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Bidder: M.W Loyd Inc. BIDDER: L'I'B W L.a Y C C SECTION 1 - BID SCHEDULE CBF- 1 BIDDER: iNl .0-, Loya3• �a-c BID SCHEDULE SCHEDULE OF PRICES FOR SIDEWALK INSTALLATION PROJECT-KLINGERMAN STREET FROM LA PRESA AVENUE TO PALJAY AVENUE PROJECT No. 21006 BASE BID SCHEDULE UNIT OF EST. UNIT ITEM NO. ITEM DESCRIPTION MEASURE QTY. PRICE COST 1 Clearing 8 Grubbing per plans LS 1 and specifications. Zit ccc. Z31FJCt, co 2 Disposal of Waste Materials. LS 1 7000 co /O C:Cj 3 Remove,dispose and Construct SF 1,250 / 00 / > ©O no 4-inch thick PCC sidewalk per i SPPWC SW. Plan 113-2. 4 Remove, dispose and Construct SF 340 PCC driveway approach per Z 9, 00 qs60, rC SPPWC Std. Plan 110-2. 5 Remove Existing, Dispose and LF 100 Construct 8-inches Curb and 24- /Off, 00 /O 5-00,oo inches Gutter per SPPWC Std. Plan 120-2. 6 Remove and dispose complete EA 3 existing parkway tree, Z 5-04 oo 7660,00 approximate 24 inches Dia. 7 Remove and dispose complete EA 1 r existing parkway tree, rat).° ccc, Ov approximate 6 inches Dia. 8 Install 36 inches box parkway EA 7 ZOOfJ I�OC>rl tree—Jacaranda Tree including co 90 days maintenance. Q �// TOTAL BASE BID PRICE (SCHEDULE BID PRICE):$ a" O b O. 00 Dollar amoutnt in written form tO6(./4 vSr CBF-2 BIDDER: LOY±1)_4..rivC 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 3-22.1 of the Standard Specifications,to stay within the budgeted amount of this project. If the Bid Documents specify alternate bid items,the following Alternate Bidamounts 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the Project The undersigned agrees that these Contract Bid Forms constitute a firm offer to the Owner which cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and after the bid opening date, or until a Contract for the Work is fully executed by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 F 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 bid bond in the amount of 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. 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 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. 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 wn ten (10)Workinq Days from the date of the Notice of Proceed and subiect 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. CBF - 3 BIDDER: i,A4 , Z-0 /0 L•" 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: Olt , w , LOS, By: iv4 r✓!/ l 36 411£1J 41c-2. Signature / Business Street Address wt (f(Q -t. 04zA_✓ 04_ of 0 ,/ 9&3i/ Type or Print Name City, State and Zip Code Title Telephone Number Bidder's/Contractor's State of Incorporation: C 4 Partners or Joint Venturers: Bidders License Number(s): ( ( ( U 3 y Department Industrial Relations /©O ocd _73 hJ/ g Registered No. NOTES: 1) By its signature on this Bid,the Bidder certifies under penalty of perjury the accuracy of the representations made on the Contract Bid Forms. 2) If Bidder is a corporation, enter State of Incorporation in addition to Business Address 3) If Bidder is a partnership or joint venture, give full names of all partners or joint venturers. As further discussed in the Instructions to Bidders, Bidder will be required to provide evidence that the person signing on behalf of the corporation, partnership or joint venture has the authority to do so. CBF-5 CERTIFICATE OF SECRETARY OF M.W. LOYD, INC. I, WILLIAM L MURDOCK, certify as follows: ' 1. That I am the duly appointed and acting secretary of M.W. LOYD, INC., a California corporation. 2. That on / 0 - Z 3 — / 7 , the Board of Directors of M.W. LOYD, INC., duly adopted the following resolution: RESOLVED, that WILLIAM L MURDOCK, is hereby authorized, as an act of and on behalf of this corporation, to Submit a contract proposal to S ii: m `T— g t^--P 4 CQ_ in accordance with its request for bid # Zyco 6 dated /0-057-17 3. That this resolution has not been amended or rescinded. Dated: /a- z-; r. 2° 7 -J William L. Murdock BIDDER rYL C9->: Loyal CRC SECTION 2 BID DATA FORMS CBF-6 Bond No. 3958 BIDDER M.N. Loyd, 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 adequatelyprovide the information required. Bidder shall ensure that every pageofits Bid Data Forms ate property identified with the Bidders name and page number. 2.A BID BOND KNOW ALL MEN BY THESE PRESENTS: THAT M.N. Loyd, Inc. as Principal, and Developers Surety and Indemnity Company as Surety, are held firmly bound unto the CITY OF ROSEMEAD (hereinafter called the OWNER) in the sum of TEN PERCENT OF THE AMOUNT OF TBE BID ******************** DOLLARS ($ 10E*****************) being not less than tan percent(10%)of the Total Bid Price;for the payment of which sum will and truly to be made,we bind ourselves, our heirs,executors,administrators,successors,and assigns,join0y and severally, finely by these presents. WHEREAS,said Principal has submitted a bid to the OWNER to perform all Work required for the SIDEWALK INSTALLATION PROJECT KLINGERMAN STREET FROM LA PRESA AVENUE TO PALJAY AVENUE as set forth in the Notice Inviting Bids and accompanying Bid Documents,dated October 25, 2017 , 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 Dovanent), 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 endorsement),and furnishes any other certifications as may be required by the Contract,then this obligation shall benull and void;otherwise It shall remain in fun force and effect. In the event suit is brought upon this bond by the OWNER and judgment is recovered,said Surely shall pay all costs Incurred by the OWNER in such suit Including reasonable attorneys fees to be fixed by the court. SIGNED AND SCALED, this 24th day of October , 2017 . Developers Surety and M.W. Loyd, Inc. (SEAL) Indemnity Company Principal ,� Surety `'� • �/`i–Presi ent By. M. —� – '(�—) William urdock–Press en[ Les M. Mantle–Attorney in Fact CBF-7 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 t.a.-t.nt. . „< ....r..Y ,crw<..<..<. ,.d,.. 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 10 -0-4-t`C / before me, Mary Martignoni - Notary Public Date Here Insert Name and Title of the Officer personally appeared Les M. Mantle Name(s)of Signers) who proved to me on the basis of satisfactory evidence to be the persons whose name(* isle subscribed to the within instrument and acknowledged to me that he/See/Self executed the same in hisfhpralyeilr authorized capacity ), and that by hisI et/ keir signature94 on the instrument the person))L 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 3 is true and correct. { MARY ibiARl IGNONI j WITNESS my hand and official seal. COMM #2123099 m iit4A V Priv ULI_ aNVI# .Hanoi i.1_� ( Sfgnatur= My Commission 4pres Sept 9,1019 Signatu er Notary Public Place Notary Seal 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(ies) Claimed by Signer(s) Signer's Name: Les M. Mantle Signer's Name: Corporate Officer - Title(s): -Corporate Officer - Title(s): -7 Partner - H Limited Li General Partner - 1' Limited L General Individual S Attorney in Fact -_J Individual El Attorney in Fact 13 Trustee Guardian or Conservator -Trustee O Guardian or Conservator Other: i- Other: Signer Is Representing: Developers Surety & Signer Is Representing: Indemnity Company b ©2014 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item #5907 POWER OF ATTORNEY FOR DEVELOPERS SURETY AND INDEMNITY COMPANY INDEMNITY COMPANY OF CALIFORNIA PO Box 19725,IRVINE,CA92623 (949)2613300 KNOW ALL BY THESE PRESENTS that except as expressly limited,DEVELOPERS SURETY AND INDEMNITY COI.PANY and INDEMNITY COMPANY OF CALIFORNIA.do each hereby make,consbtde and appoint ...Les M. Mantle"' as bei true and IaxSAtomey(s)in-Fact,to make,execute,defter and acknoMedge,for and m behalf d said corporations,as sureties,buds,undertakings and wntracs of suretyship giving and granting unto said Aboney(s)-in-Fact full power and authority to do and to perform every act necessary,requisite or proper to be done in connection beewib as each d mid omoraton could do,but reserving to eah of said corporations lull power of substitution and revocation,and all of the acts of said Attorney(s)-in-Fact pursuant to these Present,are hereby rarified and confirmed. This Paver of Attorney is granted and is signed byfasimile under and by authority of the following resolutions adopted by the respective Boards of Directors of DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA.effective as of January 1st.2008. RESOLVED.that a combination of any Mo of the Chammm of the Bond,the President,Executive Vice-President,Senior VicoPresidemto any Vice President of the corporations be,ad that each of ten hereby is,authorized to execute this PUNT&Attorney,qualifying the attomey(s)named in the Prover of Attorney to execute,on behalf of the corporations,bonds,undertakings and contracts d suretyship,and that the Secretary or any Assistant Secretary of either of the c poratom be,and earn of Men hereby is,authorized to attest the execution d any such Poser of Attorney: RESOLVED,FURRIER,that the signatures of such office may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Poorer ofAhdney or cehficate bearing such facsimile signature shall be valid and binding upon the corporations when so affixed and in be future wth respect to any bond.undertzkmg a contract of suretyship to whim it is attached. 114 WITNESS WHEREOF,DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA have severally caused these presents to be signed by thee respective officers and attested by their respective Seaetary or Assistant Secretory this bed day°t Febuary,2017. By. �'� P:•�`�I.xOtyo't,, 4ay,PANY� Oanid Young,Sena VitePesMmt :y>r#,o*eW.6;{2.. i4tooProgY em, 1936 V - x1 : ° � `yam G yal A :��'.,Gtecm!'i bei' °'L x:I `�' Mark Lanztlon,Vice-President •., coo ,.pd„• trcpw•''Y 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 Conry of Orange On Febmary 6,2017 before me, Lucille Raymond,Notary Public Lau Ham Inset Mn end Tde of the error personally appeared Dani&Young and Mark Landon tmes)asP.tx who proved to me on he bass of satisfactory evidence to be the person(s)whose name(s)is/are subscribed lobe whin instrument ad alnodedget to me that he/shebey executed time sate In his/her/that autloized apady(es).and that byhisbermek signature(s)on the nstmment the person(s),or the entity upon behalf of LUCILLE RAYMOND whim the person(s)acted,executed the Instrument. t, Commission 12011915 I Notary Public•California I retry under PENALTY OF PERJURY under the leas of the State of California that be foregoing paragraph is a Oranpa County wcorrct e and e MXComm.res.Oct 13.201p f WITNESS my hand and olM1oal sea. Place Notary Seal Above Signabse Ludic cod,Notary Pudic CERTIFICATE The undersigned,as Secretary or Assistant Secretary of DEVELOPERS SURETY AND INDEMNITY COMPANY or INDEMNITY COMPANY OF CALIFORNIA,does hereby certify Mat the foregoing Paver of Attorney swans in full force and has not been revoked and,furthermore,that the provisions of the resolution of me respective Boards el Directors of said wporabos set fab in Me Pons d Attorney are in face as of the date of this Certificate. This Certfnate is weaned in the City o Inane,California,this 24th day of October, 2017_ •��wxk,'b4 00:ANYOw V9, �. `444pPOget C1 oi, 1936 : '• x, ' ° Cassie J. stud,Assistant Se tag p jj'1 0 4fi1 i ATS-1002(02)11) ................F a' BIDDER: )/' , fN, L. Gyip ra.-C_ 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 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 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: IM . ( R-✓, Loyd_ Z+( F 2.B LIST OF PROPOSED SUBCONTRACTORS(continued) t"Duplicate Next 2 Pages n needed for psnnp ammonat subconoactareel Name and Location Description of Work of SubcontractorCC to be Subcontracted-ra Name: LJ 4' C 1 Lcea 5a- r c-e / v�-Po 644_0(„4cZ ( Address, 7, 1/4( it/ eche Li i€_ icrS1t Ovn. Cha License No.: 45Cr V 7 ©6 p7-// --(( Department of Industrial Relation Registration No./Ot co° ?.6 Name and Location Description of Work of Subcontractor to be Subcontracted Name: /P.I Address: (.57-2-7/V 5Jz47P 3/ O�U'7ur^ro CKI License No.: C' �L) // Q Department of Industrial Relation Registration No./Od c,6 !� 17 Name and Location Description of Work of Subcontractor to be Subcontracted Name: Address: License No.: Department of Industrial Relation Registration No. Name and Location Description of Work of Subcontractor to be Subcontracted Name: Address: License No.: - t Department of Industrial Relation Registration No. CBF-9 1 (63 r 3 coco rn 0 0 O A i 3 8 g $ s 0 5 rn rn z -• a E 9 3 o g g � o Ss R C o C BIDDER: 0' 02J. (-0V 0 21CC 2.0 REFERENCES e-ye:Q-' 4*a c c q4 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. 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 a o 2. 2.0 o1 a z 3 g o n I-1 z m , o nl' K V RU 03 am � •, ; m . Lal,L) s o w y o n OZ Amp n n -Irz p n <F� n z N )r Z n mmn 0 n OD Zmp = Fa n mom Cl A n 0 o O D v nc `r l,t-tff� \` � a 0 M.W. LOYD, INC. P.O. Box 4266, Chatsworth, CA 91313 (818) 882-3208 • Fax (818)718-8259 REFERENCES AGENCY CONTACT PROJECT City of Los Angeles Mr. Hamid Navid Chatsworth Metrolink 600 S. Spring St. 213-847-5109 Site Improvements Los Angeles, Ca. 90014 City of Monterey Park Mr. Bellus Sarmas Russell Reservoir 320 W. Newmark Ave. 626-307-1321 Slope Protection Monterey Park, Ca. 91754 M.T.A. Mr. Warren Fu Concrete Restoration One Gateway Plaza 213-922-5028 at Division 8 Los Angeles, Ca. 90012 Burbank-Glendale-Pasadena Mr. Dan Feger Entrance Road/Cab Lot Airport Authority Mr. Bob Anderson Modifications 2627 Hollywood Way 818-840-9456 Burbank, Ca. 91505 Caltrans Mr. Ali Solehjou On Ramp Modifications 3190-J Airport Loop Dr. 714-556-9416 Macarthur & 55 Freeway Costa Mesa, Ca. 92626 City of Garden Grove Mr. Ron Meislhan Install Clarifier at 11222 Acacia Parkway 714-741-5390 City Yard Garden Grove, Ca. 92642 Caltrans Mr. Dan Fatoorechi Concrete Channel Repair 11126 Sepulveda Blvd. 818-361-5947 Mission Hills, Ca. 91345 City of Rancho Palos Verdes Mr. Dean Allison Ryan Park Slope Repair 30940 Hawthorne Blvd. 310-541-6500 Rancho Palos Verdes, Ca. 90275 City of Simi Valley Mr. Don Penman Police Station Utility 2929 Tapo Cyn. 805-583-6701 Relocation Project Simi Valley, Ca. 93063 City of Rancho Cucamonga Mr. Mike Long Concrete Pavement Repairs 10500 Civic Center Dr. 909-477-2740 Rancho Cucamonga, Ca. 91730 Los Angeles Community College Dist. Mr. Bruce Rosky Mission College Water 770 Wilshire Blvd. 213-891-2261 Leak Repairs Los Angeles, Ca. 90017 CONTRACTORS * ENGINEERS M.W. LOYD, INC. P.O. Box 4266, Chatsworth, CA 91313 (818) 882-3208 • Fax (818) 718-8259 REFERENCES AGENCY CONTACT PROJECT State of California Ms. Jean Carr Will Rogers St. Park 1925 Las Virgenes Rd. 818-880-0357 Waterline Calabasas, Ca. 91302 Los Angeles Unified S.D. Mr. Leonard DeLeon West Hollywood E. S. 355 S. Grand Ave. 213-633-8464 Ground Improvements Los Angeles, Ca. 90071 City of Los Angeles Mr. Vernon Tabirara 25th Street Sidewalk 433 S. Spring St. 310-732-4670 Improvements Los Angeles, Ca. 90013 County of Los Angeles Mr. Harry Campell Arbor Dell Debris Basin 900 5. Fremont Ave. 626-458-3112 Alhambra, Ca. 91803 City of Hidden Hills Mr. Dirk Lovett Round Meadow Road 6165 Spring Valley Rd. 818-888-9281 Improvements Hidden Hills, Ca. 91302 City of Arcadia Mr. Carlos Zamano Trash Enclosures 240 W. Huntington Dr. 626-256-6654 Arcadia, Ca. 91007 Inglewood Unified S.D. Mr. Tom Jeffries Site Work at Centinela E.S. 401 S. Inglewood Ave. 310-680-4883 Inglewood, Ca. 90301 Inglewood Unified S.D. Mr. Tom Jeffries Site Work at Parent E.S. 401 S. Inglewood Ave. 310-680-4883 Inglewood, Ca. 90301 Antelope Valley College Mr. Doug Jensen Perimeter Sidewalk 3041 West Ave. K 661-722-6470 Improvements Lancaster, Ca. 93536 City of Los Angeles Mr. Farouk Ossman Frank Modugno Drive Street 600 S. Spring St. 213-847-5161 Improvements Los Angeles, Ca. 90014 City of Los Angeles Mr. Rand Disko Fallbrook Ave. Street 600 S. Spring St. 818-756-8457 Improvements Los Angeles, Ca. 90014 CONTRACTORS * ENGINEERS • M.W. LOYD, INC. P.O. Box 4266, Chatsworth, CA 91313 (818) 882-3208 • Fax (818) 718-8259 REFERENCES AGENCY CONTACT PROJECT City of Los Angeles Mr. Chris Regilski Lecco Lane Slope Repair 650 S. Spring St. 213-847-4016 Los Angeles, Ca. 90014 Caltrans Mr. Gary Laurent Palmdale Blvd. Ramp P.O. Box 559 805-944-0612 Modifications Pearblossom, Ca. 93553 City of Los Angeles Mr. Pascal Challita Mulholland Dr. Slope 650 S. Spring St. 213-847-4018 Repairs Los Angeles, Ca. 90014 City of Fillmore Ms. Sarnia Yaximous 1st. St. Utility 250 Central Ave. 805-524-3701 Relocations Fillmore, Ca. 93015 Caltrans Mr. Ben Ghafghazi Iuna Canyon Rd. Storm 5534 Westlawn Ave. 310-306-8791 Drain Los Angeles, Ca. 90066 Cal-State Long Beach Univ. Mr. Ted Nakasuji Site Improvements at 1250 Bellflower Blvd. 562-985-4175 7th St. Long Beach, Ca. 90840 City of Los Angeles Mr. Robert Thaung Walker Ave. Street 433 S. Spring St. 310-548-7731 Improvements Los Angeles, Ca. 90013 City of Burbank Mr. Adam Salehi Elmwood .Ave. Street 275 E. Olive Ave. 818-238-3946 Improvements Burbank, Ca. 91510 City of Bell Gardens Mr. William Pagett Ross Auditorium Drainage 8327 S. Garfield Ave. 562-806-7774 and Sump Pump Improvements Bell Gardens, Ca. 90201 Los Angeles Unified S.D. Mr. Tom Wong Kenter Canyon E.S. 355 S. Grand Ave. 213-633-7592 Ground Improvements Los Angeles, Ca. 90071 CONTRACTORS * ENGINEERS M.W. LOYD, INC. P.O. Box 4266, Chatsworth, CA 91313 (818) 882-3208 • Fax(818) 718-8259 REFERENCES AGENCY CONTACT PROJECT State of California Mr. Angel Alba Malibu Creek St. Park Dept. Parks & Recreation 818-880-0369 RV Dump Station Pleasant Valley School Dist. Mr. Chris Johnston Concrete Repair 805-445-8783 Misc. Projects State of California Mr. Oscar Rodriquez Leo Carrillo St. Park Dept.Parks & Recreation 310-457-3932 Site Improvements Los Angeles Unified School Dist. Mr. David Chapman Grading & Demolition M&O 818-654-3753 Misc. Projects CONTRACTORS * ENGINEERS BIDDER'. LM . W /_OYla �2C. SECTION 3 NON-COLLUSION AFFIDAVIT CBF- 11 BIDDER: f kL&) LED Yo 4 u)e. 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. Si or ature llic t- L, tntec.E Typed or Printed Name Owfn2V Title fr(LOCz9 KjC Bidder Subscrib-• ;•• sworn before me This_day of , 20_ (Seal) Notary Public in and for the State of California My Commission Expires: CBF- 12 CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE§8202 ,1 See Attached Document(Notary to cross out lines 1-6 below) /❑See Statement Below(Lines 1-6 to be completed only by document signer's),not Notary) 1 2 3 4 Signature of Document Signer No. 1 Signature of Document Signer No. 2 (if any) 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// // Subscribed' and sworn too�(or affirmed) before me County of 6O5 aQ//�P«s on this 2yr-1, day of 4 Ohec 20 17 J by Date Month Year ,y (1) (/, • Oen L L . / r ✓/ locA (and (2) N/� ), GREGBERNABoo Name(efof Signer _ 4 Notary PuWlc-California like Los Angeles County i`u ni Commission121%629 [ proved to me on the basis of satisfactory evidence my Comm.Expires Apr 10,2021 to be the persorl4 who appeared befor me. Signature ignature of Notary Public Seal Place Notary Seal 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/' - - n , 144 Title or Type of Document:N h • Co/% SO' . , /Y f»Intf ', /Dpcument Date: 4 Number of Pages:/Signer(s)Other Than Named Above: /r'04 02014 National Notary Association •www.NationalNotary.org•1800-US NOTARY(1-800-876-6827) Item 115910