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Kormx, Inc.1 1 1 1 1 1 1 1 BIDDER: 14,4 -M-A, I n c 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): $ I 11'z., a 1;,;,—I � n Dollar amount in written Rh(� 2��elfb CBF -2 UNIT OF EST. UNIT ITEM NO. ITEM DESCRIPTION MEASURE OTY. PRICE COST 1 Clearing & Grubbing per plans LS 1 and specifications. See technical E) . Up 5U0 0 D provisions TP -2, TP -3 & TP -4. 2 Disposal of Waste Materials. LS 1 Fjpp, 60 3 Remove, Dispose and Construct SF 21,000 4- inches thick PCC Sidewalk per SPPWC Std. Plan 113 -1.�1 y glPb• 4 Remove, Dispose and Construct SF 500 PCC Driveway Approaches perk, 52 3� 2-U 0 UO SPPWC Std. Plan 110.2. 5 Remove, Dispose and Construct LF 1,015 8- inches Curb and 24- inches Gutter per SPPWC Std. Plan X32 • 3r7 3 �i�" 120-2. 6 Remove, Dispose and Construct LF 100 8- inches PCC Curb Only per $ Do 1 sop, 00 SPPWC Sid. Plan 120-2. 7 Remove, Dispose and Construct EA 1 PCC Curb Ramp per SPPWC W2-10610, 00 . U 610- 0. p� Std. Plan 111 -4.2' 8 Install Survey property and EA 10 centerline tie Monument. Zc) �� 5�2•S TOTAL BASE BID PRICE (SCHEDULE BID PRICE): $ I 11'z., a 1;,;,—I � n Dollar amount in written Rh(� 2��elfb CBF -2 I BIDDER: i'`v- r-1X r �'1 � L. i ' 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 aftemate 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 The undersigned agrees that these Contract Bid Forms constitute a firm offer to the Owner which cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and after the bid opening date, or until a Contract for the Work is fully executed by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. ' Attachgd hereto is a certified check, a cashier's check or id bond the amount of C ° e Dollars {$� said amount being not less than ercent (10 %) of the Total ' Bid Price. The undersigned agrees that said amount shall be retained by the Owner if, upon award, we fail or refuse to execute the Contract and furnish the required bonds, certificates and endorsements of insurance and other certifications within the time provided. ' If awarded a Contract, the undersigned agrees to execute the formal Contract, which will be prepared by the Owner for execution, within five (5) Calendar Days following the Letter of Award for the Contract, and will deliver to the Owner within that same period the necessary original Certificates of Insurance, Endorsements of Insurance, Performance Bond, Payment Bond and all other documentation and certification required by the Contract. The undersigned offers and agrees that if this bid is accepted, it will assign to the purchasing body all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C. Section 15) or under the Cartwright Act.(Chapter 2 of Part 2 of Division 7 of the ' Business and Professional Code), arising from purchases of goods, materials or services by the Bidder for sale to the purchasing body pursuant to the bid. Such assignment shall be made and become effective at the time the purchasing body tenders final payment to he Contractor. Bidder understands and agrees that, when requested by Owner, he shall provide: (1) evidence satisfactory to the Owner of Bidder's California contractor's license(s) in good standing; (2) evidence that the person signing this Bid is authorized to bind Bidder to this Bid and to a contract resulting therefrom; and (3) any other information and documentation, financial or otherwise, needed by Owner to award a Contract to the lowest responsible and responsive bidder. Bidder 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 -3 I BIDDER: ' The undersigned acknowledges receipt, understanding and full consideration of the following addenda to the Contract Documents. Addenda Nos. �1116y ' 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. 1 1 1 I 1 I I 1 CBF -4 By. �- ` Signature Joe (Jriti� C c �enrls Type or Print Name Title BIDDER: KorrAx In i 5z)j°I Ay2ni A-, ( So Business Street Address City, State and Zip Code A0q) 7 _71- -1076 l'bleph ne Number Bidder's /Contractor's State of Incorporation: �_� bi & rya 6� Partners or Joint Venturers: Bidder's License Number(s): NOTES: 1) 2) 3) 1 1 1 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. 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 behatf of the corporation, partnership or joint venture has the authority to do so. CBF -5 I 1 i 1 v.. r.. --.. I W. I W - 111^5 11'Y. Bidder shall submit its Bid Data Forms. Bidders shall the information required. Identified with the Bidder's UanJlotaaaadaUl Y.UuzfuuL BIDDER: KQrWZ Tnc _ Bond NO. :SBA 800190 in accordance with the format shown on each of the following Bid Ire and use as manysheets as are necessary to adequately provide r shall ensure that every page of its Bid Data Forms are properly I and page number. 2.A BID BOND KNOW ALL MEN BY THESE PRESENTS: THAT Kormx I c. as Principal, and American 2afety Casualty Insurance Company CITY OP 110 - as Surety- arc hold firmly hound unto thr. rare natter mall d-me VwNtH) In the sum Of Ten Percent of the Total Amount of the Bid in-------- - - - - -- (------ 10�- - - -- ---------------------------- - - - - -- DOLLARS being not less than ten percent (10°x) of the Total Bid Price; for the Payrn ent of which sum will and trulyto be made, we bind ourselves, our heirs, executors, a ftinistrators, successors, and assigns, jointly and severally, firmly by these presen s. WHEREAS said Pnn fpal has submitted a bid to the OWNER to perform all Work required for the Side alk, Curb and Gutter Replacement Project as set forth in the Notice Inviting Bids and accompanying Bid Documents, anted NOW, THEREFORE, OWNER and, within fr Bid Documents, ente Documents, fumishes and the other to guaral insurance certificates i maybe required by the it shall remain in full fol the OWNER andjudgn the OWNER in such s court, SIGNED AND M said Principal is awarded a Contract for the Work by the time arid in the manner required by the above- referenced into the Written form of Contract bound with said Bid Ie required bonds (one to guarantee faithful performance le payment for labor and materials) furnishes the required d endorsements, and furnishes any other certifications as ontract, then this obligation shall be null and void; otherwise I and effect. In the event suit is brought upon this bond by rit is recovered, said Surety shall pay all costs incurred by t, including reasonable attorneys' fees to be fixed by the this 6th dayof February 2412 _(SEAL) American Safety Ca sualtEAL) $Urety nsurance Compan By' Signature Crac Lopez, Attorney -in -Fact CBF -7' CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT State of California County of Los Angeles On February 6. 2012 before me, M. S. Rodriguez, Notary Public Date Here Insert Name antl Tile of the Officer ' personally appeared GRACIE LOPEZ Names) of Signerls) M. 5. RODRIGUEZ NOTARY PUBLIC - CALIFORNIA LOS ANGELES COUNTY e COMMISSION : 1872651 •- +�' MY COMM. EXPIRES JAN. 2, 2014 Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person( whose name($) is/afwsubscribed to the within instrument and acknowledged to me that tae /she /they,- executed the same in I;Wher/t4oir authorized capacity(l@�), and that by his/her/theirsignature($) on the instrument the person(#), or the entity upon behalf of which the person($) 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 ? 2d, - zegnature of Notary Pu01I 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: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Number of Pages: Signer's Name: Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer— Title(s): ❑ Corporate Officer— Title(s): ❑ Partner —❑ Limited ❑ General _ _ ❑ Partner — ❑ Limited ❑ General Attorney in Fact ❑ Attorney in Fact ❑ Trustee Top of thumb here ❑ Trustee Top of thumb here ❑ Guardian or Conservator ❑ Guardian or Conservator ❑ Other: ❑ Other: Signer Is Representing: Signer Is Representing: 02007 National NoWn, Association• 9350 De Solo Ave., P.O Box 2402-Chatsworth, CA 91313- 2402•www.NalionalNotaryorg Ilem M5907 Reenter: Gall Toll -Free 1 A0 876 -6827 �'�` .�� j vi Y �j t I yr. a: lo,: Irc ii 'I i'lu "inn 'Oi ii''I ili'll "Vi.. '. Riml�'�I I I II��I�� POWER OF ATTORNEY KKI WNWWTHI £REg""Iat Amadoao*rty ;s€fa$y Aaaiilii 4PI has m 1661" d aplso"d Ttr�e -- — -- - mrllaRw opez Its true and lawful attorney -in -fact; for it and gs name, place, and stead to execute on behalf of the said Com y, as r bonds, u Idng tl II PI IL, w "II, Ullll VINNIII I' pIIIIIINIIIIII NI IINIftal� IN!; I i!i'ii�i�I � I' iNroY dt n r d 'et oe au e' g rI�IN� desu �of�III��hIIIIDIIIIIINN �� NNNIN�IIII��I I;1116iullll��ll�116'� "ONEAHLLIONDOLLARS ($1,000,000.00)"* This Power of Attorney Is granted and Is sighed and sealed by fac lmlle under and by the authority of the following Resolution adopted by the Board of '.. _ _ --� I�IIPIIIIIII�IIIIIII ��Illlll (9 �I� ill I'�iiiii�ulVIlulu an _= RI -= or -= an the wafaf the Company to bands, undeflakings_ recognizances, and surelyehfp obligations of 01kinds and said afters may remov ny such altonfiv - faat or agent and revoke any power of attorney prevousty granted to such persons.' Its President and atested IUU,IIIII � IiIhl�Ill I Ilu...... Vll I�II�, IIIINIIiII��IIN I�h��IIIII� ly I II II Iluuol II III ii �Iluulll��ll AmtiuJJala �. it m - —° any aut an and all have Of i may after =b imilsmdot =organ arse, or _s_�arsutesla6lfgatfo_aaof�fia ially � � � == seal to be hereunto aMked andfbess presentsto be lillll „VIII IIIIIIII�;��I I'Iilllillllll'!II!Illllllll��l IIIIIIII.I,,VIIINIIIIIIIIIilllll' IIIIIIII'III, IIII. IIIIIIIICIIII'ii q Illlllill Illill illlillll, g II IIIiI�II N IIII I;, I�IIIIII VII I Il e i I e i i. Ile State I lieu I� l li I �l �i I I I � V� I I I I III'illllll II��iIIhII� IIli�ui�6�uI�NIiuI�I,INI �'�uIIVI ulhu�- Illl ICI I �I�II I �l,Illl ORIGINALS OF THIS POI DUPLICATES SHALL HAVE THE SAME FORCE VINO l' IN�IIfIIiIIIP; lllllllhlll'l °'i�'Ili lull I "I N'IIII'I' �I'II at d�IIII�'lll��gl o'''�� VI�pI�uNIIII1�I�IIIIu��III " � Illdll INII N I�I I' ,III NII I, IIII II� �II�InIIVII�mI�II�IIII� I II�Il14111'Illlhll'�" RED it "'i i�.,. � li "i,. i,. .p. n u• �.; i” �u rli�i, °i'' hl' -'iy . .I I I I � I I I i I �I IiI I i �I I � i � t I 6V I I � iIi p l � Ii I I i I I i I i I I I � � I I I � I i l I I I II Ii I II I I� NI �I I i I I I I I � I I I I I I I � I CI I II l I I I I VI iV I I u �I l � I i I i I i l li ui i . I i 6 ,i•t li I i I I i I I � d .. . II IIII III III �I Im II I I 011 � l I i nI Q11 IVli i l OR i l l N i IN I I .i I I li � II i I I l I i ll. I I I w . I � o � I II I � . K'WNmIIV�Iiw iV6mVNl�i;w. 1IIiIIIiLIIII D IN CONJUCTION WITH THE ORIGINAL IIIUII I� II uu�� I II i I it it i i I I i I i i i t I II I I II I i V i i V i LI IIII�IIII I li l u �. IVIIII�I ulli V iu i� I i I i Ili i i I i l�� u � �� l IIII I i li I it u III I I I I I �� I � III II lu i I l u' I I it l i a it I u i iI u� III INVii uu iI � Ills ui i ii il. u u i IIIII IuI;;II VII 'VIII Iliuu;IIIIIP� I; Iiii IVlilOill Diu li ll;lVilluul Iiu i;�. I I i i i I i i i ill. u u i I i t I it i IIII;illll�lill I itlili'iul WI ';lullililliu'I'I;' �iiill;u vlliuli u' ^ii IIII, !illuuW'uWlNuo' llllllllltlllilll�I .�IIi�I�IIiIIII�iIu�I�II IIIIIIII�,NII�iIIINuII�N��NI' lu��iillll�� '�,hIIIIu�Nlllllllll i lllllno. ' BIDDER: Y-6y YYl h 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 after the deadline for submission of bids to submit the information requested by the Owner about each subcontractor, otherthan 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. 1 1 1 ' CBF -8 1 1 1 1 BIDDER: YOV Y" 1, I Yl F 2.6 LIST OF PROPOSED SUBCONTRACTORS (continued) I"Duplimte Next 2 Pages it needed for hating additional su6wntractow -) Name and Location Description of Work of Subcontractor . to be Subcontracted Name: N Address: Name and Location of Subcontractor Name: Address: Name and Location of Subcontractor Name: _ Address: Name and Location of Subcontractor Name: Address: Name and Location of Subcontractor Name: Address: c CBF -9 Description of Work to be Subcontracted Description of Work to be Subcontracted Description of Work to be Subcontracted Description of Work to be Subcontracted 1 1 1 1 BIDDER: Y6Vrn -y In C 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: 1. (- .I'tUt o* 15.-LP- Nam d Address of Owner � 111 '� ? !! O / s71 i �� 17 )3 Z0110111161 Name and telephone number of person familiar with project U, OUCH Mi? gk- Im ra��, n-ieyi c 01 261 I Contract amount Type of Work Date Completed 2. L��-1 6 F (TYinn� 3UfY �l.Pyv,�r, Aim afGn�P� Csi °1z8(n(P Name a Address of Own r Name and telephone n ber of person familiar with project S9dC) (crICV -C4-e s , R-eh ,116 lit,lliov, oLi 1 2,61 1 Contract amount Type of Work Date ComDleted 3. 1Lrkzna4- �ecFldtnals - i � ra6uv, St SIB 1? cU c CA 92YV7 Name ;r Address of Owner Name and telephone number of person familiar with project Type 11 1261 1 Date Completed 4. Cif n-� FL41IfeJ v,-363W C1jvvNrn0V1v\hqn141,�, Av �Ilpr }zvJ �I2FS3Z Name and Address of Owner w' - L- IIy Name and telephone nu er of person familiar with project amount T-)Pe of CBF -10 1 I Z61 I Date Completed I I I 1 i Li Fj 1 1 1 1 1 1 1 I 1 BIDDER: u SECTION 3 NON - COLLUSION AFFIDAVIT CBF -11 I 1 1 1 I J I J 1 1 1 LJ 1 1 1 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, orcorporation; 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. Subscribed and sworn before me This _ day of Notary Public in and for the State of California My Commission Expires: ignature 7a-e— UY Imo. (Gtr( YES Typed or Printed Name PKb If n+ Title �VYYIx� 7 � C Bidder 20_ 1 CBF -12 (Seal) I 1 1 1 1 1 1 1 1 1 CITY OF ROSEMEAD SIDEWALK, CURB AND GUTTER REPLACEMENT PROJECT PROJECT No. 24002 Jurat State of California County of�t�L�� Subscribed and sworn to (or affirmed) before me on 2o—[�,2 by proved to me on the basis of satisfactory evidence to be the personO)"who appeared before me. (Notary seal) NAV ' COMM. #1882533 oil ` Notary Public - California o Los Angeles County Comm. ices Mar. 13, 2(114 OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached document) (Title or description of attached document continued) Number of Pages Document Date (Additional information) INSTRUCTIONS FOR COMPLETING THIS FORM The wording of all Jurars completed in California after January 1, 2oo8 must be in the form as set forth within this Jurat. There are no exceptions. (fa Jura, to be completed does not follow this form, the notary must correct the verbiage by using a jumt stamp containing the correct wording or attaching n separate Jural form such as this one which does contain proper wording, in addition, the notary must require an oath or tiffirmadon from the document signer regarding the tr utolness of the contents of the document. The document must be signed AFTER the oath or q0irmadon. 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