FS ConstructionBIDDER:
CONTRACT BID FORMS
TABLE OF CONTENTS
SECTION1 BID SCHEDULE ........................................................................ ..............................1
SECTION 2 BID DATA FORMS .................................................................... ..............................5
2.A BID BOND ......................... ...............................
2.B LIST OF PROPOSED SUBCONTRACTORS.
SECTION 3 NON - COLLUSION AFFIDAVIT .......................
..... ............................... 6
..... ............................... 7
... .............................10
CBF - 13
BIDDER: '" s
SECTION 1- BID SCHEDUL
CBF -1
BIDDER: ` vSTruc�r��
BID SCHEDULE
SCHEDULE OF PRICES FOR
SIDEWALK, CURB AND GUTTER REPLACEMENT PROJECT
PROJECT No. 24002
BASE BID SCHEDULE
TOTAL BASE BID PRICE (SCHEDULE BID PRICE): 1 O
Dollar amount in written form r j
two) Fty C)I(ars o /ion
CBF -2
UNIT OF
EST.
UNIT
ITEM
NO.
ITEM DESCRIPTION
MEASURE
CITY.
PRICE
COST
1
Clearing & Grubbing per plans
LS
1
and specifications. See technical
Z D0
�oO O
provisions TP -2, TP -3 & TP -4.
r
2
Ofsposaf of Waste Materials.
LS
1
-L op0
2 0 C) 'o
3
Remove, Dispose and Construct
SF
21,000
4- inches thick PCC Sidewalk per
SPPWC Std. Plan 113 -1.
/ 0500
/
4
Remove, Dispose and Construct
SF
500
PCC Driveway Approaches per
G
SPPWC Std. Plan 110 -2.
3 0 00
i
5
Remove, Dispose and Construct
LF
1,015
8- inches Curb and 24- inches
Gutter per SPPWC Std. Plan
3O
�3 fj q 5 O
120 -2.
6
Remove, Dispose and Construct
LF
100
8- inches PCC Curb Only per
SPPWC Std. Plan 120 -2.
2 5
2 5 co
7
Remove, Dispose and Construct
EA
1
PCC Curb Ramp per SPPWC
Std. Plan 111 -4.
Z2-OO
Zyo 0
8
Install Survey property and
EA
10
centerline tie Monument.
3p0
�p 0
TOTAL BASE BID PRICE (SCHEDULE BID PRICE): 1 O
Dollar amount in written form r j
two) Fty C)I(ars o /ion
CBF -2
BIDDER: ( S 5 ����'�1°�
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.
Attachpo hereto is a certified check, a cashier's check or a bid bond in the amount of
to t o 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 bythe 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.
CBF -3
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.
BIDDER:
The undersigned acknowledges receipt, understanding and full consideration of the following
addenda to the Contract Documents.
Addenda Nos,
The Bidder understands and agrees that the Total Bid Price is inclusive of all labor, materials, and
equipment or supplies necessary to complete the Work as described in the Bid Documents. If this
bid is accepted, the undersigned Bidder agrees to enter into and execute the Contract with the
necessary bonds and accept the Total Bid Price as compensation in full for all Work under the
contract.
CBF -4
BIDDER: 1S�Yyy l o w
0
r - 1,
1 4 838 �3�e�sae S�
Business Street Address
SWt wta.r CA q ► - - - , 4 z
City, S to and Zip Code
1P-
Type or Peiht Name
O w i,Acr
Title
Telephone Number
Bidder's /Contractor's State of Incorporation:
Partners or Joint Venturers:
Bidder's License Number(s): 7 7 7 j Z6
NOTES:
1)
2)
3)
By its signature on this Bid, the Bidder certifies under penalty of perjury the accuracy of the
representations made on the Contract Bid Forms.
If Bidder is a corporation, enter State of Incorporation in addition to Business Address
If Bidder is a partnership or joint venture, give full names of all partners or joint
venturers.
As further discussed in the Instructions to Bidders, Bidder will be required
to provide evidence that the person signing on behalf of the corporation,
partnership or joint venture has the authority to do so.
CBF -5
BIDDER: CS
SECTION 2
BID DATA FORMS
CBF -6
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BIDDER: FS conct n rion
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 fvery page of its Bid Data Forms are properly
identified with the Bidder's name and page number
2.A BID BOND
KNOW ALL MEN BY THESE PRESENTS:
THAT
Principal, and as
om a
as Surety, are held firmly bound unto the
CITY OF ROSEMEAD (hereinafter calk d the OWNER) in the sum of
Ten Percent of the Total Amount of the Bid in----------------
($ inn ------------- - - - --- - - -- -- - - - - -- --- - - - - -- DOLLARS
), being not less than ten percent (10 %) of the Total
Bid Price; for the payment of which sum will and trulyto be made, we bind ourselves,
our heirs, executors, administrators, succes rs, and assigns, jointly and severally,
firmly by these presents.
WHEREAS, said Principal has submitted a b d to the OWNER to perform all Work
required for the Sidewalk, Curb and Gutter Replacement Project as set forth in
the Notice Inviting Bids and accompanying Bid Documents, dated
NOW, THEREFORE, if said, Principal is aw,
OWNER and, within the time and in the Mani
Bid Documents, enters into the written for
Documents, furnishes the required bonds (o
and the other to guarantee payment for labor
insurance certificates and endorsements, any
may be required by the Contract, then this obli
it shall remain in full force and effect. In the e
the OWNER and judgment is recovered, said
the OWNER in such suit, including reasonal
court.
ded a Contract for the Work by the
:r required by the above- referenced
, of Contract bound with said Bid
e to guarantee faithful performance
nd materials) furnishes the required
furnishes any other certifications as
3tion shall be null and void; otherwise
ant suit is brought upon this bond by
iurety shall pay all costs incurred by
e attorneys' fees to be fixed by the
SIGNED AND SEALED, this 2nd day of
Principal
By. ��✓�S
gnature
20 ] .
UT Tnc anc r'omJ
I u -
Salazar,
Attorney -in -Fact
0
CBF -7
CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT
State of California 1
County of _ Los Angeles 1
On __F ebruar--ir_ 2_,_ 2012 before me, M. S. Rodriguez Notary Public
Dale Here Insert Name and Title of the OBicer —
personally appeared ELISABETg_ SA TAM
Names) of Signer(s)
who proved to me on the basis of satisfactory evidence to
be the person(l) whose name(g) is /ase subscribed to the
within instrument and acknowledged to me that
he/she /they executed the same in his/her /th& authorized
capacity(ies), and that by Jais/her /the r signature(s) on the
instrument the person(A, or the entity upon behalf of
which the person(y) acted, executed the instrument.
M. S. RODRIGUEZ
NOTARY PUBLIC - CALIFORNIA 1 certify under PENALTY OF PERJURY under the laws
z LOS ANGELES COUNTY e 4 of the State of California that the foregoing paragraph COMMISSION :1872651 ,U 9 9 P 9 P h is
MY COMM. EXPIRES JAN. 2, 2014 �- true and correct.
NF-mr+
WITNESS my hand and official seal.
Signature --
Place Notary Seal Above . Signature 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)
Signer's Name
1 1 Individual
I Corporate Officer— Title(s):
Partner — I i Limited I I General
�Q Attorney in Fact
!_1 Trustee
i_I Guardian or Conservator
I 1 Other: _
Signer Is Representing
RIGHTTHUMBPRINT
OF SIGNER
in
Signer's Nar
LJ Individual
I Corporate Officer — Title(s): —_
I Partner — F1 Limited I, I General
I J Attorney in Fact
1_ J Trustee
LI Guardian or Conservator
❑ Other:
Signer Is Representing:
RIGHTTHUMBPRINT
OF SIGNER
A i J^GVS ✓'rl R -(:>4_l` 240 2tih a l syc c.L`CA 91 ryo Z%=�,�". - Call
(J2U0]National NOIary Assnr al on•9360D Solo AVe.. P.O. Box 2402 Chalswodh.GA 9 131 3- 29 02•w.vw.NalionalNOlaryorq II¢m k690] Reorder Toll -Free 1- 000 -816 -662]
RLI ® RLI Surety
P.O. Box 3967 1 Peoria, IL 61612 -3967
Phone: (800)645-2402 1 Fax: (309)689-2036
www.nccorp.com
Know All Men by These Presents:
POWER OF ATTORNEY
RLI Insurance Company
That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the
approving officer if desired.
That RLI Insurance Company, a(n) Illinois corporation, does hereby make, constitute and appoint:
Patricia Zenizo. Margaret Rodriguez. Pietro Micciche. Gracie Lopez. Elisabete Salazar, jointly or severally.
in the City of Los Angeles . State of California its true and lawful Agent and Attorney in Fact, with full
power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, the following described
bond.
Any and all bonds, undertakings, and recognizances in an amount not to exceed Ten Million Dollars ($10,000,000) for
any single obligation.
The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon this Company as if such bond had
been executed and acknowledged by the regularly elected officers of this Company.
The RLI Insurance Company further certifies that the following is a true and exact copy of the Resolution adopted by the Board of
Directors of RLI Insurance Company, and now in force to -wit:
"All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate
name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other
officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the
Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds, policies or undertakings in the
name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of
Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by
facsimile."
IN WITNESS WHEREOF, the RLI Insurance Company has caused these presents to be executed by its Vice President with its
corporate seal affixed this 18th day of November , 2011
RLI Insurance Company
r ,09POR41 •_ :
`:.SEAL:
•...
Roy C. Die
Vice President
State of Illinois ) ::
County of Peoria
CERTIFICATE
On this 18th day of November 2011 before me, a Notary
I, the undersigned officer of RLI Insurance Company, a stock
Public, personally appeared Roy C. Die , who being by me duly
corporation of the State of Illinois, do hereby certify that the attached
swom, acknowledged that he signed the above Power of Attorney as the
Power of Attorney is in full force and effect and is irrevocable; and
aforesaid officer of the RLI Insurance Company and acknowledged said
furthermore, that the Resolution of the Company as set forth in the
instrument to be the voluntary act and deed of said corporation.
Power of Attorney, is now in force. In testimony whereof, I have
hereunto set my hand and the seal of the RLI Insurance Company
this 2nd day of February , 2012 .
..t �• '«-
RLI Insurance Company
Jacqu ioe M. Bockler Notary Public
"OFFICIAL SEAL"
Roy C. Die
- Vice President
• weuc P JACQUELINE M. BOCKLER
9lRR L4
wwe COMMIMIONE PIR69 m /01/14
04495sso20212 A0059411
BIDDER: ( CS IY'u c 'avA
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 aboutthe construction of the Work in an
amount in excess of one -half of one percent (greater than 0.5 %) of the Bidder's Total Bid
Price, or, in the case of bids or offers for the construction of streets or highways, including
bridges, in excess of one -half of 1 percent of the Contractor's total bid or ten thousand
dollars ($10,000), whichever is greater, and shall further set forth the portion of the Work
which will be done by each subcontractor. Bidder shall list only one subcontractor for any
one portion of the Work.
Pursuant to Public Contract Code Section 4104, the Owner has determined that it will allow
Bidders twenty -four (24) additional hours after the deadline for submission of bids to submit
the information requested by the Owner about each subcontractor, other than the name and
location of each subcontractor.
If the Bidder fails to specify a subcontractor for any portion of the Work to be performed
under the Contract, it shall be deemed to have agreed to perform such portion itself, and
shall not be permitted to subcontract that portion of the Work except under the conditions
hereinafter set forth below.
Subletting or subcontracting of any portion of the Work in excess of one half of one percent
(greater than 0.5 %) 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.
BIDDER: 1 s `'B"VS -v
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:
Address:
Name and Location
of Subcontractor
Name:
Address:
Description of Work
to be Subcontracted
Name and Location
of Subcontractor
Name:
Address:
Name and Location
of Subcontractor
Name:
Address:
Description of Work
to be Subcontracted
Description of Work
to be Subcontracted
Name and Location
of Subcontractor
Name:
Address:
Description of Work
to be Subcontracted
BIDDER: PS co�s 00 4 -° , -A
2.0 REFERENCES
The following are the names, addresses and telephone numbers for three public agencies for which BIDDER
has performed similar work within the past two (2) years:
II
Name a
Name and tUleph
�
Contract amount
2. C1
of Uwner
IC.e
number
0
(o G i) Z51
f person familiar with project
Type of Work
2011
Date Completed
Name and Address of Owner U
41 N&50
3 ¢�
Name and Lblephone number of person familiar with project
_ l 3 S o 00
Oew C't.s u (A to'�N
',7 1
Contract am
Type of Work
Date Completed
t n
I ' 'A ' `o - rcpt 7
!
3.
Name and Address of Owner
i &L� N q u `-I cvx
\ s c: � 9
Name and to hone dumber of person familiar with project
SO `j oo o
1 j/
/l tw co , S4vUeL'i
- 2-o 1 O
Contract amount
Type of Work
Date Completed
Ct o.( oXV
4. X
Name and Address of Owner
Ivf yj CX
385 -7821
Name and telephone numb r of person familiar with project
«fi 00 0
'y e :.J Ca�S�UCf
Contract amount
Type of Work
Date Completed
CBF -10
BIDDER: FS CovtSKUCt�o
SECTION 3
NON - COLLUSION AFFIDAVIT
CBF -11
BIDDER:
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, orthe contents thereof, or divulged
information or data relative thereto, or paid, and will not pay, any fee to any porporation,
partnership, company association, organization, bid depository, or to any member or agent
thereof to effectuate a collusive or sham bid.
C f I &f
Si ature (�
I Typed or`Orinted Name
_ 0w K
Title
Cs
Bidder
Subscribed and sworn before me
This _ day of , 20_
(Seal)
Notary Public in and for
the State of California
My Commission Expires:
See Attached California Jurat
CBF -12
CALIFORNIA JURAT WITH AFFIANT STATEMENT
- E� , See Attached Document (Notary to cross out lines 1 -2 below)
❑ See Statement Below (Line 1 to be completed only by document signer(s), not Notary)
SibjaamofMm=ntSinerNo I
State of California
County of Los Angeles Subscribed and sworn to (or affirmed) before me on
6TH day o f FEBRUARY , by 2012
(1) --- ---- -- - -- - J. ANGEL FIERROS ----------------------
Name of Signer
JESSICA X. LOPEZ proved to me on the basis of satisfactory evidence
• Commission # 1859678
i Notary Public - California i
z Los'Angeles County n to be the person who appeared before me
My Comm. Expires Aug 28, 2013
Signature Z�V�
Place Notary Seal Above
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.
Further Description of Any Attached Document
Type of Document:
Document Date:
Signer(s) Other Than Named Above:
No. of Pages: