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Gentry Brothers Inc. BIDDER: GENTRY BROTHERS INC E__ 1 SECTION 1 - BID SCHEDULE I I CBF- 1 '"'l� BIDDER: GENTRY BROTHERS INC BID SCHEDULE SCHEDULE OF PRICES FOR ANNUAL RESIDENTIAL RESURFACING PROJECT HELLMAN AVENUE FROM JACKSON AVENUE TO NEW AVENUE PROJECT No. 21019 BASE BID SCHEDULE UNIT OF EST. UNIT ITEM NO. ITEM DESCRIPTION MEASURE QTY. PRICE COST 1 Clearing &Grubbing per plans LS 1 ._ and specifications. See technical 3 . . 00O 3,1 0 C provisions TP-2, TP-3 &TP-4. 2 Disposal of Waste Materials. LS 1 loco : SOco • 3 Cold mill 2.0-inches thick existing SF 50,700 i / S �6 pavement. 4 Construct 1.5 inches thick TONS 460 p pavement overlay ARHM-GG-C c to 766 (PG 64-16) as indicated on the n plans. 5 Construct 1.0 inches thick TONS 350 Asphaltic Leveling course D1 F -1 cc(PG 64-10) as indicated on the 7f ,R )-1 plans. 6 Remove 6-inches of existing SF 400 w pavement and replace it with 4- 'I a y G inches of AC B-PG 64-10 Base f� Course over compacted native. 7 Remove Existing, Dispose and SF 730 Construct 4-inches thick PCC Sidewalk per SPPWC Std. Plan �j 9 3 9 o 113-1. 8 Remove Existing, Dispose and LF 394 Construct 8-inches Curb and 24- / 7, 7 36 inches Gutter per SPPWC Std. 9-1./ Plan 120-2. 9 Remove Existing, Dispose and EA 4 p Construct PCC Curb Ramps per / / 00 •• 6 66 . SPPWC Std. Plan 111-4. 10 Remove Existing and Construct SF 825 6-Inches Thick Driveway cw 7 J Approach per SPPWC Std. Plan �• ,S 110-2 CBF - 2 BIDDER: GENTRY BROTHERS,INC UNIT OF EST. UNIT ITEM NO. ITEM DESCRIPTION MEASURE QTY. PRICE COST 11 Double Adjust Sewer Manhole to EA 7 „ Grade perSPPWC Std. Plan CO , ycioo 205-1 and 206-1. 12 Adjust Water Valve/Gas Valve to EA 19 Grade. /oO / 900 • 13 Install Survey Well Monument EA 3 per City of Rosemead Std. Plan 508-001. See Section 2-9 r — Surveying of the General 7J 6 f a ).TO Provision-7 per details (Cover, I Sleeve & Dome will be provided by the City at no cost). 14 Install Traffic Striping, Traffic LS 1 Signal Loops and Pavement `� 11 3 c ce - Markers per the Striping Plans 23 BCC . a i and Specifications Complete. 15 Install 36-Inch Box Parkway Tree EA 20 Pyrus New Bradford (Holmford) Pear" including 90-days maintenance eriod and tree G wells per SPPWC Std. Plan 520- �0 �0 3 UaO 4. 16 Remove and Dispose Existing EA 5 Trees 24-Inches Average 730 7 3 coo Diameter Complete. TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ °Z a'- 9 sib -7,.,e /11,i.i 4,,,-1y " .L:-.iii 7,(.,,i4_i AK._Ad r/'r, -i:;d d./ e.i 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 CBF - 3 BIDDER: GENTRY BROTHERS,INC written amount of the Bid Price and the numerical amount of the Bid Price,the written amount shall govern. Attached hereto is a certified check, a cashier's check or a bid bon in the amount of �� Dollars($ said amount being not less than cent(10%)of the Total Bid P r ? undersigned roes 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 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 Bidders California contractor's license(s)in good standing;(2)evidence that the person signing this Bid is authorized to bind Bidder to this Bid and to a contract resulting therefrom; and (3) any other information and documentation, financial or otherwise, needed by Owner to award a Contract to the lowest responsible and responsive bidder. Bidder understands and agrees that liquidated damages shall apply to this Contract in the amounts of five hundred dollars ($500.00) if project is not completed in THIRTY (30) calendar days. The Contract Time will begin to run ten (10)Working Days from the date of the Notice of Proceed and subject to the terms and conditions described in the Contract Form and the Contract Documents. Bidder acknowledges that data submitted with its Contract Bid Forms which it requires to be --I 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-4 BIDDER: GENTRY BROTHERS,INC 384 LIVE OAK AVE. By IRW INDALE CA 91706 Signatur Business Street Address Type or Print Name City, State and Zip Code jnpsldsk 35- - yv3i Title Telephone Number Bidder's/Contractors State of Incorporation: C 4 ( Partners or Joint Venturers: Bidder's ?cr.?License Number(s): i 6 8 Department Industrial Relations Registered No. / 00000 ZYO 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 Bidden,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-5 { BIDDER: GENTRY BROTHERS, INC SECTION 2 BID DATA FORMS 11 CBF-6 BIDDER: Gentry Brothers, 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 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 Gentry Brothers, Inc. ,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 DOLLARS ($10% ), being not less than ten percent(10%) of the Total Bid Price;for tie payment of which sum will and truly to be made,we bind ourselves, our heirs,executors, administrators,successors,and assigns,jointly and severally, firmly by these presents. WHEREAS, said Principal has submitted a bid to the OWNER to perform all Work required for the ANNUAL RESIDENTIAL RESURFACING PROJECT—HELLMAN AVENUE FROM JACKSON AVENUE TO NEW AVENUE as set forth in the Notice Inviting Bids and accompanying Bid Documents,dated January 21, 2015 NOW, THEREFORE, if said Principal is awarded a Contract for the Wodc 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 rewired bonds (one to guarantee faithful performance and the other to guarantee payment for labor and materials) furnishes the required insurance certificates and endorsements,and furnishes any other certifications as may be required by the Contract,then this obligation shall be null and void;otherwise it shall remain in full force and effect. In the event suit is brought upon this bond by the OWNER and judgment is recovered,said Surety shall pay all costs Maimed by the OWNER in such suit, including reasonable attorneys'fees to be fixed by the court. SIGNED AND SEALED,this 13th day of January . 2015 Gentry Brothers, Inc. (SEAL) Federal Insurance Company (SEAL) Principal -. Surety Li 6 J7 By: ` r�ANAo{ry Ltc.ci3 Sign yr-r Signature Linda D. Coats,Attorney-in-Fact CBF -7 • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§1189 :eis- crsr ---'ta7 .SZrrc:ecarat&ie sffiOCArECm A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of Orange On • rC1 V1611')✓✓I 13, 7A I S before me, Summer L.Reyes,Notary Public Dale `{ere Insert Name and Title of the Officer personally appeared Linda D.Coats Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person* whose names} is/ere subscribed to the within instrument and acknowledged to me that he/she/they executed the same in -is/her/their authorized capacity(res(,and that by hie/her/their signature(s}on the instrument the person$) or the entity upon behalf of which the person(*acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. SUMMER L.REYES WITNESS my hand and official seal. Commission # 1986627 : ',9'994':). Notary Public -California n 3 '�''' Orange County Signature My Comm. Expires Jul 29,2016 Signa e of Notary Public Place Notary Sea/Above 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: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(es) Claimed by Signer(s) Signer's Name: Signer's Name: • Corporate Officer — Title(s): ❑ Corporate Officer — Title(s): U Partner — ❑Limited C General U Partner — 7 Limited C General • Individual ❑Attorney in Fact U Individual G Attorney in Fact ❑Trustee Li Guardian or Conservator U Trustee ❑Guardian or Conservator 91 Other: H Other: Signer Is Representing: Signer Is Representing: ©2014 National Notary Association •www.NationalNotary.crg • 1-800-US NOTARY(1-800-876-6827) Item #5907 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 Linda D.Coats and Matthew J.Coats of Laguna Hills,California -each as their true and lawful Attorney-in.Fact to execute under such designation in they names and to affix their corporate seas to aria deliver for and an their behalf as surely thereon or otherwise,bonds and undetlakings and Other writings o&'gatory in the lathe Inanot(other than bail bonds)gwen or exfatta.n the course at buSE,aSS,and any instruments amending or altering the same.and consents to the modification R alteration at any'Instnbeen referred to in said bonds or odgatins. In Witness Whereof,said FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY have each executed and attested - thesepresents andaffpedtheirm'porate sea on this 1st dayp December,2011. l////\I Lam.-- .."). Kenneth O .ndN, ',swam '-RGOry David B. Jr,Vice President .". STATE OF NEW JERSEY County of Somerset onus 1st day or December,2011 before me,a Notary Public of NecJersey,personally dame Kenneth C.Yvcndet to me known to be Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY.the companies which exaatd the foregoing Power of Attorney, and the said Kennet C.Wendel, berg by me duty sworn, did depose and say that tae is Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNrTY COMPANY and knows the corporate seals tared..that the seals affixed to the foregoing Power of At Orley are such corporate seals and were thereto affixed by authority of the By-Laws of said Companies:and That he signed sad Power of Attorney as Assistant Secretary of sad Companies by like authority:and that he is acduainlee with David B.Norris,Jr.,and have him to be Vice President of bpd Companies;and that the signature of David S.Name Jr.,subscribed to said Power of Attorney is in the genuine Iandwnting of David B.Nonis.Jr.and was thereto subscribed by authority of said By- Laws and in ceponeni's presence. Natal Seal KATHERINE J.ADELMR G. / NOTARY No.2 16 NEW JF201 4 i ,{,PUBLIG 1111 Commarion bairn holy lA.2014 Notary Public ohs ere .tar re.', CERTIFICATION Extract loco the By.Laws of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY'. 'All powers of attorney for and or.behalf et the Company may and shall be executed in lie name and on behalf of the Company,either by the Chairman or the President or a Ma President or an Assistant Vice President,jointly veth the Secretary or an Assistant Sareary,under their respectve desgnafnns. The signature of such officers may be engraved,prated or lithographed.The signature of each of the follwmg officers.Chairman.President any Vice President,any Assistant Vice President,any Secretary.any Assistant Secretary and tie seal of the Company may be steed by facsimile 10 any power of attorney or to any certificate ream thereto appointing Assistant Secretares or Attorneys-In-Fact for purposes only of exactas and attesting tons and undertakings and other writings oaflgalory in the nature thereof.and any such power of attorney or certificate bearing such facsimile s'Ignature or facsimile seal shall be walk ant binding upon the Company aria any sum power so executed and certhed by such facomhk signature and facsimile seal shall he valid and binding upon the Company with respect to any band or undertaking to which t is afacned.' I,Kenneth C.Wendel,Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY the'Companies')do hereby arty that (I) the foregoing extract W the By-Laws of Ca Companies is true act correct. (ii) the Companies are duly tensed and auTor ed to transact surely buairess in all 50 Of the United States of America and the District of Columbia and are authorized by the U.S.Treassy Depart/ant;furter.Federal and Vigilant are licensed in Puerto Roo and Vie U S.Virgin Islands.and Federal is licensed in Amencan Samoa,Guam.and each of the Prosiness M Canada except Prince EdWa'd island;and pig) the foregoing Power of Attorney N true,correct and in full tree and effect. Gen under my hand and seats of said Companies at Warren,NJ this 13th day of January, 2015. " "a ✓ '�; .ci h i Ili. J€ Kenne nendel -aslant 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 15-10-0225B-U (Ed.5.03) CONSENT California 'Acknowledgment Form A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached.and not die truthfulness,accuracy.or validity of that document. State of California 1 ss. County of Los Angeles ,., On January 21, 2015 • before me, N. Smith (here insert name and title of the officer) personally appeared Rodney J. Gentry who proved to me on the basis of satisfactory evidence to be the person(ef whose name( is/are subscribed to the within instrument and acknowledged to me that he/9800191 executed the same in his/MD: 61t au- thorized capacitygiQc and that by hislkdfMXl (r signature)(on the instrument the personae), or the entity upon behalf of which the person(e 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. Seal — WITNESSmy hand and offpial seal. N.SMITH % �. rL_:. Corneal 2012524 w , Ee NOTARY PUauccOLI1;GIA N {;R/ IOSlexepESCOV2 elute of Notary dl ii Yr Caxx.EAV.RPe 210n Optional Information To help prevent fraud.it is recommended that you pros We inlmmeon about the attached document below. **lids is not required tinder California State notary public law.' Document Title: Bid Bond #of Pages: Notes ©1014 Golden State Notary,Inc. wow.Notary net (S88)26 3-1999 BIDDER: GENTRY BROTHERS,INC • 2.B LIST OF PROPOSED SUBCONTRACTORS In compliance with the "Subletting and Subcontracting Fair Practices Act," Sections 4100 through 4114 of the California Public Contract Code, and any amendments thereto, each Bidder shall provide the information requested below for each subcontractor who will perform work,labor or render service to Bidder in or about the construction of the Work in an amount in excess of one-half of one percent (greater than 0.5 %)of the Bidder's Total Bid Price, or, in the case of bids or offers for the construction of streets or highways, including bridges, in excess of one-half of 1 percent of the Contractor's total bid or ten thousand dollars ($10,000), whichever is greater, and shall further set forth the portion of the Work which will be done by each subcontractor. Bidder shall list only one subcontractor for any one portion of the Work. Pursuant to Public Contract Code Section 4104,the Owner has determined that it will allow Bidders twenty-four(24)additional hours after the deadline for submission of bids to submit the information requested by the Owner about each subcontractor,other than the name and location of each subcontractor. If the Bidder fails to specify a subcontractor for any portion of the Work to be performed under the Contract, it shall be deemed to have agreed to perform such portion itself, and shall not be permitted to subcontract that portion of the Work except under the conditions hereinafter set forth below. Subletting or subcontracting of any portion of the Work in excess of one half of one percent (greater than 0.5%)of the Total Bid Price or, in the case of bids or offers 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: GENTRY BROTHERS.INC 2.8 LIST OF PROPOSED SUBCONTRACTORS(continued) rouporate Next 2 Pages it needed for listing additional subcontradors."1 Name and Location Description of Work of Subcontractor to be Subcontracted Name: ✓ C-.�, p 5 12, 9 Address: tio�y 64. 6 (4 0 License No.: Si; a 3 6-0 - Department of Industrial Relation Registration No. Name and Location Description of Work of Subcontractor y to be Subcontracted Name: A C. - /4o K ).c.v1 K NT. ••LGJ OOtoS Address: LA PuF A,-{-z- (4 License No.: 7 9 3 9 Department of Industrial Relation Registration No. Name and Location Description of Work of Subcontractor to be Subcontracted Name: ) .,,,-� Na_ .. (nI.F L. ad.-/ a 14,4 Address: F, 4...�. License No.: -15"3'b6I Department of Industrial Relation Registration No. Name and Location Description of Work of Subcontractor to be Subcontracted Name: / /ti %air 54 ., ,,. 0.7 Address: own.,/7.: r4 RF A. �,..- 740e! License No.: 4, S y f o to Department of Industrial Relation Registration No. Name and Location Description of Work of Subcontractor to be Subcontracted Name: Address: License No.: Department of Industrial Relation Registration No. CBF - 9 BIDDER: GENTRY BROTHERS.INC 2.0 REFERENCES The following are the names,addresses and telephone numbers for three public agencies for which BIDDER has performed similar work within the past two (2)years: 1. A c1J Name and Address of Owner Name and telephone number of person familiar with project Contract amount Type of Work Date Completed 2. Name and Address of Owner Name and telephone number of person familiar with project Contract amount Type of Work Date Completed 3. Name and Address of Owner Name and telephone number of person familiar with project Contract amount Type of Work Date Completed 4. Name and Address of Owner Name and telephone number of person familiar with project Contract amount Type of Work Date Completed CBF - 10 0 S O "< o O O ¢ n O = o ° p ono p 40. o z; *:o . .5-3 ° o o " 0 z o S ° 0 3 p ° o p 3. ° 9, ° N m c a _ 00 n Z 3 3 0 ti D D c c (� _2 _ °�^ m 0 $ a m a o a r. e m 3 N � °Ni a^ 4 u m m M IQ NJ 710 -6 O m O O W U - N v N O 0 O - O N N 0 A O - 0 41 a O a d a 0 f D r - d a a w n A d v g A o y v z - D y A a D 3 3 m ? 0 m m 3 o a °$ 0 a 0 0 3 s D m g o n m ° m. _ g2 y 0 y. c mo A a ° o O S A O m_ ^ _. F O N A E 3 a N # N - co = ° do d o N `G < m a a c m 0 D n z Na rvm a 3v A _3 g i = - `c m _. -0o a3 20 - 8 > a m H w3 m ry ow° w - ° o 2 o °-' a �o y a Ua a o $ - AF 3 3m uuo G • s ng O• m a. x ♦ o � ° a A W A 2 m ', pwN PI0 m � i3 a w 0. w ,,- ? y O c < H .. n y 0 o 0 ° ¢ d a ° * 3 u 4- m a a a D N ° m A - n i 4O w (° a _ p O a ° y u y a" A - a • a a < - ° oC - w -. sw = ; � o v a z a w e 3 CO _ o D n a s p = k m `m o _ `m 0 0 0 v - w a < x 3 `-° a m cc 3 ° m CD to x m °' ( 0 0 m m `m o 3 z CO m 0 z n CO � to " R a v v 3 g wv ° v 6 A a 0 m0 N a < 0 LV O) D CO CO X X R v a 2 0 CO D _T I -1 s $ w u 3 c - - O 3 d .3 o w O � _ o ti a, 5 o _, , a cr, a U a 0 T 0 • p a • w w a w 4 x a a a a a a a a a a a a a a a a a a a a a ° ' ° VI - aa N O v w _ _ _ O o A .I U A _ 72 . O• - a C 0 AI o > o 0 0 0oow 0 000 o wooa0 00 • 9 9 > 0 N p m , � 0 • , om T p _ A A ➢ a A p wo QA -▪ 5 - - A A A • A w➢ w a w w w w A 3 m z p o D a m N 0 a 0 0 a a co 0 N w CO gif _ 0 _ _ _am o m m A m m m m A . a m m m m X 5 n ] n 'I j 72 4 1p m a O 0 0 301 1 6 - g � " - n < 3 ` Z a a ' m m m* m m - It m A m m V 01 0 0 01 p 0 n bi w O A N m A m q N M p - - 2 2 .1 D m i m F m o nq w 0j m a M m m 90 a O m a A y O m n m O d m p p en a a ' 3 = A - m , o n y g O m * O R y 6 y 2 u 90 a N - m y = T - a o < m r 3 mm3 Um ilywg - .% a tom rig mm o Q oy - °I ° omo WD J m a o m * 2 92 g o m m m co iv 2 F a l m - 3 = I N d g■ A g CO -i a A LC sl. 7 m It w a I 0 --1 m -1 10 0 O m . 8 co y 3 T = CNJ D S 41 a O A i ^ o N m m m 2a u u tl M w m m H 0 (n m w w w 0 AN A g2y m CO2 0 01 m o o o 0 e - 2 nO o o oo oo 0 oo °0 0 0 1 \ pp - •- 0R O? a c a ua _ i(T 6 A A A o x (0 a y3 a a a a N D 111 2 BIDDER: GENTRYSnnrurnq IhIc SECTION 3 NON-COLLUSION AFFIDAVIT CBF- 11 BIDDER: GENTRY BROTHERS !Air 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 /' <I 6 I Typed or Printed Name Title GENTRY BROTHERS INC Bidder Subscribed and sworn before me This_day of , 20 (Seal) Notary Public in and for the State of California My Commission Expires: CBF- 12 California Acknowledgment Form • A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy.or validity of that document. State of California 1 SS. County of Los Angeles On Sanitary 21, 2115---- — before me, N. Smith , (here insert name and title of the officer) personally appeared Rodney J. Gentry who proved to me on the basis of satisfactory evidence to be the person(Sf whose name®is/are subscribed to the within instrument and acknowledged to me that he/ifOe)(NN executed the same in his/NnffOt au- thorized capacityW and that by histtlIO b(r signature Con the instrument the person®, or the entity upon behalf of which the person(4 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. Seal 7 WITN€SS my hand and official seal. 1 ] m, 51.SMITH '�'.ya, ) N n COMM.L 2012524 N ./ /(/lam'^• [Jit xn1AAYrMrtl6 CALIFORNIA _ J / tos AxGtt[6 co,xir Signal re of Notary IAr Coss.Exi7 APR t,1017 ` Optional Information To be 1p prevent fraud.it is recommended that you provide information about he attached document beton ...mists pm required under Cal horn m State notary public link °t Document Title: Non-Collusion Affidavit #of Pages: Notes c( 4 1t 02014 Golden State Notary,Inc. nutty Notary net (MPG 81 26 3-19 77