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Sully-Miller ContractingCITY OF ROSEMEAD HELLMAN /SAN GABRIEL INTERSECTION IMPROVEMENTS PROJECT BIDDER: SULLY - MILLER CONTRACTI COMPANY BID SCHEDULE SCHEDULE OF PRICES FOR HELLMANISAN GABRIEL INTERSECTION IMPROVEMENTS PROJECT ESPL 5358 (012) BASE BID SCHEDULE CBF -1 UNIT OF EST. UNIT ITEM NO. ITEM DESCRIPTION MEASURE QTY. PRICE COST Clearing & Grubbing per plans 1 and specifications. See technical provisions TP 2, TP 3 & TP 4. LS 1 5S0 00 SS o 00, 2 Disposal of Waste Materials LS 1 3 opD- 3 000 . Remove Existing and 3 Construct 9- Inches Thick PCC Pavement (High Early Strength) 520 -A -5000. SF 22,320 g 1 70 SG C>. Construct 6- Inches Thick 4 Crushed Miscellaneous Base 95% Compaction over 90% Compacted Soil. TONS 650 5 Cold Mill 2- Inches Existing Pavement. SF 5,000 �. _ 6 Construct 2- Inches AC Pavement (C2- PG 64 -10). TONS 70 Construct 4-inch thick PCC 7 sidewalk per SPPWC Std Plan 113 -2. SF 230 g Construct PCC Curb Ramps per SPPWC Std Plan 111-4. EA 2 3 Soo 7 00 0. Remove Existing and 9 Construct 6- Inches Thick PCC Driveway Approach per SPPWC Std Plan 110 -2. SF 9D0 Install Landscape and 10 Irrigation per Plans and Specifications Complete. LS 1 I 7, 000. 1 Install Traffic Striping, Traffic 11 Signal Loops and Pavement Markers LS 1 S000. 000. CBF -1 BIDDER: MILLER CONTRACTIN COMPANY NO. ITEM DESCRIPTION UNIT OF MEASURE EST. QTY. UNIT PRICE ITEM COST 12 Construct Traffic Signal Improvements per Plans and Specifications Complete. 1 LS 77 ago, ! -7g Remove, Dispose and Construct Colored PCC Cross Walk (Chromix) with Lithochrome 13 Colorhardener on top per Plans and Specifications Complete per LM Scofield Company or Approved Equal. Contact person Bruce Umeck 818 - 324 -3534. SF 3,050 /7, S/ 14 Adjust Sewer Manhole to Grade per SPPWC Std Plan 205 -2. EA 6 1,000. Doe . 15 Adjust to Grade Water and Gas Valves Ea 10 x(37, / Lf 37 0 _ TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ l ! `J 3 f S / ` i amount in The undersigned agrees that these Contract Bid Forms constitute a firm offer to the Owner which cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and after the bid opening date, or until a Contract forthe Work is fully executed by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. 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. Attached hereto is a or a bid bond in the amount of Dollars ($ 10% ) 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 by the Owner for execution, within five (5) Calendar Days following the Letter of Award for CBF -2 BIDDER - S ULLY-MILLER CONTRACTIN COMPANY 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. The undersigned acknowledges receipt, understanding and full consideration of the following addenda to the Contract Documents. Addenda Nos. NONE 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 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. By: Signature RAYMOND SANCHEZ Type or Print Name ASSISTANT SECRETARY Title BIDDER: SULLY-MI CONTRACTING COMPANY 135 S. STATE COLLEGE BLVD., #400 Business Street Address BREA, CA 92821 City, State and Zip Code 7141578 -9600 Telephone Number Bidder's/Contractor's State of Incorporation: DELAWARE Partners or Joint Venturers: NIA Bidder's License Number(s): 747612/A & C10 NOTES: 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. 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 -4 CALIFORNIA ALL - PURPOSE ACKNOWLEDGEMENT STATE OF CALIFORNIA COUNTY OF ORANGE On April 26, 2013 before me, Adriana C. Treio personally appeared Raymond Sanchez who proved to me on the basis of satisfactory evidence to be the person(&) whose name(s) islare subscribed to the within instrument and acknowledged to me that h e/shekhey executed the same in his rhpp(th° authorized capacity(ies), and that by hi s!h°•it'h °ir signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. AORIANA C. TREJO Commission # 1991253 I certify under PENALTY OF PERJURY under the laws of the 'a -- Notary Public - California z State of California that the foregoing paragraph is true and Z Orange County > correct. My Comm. Ex Tres Oct 13, 20161 WITNESS my hand d offici seal Signature L fl C. Trejo, N ublic Notary Seal OPTIONAL Description of Attached Document Title or Type of Document: Bid Proposal- Signature Page Document Date: April 26, 2013 Number of Pages: 1 Signer(s) Other Than Named Above: None Capacity(ies) Claimed by Signer(s): Signer's Name Raymond Sanchez Signer's Name ❑ Individual ❑ Individual ❑X Corporate Officer— Title(s) Assistant Secretary ❑ Corporate Officer— Title(s) Partner — Limited /General ❑ Partner — Limited /General Attorney In Fact Right Thumbprint Attorney In Fact Right Thumbprint of Signer of Signer Trustee Trustee ❑ Guardian or conservator ❑ Other Signer is Representing: ❑ Guardian or Conservator ❑ Other SULLY - MILLER CONTRACTING COMPANY ?_ERTllFIC4]L'UR3I -Nt,Y NUI?l+ l�LJ�tTi)ti, t, f. n Cauny t . I lar n o Ir. Cl o hereby ce UtY that t ani H.�" [iGCrctl i 01 CI'y A"T'-b forviraictuig COMQMEly 3 1 ,.'c'f�;y�dlP Gm: _oc - , a!ion, an (I that a° CuC h ['Ia — v(= srce s to? and'custtc'(N U1 i -1 0" Co (IjOeP.'le "records and minute books Of said Corporatloll. Avid I do herby further" s_erify the t"ollowing persons are duly cicxted Oi 3 cers of said corporation. t'r A'LE 1 ?lA IATE Chah_rnaa of [he Board tjordon R. Crawley Freszaent David Marth. - = Vice resideuntoih. 1 f}iiiccr and y Chief Financial i Treasurer `ti Y Orchard Vice president and Assisiaitt Secretary �lchael Edwards Vice President Scott Bo toniley Secretary Anthony L. MaCahlo if Assistrart Secretary Gcor ge Aldrich Assistant Secretary Raymond Sanchez- Assistant Secreta €`y Dennis Cons I - ILl-iihe_r mrEil ", that the following, is a two and correct copy of a resolution duly adopted by the Board of Directors of said Company at a meeting held on February 15, 2012, and ti,at this resolution bas not been in any tvay rescinded, annulled, or revoked but tiro same is stilt in full force; aild ef " BID TENDERS: GE W- HRA-L RESOLVED, that any officer of the Corporation be and thoy ltereby are authorized in the name and on, behale of tea Corlporation, undez its cogoorate seal or otherwise (i) to prepare proposals and bids for the supp,Iyiug of construciiol? materials and the averforiiiance by itself or in joint venture, of v.`ork Of Whatsoever nature in coimectiml with the construction or paving of highways, roads and ai'rports and to connection wiA earthworks and civil ericrnecrrnb Projeds of all kinds, together with all wort; incidental thereto, (ii) to execute and submit any and alt such proposals and bids to any governmental authority, instrumentality, or agency of [lie Lhiited States, Its seVCral stales, tcrvitcries acid possessions, cludrtg without limitation, any nitiiticipatity or o ±her 1 olitical Qr corporal subdivision thereof, aiid to any corporation, partnership, sole proprietorship, Or other business entity, (iii) iii coiitreciioa with any such subrrrission, to deliver -bier deposits or bonds as in.ay be requited and (iv) to execute and deli ter defrnitiv agreements binding Clio Corporation to perform work in accordance - with arty - Proposals and bids authorized hereby." I-"`� Ng —�I. -I .- h n' _r h an d and 'n f _ t' Jl_..�' , 4 11a.a, _ CrCLt - -t0 sei ntj h an d nL fli_ - °eC i_tE COr00_ .iZ sea t -its r -,A ,Antb,ony `�rti y �a _ grc.Etary Sully tVl dler' Confractiu - C:;nr;atEy Federal Aid Project No. ESPL 5358 (012) Project No. NIB 2013 -03 BIDDER: Sully - Miller Contracting Company 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 Bidders name and page number. 2.A BID BOND KNOW ALL MEN BY THESE PRESENTS: THAT Sully- Miller Contracting Company as Principal, and Liberty Mutual Insurance Company , as Surety, are held firmly bound unto the CITY OF 'ROSEMEAD (hereinafter called the OWNER) in the sum of Ten Percent of the Amount Bid - -- ------------------ - - - - -- (g 10% ) , being not less than ten percent (10 %) of the Total 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 Hellman /San Gabriel Intersection Improvements Protect as set forth in the Notice Inviting Bids and accompanying Bid Documents, dated May 8, 2013 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 25th day of April , 2013 Sull - Miller o ractin CMD2ft (SEAL) Liberty Mutual Insurance Company (SEAL) Principal Surety By' By I Signatu Signature Victoria M. Campbell, Attorn in-Fact RAYMOND SANCHEZ, ASSISTANT SECRETARY CBF -5 CALIFORNIA ALL - PURPOSE ACKNOWLEDGEMENT STATE OF CALIFORNIA COUNTY OF ORANGE On April 26, 2013 before me, Adriana C. Treio personally appeared Raymond Sanchez ADRIANA C.TREJ0 Commission # 1991253 a " . . Nolary Public • California z i ( Orange Orange County > My Comm. Expires Oct 13, 2016 who proved to me on the basis of satisfactory evidence to be the person(s) whose name(&) is/are subscribed to the within instrument and acknowledged to me that h er°hahe /they executed the same in hi /her4he'r authorized capacity(ies), and that by his rh°.,,�r/.,,p'h° signature(s) on the instrument the person(s), 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 d,official seal Signature Atlriana C. Trejo, Nota P blic Notary Seal OPTIONAL Description of Attached Document Title or Type of Document: Bid Bond - Signature Page Document Date: April 25, 2013 Number of Pages: 1 Signer(s) Other Than Named Above: None Capacity(ies) Claimed by Signer(s): Signer's Name Raymond Sanchez Signer's Name ❑ Individual ❑ Individual �X Corporate Officer - Title(s) Assistant Secretary ❑ corporate Officer - Title(s) Partner - Limited /General ❑ Partner- Limited /General ❑ Attorney In Fact - Right Thumbprint Attorney In Fact Right Thumbprint of Signer of Signer - Trustee Trustee ❑ Guardian or Conservator ❑ Other Signer is Representing SULLY - MILLER CONTRACTING COMPANY ❑ Guardian or Conservator ❑ Other CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT State of California County of Orange On APR 2 5 2013 DATE before me, Julia Hien NguVen Notary Public NAME, TITLE OF OFFICER - E.G., "JANE DOE, NOTARY PUBLIC" personally appeared Victoria M Campbell , who proved to me on the basis of satisfactory evidence to be the person(s) whose names (s) is /are subscribed to the within instrument and acknowledged to me that he /she /they executed the same in his /her /their authorized capacity(ies), and that by his /her /their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. JULIA HIEN NGUYEN Commleeron s 2008350 WITNESS my hand and official seal. Z , -� Notary Public - Celdorole Is Oreope County SIGNATURE OF NOTARY OPTIONAL Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER ❑INDIVIDUAL ❑CORPORATE OFFICER DESCRIPTION OF ATTACHED DOCUMENT TITLE OR TYPE OF DOCUMENT rITLE(S) ❑ PARTNER(S) ❑ LIMITED ❑ GENERAL ® ATTORNEY -IN -FACT ❑ TRUSTEE(S) ❑ GUARDIAN /CONSERVATOR ❑ OTHER: NUMBER OF PAGES APR 2 5 2013 DATE OF DOCUMENT SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) LibertV Mutual Insurance Company SIGNER(S) OTHER THAN NAMED 1 HIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Certificate No. 595233 American Fire and Casually Company Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That American Fire & Casualty Company and The Ohio Casually Insurance Company are corporations duly organized under the laws of the Stale of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,. and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collective )y called the " Companies'), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Christina Johnson; Erik Johanson; Kim Hereof ,Linde Hotchkiss; Melissa Tetzlaff; Shirley Bauman; Victoria M. Campbell all of the city of Irvine , state of CA each individually if there be more than one named, its true and lawful attorney -in -fact 10 make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 16th day of January , 2013 �pin rArr s 1p�� ,RSUq "'N American Fire and Casualty Company wsU w 9 oa �0� o ^� The Ohio Casualty Insurance Company <' ,906 o o s,s Liberty Mutual Insurance Company West American Insurance Company STATE OF WASHINGTON ss Gregory W. Davenport, Assistant Secretary COUNTY OF KING On this 16th day of January 2013 , before me personally appeared Gregory W. Davenport, who acknowledged himself to be the Assistant Secretary of American Fire and Casualty Company, Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at Seattle, Washington, on the day and year first above written. vN'01Ae` NVV� 2 1 NOiFlRY _ By' = reauc � KD Riley, NotA4 Public This Power of Attorney is made and executed pursuant to and by authority of the following By -laws and Authorizations ofAmerican Fire and Casually Company, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV- OFFICERS- Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such afiomeys -in- fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or atlomey -in -fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE All - Execution of Contracts - SECTION 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation - The President of the Company, acting pursuant to the Bylaws of the Company, authorizes Gregory W. Davenport, Assistant Secretary to appoint such attomeys -in -fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surely obligations. Authorization - By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, David M. Carey, the undersigned, Assistant Secretary, of American Fire and Casualty Company, The Ohio Casually Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power or attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 2S day of lq -)7R(1 - .20 1-3 C� g Ik SL�� L b 1406 1 0� y �o � 1915 � ` jai �o ,,a David M. Carey, Assistant Secretary LMS_12873_092012 157 of 500 BIDDER: SULLY-MILLER CONTRACTI COMPANY 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 serviceto 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 afterthe 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. CBF -6 BIDDER: MILLER CONTRACTI COMPANY 2.B LIST OF PROPOSED SUBCONTRACTORS (continued) C ^Duplicate Nest Pages if needed for listing additional subcontractors."] Name and Location Description of Work of Subcontractor to Subcontracted Name: /'[ 9fi� Lm.�..a�j��..�n- / be (�^��!'� -q�-` Address: t,5 s6 s 1 /a 4 I4&l / - 04 7,0E Name and Location Description of Work of Subcontractor to be Subcontracted Name: VJ� Address: //Os c d ,'l/ Lo y / ��hi Name and Location Description of Work of Subcontractor to be Subcontracted J Name: Sr r Sin Address: 113 C k dry Name and Location Description of Work of Subcontractor to be Subcontracted J / v l / T l S dJ • CJI� �/ l , ��_ Name: 7 [ Address: I -o E Cr't" sx- �p/•o✓�y Name and Location Description of Work of Subcontractor to be Subcontracted I 5 Name: l� Address: Sa„ �T-(', r ti V, /It/ �9 CBF -7 BIDDER:SULLY- MILLER CONTRACTING COMPANY 2.6 LIST OF PROPOSED SUBCONTRACTORS (continued) r*Duplicats Next 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 GBF -7 BIDDER SULLY-MILLER CONTRACTI COMPANY 2 -C The following are the names, addresses and telephone numbers forth ree public agencies for which BIDDER has performed similar work within the past two (2) years: * ** PLEASE SEE ATTACHED REFERENCES *** * ** PLEASE SEE ATTACHED EXPERIENCE & QUALIFICATIONS * ** Name and Address of Owner Name and telephone number of person familiar with project Type of Work Date Completed 2. Name and Address of Owner Name and telephone number of person familiar with project Contract amount Type of Work Date Completed 3. Name and Address of Owner Name and telephone number of person familiar with project Contract amount Type of Work Date Completed 4. Name and Address of Owner Name and telephone number of person familiar with project Contract amount Type of Work Date Completed CBF -8 U FA s; i k_ 3oI1]n Los Aar ge oes a;ne,ralij Dgr(L. edn Ear N -a OMPM s 53ruine, CA Alhambra, CA Larr Serafforao, Fri jc - Eaa °aad aew Assn Adwr iya, Fkc-24 Herat 049-252-527/01 Mo J njn rrontm",) CMC F-ragBraeedng Voratarm, CGS CRIJ W Industry, CA Mark) Estuada, Am:L Comy Engineer John [AWNS, city Engineer 909 -350 -7696 626-333- C. I Segerstromuo / Samth Ceas(� P96r-a Fox Studios Operations COSt01 mesa, CA Beverly Hills, C;\ (Orant uwfls ®ra PVojece Merruproer°. _ - William m urphv j V.P. aa`• Fadikies 2il 4 °54u6- 021730 3:10-369-379 City off Baldwin Park -- Erugr. Dorallocn Baldwin Park, CA Arlan udraarao, Englnenrorvg Pdamm, ger 626 -960 °40211 Ex . 254 BHSV Railroad Commer Rosy Rogers, Consta oora Manager 323 °267 -41 LA Arena Company Staples Center — dos Angeles CA Dora Omvges, Constrarcti on Manager 213-742-7873 (City cff rullerbon rraaller ton, CA George Lin, Project Engineer 714 °738 -6845 This es°ruino Company wewtmrt Beach, Cs Peggy WOOS, SP ®lr �r °SC�ru�trra�o ®ru 949 - 720 -2000 srmurae Coraroraaa.rrawtV Development Comparav Mewuport Beach, CA Bill Martin, Vice Pr��a��uatJC�ra�trann 3uoru 949 °M-800 uobura off Apple VaiRej Apple ?y'ri@leyy, C[l L3e�Gu�urii. l'��9�r•a�ra, �O�s�da [;crglaa�sr ]G0°240- I0 -0 C�9tr °ern Ray Stokes, Regional Lraginee • &1 275 °0211 Cal State Long Heach Foundation Long Beach, CA Mo Tideonaraos, Director 562 - 985 -3489 City of Rancho Cucamonga Rancho Cucamonga, CA Cindy Hackett, Associate Engineer City of Nesperu-01 — PuNicc @fy OO&S DepL Hesperia, CA Mike Podegradz, Cotyy C anmi gee— X700 -947 -1 000 Cony ad Barstoev Darriroey, CA Mh(D Ser- :Xd@r-r;:, U Fragoruw_GY B DDDER'S UL?URNEIIN(m /� 6� D Qua Lunc -a�i rloirn Proicct Name /Number: MEDFORD SIREE / 10030C & 1012881° Year or" Project: 1/2011— 5/2012 Project Description: Project Description: AC — CONCRE TE - SI PIP ING - SIGNALS MAIi CONSTRUC CORPORA=ION Agency Name: LOS ANGELES COUNTY DEPARTT MENT OF PUBI - I C WORKS Contact Person: FAHIM RAIHIMI Telephone: 626 - 458 -3112 Fax: 626- 458 -21_97 Original Contract Amount: $1,961,576 Final Contract Amount: $1,893,032 Change in original contract amount is due to extra work and /or contract change orders adding work. Project Name /Number:. 2010/2011 ANNUAL WATERLINE & SLURRY SEAL JOB/ 11090C & /0128866 Start and Finish Dates: 5/2011 — 3/)012 Project Description:' WATER LINE AND STREET IMPROVEMENTS Agency Name: Criff OF LA HABRA Contact Person: CHUCK STEPHAN Telephone: 562- 905 -7200 Original Contract Amount: $1,507,833 Final Contract Amount: $1,443,408 Change in contract amount is due to items of work: being deleted by the agency. Project Name /Number: TORRANCE BOULEVARD / 28791C Year of Project: - 10/2008 — 05/2010 Project Description: STREET RECONSTRUCTION &ARHMOVERLAY Agency Name: CI TI Y OF I ORRANCE Contact' Person: BETH OVERSTREE-I Telephone: 310 -618 -3074 Fax: 310- 781 -6802 Original Contract Amount: $5,904,267 Final Contract Amount: $6,133,068 Change in original contract amount is due to extra work and /or contract change orders adding work. Project Name /Number: LONG BEACH ANNUAL 2009 / 28810C Year of Project: 01/2009 — 05 -2010 Project Description: AC /ARHM — CONCRETE — BASE — SIGNALS — SURVEY — STRIPING - LANDSCAPE Agency Name: Ci I `( OF LONG BEACH Contact Person: CHARLES RAMEY Telephone: 562 - 570 -5170 Fax: 562 - 570 -5176 Original Contract Amount: $5,000,000 Final Contract Amount: $4,290,000 Annual Contract — work was done on an as needed basis. ProjectName/Number: LACMA PHASE II PAVILION PP.OJECI 28006 / 29820C Year of Project: 02/2009 — 04/2010 Project Description: B PERM-1 T Agency Name: MAIi CONSTRUC CORPORA=ION Contact Person: GREG WADE T elephone , 562 -903 -2277 Fax: 562 903 -2290 133.2='- I?a LER BLD r� :R- 1 rM)KPER,Ei ENCE Am DD Q U /AHi G LC, A� 7TA0M - Original Contract Arnount: $92,507 Final Contract Amount: $420,000 Change in original contract amount is due to e-Ma work acid /or contract change orders adding work. Project Name /Number: LA SOUTHWEST COLLEGE - PARKING LOT 3 / 28795C Year of Project: 09/2005 - 01/2010 Project Description: AC - SASE - CONCRR I E - STPI PING Agency Name: CHEVRON ENERGY SOLUTIONS Contact Person: STEVE PELASYED Telephone: 714 -577 -9374 Fax: 714 -577 -1330 Original ContractAmount: $1,120,315 Final Contract Amount: Change in original contract amount is due to extra work and /or contract change orders adding work. Project Narre/Number: 2007 -2008 PAVEMENT REHABUTATION- 28750C Start and Finish Dates: 6/2008 TO 7/2008 Project Description: AC /ARHM - MANHOLES - SURVEY- STRIPING - COLD MILL Agency Name: Cry OF I IAWAIIAN GARDENS Contact Person: S EEVESTEINBRECHER T elephone: 562 -908 -6200. Fax: 562 - 695 -2120 Original ContraccAmount: $451,112 Final Contract Amount: $456,287 Change in original contract amount is due in extra work and /or contract change orders adding work. Project Name /Number: S I REET PAVING PROGRAM- 28735C Start and Finish Dates: 3/2008 TO 5/2008 Project Description: ARHM - MANHOLES - MONUMENTS - STRIPING - SWPPP- COLD MILL Agency Name: Crf(OFWEST HOLLYWOOD Contact Person: MILA SOLOGUB Telephone: 323 -848 -6338 Fax: 323 -848 -6564 Original Contract Amount: $340,986 Final Contract $315,916 Change in contract amount is due to items of work being deleted by the agency. Project Name /Number: THE LACMA TRANSFORMATION PROJECT- 27662C Start and Finish Dates: 612007 - 10 412008 Project Description: B PERM!! i Agency Name: MAT CONS I RUCTON CORPORA110N Contact Person: GREG WADE Telephone: 562- 903 -2277 Fax: 562- 903 -2290 Original Contract Amount: $912,402 Final Contract Amount: $1,363,596 Change in original contract amount is due to extra work and /or contract change orders adding work. Project Name/Number: CATALINA MEDIA / THE POiNTE- 27732C Start and Finish Dates: 1/2008 TO 3/2008 Project Description: SEWER MAIN INS T ALLA 110N ,) 9D0r ,- [R UOKPERlsUJ-'CE4AND QUALMC.AUMIMF' Agency Narne: KR ISMAR CONSTRUCTrON COMPANY, INC. Contact Person: GARY MORRISON Telephone: 310 -458 -3170 Fax: 310-458-9063 Original ContrzctAmounr: $315,955 Final Contract Amount: $411,955 Change in original contract anount is due to extra wort: and /or contract change orders adding work. Project Narne /Number: PACIFIC ELEC RIC INLAND TRAIL PHASES 2 & 3 / 27653C Stan and Finish Dates: 3/07 TO 1/08 Project Description: R/R CONCRETE /AC — LANDSCAPE /IRRIGA i ON — SIGNALS — STRIPE - U T iLi T IES Agency Name: CITY OF RANCHO CUCAMONGA Contact Person: WALTER S I CKNEY Telephone: 909 -477 -2740 Fax: 909- 477 -2746 Original Contract Amount: $3,424,7131 Final Contract Amount: $3,424,780 Change in original contract amount is due to extra work and /or contract change orders adding work. Project Afame /Number: MARQUARDT AVENUE / 27689C Start and Finish Dates: 7/2007 TO 9/2007 Project Description: R/R CONCRETE — AC ON FABRIC — ADJUST U T iLTiES Agency Name: LOS ANGELES COUN I Y DEPT . OF PUBLIC WORKS Contact Pelson: EMIL KURLYAND Telephone: 626 - 458 -3166 Fax: 626- 458 -2197 Original Contract Amount: $183,915 Final Contract Amount: $163,915 projectName/Nmnber: ALPACA STREET IMPROVEMENT PROJECT /27699C Start and Finish Dares: B/2007 TO 11/2007 Project Description: R/R CONCRETE & ASPHALT — STRIPING — ADJUST UTILITIES Agency Name: Cii IY OF SOUTH EL MON T E Contact Person: GEORGE CAS i iLLO Telephone: 562 -682 -3620 Fax: 562- 684 -0130 Original Contract Amount: $135,000 Final Contract Amount: $167,074 Change in original contract amount is due to extra work and /or contract change orders adding work. Project Name /Number: REHABILiTATON OF LA MIRADA BLVD. / 27664C Start and Finish Dates: 5/2007 TO 9/2007 Project Description: ARHM / AC PAVING, CONCRETE WORK— LOOP DETECT ORS / SIGNALS Agency Name: CITY OF LA MIRADA Contact Person: GARY SANUT Telephone.• 562 -943 -2385 Fax: 714522 -5300 Original Contract Amount: $2,164,089 Final Contract Amount: $2,575,166 Change in original contract amount is due to extra work and /or contract change orders adding work. Project Narne /Number: CSUI B PARKING LOT 13 REPAI R — REPAVE / 27694C Saari and Finish Dates: 7/2007 TO 8/2007 _� ._ _[3ir DD? LZ° r!, CPEUirg[McC E AND QUAL-ifflu AuhoHS Agency Name: CALIFORNIA S CAT E UNIVERSITY, LONG BEACH Contact Person: ENRIQUE ROBLES Telephone: 562 - 985 -0175 Project Description: Fax: 562 -985 -2308 original Contract Announi: $375,823 Filial Contract Amount: $380,572 Change in original contract amount is due to extra wort: and /or contract change orders adding work. Project ORANGE LINE - CANOGA STATION PARK AND RIDE / 25568C Start and Finish Dates: 312006 TO 1/2007 Project Description: NEW TRANSPORTATION STATION INCLUDING AC PAVING &CONCREI E WORK Agency Name: MET ROPOIT Y AN TRANSPORAi10N AUTHORi l Y Contact Person: GHULAM SIHAIKH Telephone: 818 - 262 -6300 Fax: 213- 922 -7384 original Contract Amount: 13,732,500 Final Coniract Amount: $12,415,392 Change in Contract amount is due to items of work being deleted by the agency. Project Name/Number: SOUTH COAST PLAZA PARKING LOT/26608C Start and Finish Dates: 712006 TO 10/2006 Project Description: COMPLETE REMOVE AND REPLACE OF PARIING LOT, CONCRE HE CURB & GUTTER, LOOP DETECTORS, AND STRIPING Agency Name: SOUTH COAST PLAZA Contact Person: ROBERT THOMAS Telephone: 710 -506 -0110 Fax: 714546 -9835 Original Contract Amount: $3,100,009 Final ContractAmount: $3,932,226 Change in original contract amount is due to extra work and /or contract change orders adding work. Project Name /Number: RESIDEN I IAL STREET REHABILIIA i ON WORK / 26573C Start and Finish Dates: 2/2006 to 8/2006 Project Description: ASPHALT CONCRET E OVERLAY A T VARIOUS LOCATIONS CITYWIDE Agency Name: CI — I Y OF WEST COVINA Contact Person: OSCAR CAPLN Telephone: 626 - 939 -8445 Fax: 626 -939 -8660 Original Contract Amount: $1,430,888 Final Contract Amount: $1,512,463 Change in original contract amount is due to extra work and /or contract change orders adding work. Project Name/Number: BERT H 401 -406 BACIKLAND IMPROVEMENTS / 25567C Star - and Finish Dates: 112006 to 1/2006 Project Description: ASPHALT AND CONCRETE PAVING / SUE E IMPROVEMENT PROJECT Agency Name: PORT OF LOS ANGELES Contact Person: KEN HARBOR Telephone: 310- 831 -5389 Fax: 310 -331 -5389 Original Coniract Amount: $3,286,800 Final Contraci Amount: $3,386,333 Change in original contract amount is due to extra work and /or contract change orders adding work. Project Name /Number: 195 S I P F IMPROVEMENT / 25506C Start and Finish Dates: 5/2005 to 11/2005 Project Description: MEDIAN ISLAND and STREET REP AIRS Agency Name-: Cif OF CERRT Contact Person: VICMASAYA Telephone: 562- 916 -1231 Fax: 562 -916 -1371 Original Contract Amount: $862,370 Final ConiractAmount: $742,488 Project Name/Nmnber: MALL PARKING LOT IMPROVEMEN I S / 25492C Start and Finish Dates: 3/2005 to 10/2005 Project Description: REPAIR and PLACE NEW AC PAVING and STRIPE PARKING STALLS Agency Name: CITY OF TEMPLE CITY Contact Person: JANICESTROUD Telephone: 626- 285 -2171 Far,: 909 -594 -2858 Original Contract Amount: $828,837 Final Contract Amount: $894,012 Change in original contract amount is due to extra work and /or contract change.orders adding work. Change in contract amount is due to items of work being deleted by the agency. Project Name /Number: HELLMAN AVENUE STREE T IMPROVEMENTS / 24477C Stan and Finish Dates: 6/2004 to 11 /2005 Project Description: STREET RECONSTRUCilONPROJECT Agency Name: Ci i ( OF ROSEMEAD Contact Person: KEN RUKABINE Telephone: 562 -908 -6262 Far,: 562 -695 -2120 Original ContractAmount: $1,051,667 Final Contract Amount: $1,067,429 Change in original contract amount is due to extra wort: and /or contract change orders adding work. Project Afame /Number: HOLGA I E AREA STREET REHABILTA Nu ON AND WATER MAIN / 24446C Start and Finish Dates: 3/2004 to 6/2005 Project Description: STREET REHABLITATTON AND WATER MAIN REPLACEMENT Agency Name: CITY OF LA HABRA Contact Person: CHUCK STEPHAN Telephone: 562 -905 -9720 Fax: 562 - 905 -96,3 Original Contract Amount: $2,996,461 Final ContractAmouni: $3,566,942 Change in original contract amount is due to extra work and /or contract change orders adding work. Project Name /Number: PIER 400 BACKLANDS PHASE 2 / 23301C Scar and Finish Dates: 4/2003 to 8/2004 ProjectDescrip_rion. TRANST All NER FACT PIT Y, GRADING, PAVING, UNDERGROUND, CONCRETE. PROJECT FINISHED ON TIME - ERA DAYS FOR ERA WORK ONLY Agency Name: PORT OF LOS ANGELES Contact Person: MAHMOUD Telephone-: 310 - 732 -3525 Fax: 310 -831 -5389 original Contract Amount: 30,618,798 Final Contract Amount: $30,030,429 Change in contract amount is due to iLcrns of work being deleted by agency. Project Name /Number: PHANTOM WEST S RFL IMPROVEMENT/ 82803C mgm Su1LTYJMa 1.F QIDDEF � IEr�D YL rc m(Crz f vi o uc\ LsFi!((- — If J-10H5 Stan and Finish Dates. 12/ 2002 to 8/ 2003 Project Description: UNDERGROUND, ASPHALT REHAB, CURB & GUTTER, COLD Mi LL Agency Name: CiiYOFViCTORViLI_E Contact Person: MARK MILLER Telephone: 760- 955 -9158 Fax: 760 -955 -5159 original Contract A,mounr: $4,771,477 Firal Contract Amount: $4,9 94,840 Project Afame /Number: ARROW HIGHWAY - LIVE OAK AVENUE PHASE 11 / 22273C Sta t and Finish Dates: 11/ 2002 to 8/ 2003 Project Description: AC GRIND OVERLAY — NEW MEDIANS 8& DECORATIVE CONCRET E Agency Name: C1 f f OF IRWINDALE Contact Person: KWOK T AM Te lephone: 626- 430 -2212 Fax: 626- 962 -2018 Original Contract Amount: $4,289,147 Final Contract Amount: $4,654,815 Change in original contract amount is due to extra work and /or contract change orders adding work. Change in original contract amount is due to extra work and /or contract change orders adding work. Project Name/Number: PIER 400 CONTAINER TERMINAL / 21130C Staff and Finish Dates: 1/ 20011 to 9/ 2002 Project Description: BACKLAND IMPROVEMENTS, PHASE I Agency Name: PORT OF LOS ANGELES Contact Person: MAHMOUD ISHEID Telephone: 310 -732 -3525 Fax: 310 -831 -5389 Original Contract Amount: $78,134,500 Final Contract Amount: $74,226,254 Change in contract amount is due to items of work being deleted by agency. S'() - 0 5i N41):i,I -FR t'c,NTR-Y.C'riP.lE Co. P"D R030C - u s Iu'9 VIM 1ING H 7�.Avmv 5 u OR4uli DRAHl(N, Sr�rgrcR , A jM IP9Ai1 r�-G3 RV-JPG3oV[F:MrcR71 Projc -c Name /Nurnbcr: FOSTER PARK, VALLEY VIEW AVE / FOSTER ROAD / 29891C Year of Projeci: 02/2010 - 01/2011 Projeci Description: R/R STREETS, (A,C /CMB /CAG), STORM DRFl/N IMPROVEMENTS Agency Name: C Y OF LA M I RADA Contact Person: GARY SANUI Telephone: 562- 349 -2727 Fax: 562 -943 -1464 Original Contract Arnount: $2,143,000 Final Contract Amount: $3,075,872 Change in original contract amount is due to extra work and /or contract change orders adding work. Project Name /Number: OFFSi 1 E EUCLID STREET IMPROVEMENTS / 28803C Year of Project: 11 /2008 - 05/2010 Project Description: OFFS1 i E IMPROVEMENTS, STORM DRAIN, ELECTT RICAL, AC PAVING, CONCRET E IMPROVEMENTS Agency Name: WATSON LAND COMPANY Contact Person: ROBERT DEBERARD Telephone: 310- 952 -6429 Fax: 310 -522 -8785 Original COntractAmoun : $4,083,052 Final Contract Amount: $3,849,675 Change in original contract amount is due to extra work and /or contract change orders adding work. Project Arame /Number: VALLEY WAY / ARMSTRONG ROAD / 27680C Year of Project: 0112007 - 01/2009 Project Description: PCP, STORM DRAIN, STRUC I URES, MANHOLES, AC /ARHM, CONCRETE IMPROVEMENTS, BASE, ELECTRICAL, STRIPING Agency Name: COUNT Y OF RIVERSIDE Contact Person: STAN DERV Telephone: 9S1- 955 -6785 Fax: 951 -955 -3164 Original Contract Amount: $4,813,000 Final Contract Amount: $6,190,475 Change in original contract amount is due to extra work and /or contract change orders adding work. Project Name/Number: DOUGLAS PARK S T REEF 1MPROVEMEN T S AND INFRASTRUCTURE / 26595C Year of Project: 03/2006- 07/2007 Project Description: INFRASTRUCTURE - SEWER, WATER, STORM DP.A1N Agency Name: BOENG REALTY CORPORA I10N Contact Person: SIEVE GARIS Telephone: 562 -593 -4730 Fax: 714 -850 -0086 Original Contract Amount: $11,256,511 Final Contract Amount: $19,932,964 Change in original contract arnount is due to ex -ra work and /or con change orders adding work. INA ig,S.k -EI ce'. Project Name/Number: PORTOLA SPRINGS AND MODJESKA / 255342 Fear of Project: 04/2005 - 06/2006 Project Description: SEWER, WATER, SI ORM DRAIN IMPROVEMENTS Agency Name: TP.VSNE COMMUNITY DEVELOPMENT COMPANY Contact Person: B - 1 LL MAP I IN Telephone: 714 734 -8100 Fax: 949 - 0 ,64 -9715 Original Contract Amount: $8,625,848 Final Contract Amount: $9,602,943 Change in original contract amount: is due to extra work and /or contract change orders adding work. MOM SIII,I, x-LrI Co. SPHPALT RUS B EfHZE-D Fro u mm( (amm) G� 0iimc u Project Name /Number: Star and Finish Dates: Project Description: Agency Afame: Con'tac't Person: ANNUAL OVERLAY PROGRAM / 27697C 8107 10 7/08 ARHM OVERLAY — CONCRE I E (CB:G, SIDEWALK, DRIVEWAY) - LOOPS Cif( OF CARSON P.1 CK BOLL I ROS Telephone: 310- 952 -1700 ext. 1830 Project Value: $2,397,755 Project Name/Number: 2006 -2007 MAJOR AR 71 ERiAL OVERLAY PROJECT / 27681C Start and Finish Dates: 7/07 TO 1/08 Project Description: ARHM OVERLAY — CONCRETE Si DEWALK /RAMPS — LOOPS — S I P?P?NG Agency Name: CITY OF COMP I ON Contact Person: CHARLES BERGSON Telephone: 310 -605 -5696 Project Value: $1,846,709 Project Name /Number: NORMANDIE AVENUE — STPL- 5953(451) / 26647C Start and Finish Dates: 3107 10 9/07 Project Description: ARHM /AC PAVE — LANDSCAPE — CONCRETE — Si GNALS /L GH 11NG /LOOPS Agency Name: LOS ANGELES COUN I Y — DEPT. OF PUBLIC WORKS (LACDPW) Contact Person: EMILKURLYAND Telephone: 626 - 458 -3166 Project Value: $2,713,186 SU R ( -M Ii 3.E R CC:NTR-A_CIING C,G°. uce��z 7nis �aa 135 S. STATE COLLEGE (BLVD., SUITE 400 o 3PEA, CA 92821 o PHONE 71'!- 5%39600 Pavement Preservation References; Job No Job Value Description Owner Contact 298B1c 106,411 AC paving, sealcoat and re- Kinder Morgan David Lennon stripe Carson Facility 310 -251 -GS93 29875c 257,093 Coldmill, AC overlay, sealcoat Pratt Whitney Jeff Stern and restripe the North this Rocketdyne 818- 585 -6801 at the DeSoto Facility, CA 29869c 266,286 AC paving, sealcoat and restripe Swlnerton Raj Ramanathan Salvation Amry parking lot Builders 213 -4Q -4585 in Anaheim, CA, 29853c 78,467 AC paving, sealcoal and re- Hathaway- Rena Contreras stripe parking lots at The Dinwiddle 562 -944 -9331 Buckley School. 28815t 280,472 AC paving, sealcoat and restripe _ Jorgensen Bill Vim Toyota Airlite I erminal at 925 244 -1203 - Long Beach Airport, CA. 28792c 369,575 AC repairs, sealcoat Et restripe Toyota Logisistirs Jon Keller Port of Los Angeles, CA. 714- 336 -2409 27686c 369,931 AC /PCC repairs, sealcoat and Pratt Whithey Mike Daley rest iping at two facilities In Rocketdyne 818 -586 -9052 Canoga Park, CA. 27675c 623,996 AC /PCC repairs, sealcoat and The Boeing Wayne Holt restriping at three facilities in Company 562- 497 -4284 Anaheim, Hunt ngton Beach, and Seal Beach, CA, 23293c 327,946 South Coast Drive Realignment CJ Segerstrom Grant Wilson included Type II Road Slurry & Sons 714- 438 -3276 W/2% Latex 23292c 2.66,922 Harbor Blvd realignment CI Segerstrom Grant Wilson included Type II Road Slurry &Sons 714- 438 -3276 w /2% Latex 22277c 1,450,716 South Coast Drive Realignment CJ Segerstrom Grant Wilson included Type1I Road Slurry &Sons 714 -435 -3276 42% latex BIDDER: SULLY - MILLER CONTRACTI COMPANY NON - COLLUSION AFFIDAVIT CBF -9 BIDDER SULLY-MILLER CONTRACTIN COMPANY 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 anymember or agent thereof to effectuate a collusive or sham bid. n N n Signature RAYMOND SANCHEZ Typed or Printed Name ASSISTANT SECRETARY Title SULLY - MILLER CONTRACTING COMPAN Bidder * ** PLEASE SEE ATTACHED NOTARY JURAT FOR PROPER WORDING * ** Subscribed and sworn before me This _ day of , 20_,_,_ (Seal) Notary Public in and for the State of California My Commission Expires: CBF -10 CALIFORNIA JURAT WITH AFFIANT STATEMENT STATE OF CALIFORNIA l COUNTY OF ORANGE J j Subscribed and sworn to (or affirmed) before me on this 26th day of April 2013, by Raymond Sanchez proved to me on the basis of satisfactory evidence to be the person who appeared before me. AORIANA C. TREJO Commission # 1991253 Notary Public - California z Orange County ? WITNESS my hand d official seal My Comm. Expires Oct 13. 2016 , Signature T driana C. Trejo, No ri ublic Notary Seal OPTIONAL Description of Attached Document Title or Type of Document: Non - Collusion Affidavit - Signature Page Document Date: Signer(s) Other Than Named Above: ❑ Individual Capacity(ies) Claimed by Signer(s): Signers Name Raymond Sanchez Signers Name Individual OX Corporate Officer — Title(s) Partner — Limited /General ❑ Attorney In Fact Trustee Guardian or Conservator Other Signer is Representing: Assistant Secretary 0 Corporate Officer — Title(s) 2013 None Number of Pages: 1 Right Thumbprint of Signer ❑ Partner— Limited /General Attorney In Fact Trustee Guardian or Conservator Other SULLY - MILLER CONTRACTING COMPANY Right Thumbprint of Signer CITY OF ROSEMEAD HELLMAN /SAN GABRIEL INTERSECTION IMPROVEMENTS PROJECT CITY OF ROSEMEAD HELLMAN /SAN GABRIEL INTERSECTION IMPROVEMENTS PROJECT The Bidder shall list the name and address of each subcontractor to whom the Bidder proposes to subcontract portions of the work, as required by the provisions in Section 2 -1.01, "General," of the special provisions. EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder SULLY - MILLER CONTRACTING COMPANY , proposed subcontractor ************************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** hereby certifies that he has X has not _, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former Presidents Committee on Equal Employment Opportunity, ail reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60- 1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60 -1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt) Currently, Standard Form 100 (EEO -1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60- 1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. EEOC -1 CITY OF ROSEMEAD HELLMAN /SAN GABRIEL INTERSECTION IMPROVEMENTS PROJECT Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the City of Rosemead, Los Angeles County DEPARTMENT OF PUBLIC WORKS. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares 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. Note: The above Noncollusion Affidavit is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. NA -1 CITY OF ROSEMEAD HELLMAN /SAN GABRIEL INTERSECTION IMPROVEMENTS PROJECT DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he /she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: • is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agency; • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted, convicted, or had a civil judgement rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Certification. DSC -1 CITY OF ROSEMEAD HELLMAN /SAN GABRIEL INTERSECTION IMPROVEMENTS PROJECT NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or bid, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or bid that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. 1010101 CITY OF ROSEMEAD HELLMAN /SAN GABRIEL INTERSECTION IMPROVEMENTS PROJECT DISCLOSURE OF LOBBYING ACTIVITIES 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ❑ a. contract N/A Fla- hid /offer /aonlicatinn N/A ❑ a_ initial N/A b. grant b. initial award b. material change G_ cooperative agreement c. post -award d. loan For Material Change Only: e. loan guarantee year _ quarter f. loan insurance date of last report 4. Name and Address of Reporting Entity N/A 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier _ , if known N/A Congressional District, if known S. Federal Department/Agency: N/A Congressional District, if known 7. Federal Program Name/Description: N/A 8. Federal Action Number, if known: N/A CFDA Number, if applicable 9. Award Amount, if known: N/A 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual, last name, first name, MI) address if different from No. 10a) (last name, first name, MI) N/A N/A (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) N/A 13. Type of Payment (check all that apply) N/A $ actual planned a. retainer b. one -time fee 12. Form of Payment (check all that apply): N/A c. commission B a. cash d. contingent fee b. in -kind; specify: nature a deferred value I. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: N/A (attach Continuation Sheet(s) if neces ) 15. Continuation Sheet(s) attached: N /AYes ❑ No 16. Information requested through this form is authorized by Tide 31 U.S.C. Section 1352. This disclosure of Signature: lobbying reliance was placed by the tier above when his transaction was made or entered into. This disclosure is Print Name: RAYM ND SANCHEZ required pursuant to 31 U.S.C. 1352. This information will be reported to Congress semiannually and will be ASSISTANT SECRETARY available for public inspection. Any person who fails to Title: file the required disclosure shall be subject to a civil 714/578 -9600 penalty of not less than $10,000 and not more than Telephone No.: Date: $100,000 for each such failure. Federal Use Only: Authorized for Local Reproduction Standard Form - LLL CALIFORNIA ALL - PURPOSE ACKNOWLEDGEMENT STATE OF CALIFORNIA COUNTY OF ORANGE On April 26, 2013 before me, Adriana C. Treio personally appeared Raymond Sanchez who proved to me on the basis of satisfactory evidence to be the personks) whose name(s) isAare subscribed to the within instrument and acknowledged to me that he kAe" executed the same in his /h „e :„'er° authorized capacity(ies), and that by his !herfthe signature(&) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. ADRIANA C. TREJO I certify under PENALTY OF PERJURY under the laws of the co a 199 = State of California that the foregoing paragraph is true and Z ; `o Notary ary Public - rni California z Z Orange County > correct. My Comm. Expires Oct 13, 2016 WITNESS my hand and official seal Signature l - T riana C. Trejo, Notary P I' Notary Seal OPTIONAL Description of Attached Document Title or Type of Document: Disclosure of Lobbying Activities - Signature Page Document Date: April 25, 2013 Number of Pages: Signer(s) Other Than Named Above: None 1 Capacity(ies) Claimed by Signer(s): Signer's Name Raymond Sanchez Signers Name Individual Corporate Officer - Title(s) Partner — Limited /General ❑ Attorney In Fact ❑ Trustee Guardian or Conservator Other Signer is Representing: ❑ Individual Assistant Secretary ❑ Corporate Officer - Title(s) Right Thumbprint of Signer SULLY - MILLER CONTRACTING COMPANY ❑ Partner — Limited /General Attorney In Fact Trustee Guardian or Conservator Right Thumbprint of Signer ❑ Other INSTRUCTIONS FOR COMPLETION OF SF -LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.G. section 1352. The fling of a form is required for such payment or agreement to make paymentto lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial fling and material change report. Refer to the implementing . guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and /or has been secured to Influence, the outcome of a covered Federal action. 2. lden6fy the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow -up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards Include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks " Subawardee" then enter the full name, address, city, state and zip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, ff known. For example, Department of Transportation, United States Coast Guard. 7- Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP- DE- 90 -001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award /loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in Rem 4 to influenced the covered Federal action. (b) Enter the full names of the individual(s) performing services and Include full address If different from 10 (a). Enter Last Name, First Name anr) Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (Rem 4) to the lobbying entity (Item 10). Indicate whether the payment has been made (actual) orwill be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment Is made through an in -kind contribution, specify the nature and value of the in -klnd payment 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any servlces rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing Instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. $end comments regarding the burden estimate or any other aspect of this collection of Information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0346 -0046), Washington, D.C. 20503_ SF- LLL - Instructions Rev. 06- 04- 90aENDIFn CITY OF ROSEMEAD HELLMAN /SAN GABRIEL INTERSECTION IMPROVEMENTS PROJECT