lC N c C7 C I^ �`V V a7 `\ i O U a, f L IL 4) n L Z N N O N L lL0 M C a V E a ca OZ co a) O CO U C 7 (D D 'O c N � a J C O N 0.0 X- O U (D CO ro C U N -a a 0) U) ro _U u1 � s C .0 O `a C 0 a) U_ ro c U O U C m � C � C o .� CLcM O-0 cr W a) *' � O ❑- Cam C C CD L .N \ N CO U ro � :3 O.0 H U) CU v C ro a) E ca Z c 97 0o E�lJo�fl 0011"Wament Bid Package, Co.rgy wli�; �i'a4l�i�i l No: 31019 MlJ 1 CfTI IVB/ and Urban Development Opportunity Certification Office of Housing Excerpt From 41 CFR §60-1.4(b) Federal Housing Commissioner The applicant hereby agrees that it will incorporate or cause to be incorporated into any contract for construction work, or modifi- cation thereof, as defined in the regulations of the Secretary of Labor at 41 CFR Chapter 60, which is paid for in whole or in part with funds obtained from the Federal Government or borrowed on the credit of the Federal Government pursuant to a grant, contract, loan insurance, or guarantee, or undertaken pursuant to any Federal program involving such grant, contract, loan, insur- ance, or guarantee, the following equal opportunity clause: During the performance of this contract, the contractor agrees as follows: (1) The contractor will not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. The contractor will take affirmative action to ensure that applicants are employed, and that em- ployees are treated during employment without regard to their race, color, religion, sex, or national origin, such action shall include, but not be limited to the following: Employ- ment, upgrading, demotion, or transfer; recruitment or re- cruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. (2) The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive considerations for em- ployment without regard to race, color, religion, sex, or national origin. (3) The contractor will send to each labor union or representative of workers with which it has a collective bargaining agree- ment or other contract or understanding, a notice to be provided advising the said labor union or workers' represen- tatives of the contractor's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. (4) The contractor will comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regu- lations and relevant orders of the Secretary of Labor. (5) The contractor will furnish all information and reports re- quired by Executive Order 11246 of September 24,1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to its books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation to ascertain compli- ance with such rules, regulations, and orders. Firm Name and Address 141Adc,, S� - CtLvld o �9U2 r By DepartR4€WIedFVIAVWVQs OMB Control No. 2502-0029 (exp. 7/31/2009) (6) In the event of the contractor's noncompliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, this contract may be can- celed, terminated, or suspended in whole or in part and the contractor may be declared ineligible for further Govern- ment contracts or federally assisted construction contracts in accordance with procedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law. (7) The contractor will include the portion of the sentence imme- diately preceding paragraph (1) and the provisions of para- graphs (1) through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Sec- retary of Labor issued pursuant to section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontractor or vendor. The contractor will take such action with respect to any subcon- tract or purchase order as the administering agency may direct as a means of enforcing such provisions, including sanctions for noncompliance: Provided, However, That in the event a contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency the contractor may request the United States to enter into such litigation to protect the interests of the United States. The applicant further agrees that it will be bound by the above equal opportunity clause with respect to its own employment practices when it participates in federally assisted construction work: Provided, That if the applicant so participating is a State or local government, the above equal opportunity clause is not applicable to any agency, instrumentality or subdivision of such government which does not participate in work on or under the contract. The applicant agrees that it will assist and cooperate actively with the administering agency and the Secretary of Labor in obtaining the compliance of contractors and subcontractors with the equal opportunity clause and the rules, regulations, and relevant orders of the Secretary of Labor, that it will furnish the administering agency and the Secretary of Labor such information as they may require for the supervision of such compliance, and that it will otherwise assist the administering agency in the discharge of the agency's primary responsibility for securing compliance. The applicant further agrees that it will refrain from entering into any contract or contract modification subject to Executive Order 11246 of September 24, 1965, with a contractor debarred from, or who has not demonstrated eligibility for, Government contracts and Federally -assisted construction contracts pursuant to the Executive order and will carry out such sanctions and penalties for violation of the equal opporfiunity clause as may be imposed Title CBF - 17 form HUD -92010 (3/2006) VA form 26-421 upon contractors and subcontractors by the administering agency or the Secretary of Labor pursuant to Part II, Subpart D of the Executive order. In addition, the applicant agrees that if it fails or refuses to comply with these undertakings, the administering agency may take any or all of the following actions: Cancel, terminate, or suspend in whole or in part this grant (contract, loan, insurance, guarantee); refrain from extending any further assis- tance to the applicant under the program with respect to which the failure or refund occurred until satisfactory assurance of future compliance has been received from such applicant; and refer the case to the Department of Justice for appropriate legal proceedings. Excerpt from HUD Regulations 200.410Definition of term "applicant". (a) In multifamily housing transactions where controls over the mortgagor are exercised by the Commissioner either through the ownership of corporate stock or under the provisions of a regulatory agreement, the term "applicant" as used in this subpart shall mean the mortgagor. (b) In transactions other than those specified in paragraph(a) of this section, the term "applicant" as used in this subpart shall mean the builder, dealer or contractor performing the con- struction, repair or rehabilitation work for the mortgagor or other borrower. 200.420Equal Opportunity Clause to be included in contracts and subcontracts. (a) The following equal opportunity clause shall be included in each contract and subcontract which is not exempt: During theperformance of this contract, the contractor agrees as follows: (1) The contractor will not discriminate against any em- ployee or applicant for employment because of race, creed, color, or national origin. The contractor will take affirmative action to ensured that applicants are employed, and that employees are treated during employment without regard to their race, creed, color, or national origin. Such action shall include, but not be limited to the following: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including ap- prenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employ- ment, notices to be provided setting forth the provisions of the nondiscrimination clause. (2)The contractor will in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard race, creed, color, or national origin. (3) The contractor will send to each labor union or repre- sentative of workers with which he has a collective bargain- ing agreement or other contract or understanding, a notice, to be provided, advising the said labor union or workers' repre- sentative of the contractor's commitments under this section, and shall post copies of the notices in conspicuous places available to employees and applicants for employment. (4) The contractor will comply with all provisions of Ex- ecutive Order 10925 of March 6 196 1, as amended, and of the regulations, and relevant orders of the President's Commit- tee on Equal Employment Opportunity created thereby. (5) The contractor will furnish all information and reports required by Executive Order 10925 of March 6, 1961, as amended, and by the regulations, and orders of the said Committee, or pursuant thereto, and will permit access to his books, records, and accounts by HUD and the Committee for purposes of investigation to ascertain compliance with such regulations, and orders. (6) In the event of the contractor's non-compliance with the nondiscrimination clause of this contract or with any of the said regulations, or orders, this contract may be can- celled, terminated or suspended in whole or in part and the contractor may be declared ineligible for further Govern- ment contracts or Federally -assisted construction contracts in accordance with procedures authorized in Executive Order 10925 of March 6,1961, as amende, and such other sanctions may be imposed and remedies invoke s provided in the said Executive Order or by regulations, or order of the President's Committee on Equal Employment Opportunity, or as other- wise provided by law. (7) The contractor will include the provisions of Para- graphs(1) through (7) in every subcontract or purchase order unless exempted by regulations, or orders of the President's Committee on Equal Employment Opportunity issued pursu- ant to Section 303 of Executive Order 10925 of March 6, 1961, as amended, so that such provisions will be binding upon each subcontractor or vender. The contractor will take such action with respect to any subcontract or purchase orders as HUD may direct as a means of enforcing such provisions, including sanctions for noncompliance: Provided, however, that in the event the contractor becomes involved in, or is threatened with, litigation with a subcontractor or vender as a result of such direction by HUD, the contractor may request the United States to enter into such litigation to protect the interests of the United States. (b) Except in subcontracts for the performance of construction work at the site of construction, the clause is not required to be inserted in subcontracts below the second tier. Subcontracts may incorporate by referenced to the equal opportunity clause. 200.425Modification in and exemptions from the regulations in this subpart. (a) The following transactions and contracts are exempt from the regulations in this subpart: (1) Loans, mortgages, contracts and subcontracts not ex- ceeding $10,000. (2) Contract and subcontracts not exceeding $100,000 for standard commercial supplies or raw material; (3)Contracts and subcontracts under which work is to be or has been performed outside the United States and where no recruit- ment of workers within the United States in involved. To the extent that work pursuant to such contracts is done within the Untied States, the equal opportunity clause shall be applicable; (4) Contracts for the sale of Government property where no appreciable amount of work is involved; and (5) Contracts and subcontracts for an indefinite quantity which are not to extend for ore than one year if the purchaser determines that the amounts to be ordered under any such contract or subcontract are not reasonably expected to exceed $100,000 in the case of contracts or subcontracts for standard commercial supplies and raw materials, or $10,000 in the case of all other contracts and subcontracts. CBF - 18 form HUD -92010 (3/06) VA form 26.421 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 36 of 630 CERTIFICATION WITH REGARD TO THE PERFORMANCE OF PREVIOUS CONTRACTS OR SUBCONTRACTS SUBJECT TO THE EQUAL OPPORTUNITY CLAUSE AND THE. FILING OF REQUIRED REPORTS The Obidder, Oproposed sub -contractor, hereby certifies that09she,�has as n participated in a previous contract or subcontract subject to the Equal Opp or C as required by Executive .Orders 10925, 11114, or 11246, and that�she iiRha with the Joint Committee, the Director of the Office of Federal Con r ompliance, a Federal Government contracting or administering agency; or the former President's Committee on Equal Employment Opportunity, ajLrepepts-e-Mader the applicable filing requir lents. Date: __W Project Number: ContractAward: Awarding Agency: Contractor Name: Total Number of Employees_ Affiliate Company: By: Title: NOTE: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-11(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 ( enerally only contracts. or subcontracts of $10,000 or under are.ezem,_ . Proposed prime contractors and subcontractors who have participated In a previous contractor subcontract subjectto the Executjve.Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1) prevents the.awardof contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the U.S. Departmentof the Interior or by the Director, Office of Federal Contract Compliance, U,S. Department of Labor. SF -100 (EEO -1) must be filed bv; (A) All private employers.who are: (1) Subject to Title VII of the Civil Rights Act of 1964 (as amended) with 100 or more employees, . (2) Subject to Title VII who has fewer than 100 employees, if the company is owned or affiliated with another company, or there is centralized ownership, control or management so that the group legally constitutes a single enterprise, and the entire enterprise employs a total of 100 or more employees, (B) All .federal contractors (private employers), who: (1) Are not exempt as provided for by 41 CFR 60-1.5 (2) Have 50 or more employees, and a. Are prime contractors or first-tier subcontractors, and have a contract, subcontract, or purchase order amounting to $50,000 or more; or b. Serve as a depository of Government funds in any amount, or c. Is a financial institution, which is an Issuing, and paying agent for U,S. Savings Bonds and Notes. CBF - 19 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 37 of 630 nxbibi,t. 13 County Labbytst Certification Los Angstes County Compliance Form — ro be submitted with pld Name of Address: COUNTY LOBBYIST COpB CHAPT15R 2.160 COUNTY ORDINANCE! No. 93-0031 state: _ CA zip Code, Q tJr Telephone Number: ((j I`12 -21A -1:4CA Acting on behalf of the above named firm, as its Authorized Offiolal, I make the following Certification to the County of Los Angeles and the Community Development Commission, County of Los Angeles: 1) It is understood that each person/enfity/firm who applies for a Community Development Commission contract, and as part of that process, shall certlfy that they are familiar with the requirements of the Los Angeles County Code, Chapter 2.160 (Los Angeles County Ordinance 93-0031) and; 2) That all persons/entities/firms acting on behalf of the above named firm have and will comply with the County Code, and; 3) That any person/entity/firm who seeks a contract with the Community Development Commission shall be disqualified therefrom and denied the contract and, shall be liable in civil aotion, if any lobbyist, lobbying firm, lobbyist employer or any other person or entity acting on behalf of the named firm falls to comply with the provisions of the County Code, This certification Is a material representation of fact upon which reliance was placed when this transaction was made or entered into, Submission of this certification is a prerequisite for making or entering Into contract with the Los Angeles County and the Community Development Commission, County of Los Angeles. Authorized Official ��aclorlSu>aaoxEra�eEer) y (Signa ro) 7 ra 3 6 -j�' baxa ?5 � (date) (Wile) CBF - 20 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 38 of 630 NON -SEGREGATED FACILITES CERTIFICATION Federally -Assisted Construction Projects The federally -assisted construction contractor certifies that h�she DOES NOT and WILL NOT: 1. Maintain or provide, for his/her employees, any segregated facilities at any of his/her establishments. 2. Permit his/her employees to perform their services at any location, under his/her control, where segregated facilities are maintained. The federally -assisted contractor agrees that a breach of this certification is a violation of the Equal Opportunity Clause in this contract. As used in this certification, the term segregated facilities means any waiting room, work areas, restrooms and washrooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, creed, color or national origin, because of habit, local custom, or otherwise. The federally -assisted contractor agrees that (except where he/she has obtained identical certifications from proposed subcontractors for specific time periods) he/she will obtain identical certifications from proposed subcontractors prior to the award of subcontractors exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity Clause, and that he/she will retain such certifications in his/her files. NOTE: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001 Date: C7__& 11-4 1202-? Project Number: 3101 Cor By: Tjtlt. . o,rSAA CBF - 21 City of Rosemead, California Bid Package, Garvey Parl<Gym Cooling Addition, Project No: 31019 Document Control Page 39 of 630 NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of L -)S (yteks . DEPARTMENT OF PYJBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares 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. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. CBF - 22 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 40 of 630 COMPLIANCE WITH CLEAN AIR AND WATER ACTS (Applicable to federally assisted. construction contracts and related subcontracts exceeding $100,000) During the performance of this contract, the contractor and all subcontractors shalt comply with the requirements of the Clean Air Act, as amended, 42 USC 1857, et seq„ the Federal Water Pollution Control Act, as amended, 33 USC 1251, et seq., and the regulations of the Environmental Protection Agency with respect thereto, at 40 CFR Part 16, as amended. In addition to the foregoing requirements, all nonexempt contractors and subcontractors shall furnish to the owner the following: 1. A stipulation by the contractor or subcontractors that any facility to be utilized in the performance of any nonexempt contract or subcontract is not listed on the List of Violating Facilities issued by the Environmental Protection Agency (EPA) pursuant to 40 CFR 15.20. 2. Agreement by the contractor to comply with all the requirements of Section 114 of the Clean Air Act, as amended (42 USC 1857o -B) and Section 308 of the Federal. Water Pollution Control Act, as amended (33 USC 1318) relating to Inspection, monitoring, entry, reports, and information, as well as all other requirements specified. in said Section 114 and Section 308, and all regulations and guidelines issued thereunder. 3. A stipulation that as a condition for the award of the Contract, prompt notice will be given of any notification received from the Director, Office of Federal Activities, EPA, indicating that a facility utilized or to be utilized for the contract is under consideration to be listed on the EPA List of Violating Facilities. 4. Agreement by the contractor that he will include, or cause to be Included, the criteria and requirements In paragraph (1) through (4) of this section in every nonexempt subcontract and requiring that the contractor will take such action as the Government may direct as a means of enforcing such provisions. 'err a Name of Contractor lart+��wsw�r�a CBF - 23 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 41 of 630 WORKER'S COMPENSATION CERTIFICATION I certify, by signature below, that 1 em aware of the provisions of Section 3700 of the California Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self-insurance In accordance with the provisions of that code, and I will comply wlth such provisions before commencing the performance of the work of this contract. Date: Project Number:. Project Name: ,AJ'PV Nr� &4m. cue\r4 di 1 Company Name:__ w Address: ILE I 6\ eSJ &ei S'f g7 _ <jW r ado CA %C)Uk�"" CBF - 24 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 42 of 630 To: NOTICE OF SECTION 3 COMMITMENT lAddressj Awarding Authority: :!2N e5F R��m axe _ Project Name and Number; G2n" ��j,S lrna P-4ti1�M P 2c� lmzsv) The undersigned currently holds a contract with involving Community Development Block Grant (CDBG) funds from the U.S. Department of Housing and Urban Development (HUD) or a subcontract with a prime contractor holding such contract. You are advised that under the provisions of the above contract or subcontract, and in accordance with Seotlon 3 of the Housing and Urban Development Act of 1968, the undersigned is obligated, to the greatest extent feasible, to give opportunities for training and employment to lower -Income residents of the project area and to award contracts for work on the project to business concerns that are located in or are owned in substantial part by project -area residents. Regarding employment opportunities for this' reject, the minimum number and job titles are: Regarding job referrals, request that consideration be given, to the greatest extent feasible, to assignment of persons residing in the service area or neighborhood Int1 which the project Is located. The anticipated date the work will begin is C)4 Lbi City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Project No: 31019 Document Control Page 43 of 630 Section 3 Economic Opportunity Plan 1. Name snd Address or Repotting Endly (Recipient, Sun•reciplent, Conlraotor, subcontractor);_ crosb tl m Ne,Q(xdC. SF - i2 u�d� t G `S 2. Federal Idenb6callon (ComraUVAvmro No.); d L \3 3, Dollar Amount or Award: 4. Contact Parson: K N . 5. Phone (Include Area Code): 949 29k - ESa s. Repor ting Period. -Mlb _ 7. bate Report $uhmined: .. r 8, Program Code: ((Jse a separate theotfor each Program Coda) Program Codes 1.Fiaxlbre Subsidy 2. Saafion 202181 t 3. PubliclIndian Housing Development, Operation, and Moderniralion 4. Homeless Assislance S. HOME 8, HOME --Slate Administered 7.. CD813 EnUUement 8, CDBG— StateAdministered 8 OlherCDPrograms 10 Other Housing Programs Part 1: Employment and Training Commitment JOB CLASSIFICATION TOTAL NEW HIRES SECTION 3 NEW HIRES - %OFAGOREOATE HIRES WHO ARE SECTION 3 HIRES CODE(S) RACIAL ETHNIC Protaseionals 4 Taehniclans t 1 �% 011f"Iclerl al Trade: Tiede: TOTAL: Part 11. Contract Award Commitment to Section 3 Staineseee (Sabcemrectots, SUUellera, vendors. or SeNlce Providers, SPECIFY CONSTRUCTION OR NONCONSTRUCTION NAME OF SECTION 3131JSINESS CONCERN CONTRACT CODES) CONTRACT AMOUNT RACIAL ETHNIC RACIAL BAGKOROUND; SINGLE,{ T,A EGORIE3 Q.QV.BLk CATEGORIES i. American IndtardAlask t Native S. American Indian or Alaska Native AND White Z. Asian 7, Asian AND White 3. SiedUAfriean American S. Black or African American AND White 4, Native HawaiiantOther Pacific Islander 9. American Indian or Alaska Native AND Black or African Anierfean 6. While 10, Other— for Individuals not Identified above. A. HispaplclLatino 8, Not HlspanloUtino CBF - 26 City of Rosemead, California Bid Package, Garvey Park Gym Cooling Addition, Projecl No: 31019 Document Control Page 44 of 630 Section 3 Business Certification Form) Business Name: Business Address: 1161 E`)O urs ckc_ S°t _ EM !�A71X Telephone Number; - Contract Amount: $ The above-mentioned business firm is a Section 3 business concern based on the following qualification: 1. 51 percent owned by Section 3 residents (attach Section 3 Resident Certification forms) OR 2. ® Permanent, full-time employees Include at least 30 percent Section 3 residents (attach Section 3 Resident Certification forms) OR 3. [] Written commitment to subcontract at least 25. percent of .contract amount to business concerns that meet Section 3 qualification stated In paragraph 1 or 2 above (attach Section 3 �conomlc Opportunity Plan, Section 3 Business Certification form for subcontractor, and Section 3 Resident Certification forms) OR 4. Written commitment that Section 3 qualified new hires will comprise at least 30 percent of total new hires (attach.Seotfon.3 Economic Opportunity Plan) Specify ethnicity of business ownership: 0 White American [ Black American ❑ Native American C] Hispanic American Asian Pacific ❑ Hasidic Jewish The undersigned by his/her signature affixed hereto declares under penalty of perjury that the above Information Is complete and correct. Date CBF - 27 jr w-. \.♦ • Print Name City of Rosemead, California Project Name Bid Package, Garvey Part( Gym Cooling Addition, Project No: 31019 Document Control Page 45 of 630 CERTIFICATION OF UNDERSTANDING AND AUTHORIZATION Project Number This is to certify that the principles and the authorized payroll officer have read and understand the Minutes of the Preconstruction Conference and the labor standards clauses pertaining to the subject project. The following person(s) is designated as the payroll officer for the undersigned and is authorized to sign the Statement of Compliance, which will accompany our weekly certified payroll reports for this project. Designated Payroll Officer (Name) 24rAot\$ Designated Payroll Officer (SignatureC—#,Wqb�F Authorized by (Contractor/SubeeRkQGtor) k -Ge cnsrcu& . re Employer Identification Number CBF - 28 Title Date nti Gc�nSey (mac C This is to certify that the principles and the authorized payroll officer have read and understand the Minutes of the Preconstruction Conference and the labor standards clauses pertaining to the subject project. The following person(s) is designated as the payroll officer for the undersigned and is authorized to sign the Statement of Compliance, which will accompany our weekly certified payroll reports for this project. Designated Payroll Officer (Name) 24rAot\$ Designated Payroll Officer (SignatureC—#,Wqb�F Authorized by (Contractor/SubeeRkQGtor) k -Ge cnsrcu& . re Employer Identification Number CBF - 28 Title Date