Excel PavingCITY OF ROSEMEAD
ANNUAL RESIDENTIAL RESURFACING PROJECT
MUSCATEL AVENUE
FROM GRAND AVENUE TO MARSHALL AVENUE
PROJECT No. 21846
CONTRACT BID FORMS
VALP, EMMA
BIDDER: '?4;l €aril-,, p"Wo A !
SECTION 9 - BID SIGHEDULE
CBF -0
BIDDER: MUL 11 PAING COMMY
CONTRACT BID FORMS
TABLE OF CONTENTS
SECTION 1 BID SCHEDULE ......... .. .............................................. .. ............... ............ ............... 1
SECTION 2 BID DATA FORMS ................................................................... ............................... 5
2.A BID BOND ................................................................................. ............................... 6
2.13 LIST OF PROPOSED SUBCONTRACTORS .......................... ............................... 7
SECTION 3 NON - COLLUSION AFFIDAVIT .............................................. ............................... 10
PALP. WC.DBA
BIDDER: EXCEL PAVING C" AW
BID SCHEDULE
SCHEDULE OF PRICES FOR
ANNUAL RESIDENTIAL RESURFACING PROJECT
MUSCATEL AVENUE
FROM GRAND AVENUE TO MARSHALL AVENUE
PROJECT No. 21846
BASE BID SCHEDULE
CBF -1
UNIT OF
EST.
UNIT
ITEM
NO.
ITEM DESCRIPTION
MEASURE
QTY.
PRICE
COST
1
Clearing & Grubbing per plans
LS
1
and specifications. See technical
provisions TP -2, TP -3 & TP4.
3Suo0-
ySoo� —
2
Disposal of Waste Materials.
LS
1
5'00-
$3"DD —
3
Cold mill 2.0- inches thick existing
SF
208,172
pavement.
0•Z0
-F1(,93N-`f0
4
Construct 1.5 inches thick
TONS
1,950
pavement overlay ARHM -GG-C
(PG 64 -16) as indicated on the
plans.
1735-5-0-
5
Construct 0.5 inches thick
TONS
655
Asphaltic Leveling course D1
(PG 64 -10) as indicated on the
plans.
2 '
100 21&0
6
Remove, Dispose and Construct
SF
6,755
4- inches thick PCC Sidewalk per
SPPWC Std. Plan 113 -1.
5•
3S`llb3. S
7
Remove, Dispose and Construct
SF
2,350
PCC Driveway Approaches per
SPPWC Std_ Plan 110 -2.
7. SO
11625-
8
Remove, Dispose and Construct
LF
1,214
8- inches Curb and 24- inches
Gutter per SPPWC Std. Plan
120-2.
Sqj
] 16Z(o
9
Remove, Dispose and Construct
LF
200
8- inches PCC Curb Only per
SPPWC Std. Plan 120 -2.
Z7-
10
Remove, Dispose and Construct
SF
416
PCC Cross Gutter per SPPWC
Std. Plan 123 -2,
1N—
CBF -1
1;
C EE FJ Bd J NI. . W
TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ j y�P�I �T �� 15
fiW- {tvridred hen SI 010afaiq pt fur hvna/ned �r/Pnt .a / y1'e f
14D110 s /,1� '
Dollar amount in written form
Note: The City of Rosemead reserves the right to reduce or increase the quantities of any items in
the schedule of 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 " bond in the amount of
Dollars ($ said amount being not less than ten percent (10 %) of the Total
�OF AMOUNT BID`
CBF -2
UNIT OF
EST.
UNIT
ITEM
NO,
ITEM DESCRIPTION
MEASURE
QTY.
PRICE
COST
11
Remove, Dispose and Construct
EA
20
PCC Curb Ramps per SPPWC
Std. Plan 11111.
2 oo —
LtVOOD
12
Double Adjust Sewer Manhole to
EA
30
Grade per APWA Std. Plan 205-
1 and 206-1.
(003-
2[610-
13
Adjust Water Valve /Gas Valve to
EA
29
Grade.
H71—
l3ioSq-
14
Install Survey Well Monument
EA
16
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 at no cost).
3
S
15
Install Traffic Striping, Traffic
LS
1
Signal Loops and Pavement
Markers per the Striping Plans
and Specifications Complete.
5706
TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ j y�P�I �T �� 15
fiW- {tvridred hen SI 010afaiq pt fur hvna/ned �r/Pnt .a / y1'e f
14D110 s /,1� '
Dollar amount in written form
Note: The City of Rosemead reserves the right to reduce or increase the quantities of any items in
the schedule of 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 " bond in the amount of
Dollars ($ said amount being not less than ten percent (10 %) of the Total
�OF AMOUNT BID`
CBF -2
i -
Bid Price. The undersigned agrees that said amount shall be retained by the Owner if, upon award,
we fail or refuse to execute the Contract and furnish the required bonds, certificates and
endorsements of insurance and other certifications within the time provided.
If awarded a Contract, the undersigned agrees to execute the formal Contract, which will be
prepared by the Owner for execution, within five (5) Calendar Days following the Letter of Award for
the Contract, and will deliver to the 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 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.
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
MMMMM�
By:
Signature
C.P. RROYIN, PRESIDENT
Type or Print Name
Title
Bidder's /Contractor's State of Incorporation:
Partners or Joint Venturers:
Bidder's License Number(s):
NOTES:
2230 L BON AVENUE
LONG 9FACH, CA 90806
Business Street Address
City, State and Zip Code
15621599 -5841
Telephone Number
CALIFORNIA
STATE LIC. 688659 W
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
CERTIFICATE OF ACKNOWLEDGMENT
State of California
County of LL c Angel _
On813 - -_ before me, C Phillips Notary Public
(Hera msal rtune and IUe of the offer)
personally appeared
who proved to me on the basis of satisfactory evidence to be the personal whose name(a9) is /= subscribed to
the within instrument and acknowledged to me that he%ahl*agerexecuted the same in his&mAheis authorized
capacityQtO, and that by his/FteilA& signature(3) on the instrument the person(), or the entity upon behalf of
which the person(s) acted, executed the instrument.
I certify under PENALTY OF PEFJLJRY under the laws of the State of California that the foregoing paragraph
is true and correct.
C. PHI. LIPS
CCMM. #]99 •+
WI 'NESS my hand and official seal. a - r Notary Public- California u
:T -
LOS AN6ELE5 COUNTY
yt , MY Comm. Fxpresoa 29,2016
l l'r Vl (Notary Seal)
ADDITIONAL OPTIONAL INFORMATION
INSTRUCTIONS FOR COMPLETING THIS FORM
Any "Anowledgmera completed in Cuhfornda moll contain verbiage exactly ar
appears acme in she notary section or a separate achwwledgmem form must be
properly completed and attached to that document. The only exception u if a
document is to be recorded outside of California 11 such dmlonees, any allecrue"ve
acknowledgment verbiage ar may be primed on such a document so long ar the
verbiage does not require the nolory t do something dial it illegal for a notary in
Calfomta (i.e. eeridfydng the authorized capacity of the signer). Please check die
document carefdlyfor proper nomrid wording and attach this form ifrequlred
DESCRIPTION OF THE ATTACHED DOCUMENT
(Title or description of attached document)
(Title or description of attached document continued)
Number of Pages _ Document Date
(Additional information)
CAPACITY CLAIMED BY THE SIGNER
❑ Individual (s)
❑ Corporate Officer
(rifle)
❑ Partner(s)
• Attorney -in -Fact
• Trustee(s)
❑ Other _
• Slaw and County information must be the State and County where the document
signer(s) personally appeared before the notary public for acknowledgment.
• Date of notarization must be the date Ihat the signer(s) Personally appeared which
must also be the same date the acknowledgment Is completed.
• The notary public most print his or her time as it appears within his or her
commission followed by a comma and then yam tide (notary public).
• Print the narne(s) of document signer(s) who personally appear of the time of
notarization.
• Indicate the correct singular or plural forms by crossing off incorrect forms (i.e.
helsheithey,- is fore ) or circling the correct forms. Failure to correctly indicate this
information my lead to rejection of document rceording.'
• The not" seal impression must be clear and photographically reproducible
Impression most nor cover text or lilies. If seal impression smudges, re -scul if a
sufficient area permits, otherwise complete a different acknowledgment form.
• Signature of the notary public must match the signature on file with the offlcc of
the counly clerk.
Additional udonnmion is not required but could help so ensure this
acknowledgment is not misused or attached to a different document.
Indicate title or type of attached docmnent number of pages and date.
Indicate the capacity claimed by the signer. if die claimed capacity is a
corporate officer, indicate the tide (i.e. CEO, CFO, Secretary).
• securely attach this document to the signed document
2008Versioti CAPAv12 .1007800- 873 -9865 \NVw.Nolaf}'ClnssCS.[91n
RESOLUTION DECLARING OFFICERS OF
PALP, INC. DBA EXCEL PAVING COMPANY
The undersigned, Curtis P. Brown, as the sole shareholder and the sole member of
The Board of Directors of PALP, Inc., a Corporation organized under The General
Corporation Law of California, does by this written consent take the following action and
adopt the following resolutions:
Resolved, the following Officers of the Corporation are hereby elected to serve in
the offices set forth after their respective names effective as of execution hereof with their
respective terms to continue until their successors are duly elected and qualified:
Curtis P. Brown
Curtis P. Brown III
Bruce E. Flatt
George R. McRae
Marcia S. Miller
Michele E. Drakulich
President and Chief Executive Officer
Vice President and Chief Operating Officer
Vice President and Chief Financial Officer
Vice President
Secretary
Assistant Secretary
The consent is executed pursuant to Section 307(B) and 603 of the Corporation
Code of the State of California and the By -Laws of this Corporation, which authorize the
taking of action by The Board of Directors and Shareholders by unanimous consent
without a meeting.
Dated: January 27, 2010 CJ
is is 1P. town- Shazeho er
And Sole Director
PT%W. INC.D®A
BIDDER: EXCEL. PAIANG
SECTION 2
BID DATA FORMS
CBF -5
BIDDER: PALP Inc. dba Excel Paving Comp
Bidder shall submit its Bid data in accordance with the format shown on each of the following Bid
Data Forms. Bidders shall prepare and use as many sheets as are necessary to adequately provide
the information required. Bidder shall ensure that every page of its Bid Data Forms are properly
identified with the Bidder's name and page number.
2.A BID BOND
KNOW ALL MEN BY THESE PRESENTS:
THAT PALP Inc. dba Excel Paving Company as
Principal, and Federal 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 total amount of the bid
($ 10% ) , being not less than ten percent (10 %) of the Total
Bid Price; for the payment of which sum will and trulyto be made, we bind ourselves,
our heirs, executors, administrators, 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 Annual Residential Resurfacing Project – Muscatel Avenue
From Grand Avenue to Marshall Avenue as set forth in the 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, furnishes the required bonds (one to guarantee faithful performance
and the otherto 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 24th day of July 20 13
PALP Inc. dba Excel Paving Company (SEAL) Federal Insurance Company (SEAL)
Principal Su ty
By: —�I By:
Signature Signatu Douglas A. pp
C. P, BRt VIN, PRESIDENT Attorney in Fact
CBF -6
ACKNOWLEDGMENT
State of California
County of Orange
On 07124/2013 before me, Debra Swanson, Notary Public
(insert name and title of the officer)
personally appeared Douglas A. Rapp
who proved to me on the basis of satisfactory evidence to be the person(49) whose name($) is/afe
subscribed to the within instrument and acknowledged to me that he%heffhey executed the same in
his / herflheir authorized capacity(iea), and that by hisAsAheir signature($) on the instrument the
person(8), or the entity upon behalf of which the person(jr) 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 seat. ��F' F, DEEtRA SWANSON
p m COMM. # 1997119 X
® g NOTARY PUBLIGCALIFORNIAM
ORANGE COUNTY N
MY COMM. EXP. NOV 10, 20%
Signature � �a �e�nnR� nnl�rnn (Seal)
Chubb POWER Federal Insurance Company Attn: Surety Department
OF Vigilant Insurance Company 15 Mountain View Road
Surety ATTORNEY Pacific Indemnity Company Warren, NJ 07059
Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE
COMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and
appoint Douglas A. Rapp and Timothy D. Rapp of Aliso Viejo, California --------- — ------ _- _- _ --- _ --- _ --------------- ----
each as their true and lawful Attorney- in- Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety
thereon or otherwise, bonds and undertakings and other writings obligatory in the nature thereof (other than bail bonds) given or executed in the course of business, and any
instruments amending or altering the same, and consents to the modification or alteration of any instrument referred to in said bonds or obligations.
In Witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested
these presents and affixed thercorporete seals on this 16th day of December, 2011.
Kenneth C. Wende, Assistant Secretary � f . Norris, Jr., Vice President
STATE OF NEW JERSEY `
as.
County of Somerset
On this 16th day of December, 2011 before me, a Notary Public of New Jersey, personallycame Kenneth C. Wendel, tome
known to be Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which
executed the foregoing Power of Attorney, and the said Kenneth C. Wendel, being by me duly sworn, did depose and say that he is Assistant Secretary of FEDERAL
INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof, that the seals affixed to the
foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of the By- Laws of said Companies; and that he signed said Power of Attorney as
Assistant Secretary of said Companies by like authority; and that he is acquainted with David B. Norris, Jr., and knows him to be Vice President of said Companies; and that the
signature of David B. Norris, Jr., Subscribed to said Power of Attorney is in the genuine handwriting of David B. Norris, Jr., and was thereto subscribed by authority of said By-
Laws and in deponent's presence.
Notarial Seal KATHERINE J. ADELAAR
(C'm pRY��y NO TARY PUBUC NEW JFRSFI
� Nn, 231616 665 ���� ComfniWon Flipirsti 16, 20M
n W Notary Public JE�
CERTIFICATION
Extract from the By- Laws of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY:
'All powers of attorney for and on behalf of the Company may and shall be executed in the name and on behalf of the Company, either by the Chairman or the
President or a Vice President or an Assistant Vice President, jointly with the Secretary or an Assistant Secretary, under their respective designations. The
signature of such officers may be engraved, printed or lithographed. The signature of each of the following officers: Chairman, President, any Vice President, any
Assistant Vice President, any Secretary, any Assistant Secretary and the seal of the Company may be affixed by facsimile to any power of attorney or to any
certificate relating thereto appointing Assistant Secretaries or Attomeys- in- Fact for purposes only of executing and attesting bonds and undertakings and other
writings obligatory In the nature thereof, and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding
upon the Company and any such power so executed and'cemfied by such facsimile signature and facsimile seal shall be valid and binding upon the Company
with respect to any bond or undertaking to which it is attached.'
I, Kenneth C. Wendel, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY
(the "Companies ") do hereby certify that
(i) the foregoing extract of the By- Laws of the Companies Is true and correct,
(ii) the Companies are duly licensed and aulhodzed to transact surety business in all 50 of the United Stales of America and the District of Columbia and are
authorized by the U.S. Treasury Department; further, Federal and Vigilant are licensed in Puerto Rico and the U.S. Virgin Islands, and Federal is licensed in
American Samoa, Guam, and each of the Provinces of Canada except Prince Edward Island; and
(Ili) the foregoing Power of Attorney is true, correct and in full force and effect.
Given under my hand and seals of said Companies at Warren, NJ this 24th day of July, 2013.
—Y 7V I
4 L\ a eW YdR�
Kenneth C. We el, Assistant Secretary
IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM, VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER
MATTER, PLEASE CONTACT US AT ADDRESS LISTED ABOVE, OR BY Telephone (908) 903 - 3493 Fax (908) 903 - 3656
e -mail: surety@chubb.com
Form 15 -10- 02258- U (Ed. 5- 03) CONSENT
CALIFORNIA ALL-PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
State of California
County of Los Angele
On AUG - 7 2013 before me, C Phillips Notary Public
(Here hthsm rhame and UJe of UK officer) -
personally appeared C. P.
who proved tG me on the basis of satisfactory evidence to be the persort(es) whose nami is /f w subscribed to
the within instrument and acknowledged to me that he/she executed the same in hisAginitheir authorized
capacityq@s), and that by hisleluz hcif signature(3) on the instrument the person(§), or the entity upon behalf of
which the persons) 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.
C PHILLIPS
comm. m
WITNESS my hand and official seal. w
� ) Notary Public-California a
a1 LOS ANGELES COUNTY
motel) •" My Comm Expires Oct. 29,
ffi 20ia
Silsolu Public
ADDITIONAL OPTIONAL INFORMATION
DESCRIPTION OF THE ATTACHED DOCUMENT
(Title or description of attached document)
(Title or description of atuched document continued)
Number of Pages _ Document Date
(Additional information)
CAPACITY CLAIMED BY THE SIGNER
❑
Individual (s)
[:l
Corporate Officer
(Title)
❑
Partner(s)
•
Attorney -in -Fact
•
Trustee(s)
❑
Other
INSTRUCTIONS FOR COMPLETING THIS FORM
Any acknowledgmem completed in California we contain verbiage exactly ou
appears above in the worry section or a separate aclmowledgmert form mart be
properly completed and attached to that document. The only erception is If a
document is to be recorded Outside ofCalifomia In such imtances, arty alternative
acknowledgment verbiage as may be primed on such a document so long as the
verbiage does not require the notary to do something that is illegd for a notary in
California (i.e. certifying the authorized capacity of the signer). Pleare check the
docvmew carefullyfor proper natarial wording and attach this form ifrequired
• State and County information must be the State and County when the document
sigaheh(s) personally appeared before the notary public for acknowledgment.
• Dale of notarization most be the dale that the signer(s) personally appeared which
must also be the same dale the acknowledgment Is completed.
• The notary public must print his or her time as it appears within his or her
commission followed by a comma and then yam tide (notary public).
• Print the name(s) of document signer(s) who personally appear at the time of
nmarintion.
• Indicant the tarred singular or plural fors by crossing off incorrect forms (Le.
hatshe/tey, is /ere) or circling the correct fors_ Pailure to correctly indicate this
information may lead to rejection of document recording.
• The notary seal impression must be clear and Photographically reproducible.
impromion most not cover tent or lines, If seal impression smudges, re -seal if a
sufreicmt arcs permits, otlem se complete a different acknowledgment fomh.
• Signature of the notary public must match the signature on Fide with We office of
the county clerk.
Additional hhfomhation is not required but could help to ensure this
acknowledgment is not misused or attached to a difrercnl document.
Indicate title or type of anaclhed docmnenl, number of pages and dale.
Oe Indicate the capacity claimed by the signer. If We claimed capacity is a
corpomm officer, indicate the fide (Le, CEO, CFO. Smelary).
• Securely attach this document to the signed document
2008 Version CAPA v12.10,07 800 -873 -9865 www- NotaryClasses.cam
r e
2.13 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 ($1 0,000), whichever is greater, and shall further set forth the portion of the Work
which will be done by each subcontractor. Bidder shall list only one subcontractor for any
one portion of the Work.
Pursuant to Public Contract Code Section 4104, the Owner has determined that it will allow
Bidders twenty -four (24) additional hours after the deadline for submission of bids to submit
the information requested by the Owner about each subcontractor, otherthan the name and
location of each subcontractor.
If the Bidder fails to specify a subcontractor for any portion of the Work to be performed
under the Contract, it shall be deemed to have agreed to perform such portion itself, and
shall not be permitted to subcontract that portion of the Work except under the conditions
hereinafter set forth below.
Subletting or subcontracting of any portion of the Work in excess of one half of one percent
(greater than 0.5 %) of the Total Bid Price or, in the case of bids or offers for the construction
of streets or highways, including bridges, in excess of one -half of 1 percent of the
Contractor's total bid or ten thousand dollars ($10,000), whichever is greater, for which no
subcontractor was designated in the original bid shall only be permitted in cases of public
emergency or necessity, and then only after Owner approval.
CBF -7
BIDDER: PW- MMA
2.13 LIST OF PROPOSED SUBCONTRACTORS (continued)
["Duplicate Next Pages if needed for listing additional subwntractors. *1
Name and Location Description of Work
of Subcontractor to be Subcontracted
Name: PPS (0(d 1"lanOr
Address: Lo24p Sore With?( Nl, 9/75
Name and Location
Description of Work
of Subcontractor
to be Subcontracted
Name:
41 (C. C
Address i?no E f.+
fOrenet, nA 92u�9
Name and Location
Description of Work
of Subcontractor
to be Subcont
Name: 9 (U - rrwtl S'yel
v a s+
a p t J
Addres s — SouthL
Avt , OYAAg
C' - 9ze(of
Name and Location
Description of Work
of Subcontractor
to be Subcontracted
p
F'Lf 5-c, �l•GG��LwI
Name: ryo VvFe' fMtw.(
I4prr
Address U1 h"
q,.le ==# 6 1
1? Ae 64 917'1$
Name and Location
Description of Work
of Subcontractor
to be Subcontracted
Name:
Address
CBF -8
FW. MCMA
BIDDER:
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:
,. do KXUJP kn'atL Wo GvLC GIM be
Name and Address of Owner
G
Name and telephone numbe
661 U45
Contract amount
t'.11tl'
amo
un �,
2. 0 /
6 `7U�1T�1 lJ
a and Address of Owner
Na KZ t
Name and telephone number
1.111. 114 -
Contract amount
3.
Name and Address of Owner
VAA '61Wevr �tul X38 0322
N e and telephone number of perso familiar with project
Bl 2M C,eVYUw Vc&'� A 1012a i z
Contract amount Type of Work Date Completed
4.
person familiar with project
1 4.
Type of Work
/�
14M f J %qMn.1. La
CBF - 9
BIDDER: MAIM INC
EXCEL PAVING CMftW
SECTION 3
NON - COLLUSION AFFIDAVIT
CBF -10
o::
BIDDER EZY %_ M , M u%W
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.
Signature
C P 84OW PGtFSInFNT
Typed or Printed Name
Title
PALP 114001A
EXtsEL PWNG CO~ Bldder
Subscribed and sworn before me
This _ day of AUG — 7 2013 1 20
Notary Public in and for QG . Fhillips, Notary Public,
the State of California
My Commission Expires: _
(Seal)
C. PHILLIPS
y m COMM 11199fi177 n
Notary Public California
N
L05 ANGELES TUN7Y u
My Comm..p".1 Oct. 29, 2016
CBF -11