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Icon West Inc.r CITY OF ROSEMEAD ROSEMEAD PARK AQUATIC FACILITY PROJECT No. P53251 CONTRACT BID,FORNIS r' TABLE OF CONTENTS SECTION1 BID SCHEDULE .......................................................... ............................... 1 SECTION 2 BID DATA FORMS ...................................................... ............................... 5 2.A BID BOND ................................................................... ............................... 6 2.13 LIST OF PROPOSED SUBCONTRACTORS .............. ............................... 7 SECTION 3 NON - COLLUSION AFFIDAVIT ................................. ............................... 11 SECTION 1 - BID BIDDER: /00,x! � �, we. BID FOR ROSEMEAD PARK AQUATIC FACILITY PROJECT NO. P53129 BASE BID SCHEDULE TOTAL BASE BID PRICE: Dollar amount in written form ALTERNATE BID ITEM NO. 1, 2, 3, & 4 NO. ITEM DESCRIPTION UNIT OF EST. UNIT TOTAL ITEM MEASURE QTY. PRICE COST 1 Shade Structures SF 20 20'x 20' Module,�2� 2 Solar System LS 1 3 Bleachers EA 8 '7, 16T-ib 16-9 j57 K 6 4 Entry Marquee LS 1 Sign /Supports a5, 4467 a5 -7m- TOTAL ALTERNATE BID ITEMS PRICE Al. 02) - V IQP. Wk/" fizzy P "V- 94LY Dollar amount in written form DI Note: The City of Rosemead reserves the right to reduce or increase the quantities of any items in the schedule of values above, within the limits define in Section 3 -2.2.1 of the Standard Specifications, to stay within the budgeted amount of this project. INCORPORATION BY REFERENCE Notice Inviting Bids, Instructions to Bidders, General Conditions, Technical Specifications, Geotechnical Study Report (September 3, 2010) and addenda, Asbestos and Lead Paint Survey Report (August 5, 2010) and addenda, Bidder's Proposal, Plans, Standard Specifications for Public Works Construction 2009 Edition ( "Greenbook "), Drawings, Project Manual, Required Bonds and Forms, Permits, Addenda, and all applicable codes and regulations are hereby incorporated in and made part of this Contract. The provisions of CBF -1 BIDDER: /Cen/ 7P,6r/" INC. the Greenbook shall apply to this Project except as may be modified by other provisions of the Contract. The undersigned agrees that these Contract Bid Forms constitute a firm offer to the Owner which cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and after the bid opening date, or until a Contract for the Work is fully executed by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 /CJ -44V> i--/Rt itnDollars ($ ) 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. CBF -2 BIDDER: /00.A/ WCrl INC' 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. l 004 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 131un1_a�_, /e0A/ WO-7 /rlyC By: Signature AFAPlgeo >-%HM-,w, Type or Print Name Gt�G /ygcr7 y /G82 Title Bidder's /Contractor's State of Incorporation Partners or Joint Venturers: Bidder's License Number(s): NOTES: 527 N. " P1Wk17,t- AWe Q //c Business Street Address Lx-,g1Y66L6P 04 gmSj City, State and Zip Code -f k3 • a63- &W01 Telephone Number 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. CBF -4 BIDDER: SECTION 2 BID DATA FORMS CBF -5 BIDDER: Icon West, Inc_ Bond No.: ICOWE -100 Project No.: 53251 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 Is as Principal West, Inc. ord Fire Insurance Com as Surety, are held firmly bou the CITY OF ROSEMEAD (hereinafter called the OWNER) in the Ten percent of total amount Bid id unto sum of DOLLARS ($ 10% of Bid ), being not less than ten percent (10 %) of the Total Base 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 Rosemead Park Aquatic Facility as set forth in the Notice Inviting Bids and accompanying Bid Documents, dated N/A 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 26 day of October ,2010 , Icon t, Inc. (SEAL) Hartford Fire (SEAL) S rety Insurance U6m -pany Prin ipal ,. )� , By. Signature CBF -6 Signature Matthew 1t. Dobyns Attorney in Fact Direct Inquiries /Claims to: POWER OF ATTORNEY P.O. BOXY HARTFORD 0 6 O ENUE HARTFORD, CONNECTICUT 06115 call: 888 - 2663488 or fax., 860 - 7575835 KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Code: 72- 185891 X� Hartford Fire Insurance Company, a corporation duly organized under the laws of the State of Connecticut X� Hartford Casualty Insurance Company, a corporation duly organized under the laws of the State of Indiana Hartford Accident and Indemnity Company, a corporation duly organized under the laws of the State of Connecticut Hartford Underwriters Insurance Company, a corporation duly organized under the laws of the State of Connecticut Twin City Fire Insurance Company, a corporation duly organized under the laws of the State of Indiana Hartford Insurance Company of Illinois, a corporation duly organized under the laws of the State of Illinois Hartford Insurance Company of the Midwest, a corporation duly organized under the laws of the State of Indiana Hartford Insurance Company of the Southeast, a corporation duly organized under the laws of the State of Florida having their home office in Hartford, Connecticut, (hereinafter collectively referred to as the 'Companies") do hereby make, constitute and appoint, up to the amount of unlimited., Randy Spohn, Zara Spohn, Matthew R. Dobyns of Santa Ana, CA their true and lawful Attorney(s }in -Fact, each in their separate capacity if more than one is named above, to sign its name as surety(ies) only as delineated above by ®, 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. In Witness Whereof, and as authorized by a Resolution of the Board of Directors of the Companies on January 22, 2004 the Companies have caused these presents to be signed by its Assistant Vice President and its corporate seals to be hereto affixed, duly attested by its Assistant Secretary. Further, pursuant to Resolution of the Board of Directors of the Companies, the Companies hereby unambiguously affirm that they are and will be bound by any mechanically applied signatures applied to this Power of Attorney. n ure i °°91 •, °',.itrr. ♦r, aa"b a'°r"�'w ..�. _ ��"�.r4E ..� °:�...,.., :ti ►017 „�L rr,� 'r�r`;�;�. a • 'Es;;;� ��°..w• ' ♦i� -: ,��• �L,'ryi,wn ��-- r --�JJ `°�4.,f- -,aid• Scott Sadowsky, Assistant Secretary M. Ross Fisher, Assistant Vice President STATE OF CONNECTICUT ss. Hartford COUNTY OF HARTFORD On this 30 day of March, 2008, before me personally came M. Ross Fisher, to me known, who being by me duly sworn, did depose and say: that he resides in the County of Hartford, Stale of Connecticut; that he is the Assistant Vice President of the Companies, the corporations described in and which executed the above instrument; that he knows the seals of the said corporations; that the seals affixed to the said instrument are such corporate seals; that they were so affixed by authority of the Boards of Directors of said corporations and that he signed his name thereto by like authority. it •..y .rt �� • Scon E. Paseka Nomry Public CERTIFICATE My Commission Expires October 31, 2012 I, the undersigned, Assistant Vice President of the Companies, 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 effective as of October 26th, 2010. Signed and sealed at the City of Hartford. TY!•�.t� �0•.M r, ',sir r^..I+ .4y / /~j.yV �y r !. .—y : �,c.uir.rri' ; ►osr re,d/•1 L {, �+/ ��`; �: F f�•ov �. : •` � �. rnv °n•` ••an♦ oiX970 si t9(1p7� f b ♦ f t/ L' Gary W. Stumper, Assistant Vice President CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT State of CALIFORNIA County of ORANGE On October 26, 2010 before me, Erika Guido, NOTARY PUBLIC, personally appeared MATTHEW R. DOBYNS ® 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. ERIKA GUIDO � comm. # 1843731 f I certify under PENALTY OF PERJURY under the laws of the State of 3 NOT ORANGECOULRNIA� California that the foregoing paragraph is true and correct. NTY ' My Comm, expires May 5, 2 WITNESS my hand and official seal. _. OPTIONAL Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER ❑ INDMDUAL ❑ CORPORATE OFFICER ❑ PARTNER(S) ❑ LIMITED ® ATTORNEY -IN -FACT ❑ TRUSTEE(S) ❑ GUARDIAN /CONSERVATOR ❑ OTHER: _ SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) DESCRIPTION OF ATTACHED DOCUMENT BIDDER: 608 //V('. 2.6 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 and description of work to be subcontracted. 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 one percent of the Contractor's total bid or ten thousand ($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 ' BIDDER a 16001 VI-97- IN,-. 2.6 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 A\(W A W Name: 4/--//,to L�!!�(�AIA�IEiti9t Address: `n�P",4-yo 9WA 4 Q,f !�F/� Name and Location of Subcontractor Name: Address:' Name and Location of Subcontractor Name:_ /FCtMo &U fr7ti/6 Address: 14AP• OA gt e-Z" Name and Location of Subcontractor Name:_ Address: Name and Location of Subcontractor Description of Work 'to be Subcontracted Description of Work DL< 410LrTI0Al to be Subcontracted Description of Work to be Subcontracted Description of Work kahRi71�4v to be Subcontracted Name: 14R�� -- C* /TIAX Address:_; D9 --o4ml 4A -I/�771 2.0 REFERENCES FOR BIDDER (uupivate page as needed) CBF -8 41 BIDDER: 1pIq Vl wc- 2.B LIST OF PROPOSED SUBCONTRACTORS (continued) [ "Duplicate Next 2 Pages if needed for listing additional subcontractors. "] Name and Location Description of Work U lJ,67 IZTIL/T70 of Subcontractor to be Subcontracted Name : 41-k Address: tz /"+irs g173-3 Name and Location of Subcontractor Name:_ Address: Name and Location of Subcontractor Name: V'l"A(l t&A770 aL770e� Address: Name and Location of Subcontractor Name:_ Address: Name and Location of Subcontractor Description of Work to be Subcontracted Description of Work7�6 to be Subcontracted Description of Work to be Subcontracted Description of Work to be Subcontracted Name: AL 17 Ov-d 7a Address: 4�l�dKii G� 2.0 REFERENCES FOR BIDDER (Duplicate page as needed) v I,` dcA1,-1C&7A7- CEF -8 C/ BIDDER: /w/k/ 217gyi / 2.6 LIST OF PROPOSED SUBCONTRACTORS (continued) [ "Duplicate Next 2 Pages if needed for listing additional subcontractors.- 1 Name and Location Description of Work 12&V1 & of Subcontractor to be Subcontracted V4��,Vtw" Name: Ottl 1r&41a AEG Address: GL�r_xi o_..f a4 -117W Name and Location of Subcontractor Name:_ Address: Name and Location of Subcontractor Name: L/f�1�1V0 c�OVi�2gcT1vG 1�� Address: Name and Location of Subcontractor Address: Name and Location of Subcontractor Description of Work to be Subcontracted Description of Work R� to be Subcontracted Description of Work to be Subcontracted Description of Work to be Subcontracted fjA�fb✓ ij Name: (�1 pt /Fle�7F Y.—(Aa q ,-- Address: GOa✓aA 4:.4 2.0 REFERENCES FOR BIDDER (Duplicate page as needed) 7;2Wer I! 0(,7A1ea01L=' CBF -8 G' BIDDER: IMN w4io- r //Y(' 2.B LIST OF PROPOSED SUBCONTRACTORS (continued) [ "Duplicate Next 2 Pages if needed for listing additional subcontractors."] Name and Location Description of Work ktjV01VQ of Subcontractor to be Subcontracted Name: 1)tyl, Al �,/ANOYRY / ve . Address: C'kn/Ycv C&U^17-Ay aA OM G77 Name and Location of Subcontractor Name:_ Address: Name and Location of Subcontractor Name: 7— Ot✓�72 Address:/ Name and Location of Subcontractor Name:_ Address: Name and Location of Subcontractor vr��z a -flrPi' Description of Work to be Subcontracted Description of Work�2 to be Subcontracted Description of Work to be Subcontracted Description of Work to be Subcontracted Name: �'kAh',�p. Address: CaJ 9190/ 2.0 REFERENCES FOR BIDDER (Duplicate page as needed) CBF -8 J BIDDER /w/j w� 23 LIST OF PROPOSED SUBCONTRACTORS, (continued) [ "Duplicate Next 2 Pages if needed for listing additional subcontractors. "] Name and Location Description of Work nf Subcontractor to be Subcontracted Name: P `I` A _ Address: OAR 4141" 5-A Name and Location of Subcontractor Name:_ Address: Name and Location of Subcontractor Name: Atgt" `�'HPPr /"07;t"/— . Address: CwYM/ CBuV-1XY a4 Name and Location of Subcontractor Name:_ Address: Name and Location of Subcontractor Description of Work to be Subcontracted Description of Work to be Subcontracted Description of Work to be Subcontracted Description of Work to be Subcontracted Name: {f&f(7j4f6 PY 67 t& Address: GA 2.0 REFERENCES FOR BIDDER (Duplicate page as needed) CBF -8 O BIDDER: IMu WEB INE_ 2.B LIST OF PROPOSED SUBCONTRACTORS (continued) [ "Duplicate Next 2 Pages if needed for listing additional subcontractors."] Name and Location Description of Work of Subcontractor to be Subcontracted V'GO 10114 l4/K /1 Name: OR-t- 1q20A Address: L� ,i4 0/0 Name and Location of Subcontractor Name: Addre� Name and Location of Subcontractor Name: AddreE Name and Location of Subcontractor Name:_ Address: Name and Location of Subcontractor Description of Work to be Subcontracted Description of Work to be Subcontracted Description of Work to be Subcontracted Description of Wort; to be Subcontracted Name: Address: 2.0 REFERENCES FOR BIDDER (Duplicate page as needed) CBF -8 D BIDDER: IWA4 Vtwf //fie• 2.B LIST OF PROPOSED SUBCONTRACTORS (continued) [ "Duplicate Next 2 Pages if needed for listing additional subcontractors. "] Name and Location Description of Work P't of Subcontractor to be Subcontracted Name: !Glf� tyz GAL /n!i� Address: Aif_ 71'.i� � � 9���� Name and Location of Subcontractor Name:_ Address: Name and Location of Subcontractor Description of Work to be Subcontracted Description of Work to be Subcontracted Name: T- Address: V /tire' ✓� / /�� Ofi 90��' Name and Location of Subcontractor Name:_ Address: Description of Work to be Subcontracted Name and Location Description of Work of Subcontractor to be Subcontracted Name: Address: or Ygfd7 2.0 REFERENCES FOR BIDDER (Duplicate page as needed) -w6?L_*K C[3F - 8 G BIDDER: AVV Vt7 /N('. The following are the names, addresses and telephone numbers for at least three public agencies for which BIDDER has performed similar work within the past four (4) years: 1 UC LA - 106'0 yE PR,,'r J 'A71t <k 0A 9o07�5- Name and Address of Owner Name and telephone number of public agency person familiar with project '# /a, boa 02)'Ot ld4 MMr1xaaTAJ 9 U61, � , 40D Contract amount Type of Work Date Completed 2- lO-Q - -0/ v>- V16'«, � +rYZ 7NKLFWVe M ?ate/ Name and Address of Owner Name and telephone number of public agency person familiar with project N4=0 OPAOI�WCIMIV gym g-SPDk1T mrI L<!1j C/E7�IEZi tv�k j /�i Contract amount Type of Work Date Completed 3. A5 -'/y P /On/�A� ,� w Name and Address of Owner Noow-w em 9SC�f� /9-/10A41E Dlwi - &-26 ' 371D' J-RJ�7 Name and telephone number of public agency person familiar with project I9, N2, qJV n) PAxk ACM I-2 gyp, eW7 Contract amount Type of Work Date Completed CBF -9 IUSD Name New Construction of Monroe Gymnasium & Multi Purpose Bldg (Sports Facility) Location 10711 10th Avenue, Inglewood CA 90303 Highlights Icon West, Inc. identified and provided value engineering services before the start of the project which resulted in substantial savings to the School District. Student Safety being the first priority, extensive open site trenching was replaced with the New Horizontal Directional Drilling (HDD) Technology at no extra cost to mitigate all risks that open trenches pose to students. This project also includes a New Soundproof roof system to avoid sound penetration ffrom the nearby airport. of Work Construction of State of the Art Story Gymnasium building at the Monroe Middle Schoo. The project shall have indoor basketball court with folding backstops, retractable seating, raised platfomr stage, lockers and shower rooms, coach offices, ground -level classrooms and two upper level classrooms with stairs and elevator. The building is fully air - conditioned and is equipped with a new soundproof roof system and automatic fire sprinkler system. This IUSD project also includes electrical and communication system upgrade, along with site utility works. ADA narking upgrade, site concrete work, asphalt work and landscaping work. Footage 140, 000 sq ft. Contract Amount 1$9,561,555.00 Owner IUSD - Inglewood Unified School District 1401 S. Inglewood Avenue, Inglewood CA 90301 Mr. Cornell Williams Construction Manager -IUSD 546 S. Oak St., Inglewood CA 90302 Phone 1.310.420.3689 Fax 1.310.677.0685 Architect DOUGHERTY + DOUGHERTY ARCHITECTS 319 Airport Loop Costa Mesa, Ca 92626 Contact Jeff Donati Phone: 1 -714- 427 -0277 Start Date Mar -cid Schedule of Completion 15 -Jul Completion Date 30- Sep -09 100% Completed Project Manager Michael Halaoui Asst. PM James Odango Other Info Prevailina Waae Completed Project tJ CIA Project Name IHILGARD STUDENT H Project Location 720 -824 Hilgard Avenue, Los Angeles CA 90024 -3298 Project Highlights The New buildings shall be constructed to meet reg UC- Equivalent LEED New Construction version 2.2 "Silver" Green Building requirments. Description of Work The Project shall construct two -three and four story type VA aprtment style units on two site, 720 Hilgard Avenue and 824 Hilgard Avenue, for a total of 83 studio units and type 1A subterranean parking garages. The scope of work includes: shoring, demolition, excavation, grading and construction of retaining walls; post- tension slab, provision of domestic water, fire water, sewere, gas, electrical and telecommunications utilities, installation of paving, landscaping, irrigation, site drainage and lighting, and installation of the fire sprinkler and fire alarm systems. Portions of the work are performed in the public right of way. Square Footage 141,600 sq. ft. Contract Amount 1$11,400,000.00 Project Owner UCLA 11060 Veteran Avenue, Los Angeles CA 90095 Representative Mr. Sajal Debnath Construction Manager - UCLA 360 De Neve Drive Room 13, LA CA 90024 -8301 Phone 1.310.825.9961 Fax 1.310.825.1566 ' ARCHITECTS Howard Street Francisco, CA 94105 ,ie 1.415.293.5790 1.415.293.5701 Start Date I Apr -09 Schedule of Completion August -10 Completion Date 1- Aug -10 Project Engineer I James Odango Superintendent Bruce Cooks Superintendent Louie Weis Office Engineer Nama Kartheek Other Info Prevailing Wage 720 -824 720 -824 720 -824 100% Completed Icon West Inc. Completed Project LA COUNTY- PUBLIC WORKS Project Name El Cariso Regional Park Improveme Project Location 13100 Hubbard St. Sylmar CA 91352 Description of Work Improvement & Upgrade to comply of Park/Restrooms /Walkways and Demolition a) The proposed project consist of improvements to comply with the ADA Incl. upgrades to the existing restrooms & drinking fountains, walkways and providing ADA signage. In addt'n. the proposed project will make various improvements to the park, incl. resurfacing the driveways & parking lots, replacing damaged walkways, improving the imgation system, renovating 4 play areas, replacing trees & turf, replacing 4 grp picnic shelters, incl upgrading the BBQ braziers & picnic tables. b) As part of the project, demolition of the playground equipment, removal & storage of existing picnic tables, installation of new braziers, picnic tables, benches, bike racks & car wheel stops will be performed by at -risk youth. c) Self perform 75, 000 SF of Concrete sidewalks Contract Amount 1 $ 3, 852, 980.00 Project Owner County of Los Angeles, Dept. of Public Works 15213 Pioneer Blvd., Norwalk CA 91342 Representative Alionne Dioum IP(626-300-2357) Wayne Ciu Architects 201 N. Brea Blvd., Brea Ca 92821 P(714- 990 -0995) F(714- 990 -0950) Percentage Complete 1100% Scheduled completion date I October 30,2007 Project Manager I Michael Halaoui Superintendent I James Odango Other Info Icon West Inc. Completed Project BIDDER: 'U7iU -Ve , //A/C. 23 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 A0%,9 iAI� Name V/a 71A�0 dz- IG ,049110 Address: Name and Location Description of Work of Subcontractor to be Subcontracted Name: 47 akANo V74VO Address: 1-?44N2, t?,f'tY Name and Location of Subcontractor Name: q '� 6 De*y' Address: - 04f_yf awes 9alvJi Name and Location of Subcontractor Name: j-,5N&e- �'� Address: ey /OF e, gall Name and Location of Subcontractor Description of Work to be Subcontracted Description of Work to be Subcontracted F p,,Ujk Description of Work ftkVAJ/ to be Subcontracted Name: /7H�1L Address: �'0✓ /N/1 qn� 2.0 REFERENCES FOR BIDDER (Duplicate page as needed) CBF -8 °L% 131DDER: /WN vgl- lnle - SECTION 3 NON - COLLUSION AFFIDAVIT CBF - 11 CALIFORNIA ALL - PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of LOS A QS On MC)V , 2, 2okc) personally appeared before me, ho%tw/ �(�6 \.e (Here insert nameandtille "ma officer) Ar,KIc^r who proved to me on the basis of satisfactory evidence to be the persorj�<whose name(XQ�)/are subscribed to the within instrument and acknowledged to me that 8+11 hep executed the same in ti hero ro; _.uthorized capacity�< and that by a /herftheir signatureKon the instrument the person(. or the entity upon behalf of which the personacted, 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. ADDITIONAL OPTIONAL INFOR'MLATION �7 j 0^ Signature of\otary ublic TINA YOON Commission # 1892352. • "° Notary Public - California i Los Angeles County s My Comm. Ezplres Jun 11, 2014+ (Notary Seal) DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached document) (Title or description of attached document continued) Number of Paees Document Date (Additional information) CAPACITY CLAIMED 13Y THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attornev -in -Fact ❑ Trustee(s) ❑ Other 200SV,,sion CAI'A v!'. 1407 Fla) -g71 M,i wwv:Nm:uv(;In•sea.com INSTRUCTIONS FOR COMPLETING THIS FORM Am, acknowledgment completed in California must contain verbiage exactly as appears above in the notary section or a separate to acloromledgmeat form autst be properly completed and attached to that document, The aryl, exception is if a document is to be recorded outside of Cali ornia. /n such instances, arty alternative acknowledgment verbiage as nrmv be printed on such a decuarent so long as the verbiage does not require the romp= no do something that is illegal for a notary in California (i.e. certifying the authori.ed capacity of the signer). Please check the document carefrtHi -joy proper notoval wording and attach this form ifrequired. • Slate and County information must be the State and County where The document signer(s) personally appeared before the unary public for acknowledgment. • Dale of notarization most 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 notarization. • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. he /sheohey -is /are) or circling the correct forms. Failure to corvaly indicate this information may lead to rejection ofdocumenl recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, ie -seal if a sufficient area permits, otherwise complete a different 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 tide or type ofatlached document, number of pages and date. Indicate the capacity claimed by the siguer. If the claimed capacity is a corporate officer, indicate The title (i.e. CEO, CFO, Secretary). • Securely anach this document to the signed document BIDDER: lMN 1pki We 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 agept -th re to effectuate a collu ive or sham bid. t Signature A'C&'% Aqt f � Typed or Printed Name qwE= t-Xt-6o 1 ✓p-- of? �Iast�f Title A (%N 70,P6, l At . Bidder Subscribed and sworn before me This day of 20 (Seal) Notary Public in and for the State of California My Commission Expires: