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CONTRACT 4721 Bid Other CLOSEDAgreement No. 4721
Big West Construction Corporation
City of El Segundo
Residential Sound Insulation Program
RSI 14-26 (Group 68)
To the Mayor and City Council
City of El Segundo
350 Main St.
El Segundo, CA 90245
I declare, under penalty of perjury, that I have carefully examined, become familiar with, and
understand all of the requirements of the Contract Documents and conditions under which the
Work must be performed, including the City of El Segundo's current Municipal Code, and am
fully informed as to all conditions and matters which can in any way affect the Work or its cost,
and agree to the following:
To perform all Work in strict conformity with the requirements of the Contract Documents for
Project Number RSI 14-26
"Residential Sound Insulation Program—Group 68"
at the f6flowing luny) sum rice:
RSI
ID Pro ert Address Bid Price
68.01 720 East Imperial Avenue, Unit 1 $ (6 r7 8 S
68.02 720 East Imperial Avenue, Unit 2 $ 1 (0 90 s
68.03 720 East Imperial Avenue, Unit 3 $ r10 5
68.04 720 East Imperial Avenue,Unit 4 $ 10
68.05 720 East Imperial Avenue, Unit 5 $ r7 Q 5
1111 68.06 720 East Imperial Avenue, Unit 6 $ 9
68.07 722 East Imperial Avenue, Unit 1 $ I ID
68.08 722 East Imperial Avenue, Unit 2 $
68.09 722 East Imperial Avenue, Unit 3 $ (o O
68.10 722 East Imperial Avenue, Unit 4 $
68,11 722 East Imperial Avenue, Unit 5 $ (p 7 b
68.12 722 East Imperial Avenue,Unit 6 $ (� 105
68.13 227 East Oak Avenue, Unit 101 $ O 5716 0
68.14 227 East Oak Avenue, Unit 201 $ 1-7 10
68.15 227 East Oak Avenue, Unit 301 $ I(o 910
68.16 227 East Oak Avenue, Unit 102 $ a 1 o 10
Bidding Form Appendix B-0 Last Modified:August 14,2014
Bidder's Proposal and Statement
it: ,qT�
t
City of El Segundo
Residential Sound Insulation Program
RSI 14-26 (Group 68)
68.17 227 East Oak Avenue, Unit 202 $ Q-761 (()
68.18 227 East Oak Avenue, Unit 302 $
68.19 227 East Oak Avenue, Unit 103 $ �'� in
68.20 227 East Oak Avenue, Unit 203 $ ►
68.21 227 East Oak Avenue, Unit 303 $
71vovr� Total Bid (Contract Sum)
pp
(words)
$ r
(figures)
In case of discrepancy between the words and figures, the words must prevail
Contractor Representative: 2- >A q
Signature Date
C AtOV
Name(printed or typed)
Title: � Contractor's State License Number:
Name of Firm:
Address: V;331 License Expiration Date:
Telephone Number: f
Type of Entity: ❑ Sole Proprietorship ❑ Partnership Corporation* ❑ Other
* If Corporation, evidence of authority to sign must be attached
Bidding r e Proo Proposal and Statement .�ppeiitit �, �� Last Modified:August 14,2014
p
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CORPORATION RESOLUTION
Big West Construction Corporation
January 4,2014
meeting of the of Directors was held on January 4, 2014 whereby a
resolution was adopted naming . Carr, President and Margaret J.
Carr, Vice-President/ Secretary. Both parties are authorized to execute
contracts on behalf of Big West Construction Corporation.
Stock as been redistributed as follows:
Thomas . Carr 50%
Margaret a C %
r
Thomas R. Carr, President i"+ ar garet J4 Care, icc:• r si�_
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17. BY SUBMITTING ]HIS STAf� INFORMATION&„rnY
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City of El Segundo
Residmial Sound Insulation Prtt rare
WS 14-26 (Group 68)
Bidder's Bond
(Not necessary when cashier's check accompanies[bidder's Proposal and Statement)
as principal ("Principal")and
North American S ecialt Insurance Com any — ,a corporation incorporated tiftdr
the laws of' the State o!' New mClmmrzrr-rslAirc. and licensed by the fate of
1�
California to execute bonds and uride'd8 irtgs aS sctic wrrrCty„ as urcty (;""la(€rety`"), our heirs,
executors, administrators,successors, and assigns. are jointly and severally bound to the City of
1''l Segundo, a general law city and municipal corporation existing under the laws of California,
in the surxr of
NOT TO EXCEED
he TO CXC 1 L�NINA r�N1N1 tITHOUSAND ANAND oo/loo w dollars a $99,()()0,00
to _y
_o be paid and forfeited to said City, its successors and assigns, if the Bid of the undersigned
I?rincipal with respect to RS1 14-26, Residential Sound In.sulatian Program — Cironp 68.
("P ()feet"), 3S specifically set forth in the Contract Documents, is accepted and the proposcd
Contract is awarded to said Principal, and said Principal fails or refuses to execute the
Residential Sound Insulation Program Contract goveming the Project in accordance with such
Bid as accepted and the Contract Docurncn s.
SIGNED AND SF;ALED this „ 10th day of November _ 20 14
Big West Construction orporatk)n North American Specialty'Insuralice Company
� �'un "t"'.�d"�ttilllict�
l riltoipal s President %iretyr s 1 rc„sid�itt g
Attorney-in-Fact
Prin s at.li's Secretary 'Surety's Secretary
Now, A11, signatures inust be acknowledged by a notary Public.
11rincipal's Mailing Address Surety's Mailing Address
Bi West Construction Corporation Crrr°dlr rraeA au,arr i I eraiar rrra Caanr,any
_ ,., ..m ._L„„,..,
15331 Normandre Ave. r'1"Iunon Centre ttr°ire Suite 850
Irvine, CAy„92604 Santa Ana CA 92707
Ridding Form 13°0? Last Moditi�cl;letauary 23,2014
Bidder's Bond
CALIFORNIA ACKNOWLEDGMENT
STATE OF CALIFORNIA
County of ORANGE
On NOVEMBER lU,2 14 before ms JENNIl t tt t ANAYA,NOTARY PUBLIC
Date lava tn�aa 9avma aA l'uilia gar RNw�a r�dl qua
personally appeared YUNG T.MULLICK
.. .....,
who proved to me on the basis of satisfactory evidence to
be the person( whose narnoM Ware Subscribed to the
within instrument and acknowled tent to me that helshePthey
executed the same in his authorized ca,pacity(ies),
and that by his/ ( I�*signatureiq on the instrument the
JE lf„ER C.ANAYA personal, awr the entity upon behalf of which the person(.
acted, esreouted the ins ument,
HNC,A y bg l d6gtt lit I certify under PEN A i OF `Ef-'IJLiRY under the laws of
'OUNTY 20 the State of CailforN. that t' foregoing paragraph oin is true
t�tY 'Ctd•taltf° " tlf6 and correct.
Witness my h rp and I M s,e 1.
Signature
Place Notary Seal Above Public
OPTIONAL
Though the information below is not required by law, it may grove valuable to persons relying on the document.
and could prevent fraudulent removal and reattachment of this Ponta to another document.
Description of Attached Document
Title or Type of Document:
Document Date:m .. ._ ._.. . ._ _ .._.. .. _ Number of Pages:
Signer(s) Other Than Named Above;
Caacity(les)Claimed by Signer(s)
Signer's Narne. r,.. ,..w.... wro.. ,...mmw..e. Signer's Name.w.v.._..
Corporate Officer 1
El Individual E] Individual
El corporate Otiioer�--- '°itte(s)'e_a.e . _. ,.m._ .w_ , w..., v� �1tle(s)..w
❑Partner—[I Limited Eleeneral [j Partner—El Limited ]general
�]Attorney in Fact 0 Attorney in Fact
Trustee EJ Trustee
Guardian or Conservator Top of thumb here CIGuardian or Conservator "thumb
Other;_ Other:
Signer Is Representing; E Signer Is Representing:
NAS SURETY GROUP
NORTH AMERICAN SPECIALTY INSURANCE COMPANY
WASHINGTON INTERNATIONAL INSURANCE COMPANY
GENERAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS,THAT North American Specialty insurance Company,a corporation duly organized and existing under
laws of the State of New Hampshire,and having its principal office in the City of Manchester,New Hampshire,and Washington International
Insurance Company,a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of
Schaumburg, Illinois,each does hereby make,constitute and appoint:
JENNIFER C.ANAYA,JAMES W.MOILANEN
and YUNG T.MULLICK
JOINTLY OR SEVERALLY
Its true and lawful Attomey(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its act and deed,bonds or other writings
obligatory in the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by
law,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the
amount of: FIFTY MILLION($50,000,000.00)DOLLARS
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of
Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held
on the 9d'of May,2012:
"RESOLVED,that any two of the Presidents,any Managing Director,any Senior Vice President,any Vice President,any Assistant Vice President,
the Secretary or any Assistant Secretary be,and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named
in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them
hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is
FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any
certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be
binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached."
..........._._ utaty
SEAL c r® Steven P.Anderson,Senior Vice President of Washington International Insurance Company SEAL `
m
1973 tlr� .. &Senior Vice President of North American Specialty Insurance Company ,
BY .�...... _.. _-e,........... ��
71/�yI�flllllptYl��
Day id M.Layman,Vice t tMtllde of W,ishmgton lnternational lnsm•anee Company MOO
&Vice President of North American Specialty Insurance Company
IN WITNESS WHEREOF,North American Specialty insurance Company and Washington International Insurance Company have caused their
official seals to be hereunto affixed,and these presents to be signed by their authorized officers this26th day of June 2012 .
North American Specialty Insurance Company
Washington International Insurance Company
State of Illinois
County of Cook ss:
On this 26th day of ....... June 2012 .before me,a Notary Public personally appeared Steven P.Anderson ,Senior Vice President of
Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and David M.Layman,
Vice President of Washington International Insurance Company and Vice President of North American Specialty Insurance Company,
personally known to me,who being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and
acknowledged said instrument to be the voluntary act and deed of their respective companies.
"OFFICIAL SEAL' r, f
I JNNA D�SKLENS
.........
Not Ary Ntitie,State of Illinois Donna D.Sklens,Notary Public
M Cortuuission Expires 101020 15
g y _wry_,,,,,,,,wwwww, ,wwwwwwwwwwwwot'North American Specialty Insurance Company and Washington
L Jeffrey Goldber the duly elected Assistant Secreta
International Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North
American Specialty Insurance Company and Washington International Insurance Company,which is still in full force and effect.
IN WITNESS WHEREOF,1 have set my hand and affixed the seals of the Companies this 10 day of NOVEMBER ,20 14
leffiey Craldbe,g,Vice President&Assisnal Secrelan of ......
Washington Imematmal hir—we.Company&North Ainerican specialty Insurance Company
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§1189
State of California
County of
On _ -h i ..�_, ` before me,
rr " .�Bbl1i Gpt tl'dt��")ttl�'JGLT ;
�A., pfgtlF3 d1U
personally appeared
#N3(u)W uqnis
who proved to me on the basis of satisfactory
evidence to be the person(s) 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(ies), and that by
his/her/their signature(s) on the instrument the
E
person(s), or the entity upon behalf of which the
COi3YI J Ci1R- NI person(s) acted, executed the instrument.
Commission#� 1939133
„ Notary Public-County California I certify under PENALTY OF PERJURY under the
Orange County ,
M Comm. x Tres Jun 26,,2015 laws of the State of California that the foregoing
paragraph
is true and correct.
WITNESS my hand and official seal.
Signature,,
Place Notary Seal Above uro N Wt y Public $
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document
tl and could prevent fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document: ------ ----------_-------._.-__.. _...._...._,,, .........
ft
Document Date:, _ Number of Pages:
Signer(s) Other Than Named Above: ...... ........ .— - ____................
Capacity(ies) Claimed by Signer(s)
Signer's Name: . - .....- -- ----- Signer's Name _ .... ...... f
❑ Corporate Officer — Title(s): .... ❑Corporate Officer — Title(s):
❑ Individual ❑ Individual r "
❑ Partner— ❑Limited ❑General Top of thumb here ❑ Partner — ❑ Limited ❑General
Top of thumb here
❑ Attorney in Fact ❑Attorney in Fact ;
❑ Trustee ❑Trustee
❑ Guardian or Conservator ❑Guardian or Conservator
Ll Other: , F
Ll Other: -- ---
Signer Is Representing: Signer Is Representing:
..
©2010 National Notary Association•NationalNotary.org•1-800-US NOTARY(1-800-876-6827) Item#5907
City of El Segundo
0 Residential Sound Insulation Program
RSI 14-26 (Group 68)
Non-Collusion Affidavit
The undersigned, being first duly sworn, deposes and says that he or she is authorized to
represent the party ("Bidder") making the foregoing Bid; that the Bidder has not directly or
indirectly entered into any agreement, participated in any collusion, or otherwise taken any
action in restraint of free competitive bidding in connection with such contract; that the Bid is
genuine and not collusion or sham; that the Bidder has not directly or indirectly induced or
solicited any other Bidder to put a false or sham Bid, or that anyone must 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 are true; and, further, that the Bidder has not,
directly or indirectly, submitted its 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.
I declare under penalty of perjury in accordance with the laws of California that the foregoing is
true and correct.
Name of Firm: Big West Construction Corporation
Address: 15331 Normandie Ave. Irvine, CA 92604
Telephone Number: 949-795-2219
Contractor Representative: Thomas R. Carr
Title: President
Signature:
* Must be subscribed and sworn before a Notary Public and Jurat notarization must be attached
Bidding Form Appendix B-03 Last Modified:January 23,2014
Non-Collusion Affidavit
CALIFORNIA JURAT WITH AFFIANT STATEMENT
i� . ✓ '°j�r ,? M k r , ' i,�� ;a 4' La,v�a," k � � ,m e,. „., �.° gym " Mr t 'a o�, ���a,., nati, e u .k rtl xa
State of California
Count �M
y of mom.....:. _...
Pee Attached Document (Notary to cross out lines 1-6 below)
C_1 See Statement Below (Lines 1-5 to be completed only by document signer[s], not Notary)
�a
--�--- --- Signature of Document Signer No.1 - - b gnature-of C)ocu -- --------- -
nroent tgner No.2('i any)
Subscribed and sworn to (or affirmed) before me on this
r' day of „W , by
....... ��� _ d
Date monin fie—ar
( �.. °
Narne of Si" ner
L) ersonally known to me
ROB t J.C RR-EBEL ❑ Proved to me on the basis of satisfactory evidence
Co 8310n 0 1939133 to be the person who appeared before me
Notary Public. California
(and
Orange County
COM!M.Cx Ire aun 9,CC15 )......_ _.._
Name of,d,guvor
❑ Personally known to me
❑ Proved to me on the basis of satisfactory evidence
to be the person who appeared before me.)
d
Sign#t re of Nlo my PufSk WW
Place Notary Seal Above �
OPTIONAL
Though the information below is not required by law, it may prove
valuable to persons relying on the document and could prevent . MEMO
fraudulent removal and reattachment of this form to another document. Top of thumb here Top of thumb here
Further Description of Any Attached Document
Title or Type of Document....___..........
Document Date: Number of Pages:
Signer(s)Other Than Named Above ..._.. .......
WINOI ;,q*,uw ;"", `,r,*4;,;�W i,h�,� .. .,;a,f`�'.,%e k„' ,;fin yW;�uy�s;,� ^^'r;,�,w��.�.�02f(”""U,' a� �r,�.'1"'G±.;,Y' .�,i`����'r "�w"�'C,'�.:'+'r`""�a`�.:' "".,'#,�'r,?.� ""w, bh. tir''`, r" ,a� ,m"�f✓.^"., ?of o
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02004 National Notary Association•9350 De Soto Ave.,P.O,Box 2402•Chatsworth,CA 91313-2402•www.NationalNotary.org Item#5910 Reorder:Call Toll-Free 1-800-876-6827
City of El Segundo
Residential Sound Insulation Program
RSI 14-26 (Group 68)
Bidder's Statement of Past Contract Disqualifications
Please state all instances of being disqualified,removed, or otherwise prevented from bidding
on, or completing, a federal, state, or local government project due to a violation of a law or
safety regulation.
Have you ever been disqualified from any government contract?
❑ Yes [R No
If yes, explain the circumstances:
Bidding Form Appendix B-04 Last Modified:January 23,2014
Statement of Past Contract Disqualifications
City of El Segundo
Residential Sound Insulation Program
RSI 14-26 (Group 68)
Bidder's Statement on Previous Contracts subiect to EEO Clause
The Bidder has participated ❑ has not participated in a previous contract subject to the equal
opportunity clause prescribed by Executive Order 11246, as amended, of September 24, 1965.
The Bidder K has submitted ❑ has not submitted all compliance reports in connection with
any such contract due under the applicable filing requirements; and that representations
indicating submission of required compliance reports signed by proposed subcontractors will be
obtained prior to award of subcontracts.
If the Bidder has participated in a previous contract subject to the equal opportunity clause and
has not submitted compliance reports due under applicable filing requirements, the Bidder must
submit a compliance report on Standard Form 100, "Employee Information Report EEO-I"prior
to award of the contract.
Note: Failure to complete the blanks may be grounds for rejecting the bid.
I declare under penalty of perjury that the foregoing is true and correct.
Name of Firm: Big West Construction Corporation
Address: 15331 Normandie Ave. Irvine, CA 92604
Telephone Number: 949-795-2219
Contractor Representative: Thomas R. Carr_ .... ....
Title: President
Signature
Dated this l°l day of 2014.
Bidding Form B-05 Last Modified:January 23,2014
Bidder's Statement on Previous Contracts Subject to EEO Clause
City of El Segundo
0 Residential Sound Insulation Program
RSI 14-26 (Group 68)
Certification of Non-Segregated Facilities
(Contractors/Subcontractors)
(A certificate of Non-segregated Facilities must be submitted prior to award of a contract or subcontract
exceeding$10,000 which is not exempt from the provisions of Equal Opportunity Clauses)
The Federally assisted construction contractor certifies that it does not maintain or provide for its
employees any segregated facilities at any of its establishments, and that it does not permit its employees
to perform their services at any location, under its control, where segregated facilities are maintained.
The Federally assisted construction contractor certifies further that it will not maintain or provide for its
employees any segregated facilities at any of its establishments, and that it will not permit any of its
employees to perform their services at any location, under its control, where segregated facilities are
maintained. The Federally assisted construction contractor agrees that a breach of this certification is a
violation of the Equal Opportunity clause in this contract. As used in this certification, the term
"segregated facilities" means any waiting room, work areas, rest rooms and washrooms, restaurants and
other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking
fountains, recreation or entertainment areas,transportation, and housing facilities provided for employees
which are segregated by explicit directive or are in fact segregated on the basis of race,color,religion, sex
or national origin, because of habit, local custom, or any other reason. The Federally assisted
construction contractor agrees that (except where it has obtained identical certifications from proposed
subcontractors for specific time periods) it will obtain identical certifications from proposed
subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the
provisions of the Equal Opportunity clause,and that it will retain such certification in its files.
Certification—The information above is true and complete to the best of my knowledge and belief.
Name of Firm: Big West Construction Corporation
Address: 15331 Normandie Ave. Irvine, CA 92604
Telephone Number: 949-795-2219
Contractor Representative: Thomas R. Carr
Title: President
Signature: .. .__._..
Dated this day of,�V wM$,,, 2014.
Note: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001.
Bidding Form Appendix B-06 Last Modified:January 23,2014
Certification of Non-Segregated Facilities
City of E1 Segundo
Residential Sound Insulation Program
RSI 14-26(Group 68)
Certification of Non-Segregated Facilities
(Contractors/ Subcontractors)
(A certificate of Non-segregated Facilities must be submitted prior to award of a contract or subcontract
exceeding$10,000 which is not exempt from the provisions of Equal Opportunity Clauses)
The Federally assisted construction contractor certifies that it does not maintain or provide for its
employees any segregated facilities at any of its establishments,and that it does not permit its employees
to perform their services at any location, under its control, where segregated facilities are maintained.
The Federally assisted construction contractor certifies further that it will not maintain or provide for its
employees any segregated facilities at any of its establishments, and that it will not permit any of its
employees to perform their services at any location, under its control, where segregated facilities are
maintained. The Federally assisted construction contractor agrees that a breach of this certification is a
violation of the Equal Opportunity clause in this contract. As used in this certification, the tern
"segregated facilities" means any waiting room, work areas, rest rooms and washrooms, restaurants and
other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking
fountains,recreation or entertainment areas,transportation, and housing facilities provided for employees
which are segregated by explicit directive or are in fact segregated on the basis of race,color,religion,sex
or national origin, because of habit, local custom, or any other reason. The Federally assisted
construction contractor agrees that (except where it has obtained identical certifications from proposed
subcontractors for specific time periods) it will obtain identical certifications from proposed
subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the
provisions of the Equal Opportunity clause, and that it will retain such certification in its files.
Certification—The information above is true and complete to the best of my knowledge and belief.
Name of Finn: " sip /NC
Address: 12o C© C. �... � . tea / lW
Telephone Number: S`kz %
Contractor Representative:
Title:
Signature;
Dated this day of 1&bA1Z7�A_R- „2014.
Note: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001.
Bidding Form Appendix B-06 Last Modified:January 23,2014
Certification of Non-Segregated Facilities
Nov, 18. 2014 11 : 28AM Mil Bard Windows No, 50x96 P. 4
City of Fl Segundo
Residential Sound Insulation Program
RS1 14-26(Group 68)
Certification of Non-Segregated Facilities
(Contractors/Subcontractors)
(A certificate of Non-segregated Facilities must be submitted prior to award of a contract or subcontract
exceeding$10,000 which is not exempt from the provisions of Equal Opportunity Clauses)
The Federally assisted construction contractor certifies that it does not maintain or provide for its
employees any segregated facilities at any of its establishments,and that it does not permit its employees
to perform their services at any location, under its control, where segregated facilities are maintained.
The Federally assisted construction contractor certifies further that it will not maintain or provide for its
employees any segregated facilities at any of its establishments, and that it will not permit any of its
employees to perform their services at any location, under its control, where segregated facilities are
maintained. The Federally assisted construction contractor agrees that a breach of this certification is a
violation of the Equal Opportunity clause in this contract. As used in this certification, the term
"segregated facilities" means any waiting room, work areas, rest rooms and washrooms, restaurants and
other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking
fountains, recreation or entertainment areas,transportation, and housing facilities provided for employees
which are segregated by explicit directive or are in fact segregated on the basis of race,color,religion,sex
or national origin, because of habit, local custom, or any othor reason. The Federally assisted
construction contractor agrees that (except where it has obtained identical certifications from proposed
subcontractors for specific time periods) it will obtain identical certifications from proposed
subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the
provisions of the Equal Opportunity clause,and that it will retain such certification in its flea.
Certification—The information above is true and complete to the best of my knowledge and belief,
Name of Firm: ,
Address: W 6; eA S-V, ��
Telephone Number: �.� f— C//R7 _
Contractor Representative: e. Z�.,'_q
Title: MIA
Signature:
Dated this day of 6C,,e ,2014.
Note: The penalty for matting false statements in offers is prescribed in 18 U.S.C. 1001.
Bidding Form Appendix B-06 Last Modified:January 23,2014
Certification of Non-Segregated Facilities
City of El Segundo
Residential Sound Insulation Pro rata
m RSI 14-26 (Group 68)
Certification of Non-Segregated Facilities
(Contractors/Subcontractors)
(A certificate of Non-segregated Facilities must be submitted prior to award of a contract or subcontract
exceeding$10,000 which is not exempt from the provisions of Equal Opportunity Clauses)
The Federally assisted construction contractor certifies that it does not maintain or provide for its
employees any segregated facilities at any of its establishments,and that it does not permit its employees
to perform their services at any location, under its control, where segregated facilities are maintained.
The Federally assisted construction contractor certifies further that it will not maintain or provide for its
employees any segregated facilities at any of its establishments, and that it will not permit any of its
employees to perform their services at any location, under its control, where segregated facilities are
maintained. The Federally assisted construction contractor agrees that a breach of this certification is a
violation of the Equal Opportunity clause in this contract. As used in this certification, the term
"segregated facilities" means any waiting room, work areas, rest rooms and washrooms, restaurants and
other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking
fountains,recreation or entertainment areas,transportation,and housing facilities provided for employees
which are segregated by explicit directive or are in fact segregated on the basis of race,color,religion, sex
or national origin, because of habit, local custom, or any other reason. The Federally assisted
construction contractor agrees that (except where it has obtained identical certifications from proposed
subcontractors for specific time periods) it will obtain identical certifications from proposed
subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the
provisions of the Equal Opportunity clause,and that it will retain such certification in its files.
Certification—The information above is true and complete to the best of my knowledge and belief.
Name of Firm: Discount Exteriors
Address: 17612 Beach Blvd. #13B Huntington Beach, CA 92647
Telephone Number: 714-596-6766
Contractor Representative: Robert T. Davis
Title: President
G
Signature:
Dated this 14th day of November ,2014.
Note: The penalty for making false statements in offers is prescribed in 18 U.S.C.1001.
Bidding Form Appendix B-06 Last Modified:January 23,2014
Certification of Non-Segregated Facilities
City of El Segundo
Residential Sound Insulation Progrant
RSI 14-26(Group 68)
Certification of Non-Segregated Facilities
(Contractors/Subcontractors)
(A certificate of Non-segregated Facilities must be submitted prior to award of a contract or subcontract
exceeding$10,000 which is not exempt from the provisions of Equal Opportunity Clauses)
The Federally assisted construction contractor certifies that it does not maintain or provide for its
employees any segregated facilities at any of its establishments, and that it does not permit its employees
to perform their services at any location, under its control, where segregated facilities are maintained.
The Federally assisted construction contractor certifies further that it will not maintain or provide for its
employees any segregated facilities at any of its establishments, and that it will not permit any of its
employees to perform their services at any location, under its control, where segregated facilities are
maintained. The Federally assisted construction contractor agrees that a breach of this certification is a
violation of the Equal Opportunity clause in this contract. As used in this certification, the term
"segregated facilities"means any waiting room, work areas, rest rooms and washrooms, restaurants and
other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking
fountains, recreation or entertainment areas,transportation, and housing facilities provided for employees
which are segregated by explicit directive or are in fact segregated on the basis of race,color,religion, sex
or national origin, because of habit, local custom, or any other reason. The Federally assisted
construction contractor agrees that (except where it has obtained identical certifications from proposed
subcontractors for specific time periods) it will obtain identical certifications from proposed
subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the
provisions of the Equal Opportunity clause,and that it will retain such certification in its files.
Certification—The information above is true and complete to the best of my knowledge and belief.
Name of Firm: H.K. ELECTRI CAL INC.
Address: 17428 LAHEY ST GRANADA HILLS, CA 91344
Telephone Number: 818-831-8800
Contractor Representative: HAT
ELI ZA K CHERIAN
....... __. . ... . ... _... ... .._. .......
.�
Title: CEO
Signature: .—......
��.,__. _ _ ._. ._. . ... �......
y NOM ,
Dated this 18T 1�a of NOVEMBER 2014.-„ _ _
Note: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001.
Bidding Form Appendix B-06 Last Modified:January 23,2014
Certification of Non-Segregated Facilities
City of El Segundo
Residential Sound Insulation Pm on
RSI 1426(Group 68)
Certification of Non-Segregated Facilities
(Contractors/Subcontractors)
(A certificate of Non-wgregotedl facilities must be submitted prior to award of a contract or subcontract
os eWirrg$10,000 which is not oxempt from the provisions of Equal Opportunity Clauses)
The Federally assisted construction contractor certifies that it does not maintain or provide for its
ploy ^s any a grqmed llhic^s ar any of its 'aebiisbrtrrrets,and that it does not permit its employees
to perform their services at any location,umdar its control,where segregated facilities are maintained.
"fbo.Federally assisted construction cornnau for cerfliks firrtlaoa that It will not maintain or provide for its
employees any segregated facilities at any of its establishments,ad that It will not permit any of its
employees to perform their services at any location,under its control,when segregated facilities are
maintained. The Federally assisted construction contractor agrees that a breach of this certification is a
violation of the Equal Opportunity clause in this contract As used in this certification,the term
"segregated facilities"means any waiting mom,work areas,rest rooms and washrooms,resmartouus and
other eating area, time clocks,locker rooms and other storage or dressing an-us,ding lots,dsir 3ng
fountains,recreation or entertainment areas,transportation,and housing„fl cidities provided for employees
which are segregated by explicit directive or ary In fiact sct vpwd or%the basis of race,color.religion,sex
or national origin, because of habit local custom, or any other reason. The Federally assisted
construction contractor agrees that(except where it has obtained identical certifications from proposed
snbcoutunctors for spooilk time periods) it will obtains idenrtioai oortrficationn from proposed
sarlacontracrors prior to the award of subormtmcu exceeding S10,000 which are not exempt from the
previsions of the.Equal Opportunity clause,and that it will tclaiu such r cttidiration in its files.
Certification—The information above is true and complete to the bast of my knowledge and belief.
Name of Finn: AbooNM•AbeWWAM•Osmo'
•Avo
Address: 444 Fe SprinwCA
Telephone Number
Contractor Representative.
Title: >�
Signature:
Dated this t ay of Lvl,,,2014.
Note: The penalty for making false statements in offer,is prescribed in 18 U.S.C.M.
Bidding Form Appendix B-06 Last Modifietk January 23,2014
Certification of Non-Segregated Facilities
City of El Segundo
Residential Sound Insulation Prograin
RSI 14-26(Group 68)
Certification of Non-Segregated Facilities
(Contractors/Subcontractors)
(A certificate of Non-segregated Facilities must be submitted prior to award of a contract or subcontract
exceeding$10,000 which is not exempt from the provisions of Equal Opportunity Clauses)
The Federally assisted construction contractor certifies that it does not maintain or provide for its
employees any segregated facilities at any of its establishments, and that it does not permit its employees
to perform their services at any location, under its control, where segregated facilities are maintained.
The Federally assisted construction contractor certifies further that it will not maintain or provide for its
employees any segregated facilities at any of its establishments, and that it will not permit any of its
employees to perform their services at any location, under its control, where segregated facilities are
maintained. The Federally assisted construction contractor agrees that a breach of this certification is a
violation of the Equal Opportunity clause in this contract. As used in this certification, the term
"segregated facilities" means any waiting room, work areas, rest rooms and washrooms, restaurants and
other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking
fountains,recreation or entertainment areas,transportation, and housing facilities provided for employees
which are segregated by explicit directive or are in fact segregated on the basis of race,color,religion,sex
or national origin, because of habit, local custom, or any other reason. The Federally assisted
construction contractor agrees that (except where it has obtained identical certifications from proposed
subcontractors for specific time periods) it will obtain identical certifications from proposed
subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the
provisions of the Equal Opportunity clause,and that it will retain such certification in its files.
Certification—The information above is true and complete to the best of my knowledge and belief.
Name of Firm: � A� f�� /z(x
Address: :
(If
Telephone Number: 07
Telephone
w
Contractor Representative: C,
Title;
Signature:
Datedthis4 day of AIC'71,�A ,2014,
Note: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001.
Bidding Form .......... . ���..... ,,,,,Appendix -06 ,.. �.. �,.. .� .�.�.�...Last Mo.. ....._.....................___....._.�...-......
._ .. ._. ......._ diced:January 23,2014
Certification of Non-Segregated Facilities
City of El Segundo
Residential Sound Insulation Program
RSI 14-26 (Group 68)
Trade Restriction Clauses to be Included in all Solicitations,
Contracts, and Subcontracts
The Contractor or Subcontractor, by submission of an offer and/or execution of contract,
certifies that it:
A. is not owned or controlled by one or more citizens or nationals of a foreign country
included in the list of countries that discriminate against U.S. firms published by the
Office of the United States Trade Representative(USTR);
B. has not knowingly entered into any contract or subcontract for this project with a person
that is a citizen or a national of a foreign country on said list, or is owned or controlled
directly or indirectly by one or more citizens or nationals of a foreign country on said list;
C. has not procured any product nor subcontracted for the supply of any product for use on
the project that is produced in a foreign country on said list.
Unless the restrictions of this clause are waived by the Secretary of Transportation in accordance
with 49 CFR 30.17, no contract must be awarded to a contractor or subcontractor who is unable
to certify to the above. If the contractor knowingly procures or subcontracts for the supply of
any product or services of a foreign country on the said list for use on the project, the Federal
Aviation Administration may direct, through the City, cancellation of the contract at no cost to
the government.
Further, the contractor agrees that, if awarded a contract resulting from this solicitation, it will
incorporate this provision for certification without modification in each contract and in all lower
tier subcontracts. The contractor may rely on the certification of a prospective subcontractor
unless it has knowledge that the certification is erroneous.
The contractor must provide immediate written notice to the sponsor if the contractor learns that
its certification or that of a subcontractor was erroneous when submitted or has become
erroneous by reason of changed circumstances. The subcontractor agrees to provide immediate
written notice to the contractor, if at any time it learns that its certification was erroneous by
reason of changed circumstances.
This certification is a material representation of fact upon which reliance was placed when
making the award. If it is later determined that the contractor or subcontractor knowingly
rendered an erroneous certification, the Federal Aviation Administration may direct, through the
City, cancellation of the contract or subcontract for default at no cost to the government.
Nothing contained in the foregoing must be construed to require establishment of a system of
records in order to render, in good faith, the certification required by this provision. The
knowledge and information of a contractor is not required to exceed that which is normally
possessed by a prudent person in the ordinary course of business dealings.
This certification concerns a matter within the jurisdiction of an agency of the United States of
Bidding Form Appendix B-07 Last Modified:January 23,2014
Trade Restriction Clauses Pagel of 2
City of El Segundo
0 Residential Sound Insulation Program
RSI 14-26 (Group 68)
America and the making of a false, fictitious, or fraudulent certification may render the maker
subject to prosecution under Title 18, United States Code, Section 1001.
Name of Firm: Big West Construction Corporation
Address: 15331 Normandie Ave. Irvine, CA 92604
Telephone Number: 949-795-2219
Contractor Representative: Thomas R. Carr mm
Title: President
Signature:
Dated this q day of .....L 'd U P►�-��1Z , 2014.
Bidding Form Appendix B-07 Last Modified:January 23,2014
Trade Restriction Clauses Page 2 of 2
0 I. City of El Segundo
Residential Sound Insulation Program
RSI 14-26 (Group 68)
Trade Restriction Clauses to be Included in all Solicitations,
Contracts, and Subcontracts
The Contractor or Subcontractor, by submission of an offer and/or execution of contract,
certifies that it:
A. is not owned or controlled by one or more citizens or nationals of a foreign country
included in the list of countries that discriminate against U.S. firms published by the
Office of the United States Trade Representative(USTR);
B. has not knowingly entered into any contract or subcontract for this project with a person
that is a citizen or a national of a foreign country on said list, or is owned or controlled
directly or indirectly by one or more citizens or nationals of a foreign country on said list;
C. has not procured any product nor subcontracted for the supply of any product for use on
the project that is produced in a foreign country on said list.
Unless the restrictions of this clause are waived by the Secretary of Transportation in accordance
with 49 CFR 30.17, no contract must be awarded to a contractor or subcontractor who is unable
to certify to the above. If the contractor knowingly procures or subcontracts for the supply of
any product or services of a foreign country on the said list for use on the project, the Federal
Aviation Administration may direct, through the City, cancellation of the contract at no cost to
the government.
Further, the contractor agrees that, if awarded a contract resulting from this solicitation, it will
incorporate this provision for certification without modification in each contract and in all lower
tier subcontracts. The contractor may rely on the certification of a prospective subcontractor
unless it has knowledge that the certification is erroneous.
The contractor must provide immediate written notice to the sponsor if the contractor learns that
its certification or that of a subcontractor was erroneous when submitted or has become
erroneous by reason of changed circumstances. The subcontractor agrees to provide immediate
written notice to the contractor, if at any time it learns that its certification was erroneous by
reason of changed circumstances.
This certification is a material representation of fact upon which reliance was placed when
making the award. If it is later determined that the contractor or subcontractor knowingly
rendered an erroneous certification, the Federal Aviation Administration may direct, through the
City, cancellation of the contract or subcontract for default at no cost to the government.
Nothing contained in the foregoing must be construed to require establishment of a system of
records in order to render, in good faith, the certification required by this provision. The
knowledge and information of a contractor is not required to exceed that which is normally
possessed by a prudent person in the ordinary course of business dealings.
This certification concerns a matter within the jurisdiction of an agency of the United States of
Bidding Form Appendix B-07 Last Modified:January 23,2014
Trade Restriction Clauses Pagel of 2
City of El Segundo
Residential Sound Insulation Program
RSI 14-26 (Group 68)
America and the making of a false, fictitious, or fraudulent certification may render the maker
subject to prosecution under Title 18,United States Code, Section 1001.
Name of Firm:
F
Address:
Telephone Nrunber: &. —741,2_ � '
Contractor Representative: ciL
Title: JF�T /`�i94gCK
Signature:
Dated this�7 day of ,2014.
Bidding Form Appendix B-07 Last Modified:January 23,2014
Trade Restriction Clauses Page 2 of 2
Nov, 18, 2014 11 ; 28AM Mdga,rd Windows Na, 5016 P, 5
City of El Segundo
IV Residential Sound Insulation program
RSI 14-26 ((Troup 68)
Trade Restriction Clauses to be Included in all Solicitations,
Contracts, and Subcontracts
The Contractor or Subcontractor, by submission of an offer and/or execution of contract,
certifies that it:
A. is not owned or controlled by one or more citizens or nationals of a foreign country
included in the list of countries that discriminate against U.S. firms published by the
Office of the United States Trade Representative(USTR);
B, has not knowingly entered into any contract or subcontract for this project with a person
that is a citizen or a national of a foreign country on said list, or is owned or controlled
directly or indirectly by one or more citizens or nationals of a foreign country on said list;
C, has not procured any product nor subcontracted for the supply of any product for use on
the project that is produced in a foreign country on said list.
Unless the restrictions of this clause are warred by the Secretary of Transportation in accordance
with 49 CFR 30.17, no contract must be awarded to a contractor or subcontractor who is unable
to certify to the above. If the contractor knowingly procures or subcontracts for the supply of
any product or services of a foreign country on the said list for use on the project, the Federal
Aviation Administration may direct, through the City, cancellation of the contract at no cost to
the government,
Further, the contractor agrees that, if awarded a contract resulting from this solicitation, it will
incorporate this provision for certification without modification in each contract and in all lower
tier subcontracts. The contractor may rely on the certification of a prospective subcontractor
unless it has knowledge that the certification is erroneous.
The contractor must provide immediate written notice to the sponsor if the contractor learns that
its certification or that of a subcontractor was erroneous when submitted or has become
erroneous by reason of changed circumstances. The subcontractor agrees to provide immediate
written notice to the contractor, if at any time it learns that its certification was erroneous by
reason of changed circumstances.
This certification is a material representation of fact upon which reliance was placed when
making the award. If it is later determined that the contractor or subcontractor knowingly
rendered an erroneous certification, the Federal Aviation Administration may direct, through the
City, cancellation of the contract or subcontract for default at no cost to the government.
Nothing contained in the foregoing must be construed to require establishment of a system of
records in order to render, in good faith, the certification required by this provision. The
knowledge and information of a contractor is not required to exceed that which is normally
possessed by a prudent person in the ordinary course of business dealings.
This certification concerns a matter within the jurisdiction of an agency of the United States of
Bidding Form Appendix B-07 last Modified:January 23,2014
Trade Restriction Clauses Page I of
Nov, 18s 2014 11 : 99AM Mdga,rd Windows No, 8096 PO 6
City of El Segundo
UP—% Residential Sound Insulation program
RSI 14-26(Group 68)
America and the making of a false, fictitious, or fraudulent certification may render the maker
subject to prosecution under Title 18,United States Code, Section 1001
Name of Firm: ✓
Address:
Telephone Number: ..........
��...
Contractor Representative:
Title: OA 4(1)Aa
Signature
/xI
Dated this/7 day of 2014.
.........................
Bidding form Appendix B-07 Last Modified:ranuM 23,2014
Trade Restriction Clauses page 2 of 2
City of El Segundo
Residential Sound Insulation Program
RSI 14-26(Group 68)
Trade Restriction Clauses to be Included in all Solicitations,
Contracts, and Subcontracts
The Contractor or Subcontractor, by submission of an offer and/or execution of contract,
certifies that it:
A. is not owned or controlled by one or more citizens or nationals of a foreign country
included in the list of countries that discriminate against U.S. firms published by the
Office of the United States Trade Representative(USTR);
B. has not knowingly entered into any contract or subcontract for this project with a person
that is a citizen or a national of a foreign country on said list, or is owned or controlled
directly or indirectly by one or more citizens or nationals of a foreign country on said list;
C. has not procured any product nor subcontracted for the supply of any product for use on
the project that is produced in a foreign country on said list.
Unless the restrictions of this clause are waived by the Secretary of Transportation in accordance
with 49 CFR 30.17, no contract must be awarded to a contractor or subcontractor who is unable
to certify to the above. If the contractor knowingly procures or subcontracts for the supply of
any product or services of a-foreign country on the said list for use on the project, the Federal
Aviation Administration may direct, through the City, cancellation of the contract at no cost to
the government.
Further, the contractor agrees that, if awarded a contract resulting from this solicitation, it will
incorporate this provision for certification without modification in each contract and in all lower
tier subcontracts. The contractor may rely on the certification of a prospective subcontractor
unless it has knowledge that the certification is erroneous.
The contractor must provide immediate written notice to the sponsor if the contractor learns that
its certification or that of a subcontractor was erroneous when submitted or has become
erroneous by reason of changed circumstances. The subcontractor agrees to provide immediate
written notice to the contractor, if at any time it learns that its certification was erroneous by
reason of changed circumstan ces.
This certification is a material representation of fact upon which reliance was placed when
making the award. If it is later determined that the contractor or subcontractor knowingly
rendered an erroneous certification, the Federal Aviation Administration may direct,through the
City,cancellation of the contract or subcontract for default at no cost to the government.
Nothing contained in the foregoing must be construed to require establishment of a system of
records in order to render, in good faith, the certification required by this provision. The
knowledge and information of a contractor is not required to exceed that which is normally
possessed by a prudent person in the ordinary course of business dealings.
This certification concerns a matter within the jurisdiction of an agency of the United States of
Bidding Form Appendix B-07 Last Modified:January 23,2014
Trade Restriction Clauses Pagel of 2
City of El Segundo
Residential Sound Insulation Pro apt.
.:m. RSI 14-26(Group 68)
America and the making of a false, fictitious, or fraudulent certification may render the maker
subject to prosecution under Title 18,United States Code, Section 1001.
Name of Firm: Discount Exteriors
Address: 17612 Beach Blvd. #13B Huntin on Beach,, CA 92647
Telephone Number: 714-596-6766
Contractor Representative: Robert T. Davis
Title: President
Signature: V1/ ` oe_�
Dated this 14th day of November ,2014.
Bidding Form Appendix B-07 Last Modified:January 23,2014
Trade Restriction Clauses Page 2 of 2
City of El Segundo
Residential Sound Insulation Program.
RSI 14-26 (Group 68)
Trade Restriction Clauses to be Included in all Solicitations,
Contracts, and Subcontracts
The Contractor or Subcontractor, by submission of an offer and/or execution of contract,
certifies that it:
A. is not owned or controlled by one or more citizens or nationals of a foreign country
included in the list of countries that discriminate against U.S. firms published by the
Office of the United States Trade Representative(USTR);
B. has not knowingly entered into any contract or subcontract for this project with a person
that is a citizen or a national of a foreign country on said list, or is owned or controlled
directly or indirectly by one or more citizens or nationals of a foreign country on said list;
C. has not procured any product nor subcontracted for the supply of any product for use on
the project that is produced in a foreign country on said list.
Unless the restrictions of this clause are waived by the Secretary of Transportation in accordance
with 49 CFR 30.17, no contract must be awarded to a contractor or subcontractor who is unable
to certify to the above. If the contractor knowingly procures or subcontracts for the supply of
any product or services of a-foreign country on the said list for use on the project, the Federal
Aviation Administration may direct, through the City, cancellation of the contract at no cost to
the government.
Further, the contractor agrees that, if awarded a contract resulting from this solicitation, it will
incorporate this provision for certification without modification in each contract and in all lower
tier subcontracts. The contractor may rely on the certification of a prospective subcontractor
unless it has knowledge that the certification is erroneous.
The contractor must provide immediate written notice to the sponsor if the contractor learns that
its certification or that of a subcontractor was erroneous when submitted or has become
erroneous by reason of changed circumstances. The subcontractor agrees to provide immediate
written notice to the contractor, if at any time it learns that its certification was erroneous by
reason of changed circumstances.
This certification is a material representation of fact upon which reliance was placed when
making the award. If it is later determined that the contractor or subcontractor knowingly
rendered an erroneous certification, the Federal Aviation Administration may direct,through the
City, cancellation of the contract or subcontract for default at no cost to the government.
Nothing contained in the foregoing must be construed to require establishment of a system of
records in order to render, in good faith, the certification required by this provision. The
knowledge and information of a contractor is not required to exceed that which is normally
possessed by a prudent person in the ordinary course of business dealings.
This certification concerns a matter within the jurisdiction of an agency of the United States of
Bidding Form Appendix B-07 Last Modified:January 23,2014
Trade Restriction Clauses Pagel of 2
City of El Segundo
0 1tesidemial Sound lnsoWion ram
RSI 14-26(Croup 68)
America and the making of a false,fictitious,or fraudulent ca6fication MAY render the maker
subject to prosecution under Title 18,United States Coda,Section 1001.
AMWu*Ab@Wo*A a DO-
NameofFirm: ""t hO4 AVe
90870
Address:
Telephone Number �.....� - .
ComrsciorRepresentedve: Ck
6 _ .... .,
Title: _ _LoC.J111" �.. .
�II .....�......._
Detedthie�dayof ;7l .2014.
Bidding Form Appm,d a,B-07 Lau Modified:Jammmy 23,0144
Trade Restrictlon Clauses
City of El Segundo
Residential Sound Insulation Program
RS1.14-26(Group 68)
Trade Restriction Clauses to be Included in all Solicitations,
Contracts, and Subcontracts
The Contractor or Subcontractor, by submission of an offer and/or execution of contract,
certifies that it:
A. is not owned or controlled by one or more citizens or nationals of a foreign country
included in the list of countries that discriminate against U.S. firms published by the
Office of the United States Trade Representative(USTR);
B. has not knowingly entered into any contract or subcontract for this project with a person
that is a citizen or a national of a foreign country on said list, or is owned or controlled
directly or indirectly by one or more citizens or nationals of a foreign country on said list;
C. has not procured any product nor subcontracted for the supply of any product for use on
the project that is produced in a foreign country on said list.
Unless the restrictions of this clause are waived by the Secretary of Transportation in accordance
with 49 CFR 30,17, no contract must be awarded to a contractor or subcontractor who is unable
to certify to the above. if the contractor knowingly procures or subcontracts for the supply of
any product or services of a foreign country on the said list for use on the project, the Federal
Aviation Administration may direct, through the City, cancellation of the contract at no cost to
the government.
Further, the contractor agrees that, if awarded a contract resulting from this solicitation, it will
incorporate this provision for certification without modification in each contract and in all lower
tier subcontracts. The contractor may rely on the certification of a prospective subcontractor
unless it has knowledge that the certification is erroneous.
The contractor must provide immediate written notice to the sponsor if the contractor learns that
its certification or that of a subcontractor was erroneous when submitted or has become
erroneous by reason of changed circumstances. The subcontractor agrees to provide immediate
written notice to the contractor, if at any time it learns that its certification was erroneous by
reason of changed circumstances.
This certification is a material representation of fact upon which reliance was placed when
making the award. If it is later determined that the contractor or subcontractor knowingly
rendered an erroneous certification, the Federal Aviation Administration may direct, through the
City, cancellation of the contract or subcontract for default at no cost to the government.
Nothing contained in the foregoing must be construed to require establishment of a system of
records in order to render, in good faith, the certification required by this provision. The
knowledge and information of a contractor is not required to exceed that which is normally
possessed by a prudent person in the ordinary course of business dealings.
This certification concerns a matter within the jurisdiction of an agency of the United States of
Bidding Form Appendix B-07 Last Modified:January 23,2014
Trade Restriction Clauses Page 1 of 2
City of El Segundo
Residential Sound Insulation Program
RSI 14-26(Group 68)
America and the making of a false, fictitious, or fraudulent certification may render the maker
subject to prosecution under Title 18, United States Code, Section 1001.
Name of Firm: H.K. ELECTRICAL INC.
Address: 17428 LAHEY ST GRANADA HILLS, CA 91344
Telephone Number: 1 - 1 0 0
Contractor Representative: ELIZA KHATCHERIAN
Title: CEO
Signature: ..W,_ __.,.._ w..........
Dated this 18THday of NOVEMBER 2014.
Bidding Form Appendix B-07 Cast Modified:January 23,2014
Trade Restriction Clauses Page 2 of 2
City of El Segundo
Residential Sound Insulation Program
RSI 14-26 (Group 68)
Trade Restriction uses to be Included in all Solicitations,
Contracts, and Subcontracts
The Contractor or Subcontractor, by submission of an offer and/or execution of contract,
certifies that it:
A. is not owned or controlled by one or more citizens or nationals of a foreign country
included in the list of countries that discriminate against U.S. firms published by the
Office of the United States Trade Representative(USTR);
B. has not knowingly entered into any contract or subcontract for this project with a person
that is a citizen or a national of a foreign country on said list, or is owned or controlled
directly or indirectly by one or more citizens or nationals of a foreign country on said list;
C. has not procured any product nor subcontracted for the supply of any product for use on
the project that is produced in a foreign country on said list.
Unless the restrictions of this clause are waived by the Secretary of Transportation in accordance
with 49 CFR 30.17, no contract must be awarded to a contractor or subcontractor who is unable
to certify to the above. If the contractor knowingly procures or subcontracts for the supply of
any product or services of a foreign country on the said list for use on the project, the Federal
Aviation Administration may direct, through the City, cancellation of the contract at no cost to
the government.
Further, the contractor agrees that, if awarded a contract resulting from this solicitation, it will
incorporate this provision for certification without modification in each contract and in all lower
tier subcontracts. The contractor may rely on the certification of a prospective subcontractor
unless it has knowledge that the certification is erroneous.
The contractor must provide immediate written notice to the sponsor if the contractor learns that
its certification or that of a subcontractor was erroneous when submitted or has become
erroneous by reason of changed circumstances. The subcontractor agrees to provide immediate
written notice to the contractor, if at any time it learns that its certification was erroneous by
reason of changed circumstances.
This certification is a material representation of fact upon which reliance was placed when
making the award. If it is later determined that the contractor or subcontractor knowingly
rendered an erroneous certification, the Federal Aviation Administration may direct, through the
City, cancellation of the contract or subcontract for default at no cost to the government.
Nothing contained in the foregoing must be construed to require establishment of a system of
records in order to render, in good faith, the certification required by this provision. The
knowledge and information of a contractor is not required to exceed that which is normally
possessed by a prudent person in the ordinary course of business dealings.
This certification concerns a matter within the jurisdiction of an agency of the United States of
Bidding Form ......... _.... , _.m... . ..... Appendix -07 _.....v Last Modified:January 23,2014
Trade Restriction Clauses Page 1 of 2
City of El Segundo
Residential Sound Insulation Program
RSI 14-26(Group 68)
America and the making of a false, fictitious, or fraudulent certification may render the maker
subject to prosecution under Title 18,United States Code, Section 1001.
Name of Finn:
Address:
Telephone Number:
Contractor Representative:
r
Title:
Signature:
........------------------ --
Dated this day of
..a�^"" ....... ._,2014.
_...._ mm.....-....-. ........m_.. . _.�... ..m. _.. ..._ - ......� _._.. �.........—..� fl ...-._.... --- -0- --
id � Form Appendix -07 Last Modified:January 23,2-0-1-4-
014
Trade Restriction Clauses Page 2 of 2
11/13/2014 00 :23 FAX 19499556507 C @NON 1&005/007
City of El Segundo
Residential Sound Insulation Progratn
RSI 142 26(Group 68)
Trade Restriction Clauses to be Included in all Solicitations,
Contracts, and Subcontracts
The Contractor or Subcontractor, by submission of an offer and/or execution of contract,
certifies that it:
A. is not owned or controlled by one or more citizens or nationals of a foreign country
included in the list of countries that discriminate against U.S. firms published by the
Office of the United States Trade Representative(USTR);
B. has not knowingly entered into any contract or subcontract for this project with a person
that is a citizen or a national of a foreign country on said list, or is owned or controlled
directly or indirectly by one or more citizens or nationals of a foreign count ,on said list;
C, has not procured any product nor subcontracted for the supply of any prod et for use on
the project that is produced in a foreign country on said list.
Unless the restrictions of this clause are waived by the Secretary of Transportation n accordance
with 49 CFR 30.17, no Contract must be awarded to a contractor or subcontractor, oho is unable
to certify to the above. If the contractor knowingly procures or subcontracts for the supply of
any product or services of a foreign country on the said list for use on the project, the Federal
Aviation Administration may direct, through the City, cancellation of the contracl at no cost to
the government.
Further, the contractor agrees that, if awarded a contract resulting from this solic:tatolt, it will
incorporate this provision for certification without modification in each contract and in all lower
tier subcontracts, The contractor may rely on the certification of a prospective subcontractor
unless it has knowledge that the certification is erroneous.
The contractor must provide immediate written notice to the sponsor if the contractor learns that
its certification or that of a subcontractor was erroneous when submitted or, has become
erroneous by Treason of changed circumstances. The subcontractor agrees to provide immediate
written notice to the contractor, if at any time it learns that its certification was erroneous by
reason of changed circumstances.
This certification is a material representation of fact upon which reliance was placed when
making,the award. If it is later determined that the contractor or subcontractor knowingly
rendered an erroneous certification, the Federal Aviation Administration may direct,through the
City, cancellation of the contract or subcontract for default at no cost to the government,
Nothing contained in the foregoing must be construed to require establishment o a system of
records in order to render, in good faith, the certification required by this pr vision. The
knowledge and information of a contractor is not required to exceed that whic is normally
possessed by a prudent person in the ordinary course of business dealings.
This certification concerns a matter within the jurisdiction of an agency of the United States of
Bidding Form Appendix B-07 Last Modified:January 23,2014
Trade Restriction Clauses Page I of 2
11113/2014 00:23 FAX 19498556507 C @NON fa004/007
City of El Segundo
Residential Sound Insulation Program
RSI 147 (Group 68)
America and the making of a false, fictitious, or fraudulent certification may ren er the maker
subject to prosecution under Title 18,United States Code, Section 1001.
Name of Firm: ZM I r' 0
Address: 1 1 g2l,2,-t
Telephone Number: IV 02_2
Contractor Representative: m
Title:
Signature:
U`7
Dated this 1 Z day of -el 2014.
Bidding form Appendix B-07 Last Modified:J nuary 23,2014
Trade Restriction Clauses page 2 of 2
City of El Segundo
Residential Sound Insulation Program
RS1 14-26 (Group 68)
Designation of Manufacturers and Suppliers
Manufacturer Supplier(if Applicable) Contract
Value
..§i�ctioj�-W-�40(F ......
Primary Hinged 18000
Entry Doors
...........
Section 08 32 110
li r-imum
y Sliding H $ '141593
Glass Doors
Section 08 53 00
Vinyl Windows M f Ar" $ 49,4CO
-Section 08 7100 ................ ... ...... ..........................
Latching and G
Locking $ rlqtg
Hardware
Section 10 32 00
Chimney $ 14/4
Dampers
Section 10 32 00
Fireplace Glass I !nll VIA Is N/A
Doors
Section 22 2100
Condensate $
Pumps
Section 23 09 00
Thermostats $
Section 23 34 00
Ventilators $
Section 23 54 00
Furnaces $
...........
Section
................................
Bidding Form Appendix B-08 Last Modified:January 23,2014
Designation of Manufacturers and Suppliers
City of El Segundo
Residential Sound Insulation Prograin
RSI 14-26(Group 68)
Designation of Manufacturers and Suppliers
�.�.... .. .._ _aro. . — ---
Manufacturer Supplier(if Applicable) Contract
Value
ction 08 i466
Primary Hinged $
Entry Doors
Section 08 32 OQ
Primary Sliding $
Glass Doors
Section 08...53 00 _,�..... _ ...
Vinyl Windows $
Section08 7100 ........................��.....................�.........._. ...��...�.................... ..�......_�..�._._..........................�..............._..��..�..�.....�. ��.
Latching and
Locking $
Hardware
Section 1'-0 32 00
Chimney
Dampers $
Section 10 32 00
Fireplace Glass $
Doors
Section 22 2100
Condensate
Pumps
Thermostats
coon 209 00
...,
�
3_._ �����.--l�---.- 1- � .--.. ....... -....... __ _ ....... � . ..... .. � � .. � � ..
Section 23 4 00
Ventilators
Section 23 54 00 -
�
Furnaces 1 0 $
.w.ue ecti on am- ........... _ ................�
S u. ......................� ...�..�.---—.-----------------_
Bidding orm mm ._ .. Appendix B-Q8mmmmm mm Last Modified:
g pp January 23,2014
Designation of Manufacturers and Suppliers
City of El Segundo
Residential Sound Insulation Program
RSI 14-26 (Group 68)
Buy American — Steel and Manufactured Products for Construction
Contracts
The Contractor agrees that only domestic steel and manufactured products will be used by the
Contractor, Subcontractors, materialmen, and suppliers in the performance of this Contract, as
defined in A. below.
A. The following terms apply to this clause:
1. Steel and manufactured products. As used in this clause, steel and manufactured
products include:
a.) those products produced in the United States or
b.) a manufactured product produced in the United States, if the cost of its
components mined, produced or manufactured in the United States
exceeds sixty percent (60%) of the cost of all its components and final
assembly has taken place in the United States.
1 Components. As used in this clause, components means those articles, materials,
and supplies incorporated directly into steel and manufactured products.
3. Cost of Components. This means the costs for production of the components,
exclusive of final assembly labor costs.
Name of Firm: Big West Construction Corporation
Address: 15331 Normandie Ave. Irvine, CA 92604
Telephone Number: 9 49-7 9 5-221.9
Contractor Representative: Thomas R. Carr
Title: President
Signature: �, `-t ��- .............__................_... .........................._.
Dated this 19 day of_IT_ V V �,2014.
Bidding Form Appendix B-09 Last Modified:January 23,2014
Buy American Clause
City of El Segundo
Residential Sound Insulation Program
RSI 14-26 (Group 68)
Buy American — Steel and Manufactured Products for Construction
Contracts
The Contractor agrees that only domestic steel and manufactured products will be used by the
Contractor, Subcontractors, materialmen, and suppliers in the performance of this Contract, as
defined in A.below.
A. The following terms apply to this clause:
1. Steel and manufactured products. As used in this clause, steel and manufactured
products include:
a.) those products produced in the United States or
b.) a manufactured product produced in the United States, if the cost of its
components mined, produced or manufactured in the United States
exceeds sixty percent (60%) of the cost of all its components and final
assembly has taken place in the United States.
2. Components. As used in this clause, components means those articles, materials,
and supplies incorporated directly into steel and manufactured products.
3. Cost of Components. This means the costs for production of the components,
exclusive of final assembly labor costs.
Name of Firm:
Address: /,z-040 ef" 'e44 !,f;,, � a�
Telephone Number: ��
Contractor Representative: , !
Title: PA ; Z- r" ._ ..._
Signature: _~
Dated this-a day of d-K^;W&C-X ,.._..�2014.
Bidding Form Appendix B-09 Last Modified:January 23,2014
Buy American Clause
Nov, 10. 2014 11 : 29AM Vga,rd Windows (boo 5096 P. 7
City of El Segundo
Residential Sound Insulation program
IT RSl 14-26(Group 68)
Buy American — Steel and Manufactured Products for Construction
Contracts
The Contractor agrees that only domestic steel and manufactured products will be used by the
Contractor, Subcontractors, materialmen, and suppliers in the performance of this Contract, as
defined in A. below.
A. The following terms apply to this clause:
I. Steel and manufactured products. As used in this clause, steel and manufactured
products include:
a.) those products produced in the United States or
b.) a manufactured product produced in the United States, if the cost of its
components mined, produced or manufactured in the United States
exceeds sixty percent (60%) of the cost of all its components and final
assembly has taken place in the United States.
2. Components. As used in this clause, components means those articles, materials,
and supplies incorporated directly into steel and manufactured products.
3. Cost of Components. This means the costs for production of the components,
exclusive of final assembly labor costs.
Name of Firm:
Address:
Telephone Number:
Contractor Representative: zn pa)e-
Title: ` ✓
Signature:
Dated this 1/ day of 2014,
Bidding Form Appendix B-09 Cast Modified:January 23,2014
Buy American Clause
City of El Segundo
Residential Sound Insulation Program
RSI 14-26(Group 68)
Buy American— Steel and Manufactured Products for Construction
Contracts
The Contractor agrees that only domestic steel and manufactured products will be used by the
Contractor, Subcontractors, materialmen, and suppliers in the performance of this Contract, as
defined in A.below.
A. The following terms apply to this clause:
1. Steel and manufactured products. As used in this clause, steel and manufactured
products include:
a.) those products produced in the United States or
b.) a manufactured product produced in the United States, if the cost of its
components mined, produced or manufactured in the United States
exceeds sixty percent (60%) of the cost of all its components and final
assembly has taken place in the United States.
2. Components. As used in this clause, components means those articles, materials,
and supplies incorporated directly into steel and manufactured products.
3. Cost of Components. This means the costs for production of the components,
exclusive of final assembly labor costs.
Name of Firm: Discount Exteriors
Address: 17612 Beach Blvd. #13B, Huntin on Beach, CA 92647
Telephone Number: 714-596-6766
Contractor Representative: Robert T. Davis
Title: President
Signature: W —Z�
Dated this 14th day of November____,2014.
Bidding Form Appendix B-09 Last Modified:January 23,2014
Buy American Clause
City of El Segundo
Residential Sound Insulation Program
RSI 14-26(Group 68)
Buy American — Steel and Manufactured Products for Construction
Contracts
The Contractor agrees that only domestic steel and manufactured products will be used by the
Contractor, Subcontractors, materialmen, and suppliers in the performance of this Contract, as
defined in A. below.
A. The following terms apply to this clause:
I. Steel and manufactured products. As used in this clause, steel and manufactured
products include:
a.) those products produced in the United States or
b.) a manufactured product produced in the United States, if the cost of its
components mined, produced or manufactured in the United States
exceeds sixty percent (60%) of the cost of all its components and final
assembly has taken place in the United States.
2. Components. As used in this clause, components means those articles, materials,
and supplies incorporated directly into steel and manufactured products.
I Cost of Components. This means the costs for production of the components,
exclusive of final assembly labor costs.
Name of Firm: H.K. ELECTRICAL INC.
Address: 17428 LAHEY ST GRANADA HILLS, CA 91344
Telephone Number: 818-831-8800
Contractor Representative: ZA KHATCHERIAN
...�_ ........_. ......_
Title: CEO
Signature: ...
1 y
Dated this 8THda of NOVEMBER 2414._— .... .. �.e.,..�_x
Bidding Form Appendix B-09 Last Modified:January 23,2014
Buy American Clause
City of El Segundo
" Residential Sound Insulation Program
RSI 14-26 (Group 68)
Buy American — Steel and Manufactured Products for Construction
Contracts
The Contractor agrees that only domestic steel and manufactured products will be used by the
Contractor, Subcontractors, materialmen, and suppliers in the performance of this Contract, as
defined in A. below.
A. The following terms apply to this clause:
1. Steel and manufactured products. As used in this clause, steel and manufactured
products include:
a.) those products produced in the United States or
b.) a manufactured product produced in the United States, if the cost of its
components mined, produced or manufactured in the United States
exceeds sixty percent (60%) of the cost of all its components and final
assembly has taken place in the United States.
2. Components. As used in this clause, components means those articles, materials,
and supplies incorporated directly into steel and manufactured products.
3. Cost of Components. This means the costs for production of the components,
exclusive of final assembly labor costs.
Name of Firm:
Address: .
p
Tele hone Number: pm ,
Contractor Representative: r
Title: °
....
Signature:
Dated this day of . ,2014.
Bidding Form . .. __...... ._....Appendix B-09
..........
Bidding Modified:Jan.�ary2...,2..14
..... i u 3, 014
Buy American Clause
City of El Segundo
Residential Sound Insulation Program
RSI 14-26 (Group 68)
Bidder's Assurance of Compliance with Title 49 CFR Part 26
relating to Disadvantaged Business Enterprise Participation
The Bidder hereby gives assurance pursuant to the requirements of Title 49 CFR part 26 that
Bidder has made a reasonable effort to meet goals for Disadvantaged Business Enterprise
participation specified for the Contract for which this proposal is submitted and that the Bidder,
if the contract is awarded to Bidder, will have a DBE participation of
` -W Q A � yt-T 4 `r1 �percent(��3 %) of the amount of this Bid.
Bidder further gives assurance that Bidder will submit the documentation required by said
regulations and the Contract Documents, including the Listing of Disadvantaged Business
Enterprises with which the Bidder will subcontract if the Contract is awarded and if Bidder is
unable to meet the contract goals for DBE participation, of the steps Bidder has taken to obtain
DBE participation.
Name of Firm: Big West Construction Corporation
Address: 15331 Normandie Ave. Irvine, CA 92604
Telephone Number: 949-795-2219
Contractor Representative: Thomas R. Carr
Title: President
Signature;
Dated this day of NOV-&444- ,2014.
Bidding Form Appendix B-10 Last Modified:January 23,2014
Assurance of DBE Participation
City of El Segundo
0 Residential Sound Insulation Program
RSI 14-26 (Group 68)
Suspension and Debarment Requirements
for all Contracts over $25,000
(49 CFR Part 29)
The Bidder certifies, by submission of this proposal or acceptance of this Contract,that neither it
nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible,
or voluntarily excluded from participation in this transaction by any Federal department or
agency. It further agrees by submitting this proposal that it will include this clause without
modification in all lower tier transactions, solicitations, proposals, contracts, and subcontracts.
Where the Bidder/offerer/contractor or any lower tier participant is unable to certify to this
statement, it must attach an explanation to this solicitation/proposal.
Name of Firm: Big West Construction Corporation
Address: 15331 Normandie Ave. Irvine, CA 92604
Telephone Number: 949-795-2219
Contractor Representative: Thomas R. Carr
Title: President
Signature: IT___IT
Dated this day of mmwD,,,,, P1�1� (Z ,2014.
Bidding Form Appendix B-11 Last Modified:January 23,2014
Suspension and Debarment Requirements
City of El Segundo
Residential Sound Insulation Program
RSI 14-26 (Group 68)
Suspension and Debarment Requirements
for all Contracts over $25,000
(49 CFR Part 29)
The Bidder certifies,by submission of this proposal or acceptance of this Contract, that neither it
nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible,
or voluntarily excluded from participation in this transaction by any Federal department or
agency. It further agrees by submitting this proposal that it will include this clause without
modification in all lower tier transactions, solicitations, proposals, contracts, and subcontracts.
Where the Bidder/offerer/contractor or any lower tier participant is unable to certify to this
statement,it must attach an explanation to this solicitation/proposal.
Name of Firm: � �. ✓. i
Address: �4 "
Telephone Number: ww �-�"
Contractor Representative: = A''
Title
Signature:
Dated this day of..... ,2014.
Bidding Form Appendix B-11 bast Modified:January 23,2014
Suspension and Debarment Requirements
Nov, 10, 2014 11 : 28AM I dgard Wicidows No, 096 P. 3
City of El Segundo
Residential Sound Insulation Program
RS1 14-26(Group 68)
Suspension and Debarlmeot Requirements
for all Contracts over $25,000
(49 CPR part 29)
The Bidder certifies, by submission of this proposal or acceptance of this Contract, that neither it
nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible,
or voluntarily excluded from participation in this transaction by any Federal department or
agency. It further agrees by submitting this proposal that it will include this clause without
modification in all lower tier transactions, solicitations, proposals, contracts, and subcontracts.
Where the Bidder/offerer/contractor or any lower tier participant is unable to certify to this
statement, it must attach an explanation to this solicitation/proposal.
Name of Firm; .
Address:
Telephone Number:
Contractor Representative: Oe-' %j
Title:
Signature: la94-4
Dated this�day of AC-e ,2014.
Bidding Form Appendix B-11 Last Modified:January 23,2014
Suspension and Debarment Requirements
19City of El Segundo
Residential Sound Insulation Program
, RSI 14-26 (Group 68)
Suspension and Debarment Requirements
for all Contracts over $25,000
(49 CFR Part 29)
The Bidder certifies,by submission of this proposal or acceptance of this Contract, that neither it
nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible,
or voluntarily excluded from participation in this transaction by any Federal department or
agency. It further agrees by submitting this proposal that it will include this clause without
modification in all lower tier transactions, solicitations, proposals, contracts, and subcontracts.
Where the Bidder/offerer/contractor or any lower tier participant is unable to certify to this
statement,it must attach an explanation to this solicitation/proposal.
Name of Firm: Discount Exteriors
Address: 17612 Beach Blvd. #13B, Huntington Beach, CA 92647
Telephone Number: 714-596-6766
Contractor Representative: Robert T. Davis
Title: President
Signature:
Dated this 14th day of November 2014.
Bidding Form Appendix B-11 Last Modified:January 23,2014
Suspension and Debarment Requirements
City of El Segundo
Residential Sound Insulation Program.
RSI 14-26 (Group 68)
Suspension and Debarment Requirements
for all Contracts over $25,000
(49 CFR Part 29)
The Bidder certifies, by submission of this proposal or acceptance of this Contract, that neither it
nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible,
or voluntarily excluded from participation in this transaction by any Federal department or
agency. It further agrees by submitting this proposal that it will include this clause without
modification in all lower tier transactions, solicitations, proposals, contracts, and subcontracts.
Where the Bidder/offerer/contractor or any lower tier participant is unable to certify to this
statement, it must attach an explanation to this solicitation/proposal.
Name of Firm: H.K. ELECTRICAL INC
Address: 17428 LAHEY ST GRANADA HILLS, CA 91344
Telephone Number: 818-831-8800
..
Contractor Representative:
LIZA KHATCHERIAN
Title: CEO
Signature:
Dated this 18THday of NOVEMBER w '2014.
Bidding Form Appendix B-11 Last Modified:January 23,2014
Suspension and Debarment Requirements
City of El Segundo
Residential Sound insulation l*co n
RSI I"(Group 68)
Suspension and Debarment Requirements
for all Contracts over$25,000
(49 CPR Fart 9)
"l'he Bidder certifies,by submission of this proposal or ac+cceptataco of'titis Cootract,that neither it
nor its principals is family debarred,suspended,proposed for debarment,declared ineligible,
or voluntarily excluded from pastic palion in this nsm"otion by any Federal doWnteat or
agency. It further agtoes by submitting this proposal that it will hwhtde this clause wrritltout
modification in all lower tier trratsactions,sol'ieitatious,proposals„conttatttsv and subconoatcts.
witesro tlto l3iddcr/offerer contractor or any lower ties pa nicipant is unable r;ll certify to this
statement,it must attach an explanation to this solicitation/proposal.
Abel uft Abaetarmt+M A Demo
$03 CMtte Are
Name Of Firm:
Address:
Telephone,Number:
" r
Contractor Representative: .-
Title:
signature:
Dated this dayof (4000fh�✓ .2014.
Bidding Form acndix SB-I I last Modified:January 23.2014
Suspension and Debarment Requirements
City of El Segundo
Residential Sound Insulation Program
RSI 14-26 (Group 68)
Suspension and e r ent Requirements
for all Contracts over $25,000
(49 CFR Part 29)
The Bidder certifies, by submission of this proposal or acceptance of this Contract, that neither it
nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible,
or voluntarily excluded from participation in this transaction by any Federal department or
agency. It further agrees by submitting this proposal that it will include this clause without
modification in all lower tier transactions, solicitations, proposals, contracts, and subcontracts.
Where the Bidder/offerer/contractor or any lower tier participant is unable to certify to this
statement, it must attach an explanation to this solicitation/proposal.
Name of Firm:
Address: is _ _. ..._ .. �o
Telephone Number:
r
Contractor Representative: mi7
Title:
F
.p..
Signature:
Dated this day of � .m m „z_ 2014.
Bidding Form Appendix B-11 Last Modifiedre January 14
..............._.�w_www��ww --. -..-.... ... ...__
January 23,2014
Suspension and Debarment Requirements
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Residential Sound Insulation Program
References
(Required of Bidders and any Subcontractors performing more than 10% of Work)
Name of Bidder or Subcontractor:
Please list similar projects on which you performed ork similar to the Work you would
perform on this Project. This information is to be included with the Bid, and will be used by the
City in assessing your capabilities and qualifications for perfo ing the Work. You are hereby
advised that this project is complex and requires experienced Contractors and Subcontractors.
Bids may be considered non-responsive if the information provided is untrue or is insufficient to
allow the City to adequately assess capabilities and qualifications.
1. Project Na e Project P4 " u
. -
Contact m
Agency
Dollar Value m
Person .,�u ..�` �".. ,;w Tel. NoF 1
Des ription of Project
r
nw.e., _...�.,......�..,....mm.....�......,. aa,.. .. y ..,.....m. ✓pfi.�.._�are ..... anew-..._.. _=A1. �"......e��...,.......,.�.... .. ., ...m .s _.-...--_....
2. Project Name, . _ ... Project
.. .. � ° 1 w
� V �.
Agency„ ” . " Dollar Value
Contact Pers( �df
Tel. � � '..... `
No . .
Description of Project fl
u a
J
j �;.. ' ,., _K Dollar Value ��
Agency, �. `_ . ... ........ Project ° b lr �. `.�� _ ..m. ...
Contact Person
� .__. Te
l. No i
r
csct ptiotl t1,Pro1 ec .� ,
. ..
Name
... �.Uw Project No
4. Pro ect
AgJ 3 ) �, i Dollar Value m..
i1 r k � ,
Contact l c s �n " '� '`�n� a 'R Tel. N'o� ,
Description of 1111roj eot
r
io
Bidding o �.__.�.�.��.�._..�.,.___... .. .__.._.._Appendix�l3_.._.._�..�..--.,�Last_..-.w.....,......._ .._.� m._.._ .._�.�..�
Modified: January 23,2014
References
City of El Segundo
Residential Sound Insulation Program
RSI 14-26 (Group 68)
References
(Required of Bidders and any Subcontractors performing more than 10%of Work)
Name of Bidder or Subcontractor: Glare & Associat s,___Inc.
Please list similar projects on which you performed Work similar to the Work you would
perform on this Project. This information is to be included with the Bid, and will be used by the
City in assessing your capabilities and qualifications for performing the Work. You are hereby
advised that this project is complex and requires experienced Contractors and Subcontractors.
Bids may be considered non-responsive if the information provided is untrue or is insufficient to
allow the City to adequately assess capabilities and qualifications.
1. Project Name El Segundo RSIP Project No. 37
Agoicy'C u„t v of El Se ndo Dollar Value $58, 710 . 00
Contact Person James O'Neill Tel.No. 310 . 524 .2. 385
Description of Project supili Acoustic ,.Doors frames
and hardware.
2. Project Name El Segundo RSIP Project No. 38
Agency City of—ET Segundo Dollar Value $55, 800 . 00
Contact Person James O'Neill Tel.No. 310 .5 2 4 .2 3 8 5
➢ „ Supply Acoustic Doors, frames,
Description of l :�o t.ct
and hardware.
3. Project Name El Segundo RSIP Project No. 39
Agency City of El Segundo � Dollar Value $77, 450 . 00
Contact Person James O'Neill Tel.No. 316—.524 .2385
Description of Project_ Supply Acoustic Doors frames,
and hardware.
4. Project Name El Segundo RSIP Project No. 41
AgeiacK City of E1 Segundo Dollar Value $86, 225 . 00
Contact Person James "Neill. Tel.No. 31-0 2q_._279_5_
Description ofl'roJect_ Supply Acoustic Doors, frames,
and hardware.
Bidding Form Appendix B-13 Last Modified:January 23,2014
References
City of El Segundo
Residential Sound Insulation Program
RSI 14-26(Group 68)
References
(Required of Bidders and any Subcontractors performing more than 10%of Work)
Name of Bidder or Subcontractor: Discount Exteriors
Please list similar projects on which you performed Work similar to the Work you would
perform on this Project. This information is to be included with the Bid, and will be used by the
City in assessing your capabilities and qualifications for performing the Work. You are hereby
advised that this project is complex and requires experienced Contractors and Subcontractors.
Bids may be considered non-responsive if the information provided is untrue or is insufficient to
allow the City to adequately assess capabilities and qualifications.
1. Project Name In lewood RSIP Project No. Various
Agency Dollar Value
Contact Person Anthony Barbarin Tel.No. 310-412-5289
Description of Project
Bmi&wial Sound
2. Project Name LAWA RSIP Project No. Various
Agency Dollar Value
Contact Person Tel.No. 424-646-7441
Description of Project
Resi'denfi'al Sound Insulation Pro am
3. Project Name Burbank RSIP Project No. Various
.Agency 1 g Labs Dollar Value
Contact Person Dan Btl&y Tel.No.
Description of Project
4. Project Name Project No.
Agency Dollar Value
Contact Person Tel.No.
Description of Project
Bidding Form Appendix B-13 Last Modified:January 23,2014
References
City of El Segundo
Residential Sound Insulation Pro r<ar
, EL SEGUNDO RS..
IP 14-26 GROUP 68
References
(Required of Bidders and any Subcontractors performing more than 10%of Work)
Name of&iddcr or Subcontractor: R. . ELEc,rRI t;AI, 'L C
Please list similar projects on which you performed Work similar to the Work you would
perform on this ProjecL This information is to be included with the Bid,and will be used by the
City in assessing your capabilities and qualifications For performing e Work, You art hereby
advised that this project is complex and requires experienced Contractors and Subcontractors.
Bids may be considered non-responsive if the information provided is untrue or is insufficient to
allow the City to adequately assess capabilities and qualifications.
I. Project Name, INGLEWOOD tea I 8.14 Project No, P11 5 Gtr. 14
Agency...._ l,r Off" I GL EWO ,.� Dollar Value $85, 000-00
®....._..� 310,.......... -.
Contact I�crson �. 1� "rci. No.
Description ofPropcct ALL ELECTRI C L SCOPE or
. . .... . . . i4
6-k
�SCR BF-D-1i_ �ii �
2, ro,jca Name INGL _ D.........RS...I....,,,,. w 12. �_.. PrcSjsct T+Ic�. H R 1,2
- - -
_w. ..ww. a OO Dollar Val $194, 000.00
� erne; - GAI i�' OR It'�G��Lq�. ..�_��_��.....�F . ..n.,,.
Contact Pcrsc�n T-HO' I23 TeL Nom 330-41e2-5 ' �
Description of Prt� eat ALL ELECTRICAL v,m. SCOPE OF WORK
DESCRIBED IN THE ORIGTNAL S Pr,("TFl CATIONS
l �., l e
- ..
. Project Name _IN LE OOD RSI 8. 17 _ Project Teo PH 8 OR 17
,ent y 1.x,T�..... 't I GLE OOD Dollar Value $83, 000 00
._.. �e....�.n... _.... .,_
Contact Persotl ;.'d 4T tON Rai IN Tel. No, 310-4:12-5280
Description of of I'rcaact _. L ELECTRICAL.M 50 R�
TN .., ,[Q1,JgA1s
4, Projcct t.e_a_cnt 1� -G.1 r..1-EW OD RS
f 9.5 Project No,— PH 9
GR
Agency C171 r OF tN�tt W�M Dollar Value K 9�M00
00
coe Ile rson t LtON B RIN Tel, N . 3101 412 5200
Description ALL ELECTRICAL SCOPE oF i46
PO 1 N TrI 6L2IGI i 4 X L OPr"C IF"T,.,e T 1 S
Bidding Form aAppendix B-13...� ,......Last Modified:Janu 21,2014
References
I
E
City of El
Residential lrisulation Program
RS114-26(Croup 68)
References
(Required of Bidders and any Subcontractors mor than 10;,of Woric) I
Name of Bidder or Subcontractor: 46SOd A'" - vo + 1N"r'o
Please list similar projects on which you performed Work similar to the tVork you would
perform on this Project. This information is to be included with the Bid,and t,ill be used by the
City in assessing your capabilities and qualifications for performing the Wor-You are hereby
advised that this project is complex and requires experienced Contractors ar d Subcontractors.
Bids may be considered non-responsive if the information provided is untrue c r is insufficient to
allow the City to - ' ` assess capabilities and qualifications.
1.. Project Narne --1--p G(o up qz Project No ( y
Agcnoy6 I Dollar V glue
Contact Per- 725 ew� f" Tel Nra L" :
D e prior[ofProj
°a
2. Project Name � ftrd:�� r Projock No
Agency 6(4"? e art= ems`Cb Dollar rliar V lue
J� ,
twonxact Parson 3 ern l" i"e1.Nca j d l r
Description of`Pro
1 Project Name (7 600 l'rojuct No. r
Agency(_OMM, �'� .C rtit,yl Lf{ GJ Dollar Value �?r
Contact Person 6 M�D Tel,l'tr�� <j � +�
D pr 0,Of'T �= ta_ u2 -.:W 4 ....................._ ., ,......_.
4. Project Name iy 5 �� C G G(� Prolact No J rr ,w
A en1i7"C19ara1 Vrrhst .� "�
g Cy(A(MiM
Contac[Person..
B W�
D of Pµ
Biddin Form A endix B-13 Lwt lama_ ,...14
g PP January 23,2014
City of El Segundo
Residential Sound Insulation Program
RSI 14-26 (Group 68)
References
(Required of Bidders and any Subcontractors performing more than 10% of Work)
Name of Bidder or Subcontractor:
Please list similar projects on which you performed Work similar to the Work you would
perform on this Project. This information is to be included with the Bid, and will be used by the
City in assessing your capabilities and qualifications for performing the Work. You are hereby
advised that this project is complex and requires experienced Contractors and Subcontractors.
Bids may be considered non-responsive if the information provided is untrue or is insufficient to
allow the City to adequately assess capabilities and qualifications.
1. Project Nauru w„� ,.m.. m . ®. Project No ...
c P� . � Dollar Value
1,.�nc y 1, t
Descry ttion ofrl � • Tel.�o..
P'01 al
p � u
2. Agency....
Name _ .... . 1. � t Project No
y ...t . � .. . .
Dollar Value a
Contact Person , Tel No , r �
tl.,.._
1Dcstrr°r rtirr�r of Projuut i . I •� .....�e,...�.���
�.M �... s. r
3. Project Name / Project No.
iu" .. D
1 jar Value
Agency l No. ,
g Y, s
Contact 1 ersorr J cl, No. (J",
Description of l r(r
p jc1 e. . °, .e._ a j: ��n s._m.,
m..... .
4. Project Narrrc aw• Project NoUC
getrr Dollar Value � " � �
Contact 1 +. r 1 W�..� ... Tel. No,
Ekscrrptioll of l l rttj cl
...... .......
...................... .._. . ... . .e_-.... w„ _.. .. .. .........._._.. _ .. ._. ..
Biddin g Form Appendix B-13 Last Modified:January 23,2014
References
1111312014 00:23 FAX 19499556507 C @NON 1@0071007
City of El Segundo
Residential Sound Insulation Prograir
RSI 14-2 (Group 6$)
References
(Required of Bidders and any Subcontractors performing more than 10% of Work)
Name of Bidder or Subcontractor
Please list similar projects on which you performed Work similar to the Work you would
perform an this Project. This information is to be included with the Bid, and will b,, used by the
City in assessing your capabilities and qualifications for performing the Work. You are hereby
advised that this project is complex and requires experienced Contractors and Su contractors.
Bids may be considered non-responsive if the information provided is untrue or is insufficient to
allow the City to adequately assess capabilities and qualifications.
a �. �'�' , Project No.
1, Project Warne �I �'' �
Agency Dollar Value
Contact-Person/ Tel.No,- � �
Description of Pr oj at ,,.�� �.. �-•«� ��
2. project Name CD C �r j t'roject No, p _c
gecy Dollar Value
Contact Person 4 Tel.No,
Description of Project
3. Project Name— O.D , . 2 ...,.. Project No. Z44--al - C 00 � CV
Agency ...
Tel. Na_��
Contact Persor��, Dollar Va ue� 1783
Description of lProject
ti
4. Project Name CiPro}ect No,
Agency _ .- Dollar Value
Contact person Tel. No.
Description of Project
Bidding Farm, /appendix 'B-13 Last Modified, January 23,2014
References
City of El Segundo
9 Residential Sound Insulation Prograni
0 nr� i
RSI 14-26(Group 68)
k'
Acknowledtement of Receipt of Addenda
Bidder acknowledges receipt of the following addenda, has become familiar with their contents,
and has accounted for all such changes in the Bidder's Proposal and Statement.
Addendum Number Date: 0 !U 1Y
Addendum Number
..... Date: U , 4_.. ` . Jq
Addendum Number Date:
Addendum Number Date:
Addendum Number Date:
Addendum Number Date:
Addendum Number Date:
Addendum Number Date:
Addendum Number Date:
Addendum Number Date:.
Contractor Representative: ct,— III 20
Signatwe Dific
Thomas R. Carr
Name(printed or typed)
Bidding Form B-14 Last Modified:January 23,2014
Acknowledgement of Receipt of Addenda
City of El Segundo
Residential Sound Insulation Program
ADDENDUM NUMBER 1
Date: October 15, 2014
Project: City of El Segundo
RSI 14-26 (Residential Sound Insulation Program—Group 68)
To: Prospective Bidders
This addendum forms a part of the Contract Documents and modifies the original Bidding
Documents. Portions of the Bidding and Contract Documents not altered by this addendum
remain in full force.
Bidders must acknowledge receipt of this addendum as part of their Bid. Failure to do so
may subject the Bidder to disqualification.
Item 1 The date and time of the Pre-Bid meeting is hereby revised to be Thursday,
October 30, 2014 at 10:00 a.m.
End of Addendum
Addendum#1 RSI 14-26(Group 68)
City of El Segundo
Residential Sound Insulation Program
,
ADDENDUM NUMBER 2
Date: November 14, 2014
Project: City of El Segundo
RSI 14-26 (Residential Sound Insulation Program—Group 68)
To: Prospective Bidders
This addendum forms a part of the Contract Documents and modifies the original Bidding
Documents. Portions of the Bidding and Contract Documents not altered by this addendum
remain in full force.
Bidders must acknowledge receipt of this addendum as part of their Bid. Failure to do so
may subject the Bidder to disqualification.
Item 1 The Bid deadline is hereby revised to be Wednesday, November 19, 2014 at
11:30 a.m.
Item 2 The Contract Documents, including Section 07 30 00 (Roofing), are hereby
revised to delete the requirement that roofing work is only performed by
individuals working C39 Specialty License
Item 3 Replace Appendix A-02 (Preliminary Construction Schedule) with the attached
Appendix A-02 marked "Addendum#2 (November 14, 2014)"
Item 4 Replace Appendix A-03 (Davis Bacon Prevailing Wage General Decision) with
the attached Appendix A-03 marked"Addendum#2 (11-14-2014)"
Item 5 Replace Section 01 13 00 (Worker Conduct) with the attached Section 01 13 00
Item 6 The attached Insurance Form(CG 20 10 04 13) is an acceptable alternate to the
insurance form required by the Contract Documents as long as all other insurance
requirements of the Contract Documents are met, including insuring that "the
City, its officers, employees, agents and volunteers" are covered for your work
and your ongoing operations.
Item 7 California Legislation SB 407: Neither the Contractor, nor its subcontractors, will
be responsible for providing, nor installing, low-flow toilets, shower heads, or
other plumbing fixtures as part of the scope of work for the project. Any such
requirements related to SB 407 are not expected to impact the construction
schedule, and therefore no additional costs related to SB 407 are to be
incorporated into Bids.
Addendum#2 RSI 14-26(Group 68)
City of El Segundo
Residential Sound Insulation Program
Item 8 Response to pre-bid RFI: For all plans that have a plumbing note to "Disconnect
gas line supplying existing furnace and reconnect to new furnace at same
location" and "Install a new gas line (1" in diameter) to supply new furnace,
Bidders/Contractors are to install a new gas line (1" in diameter) to supply the
new furnace and connect existing gas lines supplying existing appliances to new
(1" in diameter) gas line.
Item 9 Response to pre-bid RFI: Unless the plans for a home specifies otherwise,
bidders may use any of the types of attic insulation that meet the specification
requirements to achieve a specified R-value.
End of Addendum
Addendum#2 RSI 14-26(Group 68)
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Re: Group 68 Invitation to Bid Page 1 of 1
From: bigwestconst<bigwestconst @aol.com>
To: bigwestconst<bigwestconst @aol.com>; mdinsul <mdinsul @sbcglobal.net>; pratt2glore
<pratt2glore @yahoo.com>;VIC <VIC @ZODIACHVAC.COM>;joedupuy<joedupuy @milgard.com>;
discountx<discountx @g mail.com>; hkelectricaleliza<hkelectricaleliza @gmail.com>; chuck
<chuck @absoluteabatement.net>; mikec<mikec @specialtydoor.net>; gnichols
<gnichols @trueairinc.com>;jp<j p@westchesterelectrical.net>; rameyroofing <rameyroofing @aol.com>;
shulsey<shulsey @grahamwindows.com>;yasamifar<yasamifar @sbcglobal.net>;thomas
<thomas @azhomeinc.com>; pgj_enviro<pgj_enviro @yahoo.com>;valli<valli @rbhinsulation.com>
Subject: Re: Group 68 Invitation to Bid
Date: Mon, Nov 10,2014 5:54 pm
Attachments: Group_68_lnvitation_to_Bid.pdf(5912K)
Please see the attached information
Attachment's include:
Invitation to Bid
Notice inviting Sealed bids
Certificate of Non Segregated Facilities-Completed and Returned
Trade Restriction Clauses and form-Completed and Returned
Suspension and Debarment Requirements-Completed and Returned
References-Completed and Returned
Insurance Requirements
There is no Construction schedule provided by the city yet for Group 68
Please supply your price for this project broken out per the schedule of values in the bid documents.
If applicable: A certificate of Disadvantaged Business Enterprise must be submitted with your bid.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or
national origin.
Tom Carr
Big West Construction
(949) 795-2219
https://mail.aol.com/3 8848-916/aol-6/en-us/mail/PrintMessage.aspx 11/17/2014
0O111!11""'I I 10MON
�- Ci01j ILI'�"I dIR.��j1011lp",,,,�
tteFlti:upu Pros2ective Bidder
i.;ontpa'ny: ,
aX:
Pi..pC9ne"
Project: RESIDENTIAL SOUND
INSULATION PROGRAM
Group 8 Bid Date: 11/14/2014
VARIOUS LOCATIONS
Address: Time' '00
E,arlly Qnuotc.a are alw.,ays welcome&
City, St., Zip El Segundo, CA always confid¢ntiaap
Please mark the apap:aropuriate box pw.rud return.
Yes, P wuuu..M like to bid Pius^ pr oj. ;.:,.ct Need Plans: Yes
r,,.), not at this tiiuuue
Yes, Already haavc puiauus Slia pnpzimu,g Nu.urrauber'a
Spec Secfion(s)�
Estimators Muune:
Phone Nurriiner�
P-0*.....rnaii addre ,
`1C"lluariks in advance for your tnTie on t u s pruJect and .:bhot.uid yuuuu need anything while
looking at this Project feel free to contact our office and ask iou°:
"P'oln Parr
(949) 795-2 219
Fax (919) 253 9019
15331 1 u rl'vi i'Wie a a. �u vmm"e CIA 912604 * ( dd)795 2219 �u �� � id� p" 1506
i.irv"eII`°p"rv'e#81,20185 Piau °P"p"MV&estc IIn"!pi@ww;D1 III IIVi
Notice Inviting Sealed Bids
CITY OF EL SEGUNDO
RESIDENTIAL SOUND INSULATION PROGRAM
RSI 14-26 (Group 68)
The City of El Segundo is accepting scaled Bids for Projects RSI 14-26 (Group 68 of the
Residential Sound Insulation Program) in the City Clerk's office, 350 Main Street, El Segundo,
California 90245, until
11:00 a.m. on Tuesday, November 18,2014
at which time they will be publicly opened. Bids will not be accepted after that time.
Bidders are required to attend the pre-bid meeting scheduled for Thursday, October 23, 2014 at
10:00 a.m. in City Hall's West Conference Room located at 350 Main Street, El Segundo,
California 90245 if they did not attend at least one of the pre-bid meetings for the Group 55-67
projects. Bidders are strongly encouraged to arrive early as the meeting is expected to start
promptly. Any bidder who arrives after the start of the meeting will not be considered in
attendance.
Bidders are strongly encouraged to purchase Contract Documents and review them prior
to the pre-bid meeting to afford themselves the opportunity to have requirements that
may be unclear to them clarified by the City during the meeting.
Bids will be received for Groups 68 ("Project") of the Residential Sound Insulation Program,
which consists of sound insulation improvements and related work at twenty-one (21) homes in
the City of El Segundo, including installation of acoustically rated windows and doors, heating
and ventilation modifications, associated electrical work, attic insulation and associated
abatement of asbestos containing materials and lead-based painted surfaces.
Work on the Project must be performed in strict conformity with the Contract Documents.
Contract Documents for each project may be obtained by contacting the City of El Segundo. The
terms and conditions for bidding on the Project are described in the Instructions to Bidders in the
Contract Documents.
This Project requires payment of State prevailing rates of wages for Los Angeles County. The
Contractor must post copies of the prevailing schedule at each job site. Copies of these rates of
wages are available from the State of California Department of Industrial Relations Prevailing
Wage Unit, Telephone No. (415) 703-4774. The website for this agency is currently located at
www.d'
The Contractor to who the Contract is awarded must assist in locating, qualifying, hiring and
increasing the skills of minority group employees and applicants for employment, as set forth in
Executive Order 11246 and It 375.
Bidders must submit a Bid Security (or "bid guarantee") with their Bid, in an amount not less
than ten percent(10%) of the Total Bid (Contract Sum), as a guarantee that Bidder will fulfill its
obligation to enter into a Contract with the City in accordance with the Contract Documents.
Five percent (5%) will be deducted from each progress payment and retained by the City. The
remainder less the amount of all previous payments will be paid to the Contractor. Pursuant to
Public Contracts Code ("PCC") § 22300, the Contractor may substitute securities for retention
monies held by the City or request that the City place such monies into an escrow account. The
Contractor is notified that, pursuant to PCC § 22300, any such election will be at the Contractor
own expense and will include costs incurred by the City to accommodate the Contractor's
request.
FEDERAL REQUIREMENTS:
The proposed contract is under and subject to Executive Order 11246, as amended, of September
24, 1965, and, to the Equal Employment Opportunity (EEO)and Federal Labor Provisions.
All Labor on the project must be paid no less than the minimum wage rates established by the
U.S. Secretary of Labor.
Bidders must supply all the information required by the Contract Documents,
The EEO requirements, labor provisions and wage rates are included in the Contract Documents
and are available for inspection at the Residential Sound Insulation (RSI) offices, 333 Main
Street, Unit A, El Segundo, California 90245. Davis-Bacon prevailing wage information may
be obtained directly frorn the Government Printing Office via the internet at
Awy .access. , o.goy/da_visbac0m or call toll-free at 1-888-293-6498 or fax your request to 1-202-
512-1262.
Bidders must complete, sign and furnish, the "Bidder's Statement on Previous Contracts Subject
to EEO Clause," a "Certification, of Nonsegregated Facilities." and the "Assurance of
Disadvantaged Business Enterprise Participation."
A Contractor having fifty (50) or more employees and his Subcontractors having fifty (50) or
more employees and who may be awarded a contract of $50,000 or more will be required to
maintain an affirmative action program, the standards for which are contained in the Contract
Documents.
To be eligible for award, Bidders must comply with their affirmative action requirements.
Disadvantaged business enterprises (DBEs) as defined in 49 CFR Part 23 must have the
maxim um opportunity to participate in the performance of contracts financed in whole or in part
with Federal funds under this agreement. Consequently, the DBE requirements of 49 CFR Part
23 apply to this agreement.
All solicitations, contracts, and subcontracts resulting from projects funded under the AIP must
contain the foreign trade restriction required by 49 CFR Part 30, Denial of Public Works
Contracts to Suppliers of Goods and Services of Countries That Deny Procurement Market
Access to U.S. Contractors.
The Aviation Safety and Capacity Expansion Act of 1990 provides that preference be given to
steel and manufactured products produced in the United States when funds are expended
pursuant to a grant issued under the Airport Improvement Program.
Certification of Disadvantaged Business Enterprises (DBE) Contractors and Subcontractors by
Caltrans must be submitted for each DBE and must be submitted within forty eight (48) hours
after the opening of bids.
Dated this 16th day of October, 2014
City of El Segundo, Califs is
Tracy Weaver, City Clerk
City of El Segundo
Residential Sound Insulation Program
lR.S➢ 14 26 (Grosuujp 68)
a.
References
(Required of Bidders and any Sunbcoritractors performing more than 10%of Work)
?slaws of Bidder or Subcontractor:
Please list similar proJects on which you performed Work similar to the Work you would
perform on this Project. This information is to be included with the Bud, and wall be used by the
City in assessing your capabilities and qualifications for p erfonnpng the Work. You are hereby
advised that this project is complex. and requires experienced nced Co ntractors and Subcontractors,
Bids may be considered non-responsive of the information provided as untrue or is insufficient ciennt to
allow the City to adequately assess capabilities and qualifications..
1. Project Name Project No,.,,,
Agency.. ..- _ Dollar Valuue.
Description oflProject ..... ..
1 Project Name, Project No
A'g'ency.... Dollar Value,
Contact Person- Tel..No.
Description of l'no.n� ��t_..,....
Project]�na
Agency Dollar Value_....._._
Contact Person Tel. No.-
Description of Prc,mIcct
4. Project Name - - ]Project No._
Agency ... �a tiw. ..... .... _...._, Dollar �.
Contact Person Tel.No.
Description of Project——...
Bidding Form Appendix B-13 Last Modified-,January 23,20114
References
City of EI Segundo
' Residential Sound Insulation p:qr ogram
RS1 14-26 (Group 68)
p
Suspension and Debarment .Require is
for all Contracts over
(4 (.,:IEtt Part 29)
The ]udder certifies, by submission of this proposal or acceptance of Contract,that neither it
nor its principals is presently debarred, suspended, proposed for debarniennt, declared ineligible,
or voluntarily excluded from participation atiororn to this transaction by any Federal department or
agency. It further agrees by submitting this proposal that it will include this clause without
modification in all lower tier transactions, solicitations, proposals, contracts, and subcontracts.
Where the Bidder/offerer/contractor or any lower tier participant nt is unable to certify to this
statement, it must attach an explanation to this solicitation/proposal.
Address
Co ntrdctor t2 eparesernta.f ire-
'Title:
Signature:
Dated this day ooh ..w� 2014.
Bidding Form Appendix penndix B-l l Last Mondttae&January 23,2014
Suspension and Debarment Requirements
City of El Segundo
Residential Sound Insulation Prograni
1RSp 1426 (Group Cr )
Trade Restriction b s s to all Solicitations,
Contracts, and Subcontracts
The Contractor or Subcontractor, by submission of an offer and/or execution of contract,
certifies that it:
A. is not owned or controlled by one or unnerve citizens or nationals of a foreign country
included in the .list of countries that, discriminate against U.S. firms published by the
Office of the United States Trade Representative(USTR);
13. has not knowingly entered into any contract or subcontract for this project with a person
that is a citizen or a national of a foreign country on said list, or is owned or controlled
directly or indirectly by one or more citizens or nationals of a foreign country on said list;
C. has not procured any product nor subcontracted for the supply of any product for use on
the prrgject that is produced in a foreign country on said list.
Unless the restrictions of this clause are waived by the Secretary of Tran•nsp ortatio n in accordance
with 49 CFR 30.17, no contract must be awarded to a contractor or subcontractor who is unable
to certify to the above. If the contractor knowingly procures or Subcontracts for the supply of
any product or services of a foreign country on the said list for use on the prospect, the Federal
Aviation Administration may direct, through the City, cancellation of the contract at no cost for
the government.
Further, the contractor agrees that, if awarded a contract resulting :fr(.runn this solicitation, it will
incorporate this provision for certiffication without modification in each. contract and in. all lower
tier snubco tract,& The contractor may rely on the certification of a prospective subcontractor
unless it has knowledge that the certification is erroneous.
The contractor must provide immediate written notice to the sponsor if the contractor learns that
its certification or that of a subcontractor was erroneous when submitted or has become
erroneous by reason of changed circumstances. The subcontractor agrees to provide immediate
written notice to the contractor, if at any time it learns that its certification was erroneous by
reason of changed circumstances.
This certification is a material representation of pact upon which reliance was placed when.
making the award. If it is later determined that the contractor or subcontractor knowingly
rendered an erroneous certification, the Federal Aviation Administration may direct, through the
City, cancellation of the contract or subcontract for default at no asst to the government.
Nothing contained in the foregoing must be construed to require establishment of a system. of
records in under to render, in good faith, the certification required by this provision.. The
knowledge arnd information of a contractor is not required to exceed that which is normally
possessed by a prudent person in the ordinary course of business dealings.
This certification concerns a ratter within. the jurisdiction tif am agency of the United States of
Bidding Form Appendix 13.07 Last Modffle&January 23,2014
Trade Restriction Clauses Page i of 2
City of El Segundo
Residential Sound Insulation lln•nbgniau
BSI 14-26(Group 6 )
America and the melon.g of a false, fictitious, or fraudulent certification may render the maker
subject.to prosecution under Title 18, United States Code, Sachsen 100 L
Name of Finn:
Contractor epirese ntative
Title:
Signature:
Dated this___dad of ._...._......e_....... �...
2014,.
Bidding Form Appendix B 07 Last Modifie&January 23,2014
Trade Restriction Clauses Page 2 of 2
City of El Segundo
Residential Sound Insulation lrn orw-cun
RSl 14-26 (Group 68)
Certification of Non- . to nli s
(Contractor-,/Subcontractors)
(A certificate of°Nonn°segregated facilities must be submitted prior to award of a contract or subcontract
exceeding$10,000 which is not exempt from the provisions of Equal Opportunity Clauses)
The federally assisted construction contractor certifies that it does not maintain or provide for its
employees any segregated facilities at any of its establishments, arid that it does not pe.nnit its employees
to perform their services at any location, under its control, where segregated facilities are maintained.
The ]Federally assisted construction contactor certifies further that it will not maintain or provide for its
employees any segregated facilities at any of its establishments, and that it will not pennit any of` its
employees to perform their services at any location, under its control, where segregated facilities are
maintained. "fhe federally assisted construction contractor agrees that a breach of this certification is a
violation of the Equal Opportunity clause in this contract, As us W- in this certific:atiora, the teryn
"segregated facilities" means any waiting room, work areas, .rest rooms and washrooms, restaurants and
other eating areas, time clocks, locker roornns and other storage or dressing areas, parking lots, drinking
fountains,recreation or entertainment areas, transportation, and housing facilities provided for employees
which are segregated by explicit directive or are in fact segregated on the basis of race,color,religion„ seq.
or national origin, because of habit, local custom, or any other reason. The federally assisted
construction contractor agrees that (except where; it has obtained identical certifications from proposed
subcontractors for specific time periods) it will obtain identical certifications from proposed
subcontractors prior to the award of subcontracts exceeding $10„000 which are not exempt from the
provisions of the Equal Opportunity clause,and that it will retain such cer•tificadon in its files.
Certification--The information above is true and complete to the best of may knowledge and belief.,
Name of firrm.
Address:
Telephone Number. �. _ .........---------------- -- —----------_.........._
Contractor.Representative:
Title-
Signature. _ __-------..
Dated this day of ............. �.�. W�20f4..
Dote: The penalty for making false statements in offers is prescribed in 18 U.&C. 1001.
Bidding Form appendix -06 last Mordifne&January 23 2014
Certification of lion-Segregated Facilities
City of El Segundo
Residential Sound Insulation Program
Section 00 73 16 — Insurance Requirements
Part I General
1.01 Summary
A, Work covered by this Section includes, without limitation:
Procuring and maintaining insurance coverage which meets or exceeds the
requirements of the Contract Documents
2. Requiring each Subcontractor, who is not covered by the insurance of the
Contractor, to procure and maintain insurance coverage which meets or
exceed the requirements of the Contract Documents
3. Providing tote City all documentation necessary to clearly shoe that all
insurance requirements for the Project have been met
B. Related Sections
1. Appendix C®02 Insurance Certificate Cancellation Clause (Sample)
2. Appendix C®03 Additional Insured — Owners, Lessees or
Contractors(Form )
1,02 References
Part 2 Products
Part 3 Execution
3.01 Contractor must procure and maintain for the duration of the contract the following
insurance coverages and limits against claims for injuries to persons or damage to
property which may arise from or in connection with the performance of the Work
covered by this Agreement by the Contractor, its agents, representatives, employees or
Subcontractors:
gowra..� er .. ....__ - S - ......... .. ��......�. Si
_ cc rre ce r Combined S e Limit...._
or 8 $1 000,000
C o rehensive General I iabalaty GL_ 00 02 01 85. ....
Business Auto CA 00 01 01 87 $1.,000,000
P .... ........... .. �� � . u... .
Workers' C om errsat�on Statcatory
3.02 Contractor will provide endorsements or other proof of coverage for contractual liability.
3.03 Combined single lirnit per occurrence will include coverage for bodily injury, personal
injury, and property damage for each accident.
3,04 If Commercial General Liability Insurance or other form with a general aggregate limit is
used, the policy will be endorsed such that the general aggregate limit will apply
separately to this contract and a copy of the endorsement provided to the City,
3.05 Liability policies must contain, or be endorsed to contain the following provisions:
A. General Liability and Automobile Liability
1, The City, its officers, officials, employees, agents, and volunteers will be
covered as insureds as respects: liability arising out of activities
Sectaon 00 73..w 16 ... _ .. . ...._. .._ _30 0 Last Modified:June 26,2014
Insurance Requirements 2015 Edition
City of El Segundo
Residential Sound Insulation Program
performed by or on behalf of the Contractor,- products and completed
operations of the Contractor; premises owned, occupied or used by the
Contractor,- or automobiles owned, leased, hired or borrowed by the
Conlractor. T'he coverage will contain no special limitations on the scope
or protection afforded to the City, its officers, officials, employees, agents,
or volunteers.
2. The Contractor's insurance coverage will be primary insurance as respects
the City, its officers, officials, employees, agents, and volunteers. Any
insurance or self-insurance maintained by the City, its officers, officials,
employees; agents, and volunteers will be excess of the Contractor's
insurance and will not contribute with it.
3. Any failure to comply with reporting provisions of the policies will not
affect coverage provided to the City, its officers, officials, employees,
agents and volunteers.
4. The Contractor's insurance will apply separately to each insured against
whom claim is made or suit is brought, except with respect to the limits of
the insurer's liability.
B. Workers' Compensation
1. The insurer will agree to waive all rights of subrogation against the City,
its officers, officials, employees and volunteers for losses arising from
Work performed by the Contractor for the City,
Cu All Coverages
1. Each insurance policy required by this subsection will be endorsed to state
that coverage will not be suspended, voided, cancelled by either party,
reduced in coverage or in limits except after thirty (30) days written notice
by certified mail,return receipt requested,has been given to:
CITY CLERK
City of EI Segundo
350 Main Street
El Segundo, CA 90245
2. Notwithstanding the foregoing, the endorsement may state that insurance
may be cancelled upon ten (10) day notification for non-payment of
premium, The Contractor will provide the City with updated proof of
insurance should the Contract Time extend beyond the policy expiration
date.
3. All liability insurance will be on an occurrence basis. Insurance oil a
claims made basis will be rejected. Any deductibles or self-insured
retentions will be declared to and approved by City. The insurer will
provide an endorsement to City eliminating such deductibles or
self-insured retentions as respects the City, its officials, employees,
agents, and volunteers.
4. Except for Workers Compensation Insurance, Contractor will furnish to
City certificates of insurance and endorsements on forms acceptable to the
City's City Attorney, duly authenticated, giving evidence of the insurance
coverages required in this contract and other evidence of coverage or
copies of policies as may be reasonably required by City from time to
_ii ..... �_.... . ... ..... ... .1 _H ....Last Modified:. m... .._
Section 00 73 16 June 26,2014
Insurance Requirements 2015 Edition
City of El Segundo
Residential Sound Insulation Program
time. Certificate/endorsement for Workers Compensation Insurance will
be furnished on State Comp Fund or other industry standard forrn, Except
for Worker's compensation insurance, all insurance required herein will
be placed with insurers with a Best's Rating of not less than ANII,
Worker's compensation insurance policies will meet the requirements of
California law.
S. All Subcontractors employed on the Work referred to in this contract gust
meet the insurance requirements set forth for Contractor. Contractor must
furnish certificates of insurance and endorsements for each Subcontractor
at least five days before the Subcontractor entering the job site, or
Contractor will furnish City an endorsement including all Subcontractors
as insureds under its policies.
6, Except as otherwise provided, the Contractor will save, keep and hold
harmless the City, its officers, officials, employees, agents and volunteers
from all damages, costs or expenses in law or equity that may at any time
arise or be claimed because of damages to property, or personal injury
received by reason of or in the course of performing Work, which may be
caused by any willful or negligent act or omission by the Contractor or
any of the Contractor's employees, or any Subcontractor. The City will
not be liable for any accident, loss or damage to the Work before its
completion and acceptance.
7. The cost of such insurance will be included in the various items of Work
in the Contractor's bid and no additional compensation for purchasing
insurance or additional coverages needed to meet these requirements will
be allowed,
8, In the event that any required insurance is reduced in coverage, cancelled
for any reason, voided or suspended, Contractor agrees that City may
arrange for insurance coverage as specified, and Contractor further agrees
that administrative and premium costs may be deducted from payments
due to the Contractor. Contractor will not be allowed to Work until
alternate coverage is arranged.
End of Section 00 73 16
Section 00 73 16 32 Last Modified:June 26,2014
Insurance Requirements 2015 Edition
Reproduction of Insurance Services Office, Inc. Form
INSURER: ISO FORM CG 20 10 11 85: (MODIFIED)
POLICY NUMBER-COMMERCIAL GENET L LIABILITY
ENDORSEMENT WMBER:EXI-IMIT 1-A
THIS ENDORSEMENT CHANGES THE POLICY,PLEASE READ ITCAREFULLY.
ADDITIONAL INSURE,D—OWNERS, LESSEES OR
CONTRACTORS (FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE
The City, its officers, officials, employees, agents, and volunteers
(If no entry appears above,the information required to complete this endorsement
will be shown in the Declarations as applicable to this endorsement.)
WHO IS AN INSURED (Section 11)is amended to include as an insured the person or organization
shown in the Schedule,but only with respect to liability arising out of"your work" for that insured by or
for you.
fications to ISO form CG 20 10 1185-.
1. The insured scheduled above includes the Insured's officers, officials, employees and
volunteers.
2. This insurance shall be primary as respects the insured shown in the schedule above,
or if excess, shall stand in an unbroken chain of coverage excess of the Narned
Insured's scheduled underlying primary coverage. In either event, any other insurance
maintained by the Insured scheduled above shall be in excess of this insurance and
shall not be called upon to contribute with it.
1 The insurance afforded by this policy shall not be canceled except after thirty days
prior written notice by certified mail return receipt requested has been given to the
Entity.
4. Covenage shall not extend to any hiderrinity coverage for the active negligence or the
`Z
additional insured in any case where an agreement to indemnify the additional insured
would be i.nvalid udder S il)divisioii(l,)) section 2782 of the Civil Code.
...........
Signature.-Authorized Representative
...............
Address
CG 20 10 11 85 insurance Services Office,Inc.Form(Modified)
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