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Pavement Coatings Co.17, CITY OF ROSEMEAD ' ANNUAL 2008-2009 SLURRY SEAL PROJECT BIDDER: Pavement Coatings Co. CONTRACT BID FORMS TABLE OF CONTENTS SECTION 1 BID SCHEDULE ..........................1 SECTION 2 BID DATA FORMS ..........................5 2.A BID BOND ..........................6 2.B LIST OF PROPOSED SUBCONTRACTORS ..........................7 SECTION 3 NON-COLLUSION AFFIDAVIT .............................................................................10 BIDDER: Pavement Coatings Co. SECTION 1 -BID SCHEDUL CBF-1 I BASE BID SCHEDULE BIDDER: Pavement Coatings Co. BID SCHEDULE SCHEDULE OF PRICES FOR ANNUAL 2008-2009 SLURRY SEAL PROJECT CDBG PROJECT No. P46402 UNIT OF EST. UNIT ITEM NO. ITEM DESCRIPTION MEASURE OTY. PRICE COST 1 Clearing & Grubbing per plans and specifications. See technical specifications TP2 & TP3. LS 1 900. D D (o~ Da o. o d 2 Disposal of Waste Materials LS 1 y' oco, o p y BDd, 0 0 3 Crack Sealing LS 1 2,5 3 a. e6 ;2 S 30. DO 4 Slurry Seal Type II - See exhibit "A" & "B" per street locations & r ELT 750 l 33,5:3 i BAD 37 Sd ? a eas. , . 5 Traffic Striping and Pavement Markers - See exhibit "C" per t il d LS 1 70G 2s I Z TO& • Z S f 2 e a s. . , , TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ I y s, /,,0 7 S ' mHf- 14itf- 0"eloeoaryFjve Tike.~SAr+~ 1/X/~4I-~i~Et9f!liNT As3 566f--, Y ve !ar-rS Dollar amount in written form 1 ' The undersigned agrees that these Contract Bid Forms constitute a firm offer to the Owner which cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and after the bid opening date, or until a Contract for the Work is fully executed by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 parry, 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. 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. 1 CBF-2 1 1 BIDDER: Pavement Coatings Co. ' Atta °d 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 by the Owner for execution, within five (5) Calendar Days following the Letter of Award for the Contract, and will deliver to the Owner within that same period the necessary original Certificates of Insurance, Endorsements of Insurance, Performance Bond, Payment Bond and all other documentation and certification required by the Contract. The undersigned offers and agrees that if this bid is accepted, it will assign to the purchasing body ' all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C. Section 15) or under the Cartwright Act (Chapter 2 of Part 2 of Division 7 of the Business and Professional Code), arising from purchases of goods, materials or services by the Bidder for sale to the purchasing body pursuant to the bid. Such assignment shall be made and become effective at the time the purchasing body tenders final payment to he Contractor. ' Bidder understands and agrees that, when requested by Owner, he shall provide: (1) evidence satisfactory to the Owner of Bidder's California contractor's license(s) in good standing; (2) evidence that the person signing this Bid is authorized to bind Bidder to this Bid and to a contract resulting therefrom; and (3) any other information and documentation, financial or otherwise, needed by ' Owner to award a Contract to the lowest responsible and responsive bidder. Bidder understands and agrees that liquidated damages shall apply to this Contract in the amounts 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. P/6 ' 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-3 By: Signature DOUG FORD Type or Print NamePC@Sident Title Bidder's/Contractor's State of Incorporation: Partners or Joint Venturers: BIDDER: Pavement Coatings Co. 10240 San Sevaine Way Business Street Address Mira Loma, CA 91752 City, State and Zip Code 714/326-3011 Telephone Number California 303609 Bidder's License Number(s): 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, nartnershin or ioint venture has the authority to do so. CBF-4 MINUTES OF BOARD OF DIRECTORS OF PAVEMENT COATINGS CO. A California Corporation To Whom It May Concern: Following is an excerpt of the minutes of the Board of Directors meeting of Pavement Coatings on June 13, 2007: RESOLVED, that the Company authorizes all officers of the Company to sign bids and contracts. The following is a current list of officers: Doug Ford, President, Richard Gove, Secretary. I herefore authorize any of the above mentioned persons to sign for Pavement Coatings Co., a California Corporation. 62~~ DOUG FORD, PRESIDENT Pavement Coatings Co. ' BIDDER: Pavement Coatings rn 1 ' SECTION 2 BID DATA FORMS r CBF-5 BIDDER: Pavement Coatings Co. Bidder shall submit its Bid data in accordance with the format shown on each of the following Bid Data Forms. Bidders shall prepare and use as many sheets as are necessary to adequately provide the information required. Bidder shall ensure that every page of its Bid Data Forms are properly identified with the Bidders name and page number. 2.A BID BOND KNOW ALL MEN BY THESE PRESENTS: THAT Pavement Coatings Co. Principal, and First National Insurance Company of America . 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% of Amt Bid being not less than ten percent (10%) of the Total Bid Price; for the payment of which sum will and truly to be made, we bind ourselves, _ our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. WHEREAS, said Principal has submitted a bid to the OWNER to perform all Work required for the Annual 2008-2009 Slurry Seal Project as set forth in the Notice Inviting Bids and accompanying Bid Documents, dated March 6, 2009 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 a 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 maybe 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 r: the OWNER in such suit, Including reasonable attorneys' fees to be fixed by the court. 3.':.. SIGNED AND SEALED, this 27th day of February 2009 First National Insurance Pavement Coatings Co. (SEAL) Com an of America (SEAL) Principal. Sur By: DOUG F0 ~ 61 /Idmi- Signature President Signature Richar L. Wells, Attorney-In-Fact CBF-6 First National Insurance Company of America POWER 1001 4th Avenue OF ATTORNEY Suite 1700 Seattle. WA 99154 KNOW ALL BY THESE PRESENTS: No. 10053 That FIRST NATIONAL INSURANCE COMPANY OF AMERICA, a Washington corporation, does hereby appoint *************SUZANNE ADAMS; TED ADAMSON; LYNN A. BEIMER; RICHARD L. WELLS; Brea, CA**************** its true and lawful attorney(s)-in-fact, with full authority to execute on behalf of the company fidelity and surety bonds or undertakings and other documents of a similar character issued by the company in the course of its business, and to bind FIRST NATIONAL INSURANCE COMPANY OF AMERICA thereby as fully as if such instruments had been duly executed by its regularly elected officurs at its home office IN WITNESS WHEREOF, FIRST NATIONAL INSURANCE COMPANY OF AMERICA has executed and attested these presents this 15th day of January 2009 Dexter R. Legg, Secretary Timothy A. Mikolajewskl, Vice President CERTIFICATE Extract from the By-Laws of FIRST NATIONAL INSURANCE COMPANY OF AMERICA: "Article V, Section 13 - FIDELITY AND SURETY BONDS the President, any Vice President, the Secretary, and any Assistant Vice President appointed for that purpose by the officer in charge of surety operations, shall each have authority to appoint individuals as attorneys-in-fact or under other appropriate titles with authority to execute on behalf of the company fidelity and surety bonds and other documents of similar character issued by the company in the course of its business... On any instrument making or evidencing such appointment, the signatures may be affixed by facsimile. On any instrument conferring such authority or on any bond or undertaking of the company, the seal, or a facsimile thereof, may be impressed or affixed or in any other manner reproduced: provided. however, that the seal shall not be necessary to the validity of any such instrument or undertaking." Extract from a Resolution of the Board of Directors of FIRST NATIONAL INSURANCE COMPANY OF AMERICA adopted July 28, 1970. "On any certificate executed by the Secretary or an assistant secretary of the Company setting out. (i) The provisions of Article V. Section 13 of the By-Laws, and (ii) A copy of the power-of-attorney appointment, executed pursuant thereto, and (iii) Certifying that said power-of-attorney appointment is in full force and effect, the signature of the certifying officer may be by facsimile, and the seal of the Company may be a facsimile thereof. 1. Dexter R Legg . Secretary of FIRST NATIONAL INSURANCE COMPANY OF AMERICA, do hereby certify that the foregoing extracts of the By-Laws and of a Resolution of the Board of Directors of this corporation, and of a Power of Attorney issued pursuant [hereto, are true and correct. and that both the By-Laws. the Resolution and the Power of Attorney are still in full force and effect IN WITNESS WHEREOF, I have hereunto set my hand and affixed the facsimile seal of said corporation this 27th SEAL ,_1928,: day or February 2009 Pt X* arkj I Dexter R. Legg, Secretary S-10491DF 1109 • • safecoV and the Safeco logo are registered trademarks of Safety Corporation. WEB PDF CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT State of California County of Orange On February 27, 2009 betore me, Lynn A. Beimer, Notary Public Date Here Insert Name and Title of the Officer personally appeared Richard L. Wells Name(s) of Sgnegs) who proved to me on the basis of satisfactory evidence to be the personal whose name stare subscribed to the within instrument and acknowledge to me that/MQ%he/they executed the ume i Is/her/their authorized capacity(fes), and that b is er/the ignatures on the instrument the LYNN A. BEIMER personor the entity upon behalf of which the perso2kV Commission # 1781026 acted, executed the instrument. Notary Public - California 1 Orange County 1 certify under PENALTY OF PERJURY under the laws of MyCorrm Bow Doc 1- -0 the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. f Signature Place Notary Seal Above Sgnature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signers Name: ❑ Individual ❑ Corporate Officer - Title(s): ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: Signer's Name: ❑ Individual ❑ Corporate Officer - Title(; ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: . BIDDER: Pavement Coatings Co. 2.8 LIST OF PROPOSED SUBCONTRACTORS ' In compliance with the "Subletting and Subcontracting Fair Practices Act," Sections 4100 through 4114 of the California Public Contract Code, and any amendments thereto, each Bidder shall provide the information requested below for each subcontractor who will ' perform work, labor or render service to Bidder in or about the construction of the Work in an amount in excess of one-half of one percent (greater than 0.5 of the Bidder's Total Bid Price, or, in the case of bids or offers for the construction 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 I the information requested by the Owner about each subcontractor, other than the name and location of each subcontractor. ' If the Bidder fails to specify a subcontractor for any portion of the Work to be performed under the Contract, it shall be deemed to have agreed to perform such portion itself, and shall not be permitted to subcontract that portion of the Work except under the conditions ' hereinafter set forth below. Subletting or subcontracting of any portion of the Work in excess of one half of one percent (greater than 0.5%) of the Total Bid Price or, in the case of bids or offers for the construction ' of streets or highways, including bridges, in excess of one-half of 1 percent of the Contractor's total bid or ten thousand dollars ($10,000), whichever is greater, for which no subcontractor was designated in the original bid shall only be permitted in cases of public emergency or necessity, and then only after Owner approval t 1 1 CBF-7 BIDDER: Pavement Coatings Co 2.13 LIST OF PROPOSED SUBCONTRACTORS (continued) ("Duplicate Next 2 Pages if needed for listing additional subcontractors."] Name and Location Description of Work of Subcontractor to be Subcontracted Name: sr01,--Alllll~ Address: o hB sr~ M7N Q h RN,L (~F ? , SD 1, Name and Location of Subcontractor Name: 2tA6f)&, Z~v CtAeIC SFALANr t,- C Address: frco E. WA[-r-KT Fu ~ctrtro.i CA q24'; ltE,yp r)0 t~5 , S re, A, t- rr,aQ,C,vb5 p ✓rt 'c Description of Work to be Subcontracted c RAcrc staur1L- Name and Location of Subcontractor Name: Address: Description of Work to be Subcontracted Name and Location of Subcontractor Name: Address: Description of Work to be Subcontracted Name and Location of Subcontractor Name: Address: Description of Work to be Subcontracted CBF-8 BIDDER: Pavement Coatings Co. 2.C 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: Town of Yucca Valley, 57090 Twenty-Nine Palms Hwy, Yucca Valley, CA 92284 Name and Address of Owner 369-7207 Name and telephone number of person familiar with project $223,645. Type II Slurry Seal 07-12-07 Contract amount Type of Work Date Completed City of Pasadena, 100 N. Garfield Ave., Pasadena, CA 91101 Name and Address of Owner Elvin Jiang 626/744-6912 1 2. Name and telephone number of person familiar with project Contract amount Date Completed 3 City of Aliso Viejo, 12 Journey, Ste. 100, Aliso Viejo, CA 92656 Name and Address of Owner Angel P. Fuertes 949/425-2533 ~ a 1 1 1 Name and telephone number of person familiar with project $490,971. Type II Slurry Seal 06-19-08 Contract amount Type of Work Date Completed City of Orange, 300 E. Chapman Avenue, Orange, CA 92866 Name and Address of Owner Alan Trpunn 714/744-5544 Name and telephone number of person familiar with project $509,932. Type I & II Slurry Seal 08-19-08 Contract amount Type of Work Date Completed CBF-9 Seal 01-22-08 ' BIDDER: Pavement Coatings Co. I SECTION 3 NON-COLLUSION AFFIDAVIT 1 t 1 CBF - 10 BIDDER: Pavement Coatings Co. ' NON-COLLUSION AFFIDAVIT In accordance with Public Contract Code Section 7106, the undersigned, being first duly ' sworn, deposes and says that he or she holds the position listed below with the bidder, the party making the foregoing bid, that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly ' or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Signature DOUG FORD Typed or Printed NamePreSident 1 Title ' Pavement Coatings Co. Bidder 1 ' Subscribed and sworn beforege 09 This day of mar , 20 (Seal) Va, ' Notary Public in and for the State of California 1/1111,111111111111111111111111111111111111 ' Z VAN P. DUNCAN My Commission Expires: 5Eri~rr1;e4 ; 2610 COMM. #1689434 K IaMy NOTARY PUBLIC • CALIFORNIA 0 ORANGE COUNTY Commisalon Expiru SEPTEMBER 21, 2010 j 2.1..1..11..11..1.......1.111♦111111111111♦ I CBF - 11 1- 1. ' SECTION 3 BUSINESS CERTIFICATION FORM Pavement Coatings Co. Business Name: Business Address: 10240 San Sevaine Way Mira Loma, CA 91752 Telephone Number: 714%826-3011 Contract/Bid Amount: $ IyS, 4o~r -7 S 1 1. The above mentioned business firm is a Section 3 business concern based on the following qualifications: ' ❑ 51-percent owned by Section 3 Residents (Submit Resident Certifications with this business certification form) ' ❑ At least 30-percent Permanent, full-time employees are Section 3 Residents Total Number of all full-time employees , Number of Section 3 qualified Employees ' (Submit the Resident Certification form(s) with this Business Certification form) ' 2. The above mentioned business firm is not a Section 3 business concern, but commits to the Section 3 goal: Written Commitment (Section 3 Economic Opportunity Plan), outline intentions to: ' Hire Section 3 qualified residents at least 30-percent aggregate new hire positions, and/or Subcontract 25-percent or more of the contract amount to Section 3 qualified business concerns. THE UNDERSIGNED DECLARES THAT THE ABOVE i DOUG FORD President Signature of Owner/Principal IS COMPLETE AND CORRECT / 8-oq Date 1 Pavement Coatings Co. Business Name 303609 License Number To Be Completed by Local Contracting Agency Preference Category: oTargeted Service Area ElYouthbuild ❑Other - Census Tract Number: I -V - "NONCOLLOSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID' §7106. Any public works contract of a public entity shall Include an affidavit, in the following form: State of California County of Riverside ) ss. t Doug Ford being first duly sworn, deposes and says that, he or gkq( is Pneside+ci+ of Pavement coatings Co. , the party making the foregoing ' bid, that the bid is not made in the Interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not ' directly or indirectly Induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, ' communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested In the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid." Project Name: Annual 2008-2009 Slurry Seal ProjePtoject Number. P46402 ' Company: Pavement Coatings Co. Address: 10240 San Sevaine Wy, Mira Loma, CA. 91752 ' Signature: DOUG Fn Bn ' President Title: Date: 3-18-09 SWORN TO AND SUBSCRIBED TO BEFORE ME e44 VAN P. DUNCAN Thisday of ~-1 AQ C'N 2oQc COMM. #1689434 2 NOTARY PUBLIC • CALIFORNIA p W Nota Public: ' / V a, z ORANGE COUNTY ry Llp CAmmlwlae EqM SEPTEMBER 21, 2010 s **~tt~~N•~~~•~~t•~~~~N•~N•~ My Commission Expires: S EnriE.2 .r Za! v