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CONTRACT 4720 Bid Other CLOSEDAgreement No. 4720 Big West Construction Corporation. City of El Segundo Residential Sound Insulation Program. RSI 14-25 (Group 67) 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 14-25 "Residential Sound Insulation Program —Group 67" at the following luni p sum price: RSI ID Pro er Address Bid Price 67.01 770 West Imperial Avenue, Unit 37 $ 2.G,2(o0 67.02 943 Hillcrest Street $ 29) -,20 67.03 945 Hillcrest Street $ 21312160 67.04 938 Loma Vista Street $ 2'� ?j(v C7 67.05 225 West Walnut Avenue $ I 0 67.06 201 West Sycamore Avenue $ 67.07 818 Virginia Street $ 67.08 641 West Oak Avenue $ 4 e) $(os 67.09 709 Loma Vista Street $ 34 , 440 67.10 216 West Maple Avenue $ 91, �3 67,11 948 Eucalyptus Drive $ -j (a �S 67.12 832 Eucalyptus Drive $ 51 rJ 5'b 67.13 861 Sheldon Street $ 7jq ( �" 67.14 508 East Walnut Avenue $ Z,S a 92S 67.15 510 East Walnut Avenue $ Cl 5,; 67.16 524 East Sycamore Avenue $ L4 Bidding Form Appendix _(l l� Last Modified:August 14,2014 Bidder's Proposal and Statement . r t 114 201�{' City of El Segundo Residential Sound Insulation Program RSI 14-25 (Group 67) 67.17 905 Maryland Street $ 67.18 1117 East Acacia Avenue $ ,L4 islls 67.19 1129 East Acacia Avenue $ 67.20 1501 East Walnut Avenue $ 67.21 1419 East Walnut Avenue $ 67.22 835 Center Street $ 1 67.23 609 East Maple Avenue $ ' 1 Total Bid (Contract Sum) (words) (figures) In case of discrepancy between the words and figures, the words must prevail Contractor Representative: 1 l Signature Date 1 1 Name(printed or typed) Title: N�i A Contractor's State License Number: Name of Firm: 4q �QS[�-QS"CCI�IOC'r�O (W/baffv' 20 Address: S'3g I 0Tz'441* k& License Expiration Date: c . Telephone Number: Type of Entity: ❑ Sole Proprietorship ❑ Partnership Corporation* ❑ Other * If Corporation, evidence of authority to sign must be attached Bidding Form Ap ct�di �- Last Modified:August 14,2014 Bidder's Proposal and Statement 11i9 I CORPORATION RESOLUTION Big West Construction Corporation January 47 2014 A meeting of the Board of Directors was held on January •,2014 whereby a resolution was adopted naming Thomas R. Carr, President and Margaret J. Carr, Vice-President/ Secretary® of parties are orized to execute contracts on behalf of Big West Construction Corporation. Stock has been redistributed as follows: Thomas R. Carr 50% Margaret J. Carr 50% ........... Thomas R. Carr, President Margaret�Carr. �wm�r uui mww� s �wuw�mmmmrwwu aaaw�u�rauuw i �rJ ?p tlk., W 1 Secretwirly Nm„ State attN ��Amtut�tWtat�r� Cttt,�ta�tI�11ItCt�Nta�V�t�l:. rtt'� r� �� ulturalll COOPU'ative Corporations) : II t�tNui�d ul1 i viiiig � N u � � t� dlm��) m wC II� struct111 t'ts„ IIWPORTA14 I READ t NN'tA III III°utA CAhams 130 (',)IRE C KIIIlll N!IN 11YG 'PiflS III O tI �wwwuw.mwv�rew�wnwa uww..rnn�c�uowa wna�,�U,un�-.��,::.� .�.�,,,�,�rbwa r� ,iuuw.r« m.. rnrm ra,wm�wKGw -rw:umu ww^ :� h' "he off c (A e Secretary of State A NA of PNmr State t California bIC t/ F.:,,ST CON allRLi C,0F::aeIP0RA,...1..'l0N I s % f 2� CAL-IIFORill CORPOIll INtNMBER d m..N 't 90,13 Ci Aib"I c im II`illim)o,_i s l Only ta u No Change Statement B��t t r aNla Napa ur as u'atlak address 1 � ilonS } y, tt there 1MVe been any char to the mrm-tom ul)r to mm a a rmt am wdtli tho lastpStatement N Ice m� a 9 d �. N ... _. t ra Y � IV � See uJN aamct, �aattm nh,�`� Ctatmma°army �ta,mam°a,tm"d . Corti`9mm�t�mmmn mtulrbulmu arbr;rt r cat dlt ,or n has ttaterne mt:pmt Ilmmt m,oln tmamrm N��lu s been aw Niousillt t'uilied, NII Ili�a��torii-llrl olalrlam t be aWC�Iinillpl ted un uQ,�a�u'�rlfiroi�gr. _...� Ntmde iii ii any of I'llio, iNitrmiilrlatuealru ce'briif uulinart ira Ill htm„mt FRtgtelrriran�t 0.IrlPtrmrrrra�NicaiN PllO'y',t analuiru 911,E t'r �., ,k the box and proceed to Item 't a° ml�f�ai rll a �b rust is,r o e~' G eat ,,,, .,. N lKUri6 GN IM.'FnVwupu a'� M N »tr Addresses for the E Rm tiii tiat m arrr Ce tu t rurr a t ti city, Iterns and p smret b I'(.... y 9Neaa�,.y I iRi II 11 AlruDIR SS Cri PRIM PM P XEC l..j m/E 0111 II bllIV4,1AIf �`II1°,4"lltl 15331 NORMANDIN- AVI IRVINE, CA 92604 �51 111 ZID a AII)DIR S r OF PRINC IIP!"tN.IBUSYNdI S f bl-`{ IE I i IIwV G �wp^d'Of1.W ANY � w .rl kp rotor �ui�" rnll P�.5 ylu INCtRM aNtN,��a° ANDIE m pAVE I NRVItltlN0,ttl ill 11�1�m�1�r-o sr IIw��11�u11!tl Ilr.r� t., iy' `,1,y11 /0 01)L Names f tl r t u Y d milli to Ad rCD't td titlm; r]II limrd t N m �I s rlrreyr ttGea✓'n ra mmt list tlhese: three�ii�Arllcr�,�lr, ��;��bmr�Pa��su'�atbNe.tl:I is trur the specific N"N BUMA r IlfNJ�NatYT 6 IP ..., Pltai� Ncaui7i M uo! t nryT tsc �btltarr d „ e.. e P iC"FNiI �"�NN�V�....t A r�2dA'4, SECIRETARY JhVVIItVrll�"'ollt!ftNlf�. dta"N ��.. �._�� _a.._..� u .. ��m1 � 15331 N��N�M MARGARET JANE CARR 15331 IINC.tt�f4�ANII.)lE AVE,, NRVlNE, CA x.2604 �IAFr �.u�i.�a1a1 3 C'P0EI'FINANC lAy O RACE R/ . .r ,��MARGANtE T JANE CARR 15ttt NORMAND I _. _. AVE,., IR"a/NJIt-, CA 92604, C,OU`d ;`t,+\ri 'lIV , � Directors,,i r4111 Names and Complete Addlress t Alt Nm tlrftg tml at r Who are Also iceirs tl e ,eaup�blrlu�bl director At rr additional r rs a east Cal x ICY NAME � � � r11"CCdCILS .... f _, i y THOMAS RICHARD CARR 15331 NORMANUE AV IRVINE, CA 92604 tdd 11 NAM w AururuR I s MARGARET JANE CARR 1533 I NOI:3 tANDIE AVE Il llNll CA 92604 C1 FY arylN All,�,iruru f u �ru;u ,, or)r `� All 1 3 NUMBER OI VACANC„NII:� �P S ON FHE NSCtARi:1 ouall N.JIIfl�&I�P.PrNk{.,k,IF ANY _.��m ... ...... , :rat t ewe �t ttre-.ara, e irh i..,uminl Ylnia~ dl .id .,"' "-mow „-��, -w,.,,. A na raaNea ��t�IrQS� � ,, �,, ,ww ,� �� .,��;, address, �a N .Cd„ de>x ctdr „as is IneU ,a¢ taR:makalle.. qY tlr�:, ace,u`ud.i., mMoa and item Nt urnim" �,r�e:aaln11110l0lol"vriktr,a C.aIIltrarral@:a ,tluo ni u.)I� Np�,aa,ir�Nn.uui iraau:7t re.,udc:�in u^�adfitC�ruMU-r rr rNPfie ate lau)N°;,ulaurNN to California t:;CbN'aaaNtidlr,bao�,i P N Ner corporation, 9.Nmage„u�P Irmu.u�;>II Pns �abrl� till rw�utl7� Ipj Niit�rrlru� nCk eulrlina ONE ui 15 rroals U tb Ila tf RrUvvt. y CN I01MAS N J P IF4,Y 911:.Qbll°Ar�irylyll k P COUP P�h/S( II:C11 II Pw�D ab t'�°Ilu ru'u ke RICH Alw t:C, Al 1h 81111ru l i ADItrP SSiP,A d N Ce, r SII II I Il r� „P_^,y AN i;Al IIU Cull tlwViA, Ni'All Ilfl�NmNRrtPA9�, (.ollfV '11533 I N®RMANILDpII AVE., IRVINN�w, CA 9a:�"Ctdd ��11 �u:,f,t,,1,1 Typo of Business �w ail U eC't6CINg9 G i U 6 YPL O d11 CORPORA r, GENERAL UBMITTING NPNIS arANP-16FtlE Nr OF INI-(blrtMATIum ro 9if111 (.,At...IIFORNIA ,I )iw11_rrhtl?N oil ._ RICHARD SWII NITS kyll OR 01l,l r; 1;9114 Pu r k CLUpfN ANY A 1 'F t N S N 8 r it AEU»c eRREC1 . � ill ll4 l n i i�u �i1�bu D2l t 91Z01� � N QMA� CAR.. . PRESIDENT � R " � N Ns FORM �iN rw�Pr(IIR.IIr 0112 kiFLE G r b yl"4 �,��wwH to aka t of 1 V 111 CAR Oil: r C A N P ' \ A \ m a /u � \ «j» \ E§? 2 . < 2 I&CIP 11- \ 9 / . \ O \ \ / \ / \ o Co 6 ol 3 U v"NI 121 Ul" b050 140 0 1 1 a 0 un ray OUT and 00 ww" cJ VP i s2 lot City of El Segundo Residential SOUnd Insulation Prograin RSI 14-215 (Group 67) Bidder's Bond (Not necessary when cashier's check accompanies Bidder's Proposal and Statement) BIG WEST CONSTRUCT,110,N,,,C,,O,RPORAITION—---------- --- as principal ("Principal") and -NQRIHAMERICAN SPECIALTY INSURANCE COMPANY— ............. a corporation incorporated under the laws Of the State Of NEW HAMPSHIRE -1 and licensed by the State of California to execute bonds and 'undertakings as sole surety, as Surety ("Surety"), our heirs, executors, administrators, successors, and assigns, are jointly and severally bound to the City of El Segundo, a general lain city and municipal corporation existing under the laws of California. ("City"), in the Sum of NOT TO EXCEED NINETY NINE THOUSAND AND 00/100 dollars ($ NOT TO EXCEED$99 000.00, to be paid and forfeited to said City, its successors and assigns, if the Bid of the undersigned Principal with respect to RSI 14-25, Residential Sound Insulation Program — Group 67, ("Project"), as specifically set forth in the Contract Docurnents, is accepted and the proposed Contract is awarded to said Principal. and said Principal fails or refuses to execute the Residential Sound Insulation Program Contract governing the ProJect in accordance with such Bid as accepted and the Contract Documents. SIGNED AND SEALED this 30TH Clay of.OCTOBER 2014 BIG WEST CONSTRUCTION CORPORATION NORTH AMERICAN SPECIALTY iNSU' CJ`COMPANY � President t S te'it 11t UUICK,ATFC iNFY-IN-FACT Ty� 7Surety's Secretary Note: ALL Signatures must be acknowledged by a notary public, Principal's Mailing Address Surety's Mailing Address 15331 NORMANDIE AVE, 6 HUTTON CENTRE DRIVE,STE.850 --.................. ......................... ---------------------1-11,............ -------- IRVINE,CA. 92604 SANTA ANA,CA. 92707 ............. ................. ............... .......................... -------------........ ------------------------- .......---------...... ......................... ............................................- ......... Bidding Form B-02 Last Modified:January 2�,2014 Bidder's Bond ACKNOWLEDGMENT State of California County of Orange ) On October 30,2O1 4 before me, Christine T. Hoang,Notary Public _ (insert name and title of the officer) personally appeared . y Yung T._.Mulfiick m._.....................n.,..,.............. who proved to me on the basis of satisfactory evidence to be the person(X) whose name(y2) ishma subscribed to the within instrument and acknowledged to me that he%kt@if,t executed the same in hiss iwftek authorized capacity(*, and that by his/boftetix signature(s)on the instrument the person(*), or the entity upon behalf of which the person(x) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNES .rl hand and official seal. CHRISTINE T.HOANG N� "� COMM. #200757 w, w � �I�� r ,x'NOTARYPUBLIC•CALIFORNIA S ORANGE COUNTY MY COMM.EXP.FEB 26 2017 Signature .....° .......... (Seal) A NAS6URETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON/NTBDN&T1ONALrNSO0ANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS,THATNorth 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 it)the City of Schaumburg,Illinois,each does hereby make,constitute and appoint: Jomw/eeu��awxYx ��|emvvxxQ/cxmam uodvmw�T�mm�LzC� JOINTLY Ou3ovsnx�� 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,()00,000,00) RS This Power vf Attorney io granted and is signed by facsimile under and hx the authority vf8m following Resolutions adopted by the Boards of Directors"y both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held vn the 9*of May,20|z: "RESOLVED,that any two of the Presidents,any Managing Director,any Senior Vice President,any Vice President,any Assistant Vice President, the Secretary vrany Assistant Secretary be,and each or any vf them hereby h authorized w execute n 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 v,any nfthem hereby ix authorized/o attest oo the execution n[any such Power of Attorney and u`attach therein the seal vf the Company; and dix 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 h'facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when uo affixed and in the future with regard to any bond,undertaking m contract"f surety m which disouu,hod.^ By Steven,.Anderson,Senior Vice President u °^mxw*"*,=/*"m/"==."°c.�,""y &*=^.�=��*=,aw=m^m�=.Specialty*".="°Coca pny 01111111100 By — ^ David M. rm^+.�m"^' International Insurance Company &Vice president",n°~^American Specialty m".=."company IN WITNESS WHEREOF,North American Specialty Insurance Company and Washington International Insurance Company have caused their official seats 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"fIllinois County nfCook os On this 26th day of June x 12 before mu o 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 Laym. an Vice President of Washington International Insurance Company and Vice President of North American Specialty Insurance Company, personally known m me,who being hxmo duly sworn,acknowledged that they signed the above Power of Attorney oo officers nfand acknowledged said instrument to be the voluntary act and deed of their respective companies. ' C.'State i2t 77=4 M �ary Public.State of Illinois [l &] �V Donna D.Sdmz,,Notary Public 'ia� |. u duly elected Assistant Secretar of North American Specialty Insurance Company and Washington International Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Powe of Attorney given hx said North American Specialty Insurance Company and Washington International Insurance Company,which is still in fall force and effect. |N WITNESS WHEREOF,|have set mx hand and affixed the seals ofthe Companies this 3Vth day of OCTOBER .20l4 icffw�s*^^ v'cQ,=uu"*a*=isubmx="kar,, CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CML CODE§ 1189 c'NU',*W State of California County of C m________........._._ __ .... .. ..,,. r On t�N fore me flute o Here 9mmut Name and rifle @ the Officer �y personally appeared Na,,,,,o1 Signers) who p roved to me on the basis of satisfactory ° (k 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 ROBYN J.CARR• BL his/her/their authorized capacity(ies), and that by Commission# 1939133 his/her/their signature(s) on the instrument the F Notary Public-California person(s), or the entity upon behalf of which the Orange County person(s) acted, executed the instrument. Mi Comm.Expires Jun 26,2015 certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. ! Signatures a . Place Notary Seal Above xpngt6urw°t Netary 1 �kt4t. OPTIONAL Though the information below is not required ay prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. " Description of Attached Document Title or Type of Document: __ 4 Docume t Date: Number of i F V'4 Pages:, Signer(s) Other Than Named Above: Signer's� Name :Claimed by Signer(s) Signer's Name:, ❑ Corporate Officer — Title(s):. . ,....n,,,,m.. ....._ ❑Corporate Officer — Title(s) ❑ Individual _• ❑ Individual ❑ 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 ❑ Other: ❑Other:. I Signer Is Representing: Signer Is Representing: ting: X ©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 14-25 (Group 67) 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: Aft Title: 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 ��,M"iuh�a;"�,�J�at'oi"�wJ'✓m'�:�,�",�«.. �,,.W�`,n `�„D��.,iW�,1'�.,°r";�,i�'.:r..,err'��m.��"rrSv��,;�dwa�r.`,�ra'u r�,.`�,'��"�'1,'�,i;.�rr l.,"'+t'�r'�,�'�."�;iki�"h-�"n�.a"�a�"wsi,�u.":ti'.�,.i�,.��d�ky;�J,,m'r 1"r'�.!�k��d`"'f,-�,'��m�;!,��, ,�W.�v State of California ss. County of _ ..01 Cee Attached Document (Notary to cross out lines 1-6 below) ❑ See Statement Below (Lines 1-5 to be completed only by document signer[s], not Notary) Signature of Document Signer mNo.mm1 Signature of Document igner No. i any Subscribed and sworn to (or affirmed) before me on this day of ._. _ ' by Date WWII Year 1 �mm ( ) hi,122 Name ear ftner ersonally known to me I:::q Proved to me on the basis of satisfactory evidence to be the person who appeared before me (and Name of Signer ❑ Personally known to me ❑ Proved to me on the basis of satisfactory evidence to be the per on who appear d before me.) si n' A e 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 • • 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: CA,,", xxN14"",EK:,, ""`,21r ©2004 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402•www.Nat onalNotary.org Item#5910 Reorder:Call Toll-Free 1-800-876-6827 City of El Segundo M Residential Sound Insulation Program 0 p RSI 14-25 (Group 67) 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 ® 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 0 RSI 14-25 (Group 67) Bidder's Statement on Previous Contracts subiect to EEO Clause The Bidder R 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 X 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 Normanie Ave. Irvine CA 92604 Telephone Number: 949-795-2219 Contractor Representative: TOM C k t�IT m....mIT _ w__ Title: Signature: Dated this�_day of N Owes xea ..., , 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 14-25 (Group 67) 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 $10,000 which are not exempt from the provisions of the Equal Opportunity clause,and that it will retain such certification in its files. Certification-The information above is true and complete to the best of my knowledge and belief. Name of Firm: Big West Construction Corporation Address: 15331 Normandie AVe. Irvine, CA 92604 Telephone Number: 949-795-2219 Contractor Representative: M C 217- Title: _.. ..... P_< P..... ► .........�...... .. ... Signature: C`-�-- Dated this r q day of_Pp V 0 KgV_2 ,2014._Y. ;_..... Note: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001. Bidding Form Appendix B-06 Last Modified:January 23,2014 Certification of Non-Segregated Facilities 0 City of El Segundo RS1 14-25 (Group 67) Residential Sound Insulation Program Certification f Non ,Segregated Ali (Contractors nt:ra ctors/Subcontractors) (A certificate Gaff, p on,segregated Facilities mnu.nst be submitted prior to award of au contract our snubcontraaet exceeding$d 0,000 which is not exempt fftor n the provisions of Equal Opportunity Clauses) The Federally assisted ecamnstrnictpcamn contractor certifies that it does not maintain or provide for its employees any segregaxta.d ff°aacudpt"ues at any Gaf its establishments, and that it rimes not pneu°aTupt its emnnpmpumyees to perform their services at arty location, under its eranatrcnd„ where segregated dfaedpdtdes are maintained, 'The Federally assisted construction contractor certifies further that it will not maintain or provide for its employees any sep�,�regatecd ffpnedldtdes at aanny of its est:aablishmenats, aannd thaa.t pt °mill snot pnernnit any of its errnp loyees to perform their services at any location, under its control, where sego ga to d facilities are maintained. "rhe Federally assisted construction contractor agrees that a dan° aach of this certification as as violation of the Equal Opportunity clause in this contract. As used in this certification,ationa, the ter nu "segregated ff�edddddes," nrue .nAs any waiting room, work areas, rest ra orns and wa d'uroo nns, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, cdrptticing fountains, recreation or entertainment areas, transportation,n, an.unud housing facilities provided for employees which are segregated by expml.lept directive or are in fact segregated anted onn the basis of'race, color, religion, sex or national origin, because of habit, local euastuanrn, or any other reason, "Re Federally assisted construction contractor agrees that (except where it has obtained identical eertiff caatio ns ffrcaurn proposed subcontractors fbr specific tpnnne periods) it will obtain identical certifications frornn proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt ffflorn the provisions of the Equal Opportunity clause, and that it will retain such certification in its riles. Certification..._The umnforrmnaatdcunn above is truue,and complete to the finest off my knowledge aan d behef. Name of Firm: Abookft Abstsawft A Demo Address: w ... .. Santa F'a Springs,CA Contractor ep"aresentaatdwre: ie11, 1 t l uw.. . Signature: (� Dated tlmps -7 day off".......... 2014, Note: The pneurnamt:y for making false stateurmneurnts in offers is p reseurmmnesd in 18 t..&C. 1000 Bidding Form, Appendix B..06 1-ast Cv oduff"ue&JanmWau y 23,2014 Certification of Non-Segregated Facilities 1110712014 07 : 19 FAX 19496556507 C @NON fa0011006 Adjfibk City of El Segundo - Residential Sound Insulation Program RSI 14- 1 (Group 67) Certification of Non-Segregated Facilities (Contractors/Subcontractors) (A certificate of Non-segregated Facilities must be submitted prior to award of a contracl 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 �rovide for its employees any segregated facilities at any of its establishments, and that it does not perm t 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 orC provide for its employees any segregated facilities at any of its establishments, and that it will not ptrnit any of its employees to perform their services at any location, under its control, where segregat 1d facilities are maintained. The Federally assisted construction contractor agrees that a breach of this c reification is a violation of the Equal Opportunity clause in this contract. As used in this eertific tion„ the term "segregated facilities" means any waiting room, work areas, rest rooms and washrooms, estaurants 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 p'e erally assisted construction contractor agrees that (except where it has obtained identical eertifieations from proposed subcontractors for specific time periods) it will obtain identical certifications om proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not eAempt from the provisions of the Equal Opportunity clause,and that it will retain such certification in its t'i es. Certification—The information above is true and complete to the best of my knowledge an belief, Name of Firm: Address; �/' Telephone Number: 0-7 Contractor Representative: Title: .yam Signature: ird Dated this day of 0 6p>r 2014, Note: The penalty for making false statements in offers is prescribed in 18 U.S C. 1001. u Bidding Form Appendix B-06 Last Modified:t uary 23,2014 Certification of Non-Segregated Facilities n Cufy and H Scgun& Resldenfiall ITSI 1525(Choup 67) CedHkmlhn of NOWWWaWd INcHMes (CGIMMOMS,/SUbccjintrwrctors) (A ceaffiewe o4 4ojju� vgvcgjdu(� mjjv;P II) ,11 Pu (W to r'%Vard Of a •onflad m subcotAmcA CWMAW MQWW M&T N Mir"Mnp Rom Ow PMAMOM 01 UNA Op"awAy(b".;) Hw �vdor,dl wvd COMMsm cm"Q'r VOW, I& h W, lmn mm"Mm or pnm it: d A,, of 4:' a ld 11l"O uC IHOI bM"61 "s "m&i iv" c('noroi, whc'u'c so'gre'�" M:J fiucihhc', ,wry. lil;uou000d' Hie I conIV0001 Widker flm,O lu o4l mpl; m3w[Ort W* MPIMS M my of W and Ihm h W IMI veno; wly of h lja i1h.i, r18 a,l) it,, r,arrultiaA� fiwdific" m" Re I WaHN 'MAM.1 womnlulluil wwascuw Oprees dun a NOW C4 this 0.e"i6USM a it 6C9hllicm of tkc" ckmy�e in jh��, 'N', jtj URY�IU llq, ku-in fiK uYui, tnc'mw My, "AMW ""M +a M aacsuF, wo P"M MA "Mon"v woman MO 00M 4 360P knw hwkcr roololl,aa(p parlon�!' 4w" difild log humuijns,rcctcafioq(o,cOMMhurk"HI mrd housimq!! 4lcfli�ilo.'pro%idcd W wlik.,h ary ,Qp,qpicc3 ky dirvC6 v Fit me,ill l4ct on dw 6nvr'ks lO nicc%coio'ir, or rm6omA oOmm,y tow. Nt c Guasr M habli, Nw d cw'Wlll' m my wher ir,&mn Hic Fcdvv"W fll'tr (C,'cep wfictv il ha' o'd1w6hA N csmudG,wN aoWPtmua utacuuroe hollo j"nopo"cd liniL, jt "'11 4fmlqc�O 'rom p'opo�wcd prior to Ow a%t'ald id, 10,0100 ','Jjkl mv qos eu caruput prom the, pnown ordw iApm ,kj otl 4 WM N'ttlikk such(crlifivm4m in iis, Cey"cH601111 '11110filfiAmOm WMm k Mw mid wmMmc An Ow bw"q my kmwkQW aW jdkf. "4111nc 0 Fh'nc fAD NSUILADUN GO Addyessa, 9702 WQinqeinman stueM Swfl M Mofft,cA MY 1729 BW9-4649 Vol Dwivd flhk Nole: The IllmemmiAty fto nialdilig fallw sfatenle114s ln Offexs v Ipil escirTbed hi[ 18 llidrhng Form A 41141 u trou CCNIIJftafl�,)uj So grl gwdC(N City of El Segundo Residential Sound Insulation Prognun RSI 14-25 (Group 67) 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. s Name of Firm: i.(. � .�.. . . .... Address: i Telephone Number: .. ... .. � w_..:..0 Contractor Representative: Title: Signature: .. , n... ............................................. ..... Dated this�day of V 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 City of El Segi ndo Residential Sound Insulation lit~ gra c. RSI 14-25 (Group 67) 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 Finn: el Address; Telephone Number: �r,`° � 16 T J�G�r - _.�we .. __........................... Contractor Representative: A G 1,0AA77- Title: Rz� Signature: W-1-le Dated this 7 day of tii�d�y�lE ,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. 1, 2014 3:47PM Mi lgard Windows No. 5M P. 4 City of El Segundo 1P Residential Sound Insulation tut-am RSI 14-25(Group 67) Certification of Nan-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 or 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 $10,000 which are not exempt from the provisions of the Equal Opportunity clause,and that it will retain such certification in its files. Certification—The information above is true and complete to the best of my knowledge and belief. Name of Firm: Address: Telephone Number: Contractor Representative: e: il Title; Signature: _Z-4- Dated this__51' day of 2014. Note: The penalty for making false statements In offers is prescribed In 1$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 Program RSI 14-25 (Group 67) 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 fiuther 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, Huntin on Beach, CA 92647 Telephone Number: 714-596-6766 Contractor Representative: Robert T. Davis Title: President Signature: Dated this 7th 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 Program RSI 14-25 (Group 67) 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 0 City of El Segundo Residential Sound Insulation Program RSI 14-25 (Group 67) 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, CA92604 Telephone Number: 949-795-2219 ................ Contractor Representative: M CA11- Title: fZej'I 'DOYT Signature: Dated this lox day 2014. Bidding Form Appendix B-07 Last Modified:January 23,2014 Trade Restriction Clauses Page 2 of 2 City of El Segundo 0 Residential Sound Insulation Program RSI 14-25 (Group 67) 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 14-25 (Group 67) 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, Huntington Beach, CA 92647 Telephone Number: 714-596-6766 Contractor Representative: Robert T. Davis Title: PDre sident Signature: Dated this All day of November 2014. Bidding Form Appendix B-07 Last Modified:January 23,2014 Trade Restriction Clauses Page 2 of 2 Nov. 7. 2014 3:47PM Mi I Bard Windows No. 5016 P. 7 City of El Segundo Residential Sound Insulation PMram RS1 14-25(Group 67) 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 louver 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 snaking the award. If it is later determined that the contractor or subcontractor knowingly tendered 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 Nov, 7. 2014 3:48PM Mi Igard Windows No. 5016 P. 8 CRY of El Segundo IV Residential Sound Insulation Pro rare RSI 14-25(Group 67) 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: ID 3z'Sk1a 4E1 , Address: Telephone Number: Contractor Representative: 'title: Signature: Dated this li day of AAZ .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 R.S1 14-25 (Gronuupn 67) Trade Restriction Clauses to be Included in all Solicitations, Contracts, and Subcontracts The Contractor-r- orr Subcontractor,ntractonr, iby submission of an offer er and/onr execution of contract, certifies that it: A. is not owned ned oar controlled by one or more citizens or nationals one a foreign. country included in the list of countries that discriminate against U.S. firms published by the Office of the United States Track Representative(US"TR); B.. has moat:knowingly winngly enbtered into any contract or subcontract four this project with a person that is a citizen or a national of a foreign country on said list, or is owned ned onr 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 or 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 onl"Fransp ortationn :inn accordance with 49 C;`FR :30.17, no contract must be awarded to a contractor or subcontractor who is unable to certify to the above. If the contractor knowingly ly pnroncunres or subcontracts for the supply of any product or services of a foreign country on the said lust for use on tine project, the Federal Aviation Administration may direct, through the City, cancellation of the contract at no coat to three government. purther the contractor agrees drat, if awarded a contract resulting :from t his solicitation, it will. incorporate this provision for certdicationun without modification in each contract.and in all lower tier subcontracts, The contractor may rely on the certification oil"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 suulaca tractor was erroneous when submitted or has becon:nnno, erroneous by reason of changed circumstances. The subcontractor agrees to provide immediate written notice to the contractor, if at any tirne it learns that its certification was erroneous by reason of changed circumstances., This certification is a material representation of tact 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 iaederal. vi.atio n Administration..may direct, through the City., cancellation of the contract or subcontract for default at no cost to tiro:,government. Nothing connWined 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. 'rhe knowledge wl.e:dge and infonnation or a contractor is not required to exceed that which is normally pnozs,sessed by a prudent person in the ordinary course of business dealings. 'rhis certification concerns a matter within the jurisdiction of an agency of the United States of w addi gFnrn Appendix 13-07 _..... ... Last Modf ed-�:January 23,2014 Trade Restriction Clauses Page l of 2 0 City of El Segundo R.al 14-25 (Grow 7) America and the making of a f 1s , fictitious,s, or fraudulent ceilification may render, the maker subject to prosecution under Title 18, United Stakes Code, Section 1001,. Name of Firm: .. �dllllll��m'm� Address: ftnb Fe SPftj9,CA _QW- M Telephone Number� 14 Contractor Representative. I te Iu )II'...�� Signature: .... .,,. Dated this '.,,�day of',.. ... :. :: .., ....................... 2014 Bidding o n Appendix B-07 I-as:Modified-January 23,2014 Trade Restriction C iauuses Page of 1110712014 07: 19 FAX 19498558507 CHON /6002/008 City of E1 Segundo Residential Sound Insulation Program RS1 14125 (Group 67) i Trade Restriction Clauses to be Included in all Solicit I tions, Contracts, and Subcontracts The Contractor or Subcontractor, by submission of an offer and/or executio of contract, certifies that it: A. is not owned or controlled by one or more citizens or nationals of a f reign country included in the list of countries that discriminate against U.S. firms pu,lisped by the Office of the United States Trade Representative (USTR); B. has not knowingly entered into any contract or subcontract for this projec with a person that is a citizen or a national of a foreign country on said list, or is ovine 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 prcje , the Federal Aviation Administration may direct, through the City, cancellation of the contrac at no cost to the government, Further, the contractor agrees that, if awarded a contract resulting from this soli itation, it will III incorporate this provision for certification without modification in each contract Ad 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 contra for 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 prow de 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 subcontrac r 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 pr?vision, 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 n�ited States of Bidding Form Appendix B-07 last Modified:Ianuary 23,2014 Trade Restriction Clauses Pagel of 2 11/07/2014 07:20 FAX 19498556507 M ON 12003/006 City of El Segundo Residential Sound insulation.Program q RSl 14.25 (Group 67) America and the making of a false, fictitious, or fraudulent certification may rev der the maker subject to prosecution under Title 18, United States Code, Section 1001. Name of Firm: Address: 30 Telephone Number: ) , 07 Contractor Representative: Title; Signature: , rd r-7 71 Dated this 3, day of e 2014. p Bidding Form Appendix B-07 Last Modified; anuary 23,2014 Trade Restriction Clauses Page 2 of 2 City of El Segundo Residential Sound Insulation Program RSI 14-25 (Group 67) 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 14-25 (Group 67) 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: 818-831-8800 Contractor Representative: ELIZA KHATCHERIAN Title: CEO Signature: Dated this 7TH day of'NOVEMBER 2014. Bidding Form Appendix.B-07 Last Modified:January 23,2014 Trade Restriction Clauses Page 2 of 2 rty W Ft ",iegiundo dent W ',iuund InRdatlon 11roip,mi) RS! 14 25(Woup 67) 'Uraq.le Restrieficiri ('.'Ialjscs to Ilb IIIhmcl uqjc�d 4111 all soficitaltiollis" Contracts, and Subcoitfiracts Fhe Coulnuctor or Subumiractor, by suburdsSioll od, "'11111 M16 and/or excuution pot' contraci, c.eirlifies that it: A k mq m%nvd rjl b mic or morc cidmis Or makonak oI'a porc'�go cmam,h iridodc( irn the tis (4r ommus Wm dkrhdmw apom IS, Mm, MmAky k, Wc CVTc of Me UnAd ims Tmdv JuMmsmuMic 0 Nj R)�; 11. has in" kno"NgQ unwmd io;any oumAo " nowamm nu Wk Mm k 0 "n m a In"Amm! Of a KWUP ummg - UW IW"w k owwd m cmindmi dircc'tk chkens or nwiomd�,,of 7n o,,PaPomv, , '� tM'4aid h'c Ims nm pnWum,mg PM&O mW Nmv•WWd RW Ow qqQ'A mq uW sm &P&M TM k pwhmd W a b"Qn own, as mW jjq, he moulmh or MN CNWW mv'"d V the Scemlaq! 004WINMAo" hi acawc1mm %Qh 49(TR 311 A no ommo nmm by ammko R,a c6my9got, W su0p0,m,,h,,,h0 is un&c lo cel fitd lo dw abovc d d ffic coHh :WlM dmwt kigl�' jn'covury of mflwcmtracvS for m' m; pmom Or WmWe"o 0 RWQU pwag, ml we mod hm IN INC m; TV pnym div I 010"d Avia6m Admkrknwifm nrw� du,, uiI , "'onilracs x Dhl co"wr, pap dw,,_?,mvrmnm, Fluirthell, the colflracAm a9mcs thm, W a"anhul as YmMu rvW&g 0m; dik mWommm h a All incorporme, ulis provisiml d'u'certMcalim wilhola nkldifilcalion 41 each coiihracl and in fl 11(ro%vawjr tier subconlra%,is 'J'Joe, owy rell on flu", 01'H JW()qPCCflVC SUITOWiractermr UfitCS,'jd t`r"3,S p,uip, wlcualaer fliAa Ilse 4""'1'61'ication k 11W antmom rimm Me%We buinwow %Wkwu nmwv h"he a'pnivmr H'Ihe h.,,jp1s jjKU k" ccmikc"Aim or 1hal of a a+a�' erroneous %0vq'i m hw' kcqquc tTE`Oh lmbw'h' r%:w'on oVch Ingcd e 9r'w umi l m"'%; d pfi 4Y.adp ajra @P'ri BtVP r4'!'rccs to pro6i'k' kmat�kw." ummmm, Wm my one k lanes that A (Tminmuhm "as tumWou" h� 'T'his ccmriflc,,Ifi()jr ew a rlruvta^;uuup up prom wWat jinat,Jng the avvaird, 11 rj rra hitCr ifia° cmnraofN- or m,dxsmivac( n la,(Cvnijg y rk,ndered an erroin(Nmis Cerlificafloo, dw I c dcmi Aviaflon Adiindni,,�Irafion imjy ju(iqrgh the 01,cmumilation 1WHIc cmMmU ow qdmmrrac tor dciauft at mj� tap flic-,pm air Nodding cont,,14ic(I Err n-oc [611regonw, mmt be W, uCIiuiil'v CSIabtlAunent and systcm of records iu order to goinder, in 'good klitt-11, lhe by this pmvision Hw kinm0ledge and intIcirmathri of n coMmm k 11[r,rt sVjjhiCj[j jS Jrj[f.aj[rjjqajjj,', pommwd by a pmdmu pmam in be oMhmr,v umme Of Nahwu Whys Hfls ceillit,kafiun conceirus a maRer wiflhon Ihic imrkdpc6on (A ,jin agouuy ol'thk; Ijrjljk,oj ()I HAWg Fmn-h 2 2h A auuda ReslHcflon(Amms P��u ':)1 2 4 Ono QUM eskienfiall Sound s RSI KA25(Moup67) AmcHca and Yhc nnaUng o a fiflne, 01061k)U'S M hdUdLdCTIII cevfihica6on imay, renidai this mm alket sulljoiA R)prosecialion ufOel TWe 18, V Pnhcd Silaws Code, scoloin II 0M Name,I 0,rhnn� MID INSILA Al 1004 C Xj —UM llWa wawa Aiddirew Sm ah Ell Mixite,G A 91733-1 �129 (faW 7 9--464-c—) Tekqftine Numbep qW Contra�icwV sjwwe�! 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Timde Reside0on clauses Pyr 2 ow City of El Segundo Residential Sound Insulation Program RSI 14-25 (Group 67) . p 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 Bedding 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 14-25 (Group 67) 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: � I Signature: Dated this_?o day of_..OCIja , e..........�. ... .................��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 Pram RSI 14-25 (Group 67) 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 snore 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 Prograin RSI 14-25 (Group 67) 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: ws;-Vgsr"w-re //W, Address: /?O/o CAI* ".4 "5 7— Telephone Number: Contractor Representative: Title: Signature. Dated this 7 day of 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 14-25 (Group 67) Designation of Manufacturers and Suppliers Manufacturer Supplier(if Applicable) Contract Value Section 08 14 00 Primary Entry Doors Hinged coq e RS 1,0 0.Q $ 60"000 1 Section 08 32$0 cACOt+DpAN( 171—nTffry Sliding Glass Doors MO N PA y 6 to 0. $ 20 Section 08 53 00 Vinyl Windows 1`1 i�C�attt� �i`,C(7lvq—( 6,KTezf OM __ ___. _............ ........... ._....._._......._.._._..._...__..............__.._._......_......_.......... ..........._.................. .. Section 08 71 00 Latching and Locking <c.Uki k G (O h 2 $13/57 Hardware Section 10 32 00 Chimney � $ t) O 0 O Dampers Section 10 32 00 Fireplace Glass DoorsQRM D—I�iTE V111 llN t v o 'e $ 00 0 Section 00 �� ^+Z'� 2��c �j $ 3,400 ; Idtl gPOR6 Section 23 09 00 Thermostats $ Section 23 34 00 Ventilators $ Section 23 54 00 Furnaces $ ._.._ _........WW... W Section 0%11 oo MONMRAV 1 X(000 Suo�o�.N S,o(W DOOAO; Bidding Form Appendix B-08 Last Modified:January 23,2014 Designation of Manufacturers and Suppliers City of El Segundo Residential Sound Insulation Program RSI 14-25 (Group 67) Designation of Manufacturers and Suppliers Manufacturer ws..__.._ ........ .�................ .........._... upplier(if Applicable) Contract Value Section 08 14 00 Primary binged $ Entry Doors �. w.... 0 0 _------ ..., .w ..� ._.. ---... wee..... ....... m.,.� Section 08 32 Primary Sliding Glass Doors $ �..........�.�..... �......_. Seci ion 08 53 00 Vinyl Windows $ Section 08 71 00 Latching and Locking $ Hardware a.. ,, ..0._—,11 �� . w. �u u s. . _., Section 0 10 32 Chimney Dampers $ ..Sect.... ...�� ............�...... .......................�.....W...... ...................... �...�d ,.m,.a�.aww.w_� . .... ... ion 10 3200 Fireplace Glass $ Doors Condensate.�� . , ion222100 0C ... �, � �.�. ILcy $ 00 Pumps ion 23��....... ......... ��...... �.............�...... .. .. ..... t' 09 00 The "� rmostats p ( $ 3 o s ..._.. _ .. ............... .. __....._.. ................... ection 23 34 00 Ventilator kMUi&,f1 r o C} m ...v. a . .... ,.�-. ection 23 Furnaces 54 00 ' S'r $ goo l� Section............................ _�.�.� --:11,----—------...�� Bidding Form Appendix B-08 Last Modified:January 23,2014 Designation of Manufacturers and Suppliers City of El Segundo w Residential Sound Insulation Program y RSI 14-25 (Group 67) 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. 1 Cost of Components. This means the costs for production of the components, exclusive of final assembly labor costs. Name of Firm: Bq West Construction Corporation Address: 15331 Normandie Ave. Irvine, CA 92604 Telephone Number: - 22 1-9 Contractor Representative: "" M Title: p Jiw -Vu- .. _mm............ ........_............. Signature: C,, Dated this 1� day of__UO w Q JM, .__,2014, Bidding Form Appendix B-09 Last Modified:January 23,2014 Buy American Clause Nov. 1, 2014 3:47PM Milgard Windows No. 5016 P. 5 City of El Segundo IV Residential Sound Insulation Program RSl 14-25(Group 67) 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: LI Address: MI All I Telephone Number: Contractor Representative: Ville: l Signature: ON 7 Dated this day of 0jaV&, o!j&— 2014. Bidding Form Appendix 13.09 Last Modified:January 23,2014 Buy American Clause City of El Segundo - Residential Sound Insulation Program RS1 14-25 (Group 67) 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 terns 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: H.K. ELECTRI CAL INC Address: 17428 LAHEY ST GRANADA HILLS, CA 91344 Telephone Number: 818-831-8800 Contractor Representative: ELIZA KHATCHERIAN Title: CEO Signature: Dated this 7TH day of NOVEMBER ,2014. Bidding Form Appendix B-09 bast Modified:January 23,2014 Buy American Clause City of El Segundo Residential Sound Insulation Program RSI 14-25 (Group 67) 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 tle: President Signature: Dated this 7th day of November , 2014. Bidding Form Appendix B-09 Last Modified:January 23,2014 Buy American Clause 11/07/2014 07:20 FAX 19496556507 C@MOM f�004f006 City of El Segundo Residential Sound Insulation Program RS C 1 -' (Group 67) Buy American — Steel and Manufactured Products for Construction Contracts The Contractor agrees that only domestic steel and manufactured products will b� used by the Contractor, Subcontractors. materialmen, and suppliers in the performance of thi 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 t e cost of its components mined, produced or manufactured in the [Jnited States exceeds sixty percent (60%) of the cost of all its compon nts and final assembly has taken place in the United States, 2. Components. As used in this clause, components means those artic es, 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: 2 17 2 3 Telephone Number: a7 Contractor Representative:, Title: Signature: Dated this day of 2014. Bidding Form Appendix 8.09 Last Modified:J naary 23,2014 Buy American Clause a fuad waif d d Seguun do ddw rigodw wnauad Sound llunaanq aauouun p'M 14M 1415 tl m:.h hay)6) Buy American Steel and Manufactured Viroducts for Comi,sl rul cHo III,, Contracts d.d e u'orvracdann aagirca.s that uowudy donywsfic smecd and wnnannaudaca:nuwcad Ilpr oadlaur,ks wi ll he ii.a.anro�j dny rdue d"WwW0 Saup>Iu^,nnirnTlm.w°Tr«r l WapkaVunnon. ,w W sWNRm A We IlwuMn°pKuanuuu= vW ON Cwa asn°am w, rdcd`wmwnncd dww A. Ilnr;dmnw. A� The daakllcuovdwng cew°w�uncq apply to allno r duau.u!acs d, SWcw,ll rn wd wnnauunudu cuu:redl pcw•a adwacac. As used in dds r IlwHaun%nq.c,c,d aw�nud onwannii.ud'ncfli jj�nl;ad podums dwwcdwuadca, m. dwm^e products drro dcwwnecd in ddwau'd.dwaddcw�d Sa.Hac,� or n. ua wn¢mnaudro,ruW Il mdwt p r ocdnutmd in dw d hwndrq.r nd s accc9 dd'to c,nncc of us wannnpvonevi s wn1inecd, pwoichuccad Or wnnrwnnfacUared pmi the Unheir„d Stet(-,s n Q-,ecd nykty d°,c•cewa (605,4) of allnir cost of Qalld "B, connwp.nuownents and finah as nic nnnd-ody has dadwu,wn Ilmdace lion ffie d'�dwuuao�,cd Stawr.t"s, 2, a.uw¢rngnrdrsdw«wwa . As�nrvc°a.d qua I c;Ilam, cnunwpnwnunmawna, anon rm adna.anuw nurddcdn,wnuaa�ac^n dand�s, and^,u n fic, incwaw aorw or d directly uunucn sda a p and nnn an udaar,^wmw cd Ilnu•ndilms, d. a « a`apdiuifinl,aaIs,uiulI his p�waca can adne costs is for pnwcacduua:i un of the ccuonnducuone:nys, 1"dlrarnra,and'd°iirm MD 1110 1A ATION Co Addyicss 9WR Kddprgi;pddarrnanru d"nkdruret Srnwnddm 8 ddmrand'rn„ndda d"drdd dd V"cOrllallnuanua�° dnau p°waww. ( 7dd 4649_ rdwdw: 4 "a i CI d p�� c�aP:cad udnw.a drag uad 2dC H dducdcdwua«r,Min in A pcwnwWN ddT9 1 m NAM ollTio aa:.Wnuump,2d,2W4 ddmq.Fdmrrun°wrc,md:daaa.w e City of El Segundo Residential Sound Insulation Prograiu N RSI 14-25 (Group 67) 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: Telephone Number: Contractor Representative: w "� Title: .µ ...... .. ..... q 2014. Dated this day of .,.F�l..._.. ' .,..._......rr._............. �� ............. ........p..... _.. Bidding Form Appendix B-09 Last Modified:January 23,2014 Buy American Clause City of El Segundo Residential Sound Insulation Program RSI 14-25 (Group 67) 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: Telephone Number: Contractor Representative: A44-7 1 Title: Ate" e, Signature: Dated this 7 day of 2014, Bidding Form Appendix B-09 Last Modified:January 23,2014 Buy American Clause City of El Segundo Residential Sound Insulation Program n RSI 14-25 (Group 67) 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 I.P�I V tract is awarded tto" Bidder, will have a DBE participation of 7'M- 04 (A percent ;7 %) 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: —CD ft AAA— Title: T __.. __... ......_............................. Signature: Dated this 11 day of_w,VOv¢w►Qa ,2014. Bidding Form Appendix B-10 Last Modified:January 23,2014 Assurance of DBE Participation City of El Segundo F Residential Sound Insulation Program RSI 14-25 (Group 67) 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: pp,�" YID "� wwww...... w Title: HC��1lgL7 Signature: Dated this 19 day of 0 V e4t tR ek 2014. Bidding Form Appendix B-11 Last Modified:January 23,2014 Suspension and Debarment Requirements City of El Segundo li Residential Sound Insulation Program RSI 14-25 (Group 67) 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 7th day of November ,2014. Bidding Form Appendix B-11 Last Modified:January 23,2014 Suspension and Debarment Requirements City of El Segundo qu Residential Sound Insulation Program RSI 14-25 (Group 67) 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 LHEY ST GRANADA HILLSCA 91344 ww_A__ Telephone Number: 818-831-8800 Contractor Representative: ELIZA KHATCHERIAN� Title: CEO 4 Signature: Dated this 7TH day of„NOVEMBER 2014. Bidding Eorm Appendix B-11 Last Modified:January 23,2014 Suspension and Debarment Requirements Nov. 7, 2014 3:47PM Milgard Windows No. 5016 P. 6 d City of 1131 Segundo Residential Sound Insulation P=ram RSI 1425(Group 67) 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: Address: � IC4S�f J5'-� 1Q11eq r Telephone Number: Ins 5811- 11!1 ,�� Contractor Representative: Title: Signature: Dated this day of D o E�_,2014, Bidding Form Appendix B-I I Gast Modified:January 23,2014 Suspension and Debarment Requirements City of El Segundo W Residential Sound Insulation p rol,;,am RS1 14-25 (Group 67) Suspension and DebarmentRequirements for all Contracts oveiii- $25,0010 The Bidder certifies, by subs-mission cap"this proposal p osump c:mm° acceptance of this Contract, ttp°matt neither it nor its principals ipals us presently c:pepmarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in ttllmu.us transaction by any Federal department or agency. It um.ril"ier agrees by sm,jtbmitting this proposal osal tthatt it will include this clause without. modification in all lower tier transactions, solicitations, proposals, contracts, and subcontracts, ntractts, Where the p. idder/o "p"eirer/conttracttor or any lower tier pmamtpcppant is unable to certify to this statement, it mnuustt a:ttttac lii an explanation. to this solicitation/proposal. Name offprauma Absokde Abstemmo&Demo Santa 2 ��mmga,p„p mpapu° Q>s: W. . Telephone Number: Contractor Representative: Signature. day cp pafld tt�uW ,. , -.. ....�, _ 2014. ..,, . Bidding, a Appendix 113„ p Last ModffledAanuary 23,2014 _ .� ._._....�_ m�sp.erasion and Debarment Requirements 11/07/2014 07:20 FAX 19498556507 C @NON /6005/006 City of El Segundo Residential Sound insulation program. '§ RSI 14 2 (Group 67 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, declred 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: 4,�.3 a Telephone Number: U A;T'V Contractor Representative: Title: , Signature: Dated this 3 r day of &1" m r _,2014, Bidding Fonn ,appendix B-11 Last Modified: auivary 23,2014 Suspension and Debarment Requirements chy naf`p p Segundo lkesideraWl Sound Insuupavuuuum II"m-umigmimp .. . .�.� ..... RSl N 4 25(Group 67) Suspension wind .DeNwnV""omen t .equVll eIment for Contracts over 5115,000 t49 C'F NN 29) The III!'fiddaur certifies,by strlkarmnn.As'i�i-umi O ttlhi s PrOPO Sn d Or aua=lPttuanmaauw OfOlk tt uannttraard,tt:hm nmu ntthr;u it or napunnmtt U'Upa is a nuns e,ull draairrn c:bar d as p°na;�uma�ea9 Ilrrrc:ulpnru rap p'amr ape bammne tt npr�r,,,rp aed iinnr�Vnpsulblle, nnaun nn pug°nruu°upuaap G�puns a,annpy apu purnna; 6proaattnrcnuni uun lhn Fl OWJr ue,tt,uaanu by airily 6 eelle nd upr llaartnvne,untt of rrmuNauapnffua,uput1uufnir�n,ier agirea r, pray �uapumittfing tlhu[s pamuupwuu:„ap that it vvM unarahid this daiuse �vuilpaariul pvun°q:nnmtt prn ua nntt&apreM tt,rr rentt.meuannmttu urtt.,u. p prv�aa n ttn,n,n ttlrunnis:uefion a srupnruttaattuuunu^ p rop loran connbzclr„ a�airo uulk yhtt'pnm ru tile p urn a;u°/u°ap�a ir�a,amt actor aau �ttuu � prawura n nna^;u flff� ttau ttllrnr,,� autt.aleis uu.mut, it mum att,tt„uch an ra.ulp-unaannaatt.ionn to khk mapnaauttattnarnn/prrupu7rsaL p^tl nu neM rak"p°'iiu°nmr. MD WSULAWN(X), mach, w ^u7pN a patilbYttfq aknnnarON fteett tt`u Nelg"uhnnne Nuurubm -- (62,6) tt,.aninih a.eattrun Vuapmna;,anrett°;u.ttp nn: .m u DattodOlk day of bra T�, a�,�� ffiMng Form ygnmapum p,ll .. ttrttuian Suspension and Debarment mentt Ha°rpuuITVT[Crntts City of El Segundo Residential Sound Insulation Program RSI 14-25 (Group 67) 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: � ' Address: fµ tub b Telephone Number: ....... d � Contractor Representative: .,, Title: ........ ........ ....,.... �. Signature: Dated this day of 12014. Bidding Form Appendix B-11 Last Modified:January 23,2014 Suspension and Debarment Requirements City of El Segundo Residential Sound Insulation Program RSI 14-25 (Group 67) Suspension and Debarment Requirements for all Contracts over $25,000 (49 CFR Part 29) The Kidder certifies, by submission of this proposal or acceptance of this Contract, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declai°ed ineligible, or voluntarily excluded from pai-ticipation in this transaction by any Federal department or agency. It further agrees by subnutting this proposal that it will include this clause without modification in all lower tae° transactions, solicitations,proposals, contracts, and subcontracts. /here the I:idder/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: �&z,;"- Telephone Number: < ' yG3 96is� Contractor Representative: Title: Signature: Dated this mm e day of �L 2014. ....._..�............. Suspension and Debarment Requirements B-11 Last Modified:January 23,2014 Bidden Form s O N U 44 0 I-IN ...d p > O N U Cd N o. — 3 .^ 4a G Nom' 0, O + y - ............... f� u o o o pp x o w >1 o = C o th ° � � � � Q � � U y +. � O v� � � � s. U >1 � � � m v� pa ° tr U '� x..� on.. U �. V `" sue, ' ob o �+ O I 0 0 � 0 Z �.... ~ UO _....._.......................... _ (� C U 4•w p U R+ r M CA U '� U 4, cd Cz ^ C� w.� W y c W 0 Q o � U wi N � % 2 G "=� r �a CVl Tj 0 -0 , �► ^ t O a, w ° U -o 00 ts J o cl uo 703 0 4. 04 0 C. -4—0 � � � � � � � n � 0 p 0 to o m � � H .1 W .- Q 3 �► � kf) u u U U U ................... 0 Lo yC ---------- 2 1 u r-4 'o or- City of El Segundo Residential Sound Insulation progratrr RSI 14-25 (Group 67) References (Required of Bidders and any Subcontractors performing more than 10%of Work) Name of Bidder or Subcontractor: �� . ° ` �� .. " ., m 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 � i �._..",�► � �... I) Project No, � ...� � ge y & � ( Dollar Value Contact Person ' Tel.No. i .. i . Description of I)rolect �. �''�� ? 2. Project Names Project No. p AgencyM ............ Dollar Value Contact Person ) Tel.No. LICS Descripti 11 of Project �� 3. Pro�ectName , . � � Project No. ___j " Agency Contact Person, Tel Dollar Value No w. 1.. _ Des I of l"rc ject J " 4. ProjectyN „W Project No. _ .. l �;� _....._..... Tel.No.,, e �"�.. � y�...erc w * Dollar V ltr Contact Person ft�� Description�of'PrOic I �� . �I " . ta�� ... ��"°� �� ;Q' ��"a &,w.tt�L,"Vr Bidding Form Appendix B-13 Last Modified:January 23,2014 References City of El Segundo Residential Sound Insulation Program RSI 14-25 (Group 67) 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 Residential Sound Insulation Program, ram 2. Project Name LAWA RSIP Project No. Various Agency Dollar Value Contact Person Tel.No. 424-646-7441 Description of Project _ Residential Sound Insulation Prop-ram 3. Project Name Burbank RSIP Project No. Various Agenc W le Labs Dollar Value Contact Person 3 Tel.No. 818-383-9821 Description of Project Residential Sound Ins lation Prop-ram. 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 rain EL SEGUNDO RSI 14-25 GROUP 67 References (Required of Bidders and any Subcontractors performing more than 10%of Work) Name of Bidder or Subcontractor: H.K ELECTRICAL 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. I. Project Name INGLEWOOD RSIT 8.14 Project No, PH 8 GR 14 Agency_ CITY OF _INGLEWOOD Dollar Value $85, 606-00 Contact Person LU Tel.No 310 "1: 7n- Description of ALL ELECTRICAL K • SCOPE OF WORK j INGLEWOOD RSI V8.12 Project No. PH 8 GR 12 2. Pro cct N�r'nc 12 • Agency CITY QF I.NGLEWOOD Dollar Value $194, 000.00 Contact Person ANTHONY BARBARIN TeL.No. 310-412-5-286— p ..i F WORK Description of Lrn;°ect ALL ELECTRICAL SCOPE' O LL DESCRIBED IN THE ORIGINAL SPECIFICATIONS 3. Project Name INGLEWOOD R.SI .1?.17 Project No. PH 8 GR 17 Agcricy, C. TY OF INGLEWOOD - Dollar Value $83,000.00 Contract Person ANTHONY BARBARIN _ Tel. No, 310--412-5280 p Project COPE OF WORK Description of Pra'ect ALL ELECTRICAL S� DES RRI,4BED IN TH4,_g ITLAI 9 ECIFICATIQ NS ,s 4. Project NamcINGLEWOOD RSI 9.5 Project No. PH 9 GR 5 $ Y NGLEWOOD Dollar Value$189,000.00 Contact Person ANTHO w. NY BARBARIN Tel.No. 310-412-5280 Desch' tion or Pr o iect ALL ELECTRICA�L�SCOP.E.M.�OF _W o�RK DESCRIBED IN THE ORIGINAL SPECIFICATIONS. • Bidding Form Appendix B-13 Last Modified:January 23,2014 References f City of El Residential a RSI 14-25 ((Ircaaap 67) ,References (Required of Bidd r any Suix aanta wa°urr ;xn fp)u.aaaata � 01,� dt a Il p',uup � cry Name of Bidder or aa q,�a�.on tractor. �� Please list n pro� u: reanu Work w��, a �.ar to the "'c.rm.�. wPcn perform on this Project, ThisilAbriiiation is w lac°, t'at �tacpp rauuaR �� be used by the '.3ty in assessing our c ,pal:au&uOes acuur, (Ilia Iifi °a bons dc.r 1,1crfOruu:nng dw You are dare y advised that this ],,.)rojecut is ac.mp lcx and requires a.,xpac,6crj ecl t.;c�uuca�auc:ac.�u.; al J Stabc,ontractaars, Bids may be considered non-responsive if the information T.-)rovided is untruc c r is iriistifficient to allow the City to _ J.. msess capabilities and qual ifications, Projed Project Y raac Project Agency(,j t ... w �.,,,a. t a�a'. a .sec°;�aa�ta �a ,o s� i. No �puua� Description apt ��rcap rp ct hap Agency 6 �.,. _ n trpa ,au�c.t Contac t rrr� �� ,a:-u."�u...� �I" po Ica ln� �' m Asp P � Description as rca" � q ._ .. ..... ... ....... ..... 3, Project Nzinle �-4 aoject No �a tw..rrorat t a a° �raaa .p eL � o m. aIan O i& Project Na ie . ` ar,oa 'ecrt c olpar Value it gt Persori f Bi t Form A pendx 13-13 a* 23,20H 11/0712014 07 : 20 FAX 19498558507 UNON 1&006/006 City of El Segundo Residential Sound Insulation Program fl RSI 14-25 (Group 67) References (Required of Bidders and any Subcontractors performing more than 10% f Work) Name of Bidder or Subcontractor: 0 , N M 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. I 1. project Name As M a 1 Project No.�_ A ency Dollar Value F- Contact Description f Project - �' � Tel.No. 2. Project Name QD C 6)V Project No ,. 3 Pzl Agency Dollar Value Contact person Tel. No, .�,$.� Description of Project 3. Project Narne Cf)C rmtcp q Project No. Ova ao Agency Dollar Value - Contact Descr ption Tel.No. of project . r t� 3 I 4. Project A enc Name_ r Project No., p L� g y e Iol� r Value Contact Person q Ted:No. Description of Project - Bidding Form Appendix B-13 Last Modifie January 23,2014 References 01 owl d adpr.url daa p„ dR'cs'kaciidmall Sour(. prirsr.ud n.druro I�r'aupatrrrbk RRSI 14 25(Group 67) (Required of PPurdrdws ruuW m°w`'drrRrwridruOor^y perkaarmroummkd,rmwre An QQd%avd'WAQ ^ � Cadamrriarr,ofB6rd<dcr.or PdrrRua,aammd:r�a,dm:nm'� � �tiw �� "`k �,.i °��, s�R"'d°��✓aad,, R a, Please Quad, s�irnHam�� p�raapma,ts On which You pu rt6virule d Work s rriruudaair to Ox, 'PU<k°auuda you "nuadad v E @7ir`p,ryadaruir a a rmalkrdhics and � ouaadukkapuraua, dear rawrp�aarrmarrr pdua�d ururd a�r kam ruM„a, danR dNuar: aad dduu orokamrruafluaumdistob uurch3daaPaa�'ukdrddaa 6 advi r,ad ddmad�#his pare @ka,a,d 6 complex „amumd rce,:aPmmur°N a,r.pr�a,mra.rwed 4„rrridrmaaa;do p and a nurd,a,amuud:mra,flms s u�ru amr and uru a , p d p f R�Nma °�wamm��. h'auuu mina Vr�u+Vu� Bids uaxau d �. , y °ar aramu,uadrra,ad rvrrrri mm µaaaraauaa mRdlVum dmuRkurrruWuruua prmvuada,ad k aarvdroae or u.^h riru.,uudkudud do <mddmaw dpae C rd,d der adegiiu udr�'d3,assess caapnallmullufia s aicmirrd rkurafiRum,urRua,ur fl, N. d�ir�� ry1d„,P � Rea p aad ,rra , tlk^a.Pd.s P ) r �m'Iject No 0Y4.Vtt,yd 'addmr V rdru�” "� a.�m dr 4a;i 6 `� drr, dam a�dU� dajd 1 d"!+� uR k aamddar.d Pei ar,ua dkcsarupaB.uaama rub drr°anga,a;r a r r a dad. �_. r"krrra Ra l. R rad ard m a aa k K a d P d 1m' R nod m kaa act Pel mma k;mam rpddam of 1111 sAj z & k m". VOW d. drmapjaad l��dmarrmm; q�°m d�°� � �uimad,rw �m^m� ��mW.k'a q'ap^��a V"d'au k a aR�ad,d d rtausar�mu m R m � 4 a a � VNpga dJuw&rrm � 11 1 a� d ride �i: d Agency wa4 �Y ,m d a°�.3�lO d a R r „ dba;a��awrdpmdaiaam'm amd ProjeA;a R R d. dwra»pma d 1 J aruua l ,. u 4 P p raa p Na At _ ` w mka r sea r k r �xdR.dadnm Value Dr . d R Dcdsa:;rrprodGon of I°rajL%ja .a ............................... RkumdadmW d mnr _ kupurmarPu IId.B a^au R�%�ndullp^ d.. :.Vrrnr^ruy :� �irll<% RCa,dRara,mia e s City of El Segundo Residential Sound Insulation Program RSI 14-25 (Group 67) 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 Nam Project No ,leticy Tel.1alue Contact Prs¢ iNo Description of 1'ra jet . v ,��a t, .. 2. Project Name s w.. Jn fro cet w ..� Dollar Value x get cy� , � t .w. a,wa. . 4ena Tel.No. : � D � ption of Proj ct 14 ., -ZZI c . ''� , . w r , 3. Protect Name Project No. A g et nc y � . Dollar Value 1)�, �- : �7 Contact Person— Tel No i, C f .,....... tt�ott� �D �.... .4. Project Name . �� m.w... ............ t Project No .._.4 Agency Dollar Value- Contact el. No Description of ProJect_ . t � . d t" ..... i., lt. �...... Bidding Form _ Appendix B-13 �Last Modified:January 23,2014 References City of El Segundo a p r°, Residential Sound Insulation Program RSI 14-25 (Group 67) References (Required of Bidders and any Subcontractors performing more than 10%of Work) Name of Bidder or Subcontractor: Glore & Associates 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 RS I P Project No. 37 Agency ..... City of E1 Segundo ...,,,, Dollar Value _$58, 710 . 00 Contact Person J m s O'Neill Tel.No. 310 . 5 2 4 .2 3 8 5 Description of Project. SuT)iDlv Acoustic Doors frames and hardware. 2. Project Name El Segundo RS I P Project No. 38 Agency city 01 E S� g o Dollar Value $55, 800 . 00 Contact Person James O'Neill Tel.No. 316-. 524 .2385 Description of Project Su rpl Acoustic Doors, frames, and hardware, 3. Project Name El Segundo RS I P Project No. 39 Agerxcy�City of El Segundo Dollar Value $77, 450 . 00 Contact Person James O'Neill Tel.No. 310 . 5 2 4 . 2 3 8 5 Description of Project__, Su2ply Acoustic Doors frames, and hardware. El Segundo RSIP 4. Project Name Project No. 41 Agency City of El Segundo Dollar Value $86,225 . 00 Contact Person James O'Neill Tel.No. 31 q_72 Description of Project Supply Acoustic Doors, frames., and hardware. Bidding Form Appendix B-13 Last Modified:January 23,2014 References City of El Segundo 0 Residential Sound Insulation Program RSI 14-25 (Group 67) Acknowledgement 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: Addendum Number Date: ' a'► .f4zr W ?o I q Addendum Number Z Date: " ' � i Addendum Number Date: Addendum Number Date: Addendum Number Date: Addendum Number Date: Addendum Number Date: Addendum Number Date: Addendum Number Date: Contractor Representative: `- -� 11 1 2-o l Signature G',?sate �b M OAS 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 14-25 (Residential Sound Insulation Program—Group 67) 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 23, 2014 at 10:00 a.m. End of Addendum Addendum#1 RSI 14-21 (Group 64) City of El Segundo Residential Sound Insulation Progr :rrx ADDENDUM NUMBER 1 Date: November 10, 2014 Project: City of El Segundo RSI 14-25 (Residential Sound Insulation Program—Group 67) 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 Tuesday, November 18, 2014 at 10:30 a.m. End of Addendum Addendum#1 RSI 14-25(Group 67) City of El Segundo Residential Sound Insulation Program ADDENDUM NUMBER 2 Date; November 14, 2014 Project: City of El Segundo RSI 14-25 (Residential Sound Insulation Program—Group 67) 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 11:00 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 14-25 (Group 67) City of El Segundo Residential Sound Insulation Program Item 8 Response to pre-bid RFI: The address for Home 67. is 835 Center Street. Bidders are to correct any reference to 825 Center Street to be 835 Center Street Item 9 Response to pre-bid RFI: Replace page 1 of the plans for 67.10 with the attached page 1 (showing chase locations) Item 10 Response to pre-bid RFI: Replace page 3 of the plans for 67.14 with the attached page 3 (showing scope of work for Door C) Item 11 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 12 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. 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I Y�y. / � � �° ,, �, r: � � t �", a � �, �� 4p �, ' � �� A � i1 " � r ",' � � � q i �- � � � � � a, � �! �� -i ' 4: ! �,k i! �f 9 ,.�, ,. i F �. .,. ,. 4 ��,. e, ,, �� mmom0000mooOOwo oozozzzzozzzz } z c� Z (1) udco n 0 (1) wwwww 0 Ow pwwwwZwwwwwwzzw m C) 0 0 0 0 0 0 0 0 0 0 0 0 0 Q N N N N N N N N N N N N N N ti � ti ti ti ti ti ti ti ti ti � ti � — 0 L 0 0 0 0 0 0 0 0 0 0 0 0'O 0 a N N N N N N N N N N N N N N N N N N N N N N N N N N N N J O CIO 0 0 0 0''0 0 0 0 O 0 0 U a 0 Z LU pCf) O () d w _j U W Z a J 2 p aaJ2Y � w � p LU = V caJ >- 2dwU � F- (� � � cn > (naU O LO O LO W Cfl T CO N M N O W � O 00 Cfl Nt N CO O ti N w Z co co 00 0 00 Il � 00 o Cfl N 00 0 li 1� 00 ONr` MOM o 2 O M r'O CA CO LO M c M LO N LO C0 d ti CO M T 00 CA O O O N w w 00 O LO IT 00 IT LO LO Cfl ll M O ti ti LO M CO N 00 I- o It It M LO Cfl 00 00 Nt It N O r In r N 0 Cfl LO 00 ti CO rl- r-- M w 00 00 00 I-- ti J a W U Q cq Z Q U Q > H 2 0 Z J Z Z a w Q� aw w (n Q Z U ~ O w 2 w 2 w a Z w U Q w w Q Da �'w >- � � � > _3 Q otS w LU U U) w w J a � Q U Q U 2 w p z � wO ( ow � � = QO -) w oOJYma � � w - � 0NCD -j 2CDzacno �- 3: 5ONaaa Group 66 and Group 67 Invitations to bid Page 1 of 1 From: bigwestconst<bigwestconst @aol.com> To: mdinsul <mdinsul @sbcglobal.net>; pratt2glore<pratt2glore @yahoo.com>;VIC <VIC @ZODIACHVAC.COM>;joedupuy<joedupuy @milgard.com>; discountx<discountx @gmail.com>; hkelectricaleliza<hkelectricaleliza@g mail.com>; chuck<ch uck@absoluteabatement.net>; mikec <m ikec@specialtydoor.net>; gnichols<gnichols @trueairinc.com>;jp<jp @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: Group 66 and Group 67 Invitations to bid Date: Mon, Oct 27, 2014 10:47 am Attachments: Group_66_lnvitation_to_Bid_pdf(2614K), Group_67_lnvitation_to_Bid_.pdf(2249K) Please see the attached information Attachment's include: Invitation to Bid Notice inviting Sealed bids Preliminary Construction Schedule 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 67. 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 r' file:///C:/Users/Kids/AppData/Local/Temp/LKTE9ERF.htm 10/27/2014 " GT NSul Invitation to Bid Attention: Prospective Bidder Company: Fax: Phone: Project: RESIDENTIAL SOUND INSULATION PROGRAM Group 67 Bid Date: 11/7/2014 VARIOUS LOCATIONS Address: Time: 3:00 City, St., Zip El Segundo, CA Early Quotes are always welcome& always confidential! Please mark the appropriate box and return, Yes, I would like to bid the project Need Plans: Yes No No, not at this time Yes, Already have plans Shipping Number: Spec Section(s)! Estimators Name: Phone Number: E-mail address: Thanks in advance for your time on this project and should you need anything while looking at this project feel free to contact our office and ask for: Tom Carr (949) 795-2219 Fax (949) 253-9049 15331 Normandie Ave. Irvine, CA 92604 i (949)795-2219 • Fax(949)451-1506 License#81208510J2716PO4estconst @aol.com Notice Inviting Sealed Bids CITY OF EL SEGUNDO RESIDENTIAL SOUND INSULATION PROGRAM RSI 14-25 (Group 67) The City of El Segundo is accepting sealed Bids for Projects RSI 14-25 (Group 67 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 Monday,November 10,2014 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 9, 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 55-65 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 67 ("Project") of the Residential Sound Insulation Program, which consists of sound insulation improvements and related work at twenty-three (23) 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.dir.ca.gov. The Contractor to whom 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 11375. 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 from the Government Printing Office via the internet at www.access.gl2o.gov/davisbacon 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 maximum 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 9th day of October, 2014 City of El Segundo, California Tracy Weaver, City Clerk City of El Segundo Residential Sound Insulation Program RSI 14-25 (Group 67) 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: Address: Telephone Number: Contractor Representative: Title: Signature: ....................... ................... Dated this day of_ITmmmmIT mmmm ____... 12014. 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 Program ' RSI 14-25 (Group 67) 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 14-25 (Group 67) 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: Signature: Dated this_day of............................ 12014. 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 w RSI 14-25 (Group 67) 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: Address: Telephone Number: Contractor Representative: Title: Signature: ............ ................................. Dated this day of, .............................................._,2014. Bidding Form Appendix B-11 Last Modified:January 23,2014 Suspension and Debarment Requirements City of El Segundo Residential Sound Insulation Program RSI 14-25 (Group 67) 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 Name _...__............................_........._ Project No„�....__....... .Agency _. .._.................... Dollar Value Contact Person Tel.No. Description of Project 2. Project Name Project No. Agency.._._.................._........................ ..WUHUUW_ Dollar Value.__....._ Contact Person Tel.No. Description of Project 3. Project Name _ .. Project Agency --- Dollar Value Contact Person mmmmmmmmmm��... ........_ Tel.No. �m._�_� ..��_�.��. -- 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 Program Section 00 73 1 — Insurance Requirements Part 1 General 1.01 Summary A; Work covered by this Section includes,without limitation: 1. 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 to the City all documentation necessary to clearly show 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 B) 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: ..... .............��.....— -- .. Coverage der Occurrence ISO Form Combined Single Limit _.. Comprehensive General Liability GL 00 02 01 85 or 88 – $1,000,000 Business Auto CA 00 01 01 87 $1,000,000 . .. ... ' ompensation Statutory Workers C ®_ ...... ......... ... .. ... .r .. --... �.. 3.02 Contractor will provide endorsements or other proof of coverage for contractual liability. 3.03 Combined single limit 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 Section 00 73 16 30_ 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 Contractor. The 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. Ea 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. (..I. 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 El 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 on 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 Section 00 73 16 31 Last Modified:June 26,2014 Insurance Requirements 2015 Edition y' City of El Segundo Residential Sound Insulation Prograin �M e� time. Certificate/endorsement for Workers Compensation Insurance will be furnished on State Comp Fund or other industry standard form. 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. 5. All Subcontractors employed on the Work referred to in this contract must 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. For INSURER: ISO FORM CG 20 10 11 85: (MODIFIED) POLICY NUMBER:COMMERCIAL GENERAL LIABILITY ENDORSEMENT NUMBER:EXHIBIT 1-A THIS ENDORSEMENT CHANGES THE POLICY,PLEASE READ IT CAREFULLY. ADDITIONAL INSURED—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. Modifications 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 Named 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. 3. 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. Coverage shall not extend to any indemnity coverage for the active negligence of the additional insured in any case where an agreement to indemnify the additional insured would be invalid under Subdivision(b)of section 2782 of the Civil Code. Signature-Authorized Representative ............. Address CG 20!10 1185 Insurance Services Office,Inc.Form(Modified) .t 1 5WlC}6JI��Il C6�"Il'&WW. ABOVE OE6CW�WBEC POLICIES BE CANCELLF BEFORE THE MAIL EXPIRATION DATE THEREOF,THE ISSUING MWW"W1?SWil 4 ,. .... .- ._. „ ' LWmW W WW"WW�rE CE To THE LrFT, C�T. NOTICE TO THE AUTHORM l I MPRESPWATIVE i