PCN3 Inc.CITY OF ROSEMEAD
ROSEMEAD PARK AQUATIC FACILITY
PROJECT No. P53251
TABLE OF CONTENTS
SECTION1 BID SCHEDULE .......................................................... ............................... 1
SECTION2 BID DATA FORMS ...................................................... ............................... 5
2.A BID BOND... ............................................................................................... 6
2.B LIST OF PROPOSED SUBCONTRACTORS .............. ............................... 7
SECTION 3 NON - COLLUSION AFFIDAVIT ................................. ............................... 11
SECTION 1 - BID
BIDDER:
PCN3, Inc
BID FOR
ROSEMEAD PARK AQUATIC FACILITY
PROJECT NO. P53129
BASE. BID SCHEDULE
TOTAL BASE BID PRICE: KA $ 3. 6 9;j 000
Dollar amount in written
ALTERNATE BID ITEM NO. 1. 2. 3, & 4
NO.
ITEM DESCRIPTION
UNIT OF
MEASURE
EST.
(�7 y,
UNIT
PRICE
TOTAL
ITEM
COST
1
Shade Structures
SF
20
32
6SSro0U
20'x 20' Module
,75
2
Solar System
LS
1
100,000
/d010ac
3
Bleachers
EA
8
6,$1 S
SS,odo
4
Entry Marquee
Sign /Supports
LS
1
66, odd
6$,OoU
TOTAL ALTERNATE BID ITEMS PRICE: $ 979L d" _
DoKAr amount in written form
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
PCN3; Inc
BIDDGR�
the Greenbook shall apply to this Project except as maybe modified by other provisions of
the Contract.
The undersigned agrees that these Contract Bid Forms constitute a firm offerto the Owner
which cannot be withdrawn forthe numberof Working Days indicated in the Notice Inviting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
amouryt of the Bid Price, the written amount shall govern.
Attached heret is a certified checl�, cashiers check or a bid bond in the amount of
i� Dollars ($M51'
said amount being not less than ten percent
(10 %) c the Total Bid Price. The unde igned 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: PCN3, 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, !twill 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 safe 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 Ownerto 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. 1
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
BIDDER: PCN3, Inc
By:
Signature
Babak Abghari
Type or Print Name
Vice President
Bidder' s / Contractor's State of Incorporation: California
Partners or Joint Venturers:
Bidder's License Number(s):
NOTES:
786518
54 0 Katella Ave # 104
Business Street Address
Cypress, CA 90720
City, State and Zip Code
(562) 493 4124
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: PCN3, Inc
SECTION 2
BID DATA FORMS
CBF -5
BIDDER: PCN3, 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 PCN3, Inc.,
as 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 the Total Amount of the Bid in -------- - - - - --
----------------------------------------------- - - - - -- DOLLARS
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 Nov. 3, 20LO.
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 27th___dayof October, 2010
FIRST NATIONAL INSURANCE -
PCN3, INC. (SEAL) COMPANY OF AMERICA (SEAL) -,
Principal Surety
By: By:
Signature Signature Gracie Lopez,
Attorney -in -Fact
CBF -6
CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT
State of California
County of Los Angeles
On October 27, 2010 before me, M. S. Rodriguez, Notary Public
Date Mere Insert Name and Title of the Officer
personally appeared GRACIE LOPEZ
Name(S) of Signer(s)
NOTARY PUBIC CAUIEFORNIA EO
COMMISSIONS 181 SI
My COMM. EXPIRES IAN. 1, 1014
Place Notary Seal Above
who proved to me on the basis of satisfactory evidence to
be the person( whose name(V) is/awsubscribed to the
within instrument and acknowledged to me that
tae /she /they - executed the same in his/her /their authorized
capacity(ies), and that by his/her/theirsignature(g) on the
instrument the person(#), or the entity upon behalf of
which the person($) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph is
true and correct.
WITNESS my hand and official seal.
Signature
Sig"OlNola� dic
OPT IONAL
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:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
❑ Individual
❑ Corporate Officer— Title(s): —
IJ Partner — ❑ Limited ❑ General
ik Attorney in Fact
❑ Trustee .
❑ Guardian or Conservator
❑ Other:....
Signer Is Representing:
RIGHTTHUMBPRINT
OF SIGNER
Number of Pages:
Signer's Name:
❑ Individual
❑ Corporate Officer— Title(s): _
❑ Partner — IJ Limited ❑ General
❑ Attorney in Fact
• Trustee
• Guardian or Conservator
❑ Other:
Signer Is Representing:
I
02W7 National Notary ASSOCiabon• 9350 De Soto AW, PO, Box 2402• Chatsworth, CA 913162402•www.NahonalNotaryorg Item45907 Reorder CallTol4Free1 -B00- 6766027
10N POi bertv First National Insurance Company of America
WER 10014th Avenue
L1�i111 OFATTORNEY Suite 1700
Seattle, WA 98154
KNOW ALL BY THESE PRESENTS: No. 13263
That FIRST NATIONAL INSURANCE COMPANY OF AMERICA, a Washington corporation, does hereby appoint
* * * * * * * *VANESSA GUTIERREZ; GRACIE LOPEZ; PIETRO MICCICHE; MARGARET RODRIGUEZ; PATRICIA ZENIZO;
Los Angeles,
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 officers at its home office.
IN WITNESS WHEREOF, FIRST NATIONAL INSURANCE COMPANY OF AMERICA has executed and attested these presents
this 21st day of March 2009
Dexter R. Legg, Secretary Timothy A. Mikolajewski, 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 -tact 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 worse 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,
(1) The provisions of Article V, Section 13 of the By -Laws, and
(it) 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."
I, 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 thereto, 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 day of October, , 2010
SEAL
1928 ;
Dexter R. Legg, Secretary
S- 1049/DF 3/09
WEB PDF
BIDDER: PCN3, Inc
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 afterthe deadline forsubmission
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
BIDnt:R: PCN3, Inc
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
Name: All S ",�-P.0 Waw- .mar -a&,od
Address: _SA" 6P. Sni, j,�
Name and Location
of Subcontractor
Name: 14V.TS Cowl /j"o "•h .1 c .
Address: 44 6, A -�14 46 I. r
Name and Location
of Subcontractor
Description of Work
to be Subcontracted Oro /I�' *"
Description of Work
to be Subcontracted
Name: £/V 6% Z Zkc.
Address: —g
Name and Location
of Subcontractor
Name: { ZOO S' ('.
Address:
Name and Location
of Subcontractor
Description of Work
to be Subcontracted
Description of Work
to be Subcontracted
Name:_= /t'�Jol1a✓H
Address: �
2.0 RE ERENCESOR BIDDER (Duplicate page as needed)
li,o�tye & Tyv'4,q,
4jehd
PCN3, Inc.
5450 Katella Ave., #104. Los Alamitos, CA, 90720 Phone: 562- 493 -4124 Fax: 562- 493 -4129
List of Four largest completed projects in the last 5 years:
1St Project:
Project Name: Tuffree MS Structural modification and Renovation
Name of Prime Contractor: PCN3, INC.,
Address of Prime Contractor: 6285 E. Spring St. #291, Long Beach, CA,
90808
Owners Contract Number: 208 -26
Owner: Placentia Yorba Linda USD
Owner address: 1301 Orangethrope Ave., Yorba Linda, CA, 92870
Owner telephone #: 714 - 986 -7000
Owners Authorized Rep.: Blaine Yoder @ 760 - 801 -3849
Project Description: Demolition of all interior and selective structure of # school
Building totaling 30,000.00 Sq. Ft. Then Structurally upgrading the building and
are provide new electrical, HVAC, fire alarm, framing, misc. concrete work,
doors, windows, drywall, tack able surface along with all necessary low voltage
work in order to provide new classrooms and computer lab inside this buildings.
On the exterior of building provide new sidewalk, ramps, curb, gutter, and
handrail in order to make the site ADA complaint.
Type of Contract:
Fixed Price
Initial Contract Value:
$2,478,000.00
Final Contract Value:
$2,792,433.00
Reason for difference:
Added scope of work in approved change
orders by request of District.
Contract Start Date: July 2008
Contract initial completion Date: December 2008
Final Completion Date: January 2009
Reason for difference: Due to Added scope of work in approved
Change orders by request of District.
Assessed Value of Liquidated Damages: None
Number of Legal Claims Incurred: None
Number of legal Claims currently in litigation: None
Was your contract terminated in full or in part: No
PCN3, Inc.
5450 Katella Ave., # 104, Los Alamitos, CA, 90720 Phone: 562- 493 -4124 Fax: 562- 493 -4129
2nd Project:
Project Name: B200 Science Annex Building
Name of Prime Contractor: PCN3, INC.,
Address of Prime Contractor: 6285 E. Spring St. #291, Long Beach, CA,
90808
Owners Contract Number: 296
Owner: South Orange County Community District
Owner address: 28000 Marguerite Parkway, Mission Viejo, CA, 92692
Owner telephone #: 949 - 582 -4999
Owners Authorized Rep.: Gary Wier @ 310 - 592 -1336
Project Description: Site demo, site grading, over excavation, export of 2000.00
yard of dirt along with all work necessary to building 3 new science lab, one
classroom and ADA upgrade of existing bathroom in adjacent building. The
scope of work includes new foundation, new structural steel framing, wood
framing, new utilities, new fume hoods, new acid resistance plumbing, new
HVAC, new electrical, fire alarm, low voltage and all applicable finishes for very
modern looking science annex. On the exterior we provided decorative concrete,
landscaping, and etc.
Type of Contract:
Initial Contract Value:
Final Contract Value:
Reason for difference:
orders by request of District.
Contract Start Date:
Fixed Price
$3,523,000.00
$3,753,440.15
Added scope of work
Nov 2008
in approved change
Contract initial completion Date: October 2009
Final Completion Date: February 2010
Reason for difference: Due to Added scope of work in approved
Change orders by request of District.
Assessed Value of Liquidated Damages: None
Number of Legal Claims Incurred: None
Number of legal Claims currently in litigation: None
Was your contract terminated in full or in part: No
PCN3, Inc.
5450 Katella Ave., #104, Los Alamitos, CA, 90720 Phone: 562- 493 -4124 Fax: 562- 493 -4129
3`d Project:
Project Name: Marshall HS new track and field project along with new
restroom.
Name of Prime Contractor: PCN3, INC.,
Address of Prime Contractor: 6285 E. Spring St. #291, Long Beach, CA,
90808
Owners Contract Number: 910210
Owner: Los Angeles Unified School District
Owner address: 611 Jackson St., LA, CA, 90012
Owner telephone #: 213 - 633 -3623
Owners Authorized Rep.: Keith Reynolds @ 323 - 997 -3290
Project Description: Demolition of 160,000 Sq. ft. site, along with 5 building.
Export 8000 yards of dirt, rough grading the site for new Olympic size synthetic
football field, soccer field, new synthetic standard 400 meter track, new 500 LF
CMU retaining wall, new drainage, new fire line, new waterline, all new electrical
system for musco lighting, speakers and emergency lighting, all new fencing,
Import 5000.00 of CAB, new paving, new restroom building, and etc.
Type of Contract: Fixed Price
Initial Contract Value: $3,483,000.00
Final Contract Value: $3,982,000.00
Reason for difference: Added scope of work in approved change
orders by request of City.
Contract Start Date:
March 2009
Contract initial completion Date:
October 2009
Final Completion Date:
December 2009
Reason for difference:
Due to Added scope of work in approved
Change orders by request of district.
Assessed Value of Liquidated Damages: None
Number of Legal Claims Incurred: None
Number of legal Claims currently in litigation: None
Was your contract terminated in full or in part: No
PCN3, Inc.
5450 Katella Ave.. # 104, Los Alamitos, CA. 90720 Phone: 562- 493 -4124 Pax: 562- 493 -4129
4th Project:
Project Name: Hawaiian Library Renovation
Name of Prime Contractor: PCN3, INC.,
Address of Prime Contractor: 6285 E. Spring St. #291, Long Beach, CA,
90808
Owners Contract Number: 2007/2008:11
Owner: City of Hawaiian Gardens
Owner address: 21815 Pioneer Blvd., Hawaiian Gardens, CA, 90716
Owner telephone #: 562 - 420 -2641
Owners Authorized Rep.: Richard Wilson @ 562- 237 -4804
Project Description: Interior and exterior renovation of 30,000.00 Sq. Ft. library
building along with site improvements in the surrounding parking lot
Type of Contract: Fixed Price
Initial Contract Value: $2,528,000.00
Final Contract Value: $2,992,000.00
Reason for difference: Added scope of work in approved change
orders by request of City.
Contract Start Date: January 2008
Contract initial completion Date: October 2008
Final Completion Date: November 2008
Reason for difference: Due to Added scope of work in approved
Change orders by request of district.
Assessed Value of Liquidated Damages: None
Number of Legal Claims Incurred: None
Number of legal Claims currently in litigation: None
Was your contract terminated in full or in part: No
BIDDER: PCN3, Inc
2.13 REFERENCES FOR SWIMMING POOL CONTRACTOR (C -53 LICENSE)
(Duplicate page as needed)
All of the work in sections 13151 -13158 (of the Project Manual for City of Rosemead
Project No. P53251 Rosemead Aquatic Center) is to be the responsibility of one
experienced swimming pool contractorwith a C -53 license, which can be eitherthe bidder
or a subcontractor, primarily engaged in the construction of commercial public -use
swimming pools. A swimming pool contractor shall be considered primarily engaged as
required herein if the swimming pool contractor derived 50% of its annual revenue during
the past five years from public -use swimming pool construction. The swimming pool
contractor must have also, in the last five years, constructed at least three (3) commercially
designed municipal and public -use swimming pools, each of which shall have incorporated
a minimum size of 6,000 square feet of water surface area with a concrete and ceramic tile
perimeter overflow gutter and self-modulating balance tank. The following are the names,
addresses and telephone numbers for at least three completed projects as required:
is
Name and Address of Owner
eA
ie and
d
0S > gp . egos
of public agency person familiar with project
5041 09/Jd10
amount Project Name Date Completed
2. S44 AA-,(C; m PGA
Name and Address of Owner
%yl (M) 389- *q- 4--i 4
3.
Name and telephone number of public agency person familiar with project
amount Project Name
Name`and Address of Owner
Ai,i,,/ lal) q79' 87 /9
I
Date Completed
and telephone number of public agency person familiar with project
amount Project Name
CBF -10
BIDDER: PCN3, Inc
2.113 LIS f 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: (�Jk A Y ��c�i•h
Address: CA -L
Name and Location
of Subcontractor
Name:�$o MAYJC �P«ro• �•`
Address:, _ +��� ,�1
Name and Location
of Subcontractor
Name: A14 ' ✓P P✓of¢l�.��
Address
Name and.Location
of Subcontractor
Name: 66.%Joe C-
Address p ; -0. -1
Name and Location
of Subcontractor
Description of Work ��
to be. Subcontracted
Description of Work
to be Subcontracted {'
Description of Work I
to be Subcontracted )oo/
Description of Work
to be Subcontracted
Address:
2.0 REFERENCES FOR BIDDER (Duplicate page as needed)
14mmi
BIDDER: PCN3, Inc
SECTION 3
NON - COLLUSION AFFIDAVIT
CBF - 11
BIDDER: PCN3, Inc
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 bidderto 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, onto any member or agent thereof to ectuate a collusive or sham bid.
Signature
Babak Abgh n
5Afe (a llj&n m.
Typed or Printed Name
Vice President
Title
PCN3, Inc
Bidder
Subscribed and sworn before me f
This _I day of `71 nve&,L r 120 /61 � 136�- b0- '' I,?
p,v')� -t� byo cf s� h7f�loy evAde,,,c� -1-0 6c- (Seal)
+ 'e Kov` wV� C'epa �i-erL �c u•f•'G y✓te_
Notary Public in and`for CLAUDIA SANCHEZ
the State of California NOTARYPUBLIC- CALIFORMh
COMMISSION a 1878838
r O ORANGE COUNTY
My Commission Expires: /'<� MY Comm.Exp. FeCruary ze. 2014