Horizons Construction Co.BIDDER. Horizons Construction Co. Int'I, Inc.
BID SCHEDULE
SCHEDULE OF PRICES FOR
FEDERAL SAFE ROUTES TO SCHOOL
WALNUT GROVE AVENUE ENCHANCEMENT PROJECT
SRTSL - 6368(016)
o Acc min cri -X1111 F
CBF -1
NO
UNIT OF
EST.
UNIT
ITEM
ITEM DESCRIPTION
MEASURE
QTY.
PRICE
COST
1
CLEARING AND GRUBBING
LS
1
72 eo
JZOd
TRAFFIC CONTROL AND
LS
1
45*�az
/57(00, ^
2
BMPS /SWPPP
_
3
UNCLASSIFIED EXCAVATION
CY
264
�C'�C-
� y Sib" -
4
COLD MILL 2- INCHES
SF
6,800
/,-Os
7itro-
EXISTING PAVEMENT
CONSTRUCT ASPHALT
5
CONCRETE PAVEMENT (2"
TON
186
Y 30 /q e
THICK)
CONSTRUCT P.C.C. CROSS
6
GUTTER PER SPPWC STD.
SF
135
122 -2.
CONSTRUCT 4" P.C.C. DRIVE
SF
440
7 96,
7
APPROACH PER SPPWC
J p
STD. 110 -2
CONSTRUCT 4" PCC
SIDEWALK INCLUDING
3Q SOS'
B
EXCAVATION, EXPORT, AND
SF
5,000
7-2,v
DRIVEWAY APRONS PER
SPPWC STD. PLAN 113 -2.
_
CONSTRUCT P.C.C. CURB
LF
1,325
9
PER SPPWC STD. 120 -2 AND
111 -5
CONSTRUCT ADA CURB
10
RAMP PER SPPWC STD. 111 -
EA
3
2(
'7200
5
11
INSTALL STREET LIGHTS
LS
'
-
103500.
INCLUDING ALL CONDUITS
12
LANDSCAPE PLANTING AND LS
1
IRRIGATION I
7
b
CBF -1
BIDDER Horizons Construction Co. Int'I, Inc.
TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ 5011 q3 I
ADDITIVE ALTERNATE A
NO
CONSTRUCT TRAFFIC
UNIT OF
MEASURE
EST. EM
CITY.
CONSTRUCT6 "COLORED
SIGNAL IMPROVEMENTS AT
PORTLAND CEMENT
JPRICECOST
//
13
WALNUT GROVE AVE. AND
LS
1
/
8" CLASS II AT WALNUT
MARSHALL ST. PER PLANS
GROVE AND MARSHALL
AND SPECIFICATIONS
...._
CONSTRUCT TRAFFIC
SIGNAL IMPROVEMENTS AT
LS
1
52�
1
14
WALNUT GROVE AVE. AND
VALLEY BOULEVARD PER
SPECIFICATIONS
INSTALL SIGNAGE,
STRIPING. AND PAVEMENT
1
15
MARKINGS AT VARIOUS
LS
LOCATIONS
TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ 5011 q3 I
ADDITIVE ALTERNATE A
NO
ITEM DESCRIPTION
UNIT OF
MEASURE
EST. EM
CITY.
CONSTRUCT6 "COLORED
PORTLAND CEMENT
JPRICECOST
//
Ai
CONCRETE CROSS WALK on
SF
3250 63�
8" CLASS II AT WALNUT
GROVE AND MARSHALL
STREET
...._
TOTAL ADDITIVE ALTERNATE A BID PRICE (SCHEDULE BID PRICE):$✓_.
The undersigned agrees that these Contract Bid Forms constitute a firm offer to the Owner which
cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and
afterthe bid opening date, or until a Contract for the Work is fully executed by the Owner and a third
party, whichever Is earlier. The undersigned also agrees that if there is a discrepancy between the
written amount of the Bid Price and the numerical amount of the Bid Price, the written amount shall
govern.
CBF -2
BIDDER. Horizons Construction Co. Intl, Inc.
If the Bid Documents specify alternate bid items, the following Alternate Bid amounts shall
be added to or deducted from the Total Bid Price entered above. The owner can choose to
include one or more of the alternates in the Total Bid Price of the Project. If any of the
Alternate Bids are utilized by the Owner, the resulting amount shall be considered the Total
Bid Price for the Project.
Attached hereto is a certified check, a cashier's check or a bid bond in the amount of
10% Dollars ($ ) 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.
CBF -3
BIDDER: Horizons Construction Co. Int], Inc.
If awarded a Contract, the undersigned agrees to execute the formal Contract, which will be
prepared by the Owner for execution, within five (5) Calendar Days following the Letter of Award for
the Contract, and will deliver to the Owner within that same period the necessary original
Certificates of Insurance, Endorsements of Insurance, Performance Bond, Payment Bond and all
other documentation and certification required by the Contract.
The undersigned offers and agrees that if this bid is accepted, it will assign to the purchasing body
all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton
Act (15 U.S.C. Section 15) or under the Cartwright Act (Chapter 2 of Part 2 of Division 7 of the
Business and Professional Code), arising from purchases of goods, materials or services by the
Bidder for sale to the purchasing body pursuant to the bid. Such assignment shall be made and
become effective at the time the purchasing body tenders final payment to he Contractor.
Bidder understands and agrees that, when requested by Owner, he shall provide: (1) evidence
satisfactory to the Owner of Bidder's California contractor's license(s) in good standing; (2)
evidence that the person signing this Bid is authorized to bind Bidder to this Bid and to a contract
resulting therefrom, and (3) any other information and documentation, financial or otherwise,
needed by Owner to award a Contract to the lowest responsible and responsive bidder.
Bidder 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.
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. 1 8, Notice of Clarification
The Bidder understands and agrees that the Total Bid Price is inclusive of ail 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 anoXept the Total Bid Price as compensation in full for all Work under the
contract.
By: 432 W. Meats Ave.
Sign at Business Street Address
Kinan Kotrash Orange, CA 92865
Type or Print Name City, State and Zip Code
V. President (714)626 -0000
Title Telephone Number
CBF -4
BIDDER. Horizons Construction Co. Int'I, Inc.
Bidder's /Contractor's State of Incorporation: California
Partners or Joint Venturers:
Bidder's License Number(s):
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 II
to provide evidence that the person signing on behalf of the corporation,
partnership orjoint venture has the aUthurilN lo d, u,.
CBF -5
H.,izous Consvuction
BIDDER: Company InRmational, Inc.
Bond No, HORCO -109
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
property identified with the Bidder's name and page number.
2A BID BON
KNOW ALL MEN BY THESE PRESENTS:
THAT Horizons Construction Company International, Inc, _as
Principal, and Old Republic Surety Company
. as Surety, are held firmly bound unto the
CRY OF ROSEMEAD (herelnaffer sled the OWNER) in the sum of
Ten Percent of the Total Amount Bid
DOLLARS
(f to %ofthe Bid ), being not less than ten percent (10%) of the Total
Bid Prim; for the payment of Which sum VA11 and truy, to be made, we bind
ourselves, ourheirs. encwtore, administration, successors, and assigns, jointly and
severely, finny by these presents.
WHEREAS, saki Principal has submitted a hid to the OWNER to perform all Work
required for Use Federal Safe Routes to School Wehrut Drove Avenue
Enhanesmem Protect as setforll in the Notla Inviting Bids and accompanying Bid
Daeumentt, dated September i, 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 Doaanenb, erdens into the wrllien form of Contrad bound with said Bid
Documents, furnishes the required bonds (one to guarantee faithful performance
arid the oowle, gusraMsepaymentiorlabar and matsrials) MYshptlrerequked
insurenee cetgleafss and endoreamentt, and furnlshas any othercertdieatiorw as
may be required by the Cordrad, than lids oblgialon shall be nut and void;
dlvervdse it"amain in UdI faro and affect In to event sud is 61,040ht upon
this bond by the OWNER and Judgment b recovered, said Surety shall pay al coals
ineurred by ire OWNER In such suit, Including venerable attembys' few to be
by the court
SIGNED AND SEALED, this 29 day of Ammst 2014
Horizons Construction Compan International, Ine.(SEAL) Old Republic Surety Company SEAI,)
Pdrra{f 3
By BY
SIg (Yrewl( lull KQ Lf.�jl B city Spohn
�re
i orncy -In -Fact
� . h.den t
CBF - fi
*
* OLD REPUBLIC SURETY COMPANY
* * POWER OF ATTORNEY
* **
KNOW ALL MEN BY THESE PRESENTS'. That OLD REPUBLIC SURETY COMPANY, e Wisconsin stuck insurance corpantiov, does make, constitute and
appoint
RANDY SPOHN, MATTHEW R. DOBYNS, HAMILTON KENNEY. OF SANTA ANA, CA
its we end lawful Avomeynd-fir Fact, with full power and audenty, not exceeding $50,000,000, for add on behalf of the company as surety, to execute and deliver
and a0ix the seal of the company thereto (its seal is resuncep, bands, underedungn, rerngnizannce or other written obligations in the nature thereof. (other than bail
bands, bank do simry bonds, mortgage deficiency bonds, manure, guaranty hems, guarantees of installment paper and note guaranty bunt, self-insurance workers
ompensa for bands guaranteeing payment of bendns, asbestos abatement comeaet bonds, waste management M ds, haeerdous waste remclmtion bonds or black lung
bands, as follows
ALL W BITTEN INSTRUMENTS IN AN AMOUNT NOT TO EXCEED AN AGGREGATE OF
TEN M ILLION DOLLARS IS 10,Ap0mH FOR ANY SINGLE
OBLIGATION, REGARDLESS OF THE NUMBER Of INSTRUMENTS ISSUED FOR 1'HE OBLIGATION.
add to bind OLD REPUBLIC SURETY COMPANY meths, and all I fthe is of sued Attorneys in -Fact, pursram to these presents, are ratified and confirmed
This dearer lis not valid unless pnntulon colored background and is multicolored This appointment is made under and by authority f the brand of directors
at a special meeting held on February 18 ,1982- This Power of Altemey is signed andscaled by facsimile underand by the authority v1 the following revolutions
adopted by the board of directors of OLD REPUBLIC SURETY COMPANY on February 18, 1982
RESOLVED that, the president any vice yrosadent. or assistant vino president, in conjunction with the Axnehrry or any assiawnl were ary, rvay appoint
avomeys -in -fact or agents with authority as defined or limited in the instrument evidencing the appointment in each case, for and on bchalfof the company In
,cum and deliver and affix the seal of the company to bonds, undertakings, recognizanees, and suretyship obligations of all kinds, and said officers may remove
any such i uom ry -in -fact or agent and revoke any Power of Attiormay previously granted to such person.
RESOLVED FURTHER, that any Wad, undertaking, recognzance, or suretyship obligation shall be valid and binding upon the Company
(0 when signed by the president, any vice president (it assistant vice president, and wrested and sealed (ifa seal be respond) by any secretary or assistant
'ecretary; or
(a) whin signed by the president, any vice president on assistant vice prieidem, smmtery or assistant secmW,. and coin ,r ignd and sealed (fa seal he
reyuintl) by a duly authorizW atmmey-in -tact or agent; or
when duly executed and sealed (ifa seal be inquired) by one or mom aporneyvin -fact (it agents pursuant to and within the limits of authority
evidenced by the Power of Attorney issued by the company In such pi or persons.
RESOLV ED FURTHER, that he signature of any authorized officer and the seal of the company may N affixed by Raesimile to any Power of Attorney or
unification thereof authorizing the execution and salivary of any bond, undertaking, recognizance, or ether suretyship obligations of (be company; end such
signature and seal when so coed shall have the same force and effect as though instantly affixed
IN WITNESS WHEREOF, OLD REPUBLIC SURETY COMPANY has caused these
affixed this ISI dnyof_ AUGUST 2014.
Mi'f�A�'s^L L- g SEAL
STATE OF QF WISCONSIN, COLNTY OF WAUKESHA -SS_.
prevents to he signed by its proper otYecr, and its corporate seal to be
OLD REPU BLI�C SSUU RETY COMPANY
President
On this IST day of AUGUST 2014 , personally came before me, Alan Profit, _ and
Phvllis M- Johns._ ,mmekntwne, he thembeideathindofficcrs of the OLD REPUBLIC SUR FTYCAMPA NY who rsocmudwsbove
inswmeml, and they each avarawldgul the excem an or dre same, and being by me duly swum, did severally J 4ane and say, that hey are the said oRcers aT the
eomnr4on aforesaid and that the seal atfixad to the above instrument is the swl of Ibe corporation and that sued corpsei seal and their signatures as sash officers
were July a(BxeJ UnJ aubsoribedmthe sail instrument by the authority ofMCbaaM Ofdirectoa of said wrgvrulion. �//
t ^uexF : Notary Public
My cor for nissron expires. 91
CERTIFICATE (Expiration of notary commleslon doer not Invalidate this Instrument)
I, the undersigned, assistant rearcwry of the OLD REPUBLIC SURETY COMPANY, a W ive...in z r n nti m, CERTIFY that the foregoing and a¢aehed Power
of Attomcy remain in full force and has I., been revoked; and fivahermore, that the Resolutions of heard ofmiectors set forth in the Power ofAtomry, are now in
force
747092 Srun ' e da .sc ndnldatmc CiNul'Brookfield WI Fri, 29 day of August 2014
a
g SEAL a <'
CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT
State of CALIFORNIA
County of ORAN E
On before me, ERIKA GUIDO, NOTARY PUBLIC.
personally appeared RANDY SPOHN
® who proved to me on the basis of satisfactory evidence to be the persor
whose name(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 Oes), and that by his /her /their signatures) on the
instrument the person(s), or the entity upon behalf of which the persor
acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of
r California that the foregoing paragraph is true and correct.
ERIKA 6UID0 1
GOMM. #2022671 *r m ttt�� rand and official seal.
NOTARY ICOUNTYRNIAO \
ORANGE COUNTY
;I Mv,, ezpine May 5. 209 �I
'g ature otary
Ih the data below is not required by law, it may prove valuable to persons relying on the document and
prevent fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT
❑ INDMDUAL
❑ CORPORATE OFFICER
❑ PARTNER(S) ❑ LIMITED
® ATTORNEY -IN -FACT
❑ TRUSTEE(S)
❑ GUARDIAN /CONSERVATOR
❑ OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
BIDDER. Horizons Construction Co. Int'I, Inc.
2.8 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 Contractor's total bid or ten
thousand dollars ($10,000), whichever is greater, and shall further set forth the portion of
the Work which will be done by each subcontractor. Bidder shall list only one subcontractor
for any one portion of the Work.
Pursuant to Public Contract Code Section 4104, the Owner has determined that it will allow
Bidders twenty -four (24) additional hours after the deadline for submission of bids to submit
the information requested by the Owner about each subcontractor, other than the name and
location of each subcontractor.
If the Bidder fails to specify a subcontractor for any portion of the Work to be performed
under the Contract, it shall be deemed to have agreed to perform such portion itself, and
shall not be permitted to subcontract that portion of the Work except under the conditions
hereinafter set forth below.
Subletting or subcontracting of any portion of the Work in excess of one half of one percent
(greater than 0.5 %) of the Total Bid Price or, in the case of bids or offers forthe construction
of streets or highways, including bridges, in excess of one -half of 1 percent of the
Contractor's total bid or ten thousand dollars ($10,000), whichever is greater, for which no
subcontractor was designated in the original bid shall only be permitted in cases of public
emergency or necessity, and then only after Owner approval.
CBF -7
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BIDDER. Horizons Construction Co. Int'I, Inc.
2.B LIST OF PROPOSED SUBCONTRACTORS (continued)
� ^own��a em s vase :'e �reeea m. rnms aaamo�ai :vo=vm,a=co+. °�
Name and Location Description of Work
of Subcontracttoor� to be Subcontracted
Name..
Address.
Name and Location Description of Work
of Subcontractor to be Subcontracted
� D� r 1
Name `C%I-� f l IUD yy L�
Address.
Name and Location Description of Work
of Subcontractoorr^ to be Subcontracted
Name.
t
Address:
Name and Location Description of Work
of Subcontractor to be Subcontracted
Name
Address:
Name and Location Description of Work
of Subcontractor to be Subcontracted
Name.
Address:
CBF - 10
BIDDER Horizons Construction Co. Int'I, Inc.
2.0 REFERENCES
The following are the names, addresses and telephone numbers for three public agencies for which BIDDER
has performed similar work within the past two (2) years.
of Rialto 335 W. Rialto Ave. Rialto, CA 92376
and Address of Owner
John Wheatley (909)421 -4999
Name and telephone number of person familiar with project
$4,421,900 New Fire Station December 2012
Contract amount Type of Work Date Completed
2, Santa Ana Unified School District 1601 E. Chestnut Ave. Santa Ana, CA 92701
Name and Address of Owner
David Amundson (949)261 -5100
Name and telephone number of person familiar with project
$1,387,000 School Modernization including Parking Lot_, August 2012
Contract amount Type of Work Date Completed
3. City of Costa Mesa 77 Fair Drive, Costa Mesa, CA 92628
Name and Address of Owner
Tom Banks (714)754 -5335
Name and telephone number of person familiar with project
$497,603 Street Concrete repair and new sidewalk August 2014
Contract amount Type of Work Date Completed
q City of Mission Viejo 200 Civic Center, Mission Viejo, CA 92691
Name and Address of Owner
Jerry Hill (949) 470 -3085
Name and telephone number of person familiar with project
$354,253 Marguerite Parkway Improvements June 2013
Contract amount Type of Work Dale Completed
CBF - 11
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 Horizons Construction Co. Int'I, Inc. ,proposed
subcontractor hereby certifies that he
has_, 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 fled with the Joint Reporting Committee, the Director of the Office of Federal
Contract Compliance, a Federal Government contracting or administering agency, or the former
President's Committee on Equal Employment Opportunity, all reports due under the applicable filing
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 arc exempt
from the Equal Opportunity Clause are set forth in 41 CPR 60 -1.5. (Generally only
contracts or subcontracts of $10,000 or under we 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 CPR 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
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, orto 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
NONLOBBYING CERTIFICATION
FOR FEDERAL -AID CONTRACTS
The prospective participant certifies, by signing and submitting this bid or proposal, to the best
of his or her knowledge and belief, that:
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 snail complete and submit Standard Form -LLL,
"Disclosure of Lobbying Activities." in accordance 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 proposal 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 sub recipients shall certify and disclose accordingly.
NL.0 -I
DISCLOSURE OF LOBBYING ACTIVITIES
1. "Type of Federal Action: 2. Status of Federal 3. Report Type:
Action:
a- conuaa = a. bid/offcr /oppll.tsn o. initial
It grant b. inifial award b. mmerial change
e cooperative egrem rein pwbawnrd
J. loan For Material Change only:
e. loon gtmamce yam_ goarter
L loan Insurance dole of last report_ _
4. Name and Address of Reporting Entity S. If Reporting Entity in No 4 is Subawardee,
Enter Name and Address of Prime:
El Rime n Subawardee
Tic, _ - if known
Congressional District, if knon'n
6. Federal Department/Agency:
8, Federal Action Number, dknm.a:
10. a. Name and Address of Lobby Entity
(If individual, last name, first name, MI)
Congressional District, ifknom
7. Federal Program Name /Description:
CFDA Number, if applicable
9. Award Amount, ifknown'.
It. Individuals Performing Services (including
addmss if different fmm No loo)
(last name, first name, MI)
ola", h[ ommmilloc 9heells) II "'I'll,I
11. Amount of Payment (check all that apply) 13. -tape of Payment I, hook :dl that nPpIY1
S El 11 I1 1 phoned ., :.lamer
b. anrlime fcc
12. Form of Paymentncc,k.Jlthat apply): I commuslon
o. cash d. conlingenl 4c
b. In -kind; spmfy. nature c deferral
vNuc f other, spccifi
14. Brief Description of Services Performed or to be performed and Dates) of Service, including
oRcer(s), employespy, or membero) contacted, for Payment Indicated In Item 11:
(atmch Continuation Shecta) if necessary,
15. Continuation Sheets) attached Yes ❑
N
16 Information equest d though this farm is outhorwed by
TLc31U3C Sician 352 This d' 1 e of l navng
Slgnat .
nfanc that b her ltsl on
w amad anefea his le hon nu ba
L
Pr nl name' an Kotrash
as 11 4.c 13a 2
report tlto( lei: I I S dwell be
rme V. President
,blo ooc,a,o�
pabrc a ,... typrr n nEmrmn eamrm
msclosun shall be mat m n Lail venal(, of not less than
714 -626 -0000
S10,uoo ad .1 a,m bar $100,000 Ira cash saA nm,e
Telephone No Hate,
Federal Use Only:
DLA -I
Amhorimd lot Local Reproduction
Smodurd Form - LLI,
Federal -aid Project.Nb.
DBE INFORMATION —Goolr FAITH EFFORTS
DBE INFORMATION - GOOD FAITH EFFORTS
Bid Opening Date 09/03/2014
The (City /County of) _established a Disadvantaged Business Enterprise (DRE) goal of
for this project The information provided herein shows that a good faith effort was made.
Lowest, second lowest and third lowest bidders shall submit the following information to document adequate
good faith OTorts. Bidders should submit the following information even if the "Local Agency Bidder DBE
Commitment" form indicates that the bidder has met the DBE goal. This will protect the bidder's eligibility for
award of the contract if the administering agency determines that the bidder failed to meet the goal for various
reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error.
Submittal of only the "Local Agency Bidder DBE Commitment" (urn may not provide sufficient documentation
to demonstrate that adequate good faith efforts were made.
The following items are listed in the Section entitled `Submission of DBE Commitment" of the Special
Provisions:
A. The names and dates of each publication in which a request for DBE participation for this project
was placed by the bidder (please attach copies of advertisements or proofs of publication):
Publications Dates of Advertisement
B. The names and dates of written notices sent to certified DBEs soliciting bids for this project and
the dates and methods used for following up initial solicitations to determine with certainty
whether the DBEs were interested (please attach copies of solicitatious, telephone records, fax
confirmations, etc -).
Names of DBEs Solicited Date of Initial Follow Up Methods mid Dates
Solicitation
GFE -1
C. The items of work which the bidder made available to DBE firms including, where appropriate,
any breaking down of the contract work items (including those items normally performed by the
bidder with its own forces) into economically feasible units to facilitate DBE participation. It is
the bidder's responsibility to demonstrate that cuff dent work to facilitate DBE participation was
made available to DBE ]isms.
Items of Work Bidder :formally Breakdown of Amount percentage
Perfurnrs Item Items W Of
I A /N) Contract
D. The names, addresses and phone numbers of rejected DBE firms. the reasons for the bidder's
rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the
firms involved), and the price difference for each DBE if the selected firm is not a DBE:
Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection
of the DBEs
Names, addresses and phone numbers of firms selected for the work above:
E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any
technical assistance or information related to the plans, specifications and requirements for the
work which was provided to DBEs:
GEE -2
F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or
related assistance or services, excluding supplies and equipment the DBE subcontractor
purchases or leases from the prime contractor or its affiliate:
G. 'The names of agencies, organizations or groups contacted to provide assistance in contacting,
recruiting and using DBE Gmvs (please attach copies of requests to agencies and any responses
rcceiced. i c., lists, Interim pa'e do�cnl 'ac, dc. r.
Nmnco Aeencv /(rrrz:mlr.,nimr AIclhad. Dale of Contact Result,
H. Any additional data to support a demonstration of good faith efforts (use additional sheets if
necessary):
NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY.
GFE -3
To All Prospective Bidders:
Please note the following revisions on the specifications for the above project:
1. In the Section. "Prevailing Wages" has been updated and shall be replaced with the
following attachment of General Docision No. CA140033. Modification No 16,
Dated 08/22/2014.
2. In the Section: "Technical Provisions" has been updated with an addition page "iP-
20. The updated page will include the description for "Unclassified Excavation" for
Bid Item No. 3. The quantity shown on the plan for unclassified excavation is an
estimate only, and is only to be utilized if applicable to this project.
The Addendum No. 1 forms a part of the Contract Documents for the above project and
shall supplement or supersede reference sections of original specifications. This
Addendum No. 1 must be signed, acknowledge on Page CBF - 4 of the Contract Bid
Forms of the Specifications and submitted along with the Bidder s Proposal.
BY ORDER OF THE CITY OF ROSEMEAD
Date August 28, 2014 F.
By
Rafael M. Fajardo
�y Associate Civil Engineer
Acknowledgement tVl�1 -
Bidder
Title- +-
Date:
Page I of I
M,
2rr.
unna v¢o nnn
'` ".
a;1I VAII rL I I V 01, lnbVAIJJ
_ KMMI -nocA1
r of ucu_trhamrtrt¢
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lII1'1101\11 61 �"`I'101)
�
IYlX026)iW 1, IN
I.o,mlM1v.
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CITY OF ROSEMEAD
ROSEMEAD, CALIFORNIA
ADDENDUM No. 1
FEDERAL SAFE ROUTES TO SCHOOL
WALNUT GROVE AVENUE ENHANCEMENT PROJECT
PROJECT No. SRTSL -5358 (016)
To All Prospective Bidders:
Please note the following revisions on the specifications for the above project:
1. In the Section. "Prevailing Wages" has been updated and shall be replaced with the
following attachment of General Docision No. CA140033. Modification No 16,
Dated 08/22/2014.
2. In the Section: "Technical Provisions" has been updated with an addition page "iP-
20. The updated page will include the description for "Unclassified Excavation" for
Bid Item No. 3. The quantity shown on the plan for unclassified excavation is an
estimate only, and is only to be utilized if applicable to this project.
The Addendum No. 1 forms a part of the Contract Documents for the above project and
shall supplement or supersede reference sections of original specifications. This
Addendum No. 1 must be signed, acknowledge on Page CBF - 4 of the Contract Bid
Forms of the Specifications and submitted along with the Bidder s Proposal.
BY ORDER OF THE CITY OF ROSEMEAD
Date August 28, 2014 F.
By
Rafael M. Fajardo
�y Associate Civil Engineer
Acknowledgement tVl�1 -
Bidder
Title- +-
Date:
Page I of I
Yg"
IA1 1 11 1 \R1I[',W1I\
[I A � 1, VII ON i I �, / i0
I I I I P , 'r;Nl, V� '1111,
CITY OF ROSEMEAD
ROSEMEAD, CALIFORNIA
NOTICE OF CLARIFICATION
FEDERAL SAFE ROUTES TO SCHOOL
WALNUT GROVE AVENUE ENHANCEMENT PROJECT
PROJECT No. SRTSL-5358(016)
To All Prospective Bidders:
Please note the following clarifications on the specifications for the above. project
1. For BID ITEM No. 14: CONSTRUCT TRAFFIC SIGNAL IMPROVEMENTS AT
WALNUT GROVE AVE. AND V/U_LEY Rij) a,t-w%r,t o vml
please refer to Section' Tech rucal Provision page
2. For BID ITEM No. 15: INSTALL SIGNAGE, 'nTRWING, AND PAVEMENT
MARKINGS AT VARIOUS LOCA1 IONS, please refer to Section 'Technical
Provision", page TP-16-17 of Specifications. Under "TRAFFIC STRIPES AND
PAVEMENT MARKINGS", Section 84-2 THERMOPLASTIC, the Specifications calls
for all striping to be thermoplastic
BY ORDER OF THE CITY OF ROSEMEAD
Date September 2. 2014
By
Rafael M. Fajardo
Associate Civil Ftigineei
Acknowledgement:
Bidder
Title:
Date:
Plg, I of i