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Silvia Constuctions IncCITY OF ROSEMEAD MISSION DRIVE STREET RESURFACING PROJECT FROM WESTERLY CITY LIMIT TO ROSEMEAD BOULEVARD PROJECT No. 21007 CONTRACT BID FORMS BIDDER: SILVIA CONSTRUCT INC. CONTRACT BID FORMS TABLE OF CONTENTS SECTION 1 BID SCHEDULE SECTION 2 BID DATA FORMS ............................................ ............................... 2.A BID BOND-_ ... __ ........ ..................................... I ............................... 2.6 LIST OF PROPOSED SUBCONTRACTORS ... ............................... SECTION 3 NON - COLLUSION AFFIDAVIT ......................... ............................... ....... 1 6 7 ... 10 BIDDER: SILVIA CONS TR UC T I ON, INC. SECTION 1- BID SCHEDUL CBF -1 BIDDER: SILVIA CONSTRUCTION, INC. BID SCHEDULE SCHEDULE OF PRICES FOR MISSION DRIVE STREET RESURFACING PROJECT FROM WESTERLY CITY LIMIT TO ROSEMEAD BOULEVARD PROJECT No. 21007 BASE BID SCHEDULE CBF -2 UNIT OF EST. UNIT ITEM NO. REM DESCRIPTION MEASURE QTY. PRICE COST 1 Clearing & Grubbing per plans LS 1 and specifications. See technical provisions TP -2, TP -3 & TP-4. 2y q� eo ay . 2 Disposal of Waste Materials. LS 1 3 Cold mill 2.0- inches thick existing SF 291,300 pavement. r2 3H 'p 4 Construct 1.5 inches thick TONS 2,735 pavement overlay ARHM -OG -C (PG 64 -16) as indicated on the plans. g X3 9,21603 5 Construct 1.0 inches thick TONS 1,825 Asphaltic Leveling course D1 (PG 64 -10) as indicated on the plans. # 72 /32,y/y.Z 6 Remove 64nches of existing SF 500 pavement and replace it with 3.5- inches of AC B -PG 64 -10 Base Course over compacted native. $ 7 Remove, Dispose and Construct SF 5,700 4- inches thick PCC Sidewalk per SPPWC Std. Plan 113 -1. 8 Remove, Dispose and Construct SF 820 PCC Driveway Approaches per SPPWC Std. Plan 110 -2. y9�� 9 Remove, Dispose and Construct LF 423 &inches Curb and 24- inches Gutter per SPPWC Std. Plan 120 -2. 10 Remove, Dispose and Construct SF 1,500 PCC Cross Gutter per SPPWC Std. Plan 123-2. o0 CBF -2 BIDDER: SILVIA CONSTRUCTION, INC. TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ ?3' 2' Dollar amount CBF -3 UNIT OF EST. UNIT ITEM NO. ITEM DESCRIPTION MEASURE QTY. PRICE COST 11 Remove, Dispose and Construct EA 3 PCC Curb Ramps per SPPWC Std. Plan 111-4. 12 Adjust Sewer Manhole to Grade EA 58 per APWA Std. Plan 205 -1 and 206-1. 13 Adjust Water Valve /Gas Valve to EA 50 oa Grade. PC $ 3 ow i 14 Install Survey Well Monument EA 13 per City of Rosemead Std. Plan S08 -001. See Section 2 -9 Surveying of the General Provision -7 per details (Cover, Sleeve & Dome will be provided by the City no cost). a9 at yyN.� g Ag a 15 Install Traffic Striping, Traffic LS 1 Signal Loops and Pavement Markers per the Striping Plans and Specifications Complete. yo i yo Szv'°9 16 Prepare a Storm Water Pollution LS 1 Prevention Plan (SWPPP) DDD•oD 3 �'� 17 Remove, Salvage and Install EA 47 Street Name Signs on Existing '15 Poles; City will provide the Signs. 3, 76 1 as 18 Remove, Salvage and Install EA 6 Stmt Name Signs on Existing Poles; City the Signs. will provide q U . 19 Furnish and Install Solar In -Road EA 2 Pavement Lighting System Complete per Plans and Specifications. 2 Locations with total of 36 In -Road Pavement Lights, L(j,$pp. S7ew 20 Furnish and Install Solar Speed EA 2 Feedback Sign System Complete per Plans and Specifications. yq [,pp. v y TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ ?3' 2' Dollar amount CBF -3 BIDDER: SILVIA CONSTRUCTION, INC. Note: The City of Rosemead reserves the right to reduce or increase the quantities of any items in the schedule of bid items above, within the limits define in Section 3 -2.2.1 of the Standard Specifications, to stay within the budgeted amount of this project. If the Bid Documents specify alternate bid items, the following Alternate Bid amounts shall be added to or deducted from the Total Bid Price entered above. The owner can choose to Include one or more of the alternates in the Total Bid Price of the Project. If any of the Alternate Bids are utilized by the Owner, the resulting amount shall be considered the Total Bid Price for the Project The undersigned agrees that these Contract Bid Forms constitute a firm offer to the Owner which cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and after the bid opening date, or until a Contract for the Work is fully executed by the Owner and a third party, whichever is earlier. The undersigned also agrees that if there is a discrepancy between the written amount of the Bid Price and the numerical amount of the Bid Price, the written amount shall govern. Attached hereto is a certified check, a cashier's check or a bid bond n the amount of TIN PIItCQVP CF BID 90 M Dollars ($ 1� said amount being not less than en 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 by the Owner for execution, within five (5) Calendar Days following the Letter of Award for the Contract, and will deliverto the Ownerwithin 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 of five hundred dollars ($500.00) if project is not completed in thirty (30) calendar days. The Contract Time will begin to run ten (10) Working Days from the date of the Notice of Proceed 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 CBF -4 BIDDER: SILVI CONSTRUCT INC. 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. _ IUrn vt9 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 -5 -' A By _i Signature KURTIS AKABORI Type or Print Name VICE PRESIDENT Title BIDDER: SILVIA_CONSTRUCTI INC. 9007 CENTER AVENUE Business Street Address RANCHO CUCAMONGA, CA 91 730 -5311 City, State and zip Code (909) 481 -8118 Telephone Number Bidders /Contractor's State of Incorporation: CALIFORNIA Partners or Joint Venturers: Bidders License Number(s): NOTES: 1) 2) 3) n/a 568194 A, C12 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, nartnershin or ioint venture has the authoritv to do so. CBF -6 CALIFORNIA JURAT WITH AFFIANT STATEMENT R See Attached Document (Notary to cross out lines 1 -6) ❑ See Statement Below (Lines 1 -5 to be completed only by document signer[s], not Notary) -- ------------------------------------------------------ - - - - -- --- 2. ------- - - - - -- -------------------------------- - - - - -- --------------- 3. 4. 5. or vocumenr signer NO. i STATE OF CALIFORNIA COUNTY OF SAN BERNARDINO PATRICIA BURKE Com Mselon • 1975881 Notary Public - cmdornla Son Berm Ono County M Comm. Illm May 25 2016 Subscribed and sworn to (or affirmed) before me on this 05 day of JUNE , 2012, by KURTIS AKABORI proved to me on the basis of satisfactory evidence to be the person who appeared before me. Signature of Notary Public 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 Title Or Type Of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: I © © g 1 S . f -: i x SILVIA CONSTRUCTION, INC. CORPORATE RESOLUTION SPECIAL MEETING OF TBE BOARD OF DIRECTORS JUNE 1, 2011 A special meeting of the Board of Directors was called on June 1, 2011. Present were Joseph W. Silvia, Chairman of the Board, Benjamin Day, Member of the Board and invited to sit in on the meeting were corporate officers, Mera Silvia, Vice President Carolyn Parker, Corporate Secretary and Kurtis Akabori, Vice President. RESOLUTION NO.1 The Corporation (Silvia Construction; Inc.) has purchased from Benjamin Day his remaining 680 shares of common stock. Accordingly, as of June 1, 2011, the date of the transaction, Joseph Wayne Silvia is the owner of 2622.25 shares of common stock representing a ninety- six and one-half percent (96.5 stock ownership interest in the Corporation. Kurtis Akabori, is the owner of 97.75 shares of common stock representing a three and one -half percent (3.5 %), stock ownership interest in the Corporation. This Stock Repurchase Agreement has been entered effective as of June 1, 2011 by and between Benjamin Day and Silvia Construction, Inc. RESOLUTION NO.2 The board of Directors hereby names, resolves and authorizes the following named officers to sign State, City or County contracts and other related documents on behalf of the Corporation: Joseph W. Silvia, President, Chief Executive Officer and Shareholder Kurtis Aka by ice President and Shareholder Mera Si a Vi President ------- ------ mw"M � W. Silvia Ch. an of the Board Berjami4fiay, Mem r of the Board 9007 CENTER AVENUE • RANCHO CUCAMONGA. CA 91730 • (90914B1 -811 B • FAX (909) 481 -8122 • UCENSE #568194 A State Of California (A STATE LICENSE BOARD 7711 ACTIVE LICENSE Consumer Affairs .,«, 568194 EMN CORD . ,,s SILVIA CONSTRUCTION INC cwSmficL"s C12 A PS rm.mm n,0 05/31/2013 www.cslb.ca.gov • BIDDER: SILVIA CONSTRUCTI INC. SECTION 2 BID DATA FORMS CBF -7 BOND# 08560291 CPREMIUM'INIL INC. Bidder shalf submit Its Bid data in accordance with the format shown on each of the following o Bid Data Forms; Bidders shall prepare and use as manyshee page Bid Data Forms are Proferl as are nec-essarYtO adequately Identified with the re idders B ame and page ve P page numb re g 2,A BID l BOND KNOW ALL MEN BY THESE PRESENTS: THAT SILVIA CONSTRUCTION, INC. as $ ,being not less than ten percent (10%) of the Total B id Price; forthe payment of which sum will and truly to be mado, we bind ourselves, our halts, executors, administrators, successors, and assigns, joinHy and severally, finny by those presents. WHEREAS, said Principal has submitted a bid to the OWNER fo perform all Work required for the Mission Drive Stre ®t Resurtaoing Project as set�orlh �n Notice Inviting Bids and accompanying Bid Documents, dated 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, fumishes the required bonds (one to guarantee faithful performance and1the 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 3 To x day of MAIDEiiT, LV NSTRUCTION Il (SEAL) COMPANY Principal � � Su QOT By ' By: Signature KURTIS AKABORI Sig VICE PRESIDENT 20 12 r A 5'DEPM= YLAND I , e CHARLES L. FLAKE ATTORNEY -IN - FACT Principal, and D TY "" unr� as Surety, ere held firmly bound unto the in the sum of aITY OF ROSI pOFAD (hereinafter called the OWNER) CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA COUNTY OF SAN BERNARDINO On JUNE 05, 2012 before me, PATRICIA BURKE, NOTARY PUBLIC personally appeared KURTIS AKABORI , who proved tome on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature 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. PATRICIA BUXKE Commission M 1876661 WITNESS my hind and official seal.? ON1 Notary Public - California San Bernardino County '� Comm. Evnim. u.0 26, 2018 of Notary Public --------------------------- - - - - -- OPTION Place Nolary Seal Above 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 NUMBER OF PAGES: .TE OF DOCUMENT: Signer(s) Other Than Named Above: CAPACITY CLAIMED BY SIGNER Singers Name: Kurtis Akabori INDIVIDUAL PARTNER ® CORPORATE OFFICER VICE PRESIDENT ❑ ATTORNEY IN FACT TITLE TRUSTEE GUARDIAN OR CONSERVATOR Other Signer is Representing: SILVIA CONSTRUCTION, INC. NAME OF PERSON(S) OR ENTITY(S) RIGHT THUMBPRIM OF SIGNER C ALIFORNIA ALL ACKNO WLEDGMENT STATE OF CALIFORNIA County of Orange On 5 -30 -12 before me, Lexie Sherwood. Inser Notary Public Date Here t Name and Title of the Officer personally appeared Char L. Flake Name(s) of Signer(s) tinn_ LEX S�HERWOODD CO MM. #1856389 NOTA P usu eCALIFORNIA n ORANGECOUNTY { " Comm. Exp. JULY 27 2013 W Div v"rv'v�/'wvv"rvv 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 /shefthey 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. 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 U , cU29Bt� Place Notary Seal Above Signature o d6 a Pudic 2 OPTIONAL Though the information below is not required bylaw, 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 Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s):_ ❑ Padner— ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Individual ❑ Corporate Officer — TiUe(s)_ ❑ Partner —❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 0 2007 Natlunal Notary Asseclation • 9350 De Solo Ave., P.O. Box 2402 • Chalsworth, CA 91313 -2402 • www.NalionalNotarrorg Item 45907 ReoNer. Call Toll -Free 1- 800 - 876 -6827 Power of Attorney FIDELITY AND DEPOSIT COMPANY OF MARYLAND KNOW ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a corporation of the State of Maryland, by WILLIAM J. MILLS, Vice President, and ERIC D. BARNES, Assistant Secretary, in pursuance of authority granted by Article VI, Section 2, of the By -Laws of said Company, are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date h e dds by nominate, constitute and appoint Richard A. COON, Charles L. FLAKE, David L. CULB n e OOD, all of Anaheim, California, EACH its true and lawful agent and a N ,° d deliver, for, and on its behalf as surety, and as its act and deed: any an ° n xecution of such bonds or undertakings in pursuance of these prese in , as fully and amply, to all intents and purposes, as if they had been d @S t lawn ularly elected officers of the Company at its office in Baltimore, Md., ip per ° attorney revokes that issued on behalf of Richard A. COON, Charles L. FLAKE, a ew P. FLAKE, Lexie SHERWOOD, dated November 7, 2005. The said Assistant Section 2, of the By- certify that the extract set forth on the reverse side hereof is a true copy of Article VI, and is now in force. IN WITNESS WHEREOF, the said Vice - President and Assistant Secretary have hereunto subscribed their names and affixed the Corporate Sea] of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 15th day of November, A.D. 2006. ATTEST: O f n Fp State of Maryland ss: City of Baltimore FIDELITY AND DEPOSIT COMPANY OF MARYLAND Eric D. Barnes Assistant Secretary 1 ff 4 ljt✓t/' (/ X* By: 7 William J. Mills Vice President On this 15th day of November, A.D. 2006, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, came WILLIAM J. MILLS, Vice President, and ERIC D. BARNES, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being by me duly sworn, severally and each for himself deposeth and saith, that they are the said officers of the Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and d'ir'ection of the said Corporation. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. ` ,nnuup, IrLJ -- ��• ��� Constance A. Dann Notary Public My Commission Expires: July 14, 2015 POA -F 012 -4150H BIDDER: SILVIA CONSTRUCTION, INC. 2.113 LIST OF PROPOSED SUBCONTRACTORS In compliance with the "Subletting and Subcontracting Fair Practices Act," Sections 4100 through 4114 of the California Public Contract Code, and any amendments thereto, each Bidder shall provide the information requested below for each subcontractor who will perform work, labor or render service to Bidder in or about the construction of the Work in an amount in excess of one -half of one percent (greater than 0.5 %) of the 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 forthe 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. CBF -9 BIDDER: SILV CONSTRUCT INC. 23 LIST OF PROPOSED SUBCONTRACTORS (continued) IWwplimte Next 2 Pages If rre ded for Hating additional subwntraclora- "i Name and Location Description of Work of Subcontractor to be Subcontracted .. '1L U l lj.:•.. Name and Location Description of Work of Subcontractor nn 11 A lJ to be Subcontracted I Name: F&5 (.({il!j. b ..12✓ A, L. Address /V6 E. wm 96. 01M. ez PA Y1879 Name and Location of Subcontractor Name and Location of Subcontractor Name: Address: Description of Work to be Subcontracted Name and Location of Subcontractor Name: Address: Description of Work to be Subcontracted CBF -10 BIDDER:SILVIA CONSTRUCTION, INC. 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, CITY OF ONTARIO, 303 EAST "B" STREET, ONTARIO, CA 91764 Name and Address of Owner WIL LIAM "BILL" BRAUN, (909) 395 -2025 Name and telephone number of person familiar with project $1,510, '11 PA VE. REH — PH. "A" OCT 201 Contract amount Type of Work Date Completed 2 CITY OF CHINO HILLS, 14000 CITY CENTER DRIVE, CHINO HILLS, CA 91709 Name and Address of Owner ANNE DUTREY, (909) 364 -2760 Name and telephone number of person familiar with project 813,808.40, CHINO HILLS PKWY REHAB., #511008, AUGUST, 2 011 act amount Type of Work Date Completed g, CITY OF LAKEWOOD, 5050 CLARK AVENUE, LAKEWOOD, CA 90712 Name and Address of Owner MAX WITHROW, (562) 866 -9771 ext. 2502 Name and telephone number of person familiar with project 2,168,294.94, '11 CDBG, RESIDENTIAL ST., #PW11 -2 AUGUST, 2011 mtract amount Type of Work Date Completed 4 CITY OF DUARTE, 1600 HUNTINGTON DRIVE, DUARTE, CA 91010 Name and Address of Owner STEVEN ESBENSHADE, (626)357 -7931 ext. 233 Name and telephone number of person familiar with project $1,418,381.28, HUNTINGTON DR. REHAB. PROJECT, SEPTEMBER, 2010 Contract amount Type of Work Date Completed CBF -11 BIDDER: CONSTRUCTI INC. SECTION 3 NON - COLLUSION AFFIDAVIT CBF -12 BIDDER: SILVIA CONSTRUCTION, 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 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. "I , Signature KURTIS AKA Typed or Printed Name VICE PRESIDENT Title SILV CO INC. Bidder Subscribed and sworn before me This 05thday of JUNE 1 20 12 (Seal) LOOSE JURAT ATTACHED Notary Public in and for the State of California My Commission Expires; MAY 26, 20 16 CBF -13 CALIFORNIA JURAT WITH AFFIANT STATEMENT []''See Attached Document (Notary to cross out lines 1 -6) ❑ See Statement Below (Lines 1 -5 to be completed only by document signer[s], not Notary) z. 3. 4. 5. 6. STATE OF CALIFORNIA COUNTY OF SAN BERNARDINO PATRICIA BURNE Commission M 1976661 = Notary Public - California San Bernardino County My Comm. Expires May 26, 2016 Place Notary Seal Above Subscribed and sworn to (or affirmed) before me on this 05 day of JUNE , 2012, by KURTIS AKABORI proved to me on the basis of satisfactory evidence to be the person who appeared before me. Signature of Notary Public 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 Title Or Type Of Document: Document Date: Signer(s) Other Than Named Above: Number of Pages: RIGHTTHUMOPRIWOF SIGNER RIGHTTHWHPRMTOF SIGNER