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1st California ConstructionCITY OF ROSEMEAD ROSEMEAD PARK IMPROVEMENTS PROJECT BASKETBALL COURTS PROJECT No. 41020 CONTRACT BID FORMS (I BIDDER: G 0 CONTRACT BID FORMS TABLE OF CONTENTS SECTION1 BID SCHEDULE ...................... ___ ......................... ................... I SECTION2 BID DATA FORMS ................................................................... ............................... 5 2.A BID BOND .......... .................. ... ......... _..__....... ._ ...... .............. ..............._.. ............ 6 2.6 LIST OF PROPOSED SUBCONTRACTORS ... ..... ............... ............. .................. .. 7 SECTION 3 NON - COLLUSION AFFIDAVIT- ................................ ..... I ..... .............................. 10 BIDDER: 14 r a ( fkrn a SECTION 1 - BID SCHEDULE CBF -1 /� BIDDER: (t fA IW l I QAIIN BID SCHEDULE SCHEDULE OF PRICES FOR ROSEMEAD PARK IMPROVEMENTS PROJECT BASKETBALL COURTS PROJECT No. 41020 TOTAL BASE BID PRICE (SCHEDULE BID PRICE)::$ v NUr1jred SevekY Si X I6v 'and Fc', Ir n ✓Jand / "'n"—nJ &T 114n N CBF - 2 UNIT ITEM NO. ITEM DESCRIPTION UNIT QTY. PRICE COST 1 Clearing & Grubbing per plans and LS 1 _ v IO . I� IS CC specifications. 2 Disposal of Waste Materials. LS 1 q (56 .d 0 C (, (5Q1 00 3 Remove, Dispose existing and Tons 345 A � 7, 94 S , 0 u Construct 4- Inches Thick CMB 95 % pI co Relative Compaction Over 90 % Or Compacted Native As Indicated on Plans and Specifications Complete. 4 Construct 4- Inches Thick PCC SF 11,850 �� Basketball Court (3250 PSI) as Indicated on the Plans and Specifications Complete. 6 Construct 4- Inches Thick Colored SF 2,000 Concrete (Chromix) with Lithochrome Colorhardener on lop 5 � �3, 160 per Plans and Specifications I ( Complete per LM Scofield Company or Approved Equal. 6 Construct Concrete Seat Wall LF 200 �.. including grading, concrete stairs, '75 �C weep holes and miscellaneous as e 1 S� . indicated on the Plans and Specifications Complete... 7 Install Basketball Court Pole and EA 6 Backboard Per Manufacturer a 7 Z. r Recommendations Complete; City will provide equipment 8 Install Basketball Court Striping as LS 1 A.' L' v {f' 2 0 Indicated on the Plans and yAi Specifications Complete. p0 villa. �] 00 91 1la. TOTAL BASE BID PRICE (SCHEDULE BID PRICE)::$ v NUr1jred SevekY Si X I6v 'and Fc', Ir n ✓Jand / "'n"—nJ &T 114n N CBF - 2 I BIDDER: I ,/ ��("KYnta 0 4J+On�1�Q 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. A@a ed a to Is a ceryfieq check, a cashiers check or a bid bond in the amount of otters ($ 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 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 I 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 Bidders California contractors license(s) in good standing; (2) evidence that the person signing this Bid is authorized to bind Bidder to this Bid and to a contract resulting therefrom; and (3) any other information and documentation, financial or otherwise, needed by Owner to award a Contract to the lowest responsible and responsive bidder. CBF - 3 Bidder acknowledges that data submitted with its Contract Bid Forms which it requires to be incorporated into a Contract arising out of this Submittal has been so identified by Bidder. Bidder further acknowledges that the Owner may, at its discretion, incorporate any of the remaining data submitted herewith into a contract arising out of this Bid_ J , BIDDER: The undersigned acknowledges receipt, understanding and full consideration of the following addenda to the Contract Documents. Addenda Nos. MV & The Bidder understands and agrees that the Total Bid Price is inclusive of all labor, materials, and equipment or supplies necessary to complete the Work as described in the Bid Documents. If this bid is accepted, the undersigned Bidder agrees to enter into and execute the Contract with the necessary bonds and accept the Total Bid Price as compensation in full for all Work under the contract. CBF -4 '�I f t� /' i BIDDER: I CCI �' 0rrt 14 (0 � VC�7 brit W . 0 Title 3/c C' /Uew"r\ Ave Business Street Address P . p . P—G7e 70 3 (/G aryd�a, Cn 91ff6 / City, State and Zip Code Telephone Number d /' Q Bidder's/Contractor's S�CQ or's State of Incorporation: J4f'Ct ✓✓tle, �s rvC h ''Cp'MFItLt li � rnlm Partners or Joint Venturers: Bidder's License Number(s): x 51 Y — I 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. U7e11dc] Check a License - License Detail - Contractors State License Board Page I of 2 ® DEPARTMENT OF CONSUMER AFFAIRS . Contractors State License Board Contractor's License Detail - License n 845184 It DISCLAIMER: A license status cheek provides Information taken from the CSLB acesse database. Before retying on this Information, you should be aware of the following limitations. -'> CSLB complaint disclosure is restricted by law (B8P 7124.61 If this entity is subject to public complaint disclosure , a link for complaint disclosure will appear below. Click on the link or button to obtain complaint ardlor legal action information. Per B8P 7077.17 , only construction related civil judgments reported to the CSLB are disclosed. Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. Due to workload, there may be relevant information that has not yet been entered onto the Board's license database. License Number 845184 Extract Data 1/202014 1 ST CALIFORNIA CONSTRUCTION INC Business Phone Number. (626) 5335673 Business Information P O BOX 70316 PASADENA CA 91117 Entity Corporation Issue Data 081232004 Reissue Data 04/112007 Expire Data 04130/2015 ACTIVE License statue This license is current and active. All information below should be reviewed. CLASS DESCRIPTION B GENERAL BUILDING CONTRACTOR Classifications A GENERAL ENGINEERING CONTRACTOR Bonding CONTRACTOR'S BOND This license filed a Contractor's Bond with AMERICAN SAFETY CASUALTY INSURANCE COMPANY Bond Number: 407750 Bond Amount: $12,500 Effective Date: 041302013 Contractors Bond History BOND OF QUALIFYING INDIVIDUAL 1. The Responsible Managing Officer (RMO) ZAMANI ALIREZA certified that he/she owns 10 percent or more of the voting stock/equity of the corporation. A bond of qualifying individual is cot required. htt ps:// www2. cslb. ca. gov/ OnlineServices/ CheekLicenseII lLicroseDetail.wpx ?LicNum =84... 1/20/2014 Check a License - License Detail - Contractors State License Board Page 2 of 2 Effective Date: 04 1172013 SQI's Band History WORKERS' COMPENSATION This license has workers compensation insurance with STATE COMPENSATION INSURANCE FUND Workers Compensation Policy Number: 9047193 Effective Date: 03/012013 Expire Date: 03/012014 Workers' Compensation History DATE DESCRIPTION Miscellaneous Information 041112007 LICENSE REISSUED TO ANOTHER ENTITY Personnel Lis[ Conditions of Use I Privacy Policy Copyright ® 2010 State of California https: / / wwW2. cslb. ca. gov /OnlineSe ices/ CheekLicemeII /LicenseDetail.wpx ?LieNum =84... 1/20/2014 BIDDER: 1 I G(1 r4 �j SECTION 2 BID DATA FORMS CBF - 6 BIDDER: I st Cali fornia Construction Inc. 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 ovary page of its Bid Data Forms are property identified with the Bidder's name and page number. 2.A BID BOND KNOW ALL MEN BY THESE PRESENTS: THAT Ist California Construction Ina aq Principal, and Contractors Bonding and Insurancc Company as Surety, are held firmly bound unto the CITY OF ROSEMEAD (hereinafter called the OWNER) in the sum of Ten Percent of Amount Bid DOLLARS being not less than ten percent (10 %) of the Total Bid Price; for the payment of which sum will and trulyto be made, we bind ourselves, our heirs, executors, administrators, 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 ROSEMEAD PARK IMPROVEMENTS PROJECT — BASKETBALL COURTS as set forth in the Notice Inviting Bids and accompanying Bid Documents, dated January 22. 2014 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, than 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 16th day of January 20 1st California Construcion N, (SEAL) SEAL) Principal Surety By . - - - Ure Signature Will Syrkin- Attomev- In -F'ac� CBF -7 Know All Men by These Presents: POWER OF ATTORNEY Contractors Bonding and Insurance Company That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the approving officer if desired. That Contractors Bonding and Insurance Company, a Washington corporation, does hereby make, constitute and appoint: William Syl Stargic, D j!gcham. Rebecca f girilly or severally In the City of Irvine , State of California its true and lawful Agent and Attomey in Fact, with full power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, the following described bond. Any and all bonds, undertakings, and recognizances in an amount not to exceed Ten Million and 00 /100 Dollars ( $10.000.000.00 1 for any single obligation. The acknowledgment and execution of such bond by the said Attomcy in Fact shall be as binding upon this Company as if such bond had been executed and acknowledged by the regularly elected officers of this Company. The Contractors Bonding and Insurance Company further certifies that the following is a true and exact copy of the Resolution adopted by the Board of Directors of Contractors Bonding and Insurance Company, and now in force to -wit: "All bands, policies, undertakings, Powers of Attorney or other obligations of the Corporation shall be executed in the corporate name of the Corporation by the President, Secretary, any Assistant Secretary,'Ireasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bands, policies or undertakings in the name of the Corporation. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the Corporation. The signature of any such officer and the corporate seal may he prin by facs imile or other electr i IN WITNESS WHEREOF, the Contractors Banding and Insurance Company has caused these presents to be executed by its ylr� President with its corporate seal affixed this 17th day of July , 2013 " aM4 X0 n. ,. Contractors Bonding and Insurance Company SEAL State of Washington 1 % ••. 1979 Roy C. Die Vice President j SS " +axixua ^ County of King On t 17th day of July 2019 before me, a Notary Public, personally appeared Roy C Did , who being by me duly swom, acknowledged that he signed the above Power of Attorney as the aforesaid officer of the Contractors Bonding and Insurance Company and acknowledged said instrument to be the voluntary am and deed of said corporation. Brian r Notary Public CERTIFICATE 1, the undersigned officer of Contractors Bonding and Insurance Company, a stock corporation of the State of Washington, do hereby cedify that the attached Power of Attomey is in full force and effect and is ma,caable; and fhrtherow, , that the Resolution of the Company as set forth in the Power of Attorney, is now in fume. In testimony whereof, I have hereunto set my hand and t ecal of the Co rnetora B ndipg a Insurance Company [his `,H� day of L( Contractors Bonding and Insurance Company rvm.rr abt. or. wmlXrw° Roy C Die Vice P¢sident BREW q aeHICK MV COMMISSION E %PIREa r -- 6. -- W)5t9apa2914 A11059511 cN5n and Insurance Company Me 3101 3101 Ant,, Suite 300 ..nuo —, e onA 9 Air1 SeattleWA 98 Know All Men by These Presents: POWER OF ATTORNEY Contractors Bonding and Insurance Company That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the approving officer if desired. That Contractors Bonding and Insurance Company, a Washington corporation, does hereby make, constitute and appoint: William Syl Stargic, D j!gcham. Rebecca f girilly or severally In the City of Irvine , State of California its true and lawful Agent and Attomey in Fact, with full power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, the following described bond. Any and all bonds, undertakings, and recognizances in an amount not to exceed Ten Million and 00 /100 Dollars ( $10.000.000.00 1 for any single obligation. The acknowledgment and execution of such bond by the said Attomcy in Fact shall be as binding upon this Company as if such bond had been executed and acknowledged by the regularly elected officers of this Company. The Contractors Bonding and Insurance Company further certifies that the following is a true and exact copy of the Resolution adopted by the Board of Directors of Contractors Bonding and Insurance Company, and now in force to -wit: "All bands, policies, undertakings, Powers of Attorney or other obligations of the Corporation shall be executed in the corporate name of the Corporation by the President, Secretary, any Assistant Secretary,'Ireasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bands, policies or undertakings in the name of the Corporation. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the Corporation. The signature of any such officer and the corporate seal may he prin by facs imile or other electr i IN WITNESS WHEREOF, the Contractors Banding and Insurance Company has caused these presents to be executed by its ylr� President with its corporate seal affixed this 17th day of July , 2013 " aM4 X0 n. ,. Contractors Bonding and Insurance Company SEAL State of Washington 1 % ••. 1979 Roy C. Die Vice President j SS " +axixua ^ County of King On t 17th day of July 2019 before me, a Notary Public, personally appeared Roy C Did , who being by me duly swom, acknowledged that he signed the above Power of Attorney as the aforesaid officer of the Contractors Bonding and Insurance Company and acknowledged said instrument to be the voluntary am and deed of said corporation. Brian r Notary Public CERTIFICATE 1, the undersigned officer of Contractors Bonding and Insurance Company, a stock corporation of the State of Washington, do hereby cedify that the attached Power of Attomey is in full force and effect and is ma,caable; and fhrtherow, , that the Resolution of the Company as set forth in the Power of Attorney, is now in fume. In testimony whereof, I have hereunto set my hand and t ecal of the Co rnetora B ndipg a Insurance Company [his `,H� day of L( Contractors Bonding and Insurance Company rvm.rr abt. or. wmlXrw° Roy C Die Vice P¢sident BREW q aeHICK MV COMMISSION E %PIREa r -- 6. -- W)5t9apa2914 A11059511 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENY CIVIL CODE § 1189 State of California County of Oran I On 1116/2014 _ before me, R. Paramu N Public Date Here Insert Name and Title of the Officer personally appeared \4'illi _rkin Name(s) of Signers) R PARAMO Commission x 2035890 Notary Public - California z Orange County M Comm. Er ires Aug 5, 2017 J Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person(e) whose names) is/ere subscribed to the within instrument and acknowledged to me that he /skekksy executed the same in his /berNlaeir authorized capacity(iea), and that by his /Vaedell signaturefei on the instrument the Person*,, or the entity upon behalf of which the person(e) acted, executed the instrument. I ce MERJURY under the laws foregoing paagraph ' true and WITNESS seal. Sign Signature of Notary Public OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Bid Fond —_ Document Date: 1/16/2014 Number of Pages: One (1) Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: _ William Sorkin 17 Corporate Officer— Title(s): ❑ Partner — C Limited ❑ General -)Individual OAHOrney in Fact Trustee ❑. Guardian or Conservator Other Signer's Name: _- ❑ Corporate Officer — Tltle(s): _. J Partner — ❑ Limited General Individual ❑ Attorney in Fact ❑ Trustee E. Guardian or Conservator Other: Signer Is Representing: Signer Is Representing Contractors Fonding and Insurance Co.. pour © 2013 National Notary Association • www.NetionalNotary.org • 1- 800 -US NOTARY (1- 800 -876 -6827) Item #5907 BIDDER: 1 1 1 q r•C�jOI� /)�(� 23 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 Bidders 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 Contractors total bid or ten thousand dollars ($10,000), whichever is greater, and shall further set forth the portion of the Work which will be done by each subcontractor. Bidder shall list only one subcontractor for any one portion of the Work. Pursuant to Public Contract Code Section 4104, the Owner has determined that it will allow Bidders twenty-four (24) additional hours after the deadline for submission of bids to submit the information requested by the Owner about each subcontractor, other than the name and location of each subcontractor. If the Bidder fails to specify a subcontractor for any portion of the Work to be performed under the Contract, it shall be deemed to have agreed to perform such portion itself, and shall not be Permitted to subcontract that portion of the Work except under the conditions hereinafter set forth below. Subletting or subcontracting of any portion ofthe Work in excess of one half of one percent (greater than 0.5 %) of the Total Bid Price or, in the case of bids oroffers 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 -8 BIDDER: 1 1 (' '(r1 r .J ' ch fyu 2.13 LIST OF PROPOSED SUBCONTRACTORS (continued) F5 ieEle Ni z Pwes'if needed for list aYlltlony subcontrecl - 1 Name and Location Description of Work of Subcontractor to be Subcontracted 11 Demo - (Lacmtevl✓©rk Name: 5J �v fj(BltCr I (Mu rod'r OA,11C Address: 1 "LAW Az Lan(hsldri CA 93ii Name and Location of Subcontractor Name: Address: Description of Work to be Subcontracted Name and Location of Subcontractor Name: Address: Description of Work to be Subcontracted Name and Location of Subcontractor Name: Address: Description of Work to be Subcontracted Name and Location of Subcontractor Name Address: Description of Work to be Subcontracted CBF -9 BIDDER: 1a'Ca ���t�V'nw Gin14 Ina 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: 6Zc w' kA Ive 1. l3u�IJ LAGCD (I -StmpP Lv, �.k(2„(( "� >�l�c�) wrzd(n� 1��11��cA 11 Name and Address of Owner IvJr.,(Pr,:IaJ P0,tdA�) XIXUSI -4476 person 2. 3. Sus �, - A"' (�CCIA �(c111[ gcr) 310 — Z'R` -118X Name and telephone number of person familiar with project 0 0 t K , a. - Name'and Address of Owner Name and telephone number of person famili with project Z. 1 A Contract amount ype of Work Date Completed A qna /o CBF - 10 $ - 3f (4, c N'A'i Fad 1 WQ n�f7a (a Id �o I Contract amount Type of Work Date Completed BIDDER* _Va �i �L+�s11YF1'i�n SECTION 3 NON - COLLUSION AFFIDAVIT CBF - 11 BIDDER: ]5 a t1 r11 A A -1 1 1A rQn,IAC- NON-COLLUSION AFFIDAVIT In accordance with Public Contract Code Section 7106, the undersigned, being first duly swom, 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 of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, orthe contents thereof, ordivulged 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. ature Subscribed and sworn before me This _ day of Typed or Printed Name Title IIi 1-j Bidder See attached notarial certificate (Seal) Notary Public in and for the State of California My Commission Expires: CBF -12 CALIFORNIA JURAT WITH AFFIANT STA rl See Attached Attached Document (Notary to cross out lines 1-6 below) See Statement Below (Lines 1 -5 to be completed onh by document signer[s]. tmr Notary 2. 3. 4. 5. 6. Sil,nalnN (It Ou uincin srJl6r Nn. i $iy'nalvm or oJCY[II[nl ShnC� NO z or -1) State of California Subscribed and worn to (or al7mned) before me on this County of Los Angeles 21st JANUA _ 2014 Dma dvn of ntunn 1'.ur by (1) ALIRBZA ZAMANI Nanm of Signet proved to me on the basis of satisfactory evidence LINA REYES to be the person who appeared before me L) (,) a Gommission u 1990467 8l �� Notary Public - Callf0fuia n Los Angeles BouNy (find My Comm. Expires Sep 7.2016 (2) ________________ _______________________________ C;amc ol'Sl:nw proved to one on the basis ot'salistactray evidence to be the person ,hr ap eared before o t s,rI lurc 6Public Plna. Noun, scal Abm< OPTIONAL lhoughbeLibnnnlionbelm is nut I'll" I'd by l ex.anup pro.a lalghl lhlmlbpnnl Nlgta Thumbprim va ll I p mlying on 6, do,vmcm and could prcvonl II Sumro l III Siper 42 fna'a"I nl mnmaal mtl rcnlle'll I of ar, Ibnn m ry Iah" o ,nn",. Further Description of Any Attached Document Ialc or pc of oo,.nnnlr NO N - COL LUSION A F FIDA VIT Documan Dale 121 _ Number ut Purl Sie er(s)(,h,, I'oon Named Abo>e. NO OTHER SIGNERS_ _