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Excel Paving CompanyJ BASE BID SCHEDULE BIDD~h EC PAVING COMPACdY LONG BEACH, CA 90806 BID SCHEDULE SCHEDULE OF PRICES FOR SAFE ROUTE TO SCHOOL PROJECT SR2SL 5358 (011) UNIT OF EST. UNIT ITEM NO. REM DESCRIPTION MEASURE QTY. PRICE COST 1 Clearing & Grubbing per plans and LS 1 2700.°° a700.00 specifications. 2 Disposal of Waste Materials. LS 1 1100-00 n oo 3 Furnish and Install Solar In-Road EA 7 611w,50 .0* NZ 550 Pavement Lighting System 3y650 0" Complete per Plans and Specifications. 7 Locations with a Total of 88 In-road Pavement Lights. 4 Furnish and Install Solar Speed EA 10 1(0500. 1(05000 • pO Feedback Sign System Complete per Plans and Specifications. 5 Furnish and Install Signing and LS 1 155(050. °O t55(oSa. QO Striping per Plans and Specifications. 6 Furnish and Install Pedestrian EA 38 L150.00 .(e 1"7100, pO Count Down Heads Complete per Plans and Specifications. TOTAL BASE BID PRICE (SCHEDULE BID PRICE): $ 5?N~100 • 00 j r amount in written CBF-1 I I Jun 10 10 02:19p MAYOR: MARGARET CLARK MAYOR PRO TEM: GARY TAYLOR COUNCIL MEMBERS: SANDRAARMENTA POLLY LOW STEVEN LY June 10, 2010 6265692303 p•1 Posmead 8838 E. VALLEY BOULEVARD • P.O. BOX 399 ROSEMEAD, CALIFORNIA 91770 TELEPHONE (626) 569-2100 FAX(626)307-9218 PALP INC.DBA EXCEL PAVING COMPANY ADDENDUM No. 1 SAFE ROUTE TO SCHOOL PROJECT (Bid Opening Date: June 16, 2010) To All Prospective Bidders: Please note the following revisions on the plans and specifications for the above project: 1. Page CBF-1 : Add the following Alternate Item to the proposal: ALTERNATE BID ITEM #1 UNIT OF EST. UNIT ITEM NO. ITEM DESCRIPTION MEASURE CITY. PRICE COST 7 Clearing and Grubbing (Including ~7op. pO 6700 • pO Disposal of Waste Materials) LS 1 p, 30 00 8 Construct 4-Inch thick PCC Sidewalk SF 200 1750-00 7Hoo . 00 9 Construct PCC Curb Ramps per APWA Std. Plan 111-3 including truncated domes ARMORCAST replaceable yellow cast in place or approved equal. EA 4 3(v 00 9000 - 00 10 Construct 8-inch PCC Curb and 24-inch PCC gutter per APWA Std Plan 121-2. LF 250 "'Op 3300' oo 11 Construct cross and longitudinal gutter per APWA Std Plan 122-2. SF 300 Page 1 of 2 Jun 10 10 02:19p 6265692303 p.2 oP . -7Soo.ao 12 Construct 6-inch thick AC patch (p,50 over 90% Compacted Native. SF 1200 TOTAL ALTERNATE BID PRICE #1: Ft VC- Dollar amount in written form TOTAL BASE BID PRICE INCLUDING ALTERNATE BID ITEMS:$ (off 9&0 . Go S)Y,NuNaE17 r.lf tit N 7HouSAN1J 1ui uE nuN6/16ij SI X74 DO LEA4?-S Dollar amount in written form If the Bid Documents specify alternate bid items, the following Alternate Bid amounts shall be added to or deducted from the Total Bid Price entered above. The owner can choose to include one or more of the alternates in the Total Bid Price of the Project. If any of the Alternate Bids are utilized by the Owner, the resulting amount shall be considered the Total Bid Price for the Project. The addendum No. 1 forms a part of the Contract Documents for the above described project and shall supplement or supersede referenced sections of original plans and specifications. This Addendum No. must be signed by the Bidder and submitted along with the Bidder's Proposal. Failure to acknowledge receipt of addendum will disqualify the Bidder. Very truly ours, afael FaIar o Associate Civil Engineer Acknowledgement: PALP. INC.DBA Bidder: EXCEL n r R Date: Title: P f GA BROWN, PRESIDENT OJ $ 351,s(00 . JUN 16 2010 Page 2 of 2 BIDDER: PALP INUBA C P G COMPANY Note: The City of Rosemead reserves the right to reduce or increase the quantities of any items in the schedule of bid items above, within the limits define in Section 3-2.2.1 of the Standard Specifications, to stay within the budgeted amount of this project. If the Bid Documents specify alternate bid items, the following Alternate Bid amounts shall be added to or deducted from the Total Bid Price entered above. The owner can choose to include one or more of the alternates in the Total Bid Price of the Project. If any of the Alternate Bids are utilized by the Owner, the resulting amount shall be considered the Total Bid Price for the Project. The undersigned agrees that these Contract Bid Forms constitute a firm offer to the Owner which cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and after the bid opening date, or until a Contract for the Work is fully executed by the Owner and a third party, whichever is earlier. The undersigned also agrees that if there is a discrepancy between the written amount of the Bid Price and the numerical amount of the Bid Price, the written amount shall govern. Attached hereto is a certified check, a cashier's check or a bid bond in the amount of N P CENTOFAMO(J8SMI0?($ ) said amount being not less than ten percent (10%a) 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. CBF-2 PALP INIGMA BIDDER: pWE PAVING COMPAW The undersigned acknowledges receipt, understanding and full consideration of the following addenda to the Contract Documents. Addenda Nos. L 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. BF-3 PALL INC.DBA BIDDER: EXCFI PAIONG ;OMPAIN By: C. Signature GA BROWN, PRESIDENT Type or Print Name Title (56215995841 Telephone Number Bidder's/Contractor's State of Incorporation: FO PAIA Partners or Joint Venturers: 2230 LEMON AVENUE 90606 Business St Address City, State and Zip Code STATE LfO. 688659 °A" 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, partnership or joint venture has the authority to do so. CBF=4 PALP. WC.DBA BIDDER: EME: `~i ~Pp,n '~^~A COMPANY ABCL""-`iv~n~ T SECTION 2 BID DATA FORMS CBF-5 PALP Inc. dba BIDDER: Excel Paving Company 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 PALP Inc. dba Excel Paving Company , as Principal, and Federal Insurance Company as Surety, are held firmly bound unto the CffY OF ROSEMEAD {hereinafter called the OWNER) in the sum of Ten percent of the total amount of the bid t o% 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, jointlyand severally, finny by these presents. WHEREAS, said Principal has submitted a bid to the OWNER to perform all Work required for the SAFE ROUTE TO SCHOOL PROJECT as set forth in the Notice Inviting Bids and accompanying Bid Documents, dated June 16, 2010 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 80h day of June 20 to PALP Inc. dba Excel Paving Company (SEAL) Federal Insurance Company (SEAL) Principal r ' S _ By: -~-I- By: Signature ignature Timothy D.' Attorney in Fact GA ISROWN, PRESIDENT r, CBF-6 CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Orange On '06/08/2010 before me, Debra Swanson, Notary Public (Here insert runic and tioc of the omcce) personally appeared Timothy D Rapp who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/eae subscribed to the within instrument and acknowledged to me that he/sfW#wy executed the same in hisAwFEttreiF authorized capacity(ier), and that by his/4wAhsicsignature(s) on the instnunent the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Sipunue of Noukry Public ~.'10r+y DEBRA SWANS COMM.01822117 X w NOTARf % OUGCALIFORNIA ;U ORANGE COUNTY N (Notary Scal) + MY Comm. Erdres Noy 18, 2012 ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUtvfENT frisk or description or-as, hod document) (Tick or description of ituachod documents continued) Number of Pages _ Document Daa e (Additions] information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (ride) ❑ Ptutncr(s) ❑ Attorney-in-Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Arty aebrowlydgmrm compileted In California must contain wrbiage rsacity as an*w, above N the rotary mcaarr or a oparnu ocbsowiedgmem form must be pnperfy complard and arlocW to that docamrtm. 17w ordy aoeption u if a doesswtar 1, to be metaled outsrde of CalVf " In rude Innanres, on7 a/rntraive acknowtrdgmrs, wrbtage ar may be printed on stch o dacvmrm so long err the wrbkge does nor ngdn the notary to do something that is illegal for a notary in California (L, cers(/ying the authorized capacity of the signer). Please check the document c v q; llyfor proper notarial worairw and attach dds form if rrquvrd • Sum w4 County mfomu[iom must be the Smote snd County where the document signet(s) pasoos0y appearod before the notary, public for scknovelodgmcm Date of ratariratian must be the date than the signer(s) pasonW ly sppcarod Ati ch must also be the rime dam the acknowledgment 6 complctod. • Tlhe notary public must print his or her rume ss it appears within his or her commission followed by a comma and then your tide (notary public). • Print the name(s) of document signer(s) who pussrully appear st the titre of ootasimioa • indinte the correct singular or plural forms by tossing off incorrect foam (i.c. Wshd6yr• ishra) or circling the correct fours. Failure to corsccdy indicant Nis abrm adont may lad to rejection of document recording. • The notary sell impression must be clear and photographically reproducible. Impression most not cover text or lines. If sea) impression smudges, re-scat if a sufficient art permits, otherwise complete a different achmwlodgrnent form. • Signah" of the rotary pudic must match the sigrueure on file with the otiice of tiro conmy dat a' O Additional infotmatioa is not required but could help to ernsurc this ae)mowlafymeal is not misused or attached to a ditfaent docurrcnt O Indicate tide or type of atuched doeumwt, numb" of pages and date. O Indicate the capscrry claimed by the signer. If the claimed capacity is a corporate offices-, indicate the tide (i.e. CFA, CFO, Socrctary). • Securely attach this document to the siped docurrent 200$ Versions CAPA vl2.10.07 800473.9665 tvww.NowyClassa.com Chubb POWER Federal Insurance Company Attn: Surety Department OF Vigilant Insurance Company 15 Mountain View Road Surety ATTORNEY Pacific Indemnity Company Warren, NJ 07059 iolliuEm Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and appoint Linda D. Coats, Matthew J. Coats, Douglas A. Rapp and Timothy D. Rapp of Laguna Hills, California--- each as O,eir bus rind lawful Aeun,ey- In- Fact tv eaeculu under suds deslgnallun in Ibui, comes end tu a04 Ihei, o,Po,ete ...Is to m,d deliver lo, and a, 1heil behalf as surety thereon or otherwise, bonds and urdertziings and other writings obligatory In the nature thereof (other than hail bonds) given or executed in the course of business, and any instruments amending or altering the same, and consents to the modification or alteration of any instrument referred to in said bonds or obligations. In Witness Whereof, Mid FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested mesa presents and affixed their corporate seals on this 16Th day of November, 2009. ennelh C. enr7eT, Assstant Secretary It. Norris, Jr., vice tg ant STATE OF NEW JERSEY ss. County of Somerset On this pith day of November, 2009 before me, a Notary Public of New Jersey, personally came Kenneth C. Wendel, to me known to be Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies wfiich executed the foregoing Power of Attorney. and the sad Kenneth C. Wendel, being by me duty swum, did depose and say Mat he Is Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof, that the seals affixed to the foregoing Favor of Attorney are such corporate seals and were thereto affixed by authority of the By- Laws of said Companies; and that he signed saitl Power of Attorney as Assistant Secretary of saitl Companies by like authoriy, and that he is acquainted myth David B. Norris, Jr., and knows Nm to be Vice Plesldent of Mid Companies; and that the signature of David B. Norris, Jr., subscribed to said Power of Attorney is In the genuine handAddng of David B. Norris, Jr., and was thereto subscribed by authority of said By, Lam and in-deponents presence. Notarial Seal KATHERINE J- ADELAAR N NOT0Y PI.IRLIC OF NEW JERSEY p10TARY No 4316685 Commissien Expires Joly 16, 401d . s►rr pUBll~ Nptary Public yE1VJER9~ CERTIFICATION EMred from the By. Le„n of rLDCML INGUDANCC COMPANY, VIGILANT INGunANCC COMPANY, and PACInC INDCMNITY COMPANY: 'All powers of ahomey for and on behalf of the Company may and shall be executed In the name and on behalf of the Company, either by the Chairman or the Presidem or a Vice President or an Assislant Vice President, jointly with the Secretary or an Assistant Secretary, under their respective designations. The signature of such officers may be engraved, printed or lithographed. The signature of each of Me followng officers Chairman, President, any Vice President. any Aealswm Vice Probluen1, arty Secretary, any Assistant Secrerary and me seal of rhe Company may be affixed by facsimile 10 any power or atlomey or to any certificate relating thereto appointing Assistant Secretaries or Attorneys. in- Fact for purpasas only of executing and atlesf rig bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of attorney or certificate Opening such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certilied by such facsimile signature and facsimile seal shal be valid and binding upon the Company with respect to any bond or undertaking to wfik:h it is attached." I, Kenneth C. Wendel. Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the Tompanles) do hereby certify that (I) the foregoing extract of the By- Laws of the Companies is true and correct, (u) via "IPPanlee ma awry Ilcerl ed and auttenzea Ia iansact surety wwriess in all ao of the Unlteo States a Amer" and the District at Gotumdla and are authorized by the U.S. Treasury Department; further, Federal and Vigilant are licensed in Puerto Rico and the U.S. Virgin Islands, and Fedora] is licensed in American Samoa, Guam, and each of the Provinces of Canada except Prince Edward Island; and (lip the foregoing Power of Attorney is true, corecl and In full force and affect. Given under my hand and seals of Said Companies at Warren, NJ this June 8, 2010 _ pc ~ r ~~~"`Er• s ~ xA'dANA s •~e'YO4fa IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM, VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER, PLEASE CONTACT US AT ADDRESS LISTED ABOVE, OR BY Telephone (908) 903- 3493 Fax (908) 903- 3656 e-mail: euM"Ghubb Com Kenneth C. Wendel Assistant Secretary , FUrm 15-10-02256-U (Ed.5-03) CONSENT CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Los Angeles On JUN 16 2010 before me, C. Phillips,_Notary_Public (I Jere inscn none and title of the officer) personally appeared PALP DBA EXCEL PAVING CO. BY C. P. BROWN, PRESIDENT who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) isljtw subscribed to the within instrument and acknowledgement to me that he/atus they executed the same in hisAx3cAkair authorized capacity(ies), and that by hishk=kkoir signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. 1 certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature I otary Public C. PHILLIPS COMM. #1809758 v Notary Public-California e L05 ANGELES COUNTY (Notary Seal) My Comm. Ei hasAug. 16, 2012 :vUn:rm ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT BIDDER'S BOND SIGNATURE PAGE (Title or description of attached document) (Title or description of attached document continued) Number of Pages Document Date Additional Information CAPACITY CLAIMED BY THE SIGNER ❑ Individual(s) ❑ Corporate Officer (Title) ❑ Partner (s) ❑ Attomey-in-Pact ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Any acknoudedgatent conrpleled in Cal fo, mar awst contain verbiage exactly as appears above in the notay section or a separate acknortedgrnent forrrr must be propero• completed and attached to that document. The only exception is if a doaoieat is recorded outside ofCaliforma. In inch instances. any alter native acknowledgment verbiage as may be printed on inch a donunent so long as the verbiage does not require the notary to do something that is illegal for a nolaty in California (i.e, "rrh•ing the authorized capacity of the signer). Please check the document carefully for proper notarial uvording and attach Muslin m if required • Slate and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notnr Lallon. • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e, be/she/dmey, Ware) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover test or lines. If seal impression smudges, a-seal if a sufficient area permits, otherwise complete a diftereru acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. Indicate title or type of attached document. number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CFO. CPO. Secretary). • Securely attach this document to the signed document. PALP. INUBA BIDDER: EXCEL PAVING CONIPAW 2.113 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 Bidders 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 Contractors total bid or ten thousand dollars ($10,000), whichever is greater, and shall further set forth the portion of the Work which will be done by each subcontractor. Bidder shall list only one subcontractor for any one portion of the Work. Pursuant to Public Contract Code Section 4104, the Owner has determined that it will allow Bidders twenty-four (24) additional hours after the deadline for submission of bids to submit the information requested by the Owner about each subcontractor, other than the name and location of each subcontractor. If the Bidder fails to specify a subcontractor for any portion of the Work to be performed under the Contract, it shall be deemed to have agreed to perform such portion itself, and shall not be permitted to subcontract that portion of the Work except under the conditions hereinafter set forth below. Subletting or subcontracting of any portion of the Work in excess of one half of one percent (greater than 0.5%) of the Total Bid Price or, in the case of bids or offers for the construction of streets or highways, including bridges, in excess of one-half of 1 percent of the Contractors 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-7 - PAP. INUM BIDDER: FXrq pAwkig crnu Aflrif' 2.13 LIST OF PROPOSED SUBCONTRACTORS (continued) ["Duplicate Nerd 2 Pages if needed for listing additional sutltontractors..l Name and Location Description of Work of Subcontractor to be Subcontracted Name: Lc6 Ar+fiG-LL'S SIAPJAL_ Address: 155 N &ucLA S.4N PIMA5ICA gf713 E(C"rR,CA L- Name and Location Description of Work of Subcontractor to be Subcontracted Name: T. C • L, SCR IP i. tIC? Address: Fb 13on Kotik LO NC7 0&*" tC4- goh(,. Name and Location of Subcontractor Name: A.M. cov lcfz 7t Address: go5o tvoRe45 *%K-. s W VA-u,t,CA gi553 Description of Work to be Subcontracted Mk5c. comc",Tt Name and Location of Subcontractor Name: 045E 6^4 SucdN Address: 6!t/ t if. ECtaFP . . 00AN467A, Cst 90P6k Description of Work to be Subcontracted ,Supv,&j Name and Location of Subcontractor Name: Address Description of Work to be Subcontracted CBF-8 BIDDER: PA.INMA iivu SECTION 3 NON-COLLUSION AFFIDAVIT CBF-10 PALP, IfUUBA BIDDER: EXCFI PA1ngig rnagnaaro »-...i 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. Cal.l ' Signature G. P, BROWN, PRESIDENT Typed or Printed Name Title PALE! MMA Bidder aCE A i Subscribed and sworn before me This - day of JUN 16 2010 20 Notary Public i nd for the State of Cal rnia My Commission Expires: W kq- C. PHILLIPS Y COMM. #1809758 r Notary Public-0alifornla C LOS ANGEL€9 COUNT W My Comm Emlres Aug. to, 2012 vwkwok~a (Seal) CBF - 11