CONTRACT 4898 Public Works Contract CLOSEDAgreement No. 4898
PUBLIC WORKS CONTRACT
BETWEEN
THE CITY OF EL SEGUNDO AND
JOSE ANGEL FIERROS dba FS CONSTRUCTION
REBID OF FY 14/15 CURB, GUTTER, SIDEWALK, AND OTHER
CONCRETE IMPROVEMENTS PROJECT
PROJECT NO.: PW 14 -16
This CONTRACT is entered into this 2nd day of September, 2015, by and between the
CITY OF EL SEGUNDO, a general law city and municipal corporation ( "the City ") and JOSE
ANGEL FIERROS dba FS CONSTRUCTION, a sole proprietorship, ( "the Contractor ").
1. WORK.
A. The Contractor will provide all work required by the Contract Documents (the
"Work "). The Contractor agrees to do additional work arising from changes
ordered by the City in accordance with the Contract Documents.
B, The Contractor and the City agree to abide by the terms and conditions contained
in the Contract Documents;
C„ The Contractor will furnish all of the labor; supplies and materials; equipment;
printing; vehicles; transportation; office space and facilities; all tests, testing and
analyses; and all matters whatsoever (except as otherwise expressly specified to
be furnished by the City) needed to perform and complete the Work and provide
the services required of the Contractor by the Contract Documents.
D. "Contract Documents" means the Notice Inviting Bids; Instructions to Bidders;
Supplementary Instructions to Bidders; Proposal; this Contract; Standard
Specifications; Supplementary Conditions; Exhibits; Technical Specifications;
List of Drawings; Drawings; Addenda; Notice to Proceed; Change Orders;
Notice of Completion; and all other documents identified in the Contract
Documents which together form the contract between the City and the Contractor
for the Work. The Contract Documents constitute the complete agreement
between the City and the Contractor and supersede any previous agreements or,
understandings.
2. CONTRACT SUM. The City agrees to pay the Contractor a sum not to exceed Two
Hundred Twenty Nine Thousand Nine Hundred "'I "went '1'wo Dollars and Seven! Five
Cents ($229 22.75) for the Work in the manner set forth in the Contract Documents. The
City may adjust this amount as set forth in the Contract Documents.
3. TIME FOR PERFORMANCE.
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Agreement No. 4898
A. The Contractor will fully complete the Work within one hundred twenty (120)
working days (the "Contract Time. ")
B. The Contract Time will commence when the City issues a Notice to Proceed.
The Contract Documents will supersede any conflicting provisions included on
the notice to proceed issued pursuant to this Contract.
C. The Contractor may not perform any Work until:
The Contractor furnishes proof of insurance as required by the Contract
Documents; and
ii. The City gives the Contractor a written, signed, and numbered purchase
order and notice to proceed.
D, By signing this Contract, the Contractor represents to the City that the Contract
Time is reasonable for completion of the Work and that the Contractor will
complete the Work within the Contract Time.
E. Should the Contractor begin the Work before receiving written authorization to
proceed, any such Work is at the Contractor's own cost and risk.
4. DISPUTES. Disputes arising from this contract will be determined in accordance with the
Contract Documents and Public Contracts Code §§ 10240 - 10240.13.
5. THIRD PARTY CLAIMS. In accordance with Public Contracts Code § 9201, the City will
promptly inform the Contractor regarding third -party claims against the Contractor, but in no
event later than ten (10) business days after the City receives such claims. Such notification
will be in writing and forwarded in accordance with the "Notice" section of the Contract
Documents. As more specifically detailed in the Contract Documents, the Contractor agrees
to indemnify and defend the City against any third -party claim.
6. TAXPAYER IDENTIFICATION NUMBER. The Contractor will provide the City with a
Taxpayer Identification Number.
7. PERMITS AND LICENSES. Unless otherwise provided, the Contractor, at its sole
expense, will obtain and maintain during the Contract Time, all necessary permits, licenses,
and certificates that may be required in connection with the Work.
8. OWNERSHIP OF DOCUMENTS. All documents, data, studies, drawings, maps, models,
photographs and reports prepared by the Contractor under the Contract Documents are the
City's property. The Contractor may retain copies of said documents and materials as
desired, but will deliver all original materials to the City upon the City's written notice.
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Agreement No. 4898
9. INDEMNIFICATION. The Contractor agrees to indemnify, defend, and hold the City
harmless as set forth in the Contract Documents. The requirements as to the types and limits
of insurance coverage to be maintained by the Contractor as required by the Contract
Documents, and any approval of such insurance by the City, are not intended to and will not
in any manner limit or qualify the liabilities and obligations otherwise assumed by the
Contractor pursuant to the Contract Documents, including, without limitation, to the
provisions concerning indemnification.
10. INDEPENDENT CONTRACTOR. The City and the Contractor agree that the Contractor
will act as an independent contractor and will have control of all work and the manner in
which is it performed. The Contractor will be free to contract for similar service to be
performed for other employers while under contract with the City. The Contractor is not an
agent or employee of the City and is not entitled to participate in any pension plan,
insurance, bonus or similar benefits the City provides for its employees. Any provision in
this Contract that may appear to give the City the right to direct the Contractor as to the
details of doing the work or to exercise a measure of control over the work means that the
Contractor will follow the direction of the City as to end results of the work only.
11. AUDIT OF RECORDS. The Contractor will maintain full and accurate records with
respect to all services and matters covered under this Contract. The City will have free
access at all reasonable times to such records, and the right to examine and audit the same
and to make transcript therefrom, and to inspect all program data, documents, proceedings
and activities. The Contractor will retain such financial and program service records for at
least three (3) years after termination or final payment under the Contract Documents.
12. NOTICES. All communications to either party by the other party will be deemed made
when received by such party at its respective name and address as follows:
The .City
The Contractor
Stephanie Katsouleas
Jose Angel Fierros
Public Works Director
Owner
City of El Segundo
Jose Angel Fierros dba
350 Main Street,
FS Construction
El Segundo, CA 90245
14838 Bledsoe St.
(310) 524 -2356
Sylmar, CA 91342
(818) 838 -6040
Any such written communications by mail will be conclusively deemed to have been received by
the addressee three (3) days after deposit thereof in the United States Mail, postage prepaid and
properly addressed as noted above. In all other instances, notices will be deemed given at the
time of actual delivery. Changes may be made in the names or addresses of persons to whom
notices are to be given by giving notice in the manner prescribed in this paragraph.
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Agreement No. 4898
13. NO THIRD PARTY BENEFICIARY. This Contract and every provision herein is for the
exclusive benefit of the Contractor and the City and not for the benefit of any other party.
There will be no incidental or other beneficiaries of any of the Contractor's or the City's
obligations under this Contract.
14. INTERPRETATION. This Contract was drafted in, and will be construed in accordance
with the laws of the State of California, and exclusive venue for any action involving this
Contract will be in Los Angeles County.
15. EFFECT OF CONFLICT. In the event of any conflict, inconsistency, or incongruity
between any provision of the Contract Documents, precedence will be as follows:
A. This Contract;
B. The Standard Specifications; and
C. Precedence of documents as determined in the Standard Specifications.
16. SEVERABILITY. If any portion of the Contract Documents are declared by a court of
competent jurisdiction to be invalid or unenforceable, then such portion will be deemed
modified to the extent necessary in the opinion of the court to render such portion
enforceable and, as so modified, such portion and the balance of this Contract will continue
in full force and effect.
17. AUTHORITY/MODIFICATION. The Parties represent and warrant that all necessary
action has been taken by the Parties to authorize the undersigned to execute this Contract and
to engage in the actions described herein. This Contract may be modified by written
amendment. The City's city manager, or designee, may execute any such amendment on the
City's behalf.
18. ACCEPTANCE OF FACSIMILE SIGNATURES. The Parties agree that this Contract,
agreements ancillary to this Contract, and related documents to be entered into in connection
with this Contract will be considered signed when the signature of a party is delivered by
facsimile transmission. Such facsimile signature will be treated in all respects as having the
same effect as an original signature.
19. COVENANTS AND CONDITIONS. The parties agree that all of the provisions hereof
will be construed as both covenants and conditions, the same as if the words importing such
covenants and conditions had been used in each separate paragraph.
20. CAPTIONS. The captions of the paragraphs of this Contract are for convenience of
reference only and will not affect the interpretation of this Contract.
21. TIME IS OF ESSENCE. Time is of the essence for each and every provision of the
Contract Documents.
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Agreement No. 4898
IN WITNESS WIJEREOF the parties hereto have exectite(l this contract the day and
year first hereinabove written.
Al-I'EST:
Tra )Y149ker,
C 7C,lbf`k
,e
APPROVED M5 ]'O?'r"'l
'
"A
MARK D. 114F ttorney
By:
Karl H. Berger
Assistant City,'Al" I rney
Insurance Reviewed by:
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Taxpayer ID No. 01- O(A 7g9D
Contractor State
License No.:
Contractor City Business
License No.: ! 7
Agreement No. 4898
I, i 1 •
MILORGIF01
' 1 1
.4
Date 20-,
Company Name.
p Y,.. ......... .�......_.
In accordance with the City of El Segundo's Notice Inviting Sealed Bids, the undersigned
BIDDER hereby proposes to furnish all materials, equipment, tools, labor, and incidentals
required for the above stated project as set forth in the Plans, Specifications, and contract
documents therefor, and to perform all work in the manner and time prescribed therein.
BIDDER declares that this proposal is based upon careful examination of the work site, Plans,
Specifications, Instructions to Bidders, and all other contract documents. Submittal of this bid
shall be considered evidence that the BIDDER has satisfied himself regarding the contract
documents, access and any other field conditions which may effect bid prices. If this proposal is
accepted for award, BIDDER agrees to enter into a contract with the City of El Segundo at the
unit and /or lump sum prices set forth in the following Bid Schedule. BIDDER understands that
failure to enter into a contract in the manner and time prescribed will result in forfeiture to the
City of El Segundo of the proposal guarantee accompanying this proposal.
BIDDER understands that a bid is required for the entire work, that the estimated quantities set
forth in the Bid Schedule are solely for the purpose of comparing bids, and that final
compensation under the contract will be based upon the actual quantities of work satisfactorily
completed. THE CITY OF EL SEGUNDO RESERVES THE RIGHT TO INCREASE OR
DECREASE THE AMOUNT OF ANY QUANTITY SHOWN AND TO DELETE ANY
ITEM FROM THE CONTRACT. It is agreed that the unit and /or lump sum prices bid include
all apparent expenses, taxes, royalties, and fees. In the case of discrepancies in the amounts bid,
unit prices shall govern over extended amounts, and words shall govern over figures.
If awarded the Contract, the undersigned further agrees that in the event of the BIDDER'S
default in executing the required contract and filing the necessary bonds and insurance
certificates within ten working days after the date of the City of El Segundo's notice of award of
contract to the BIDDER, including sending by U.S. Mail a Public Works Contract for signature
by the Awardee, the proceeds of the security accompanying this bid shall become the property of
the City of El Segundo and this bid and the acceptance hereof may, at the City of El Segundo's
option, be considered null and void.
K CAIJ hpI'1�I,['1I +;.I. �GIPORTUNITY COMPLIANCE
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Agreement No. 4898
requirements of the contract documents.
NONCOLLUSION AFFIDAVIT
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Agreement No. 4898
BIDDER'S INFORMATION
BIDDER certifies that the following information is true and correct:
Form of egal Entity (Le., inclividtud, parinevship, coq�,)oralioii, ete)
State Contractor's License No. and Class
"d Expiration Date
Original Date Issued.,
The following are the names, titles, addresses, and phone numbers of all individuals, firm
members, partners, joint venturers, and/or corporate officers having principal interest in this
proposal.
"- ............. .
The date of any voluntary or involuntary bankruptcy judgments against any principal having an
interest in this proposal is as follows:
(2,
All current and prior DBA's, aliases, and/or fictitious business names for any principal having
an interest in this proposal are as follows:
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Agreement No. 4898
Company Name: ".j,
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1196,
Agreement No. 4898
III-) IPWAV94 ecutes ana SUDMILS this proposal with the names, titles,
hands,
..........
I (-�' -) ( I , : a� r
Subscribed and sworn to this day of 20
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ON
Agreement No. 4898
J 12 al LIM
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document,
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State of California
County of Los Angeles Subscribed and sworn to (or affirmed) before me on
24TH day of AUGUST — 2015 by
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.
---- - - - - -- -JOSE ANGEL FIERROS-m ------------
(1) —
X OSO
4
NATHAN MAX OSORIO
096
Commission 0 1�992096
Notary Public • California z
proved to me on the basis of satisfactory evidence
Los Angeles County
Comm.
to be the person(s) who A)jj,%Amd before me.
Signature
Place Notary Seal Above
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.
Agreement No. 4898
BID SCHEDULE
REBID OF FY 14/15 CURB, GUTTER, SIDEWALK, AND OTHER CONCRETE
IMPROVEMENTS PROJECT
PROJECT NO.: PW 14 -16
Company Name:.. �...._"
BASE BID ITEMS
.— 11 m.mm.. . m a. , _.
Item .�....... _ .,.m.1„�
Description
1 4" Thick Sidewalk
2 6" Thick Driveway Approach .. ..
3 6" High Curb
4 � 6" High Curb and 2' Gutter
Core, -hole existing sidewalk for new
w_ hcrita a stone
6 Remove existing heritage stone and
p concrete cover
replace Lace wrt e o
-_ v. .p, � _._.
7 Concrete Improvements at 301 E,
Eucalyptus Drive
Grand
Avenue on mmIT....m µ
ADA Ramp
TOTAL BID = $
Unit
QT Y
Unit
Price
Total
20,880.50
U
S F
„�m..
$
....__
..�... a ...
$ }
301
LF
�.
10
EA
$
$
10
EA
$
a)w��
$
LS
LS
$
,.q! q O
.__....
_.EA
----- --
TOTAL BID WRI'I'I'EN IN WORDS
r
Note: Any additional concrete work similar in scope as described above
and approved as project's change order shall be calculated at the
Contractor's unit bid cost.
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Agreement No. 4898
1111 11 1 ii
REBID OF F'T" 14/15 C1,11B, G41-VER, SfDEV—JZc�>t•�,
CONCRETE IMPROVEMENTS PROJECT
PROJECT NO.: PW 14-16
KNOW ALL MEN BY THESE PRESENTS that,
FS Construction
as BIDDER, and
RLI Insurance Company as SURETY, are held and firmly bound unto the
Ten Percent of the Total
City of El Segundo, in the penal sum of Amount of the Bid in DOLLARS ($10 ° / ®, which is ten
(10%) percent of the total amount bid by BIDDER to the City of El Segundo for the above
stated project, for the payment of which sum, BIDDER and SURETY agree to be bound,
jointly and severally, firmly by these presents.
THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas BIDDER is about
to submit a bid to the City of El Segundo for the above stated project, i fsaid bid is rejected, or if
said bid is accepted and a contract is awarded and entered into by BIDDER in the manner and
time specified, then this obligation shall be null and void, otherwise it shall remain in full force
and effect in favor of the City of El Segundo.
IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seals this
-21st day of August 2015 .
BIDDER* FS Construction 14838 Bledsoe St. Sylmar, CA 91342 (818) 838-6040
SURETY* RLI Insurance Company 16150 N Arrowhead Fountains Ctr. Dr. Peoria, AZ 85382 (623)412-5793
Elisabete Salazar;Atlorney-in-F act 1800 McCollum St., Los Angeles, CA 90026 (323)663-7814
Subscribed and sworn to this day of' 20
NOTARY PUBLIC
*Provide BIDDERISURETY name, title, address and telephone number and the name, title,
address and telephone number for authorized representative.
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R L Ckic
.n atu CanaaY
9025 N. Lindbergh Dr, I Peoria, IL 61615
Phone: (800)645.24021 Fax: (3D9)689-2036
Know All Men by These Presents:
Agreement No. 4898
POWE F ATTORNEY
RLI Insurance Company
Contractors Bonding and Insurance Company
That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the
approving officer if desired.
That this Power of Attorney may be effective and given to either or both of RLI Insurance Company and Contractors Bonding and
Insurance Company, required for the applicable bond.
That 111.1 Insurance Company and /or Contractors Bonding and Insurance Cotnpnny, catch lllinois corporations, (as apphcttblc,), each
nuthorized and licensed to do business in all states and the District of Columbia do 'horoby make, constitute kind appoint:
PRtriQiF1 7eni7n. Maran Rret R nd.rh_.1ez Pietrn Micciche Rlisahotr Rai oar r.. Marearita Lonez. inintiv . or severally
in the City of Us
a on htni r t n ign, execute, ackii^owled e�and California dediver for and on t Attorney in Fact, Surety, laid power and atatltority hereby
p Il d g ty, m general, any and all bonds,
undertakings, and recognizances in an amount not to exceed Ten Million Dollars
( $11 .0 00.000,90 Ilt111,0f1 ) for any single obligation.
The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon this Company as if such bond had
been executed and acknowledged by the regularly elected officers of this Company.
RLI Insurance Company and Contractors Bonding and Insurance Company, as applicable, have each further certified that the
following is a true and exact copy of the Resolution adopted by the Board of Directors of each such corporation, and now in force, to -wit:
"All bonds, policies, undertakings, Powers of Attorney or other obligations of the Corporation oration shall be executed i
p g y g p n the
corporate name of the Corporation by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by
such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant
Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds, policies or
undertakings in the name of the Corporation. The corporate seal is not necessary for the validity of any bonds, policies,
undertakings, Powers of Attorney or other obligations of the Corporation. The signature of any such officer and the corporate
seal may be printed by facsimile or other electronic image."
. _.. ........ _ _. "w.. ----------
_ ........... ..... ..
IN WITNESS WHEREOF, RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have
caused these presents to be executed by its respective Vice President with its corporate seal affixed this -2,$h day of jdy, 2=.
a - RLI Insurance Company
„ daa a C Ot
Contractors Bonding and Insurance Company
cll
SEAL i
State of Illinois
W Roy C. Die Vice President
S$ 4ft¢aowttNt
County of Peoria
CERTIFICATE
On this 28th day of May , 2015
before rne, a 'Notary Public, Personally appeared ov C who
being by uric duty swoni, acknowledged that lie signed the above Power of
Attorney as the aforesaid officer of the RIA Insurance Company and/or
Contractors Bonding and Insurance Company, and acknow ledged said
intrurn nt to be the 61tai ary act and deed of said corporation,
1, the undersigned officer of R�I�I Insurance Company, and/or
Contractors Bonding and Insurance Company„ each Illinois
co orations, do hereby certify that the attaclucd Mower of Attorney is
in Tall force and effect and is irrevocable; and frtrthennore, that the
Resolution of the Company as set forth in the Power of Attorney, is
now in force. In testiniony whereof, I have hereunto set my hand and
the seal of the RLI Insurance Company and/or outractors
Bonding and Insurance Company this
RLI Insurance Company
ne ugh Ilockle Notary Public Contractors Bonding and Insurance Company
JACQUELINE M. BocKLER
�Y 'OFFICIAL SEAL"
w� �w� Roy C. Die Vice President
e ,wa�a�w .. .., .
err
',ICOMM18810N 6xPIREB 01,14118
ririixY �� 0449653020212 A0059115
Agreement No. 4898
Ma WAR
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Class No.-,
-L-4-
2. The expiration date of BIDDER'S Contractor License is-
20 JL_.
3. BIDDER acknowledges that Section 7028.15(e) ofthe Business and Profiessions
Code provides as follows:
1[K1TM7,=ffl3M- M M . I M
by the undersigned in this bid proposal are trLIC and correct,
Executed on
20 at
CA (insert City and State where Declaration signed),
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Si64W,aiure - — ----- - ------------- . . ......... -
Title
Company Name
MW
State ofCalifornia }
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C.'Ounty 0
Agreement No. 4898
NON-COLLUSION
E Y ! I ! ".,.!
being first duly sworn, deposes and say that he or she is
of
the party making the foregoing bid that the bid is not made in the interest of, or on behalf of', any
undisclosed person, partnership, company, association, organization, or corporation; that the bid
is genuine and not collusive or sham; that the BIDDER has not directly or indirectly induced or
solicited any other BIDDER to put in a false or sham bid, and has not directly or indirectly
colluded, conspired, connived, or agreed with any BIDDER or anyone else to put in a sham bid,
or that anyone shall refrain from bidding; that the BIDDER has not in any manner, directly or
indirectly, sought by agreement, communication, orconference with anyone to lix the bid price
of the BIDDER or any other BIDDER, or to fix any overhead, profit, or cost element of the bid
price, or of that of any other BIDDER, or to secure any advantage against the public body
awarding the contract of anyone interested in the proposed contract; that all statements contained
in the bid are true; and further, that the bidder has not, directly or indirectly, submitted his or her
bid price or any breakdown thereof, or the contents thereof, or divulged information or data
relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company
association, organization, bid depository, or to any member or agent thereof to effectuate a
collusive or sham bid.
Signal ire
Typed Name
Title
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Name of Bidder /Company Name
Date
Agreement No. 4898
WORK 1t'S OMP'1„ NSA"1' ION CERTIFICATION
ICATIO
Section 1861 OF THE LABOR CODE
(Workers' Compensation)
Pursuant to Section 1861 of the Labor Code, the BIDDER, in submitting.his /her
PROPOSAL, shall sign the following certification:
"I am aware of the provisions of Section f +,'° which require
employer to be insured against liability for workers' compensation or to undertake self-
insurance in accordance with the provisions of that code, and I will comply with such
provisions performance of a
l�
Signature of Bidder:
_..
Title:
Business Name:
Business Address: "���$' "�' :" k
Telephone Number
w -� a
Dated this day of 20 r"
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Agreement No. 4898
IE4
REFERENC',ES
Company Name: i
Agreement No. 4898
The following are the names, addresses, and telephone numbers for public agencies for which
BIDDER has performed similar work as the prime contractor or major Subcontractor within the
past five (5) years:
I Project Title: J4
Nani� and address of owner
Nr"
..... .. ..... . ..
Name and current telephone
number of person familiar with project
v
Type of Work: Ncix`
Contract amount: $ Date cornpleted�, 'I
. . . .. . . ........... - 1-z .d t
Amount of work done by my/our firm Linder contract $
. . ........
Did your firm have any financial interest in Project? U
........ ..
2. Project Title:
Locatiow V V' V'J� )r All"I CA c
16 �5
and addl'o.,& of owner
...... .......
Name and current telephone number of person familiar with project
Type of Work: k , � 2 ". ' . ......... ,,, .�"
Contract amount: Date completed:
Amount of work done by my/our firm under contract $
Did your firm have any financial interest in Project?
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Agreement No. 4898
Project Title: `'d
fl
Location:
-Winic and address ol'owner
Name and current telephone number of person familiar with project
Type of Work:
Date completed-,
Contract amount: $
Amount of work done by my /our firm under contract
Did your firm have any financial interest in Project?
4. Project Title:
Location:
L
Narric'and address of owner
Name and current telephone nwiiber of person familiar with project:
Type of Work:
Contract amount: Date completed:___
Amount of work done by my/our firm under contract $
Did your firm have any financial interest in Project?,-
5. Project Title: c'
Location:
V'I
Name t 'Ind address of owner
I-C- 13
Agreement No. 4898
Name and current telephone number of person familiar with project:
Type of Work:�fw.'
Contract amount:, V `.� Datc completed: m
Amount of work done by my /our firm under contract $ '
Did your firm have any financial interest in Project?
Bidder may attach additional reference pages if necessary.
'rhe following are the names, addresses, and telephone numbers for all brokers and sureties from
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Agreement No. 4898
Nols-A-w4w QMNJIW���
I my-1 Kai I IV ON ma" 0 u 61111Y., I in I W ler.1 0 E410 &I
REBID OF FY 14/15 CURB, GUTTER, SIDEWALK, AND OTHER
CONCRETE IMPROVEMENTS PROJECT
PROJEC'r NO.: PW 14-16
Company Name: ks
Please state all instances of being disqualed, removed, or otherwise prevented from
bidding on,-QLQ2mfledng. a -tcdcral. state*41iAt1wi
law or safety regulation.
P,
Yes ❑ No
Iryes, explain the circumstances:
3, Are you registered in accordance with Labor Code § 1725.5 [Note: failure to register
requires the City to reject your bid as nonresponsive]?
Yes d No 0
--- "
S
. ..............
Narne (Please Print)
mek
Agreement No. 4898
INSURANCE REQUIREMENTS
(MUST BE SUBMITTED WfTH PROJFCTPROPOSAL]
REBID OF FY 14/15 CURB, GUTTER, SIDEWALK, AND OTHER CONCRETE
1'o be awarded this contract, the successful bidder mum( pmCurc and maintain the [bUovv|ng \ypcs of
\nmumncevvifhuovcmgoUm(tscomp|ying,a1aminimum.wKhdhoUm|tsse|Rorthbo|ow:
T1pe21' 1 nsurance Limits
Commercial general liability: $2.000\000
Business nuk»mo6ileliability; 0^000000
Workers compensation: Siu|utoryrequ|ncmuni
Commercial general liability insurance must moctorwxcced the requirements of IBO-COi Form No. CG
OO 01 )| 85 or 88. The amount of insurance yet forth above must be n ummb|mud single limit per
oocu,/enoo for bodily injury, po/omno| injury, and property dumo&u for the policy coverage, Liability
policies must be endorsed k/ name the City, its officials, and employees as "additional insureds" undor
said insurance coverage and tu state that such insurance will be deemed °primury" Such that any other
insurance that may be carried hy the City will be excess thereto, Such endorsement Must bu reflected oil
ISO Form No. CG2U 10 || 85nr88.orequivalent, Such insurance Must buun all "ucour,unom." not u
"claims muJu'" basis and will not bu cancelable orSubject tu reduction except upon thirty (30) clays prior
written notice to the City.
|nyunx will agree in writing to waive all rights u[subrogation against the C|ty, its officers, officials,
employees and Volunteers for losses arising from work performed by Contractor for the City.
Automobile coverage Must be written on ISO Business Auto Coverage Form CA 00 0 1 O092,including
symbol l (Any Auto).
Tliu Consultant must furnish to the City duly authenticated Certificates u[ Insurance evidencing
maintenance of the insurance required under this Agreement, endorsements as required herein, and Such
other evidence Of insurance or copies of policies as may be reasonably required by the City from th-ne to
time, Insurance must be placed with admitted insurers with u current A.M. Best Company Rating
equivalent toot least a]lakiogof"A:VU." Cedificatu (a)muotreO*o(thwt the insurer will provide thirty
O0 day notice oyany cancellation ofcoverage. I'lie Consultant will require its insurer N modify Such
ucrtifivatauto delete any exculpatory wording stating that failure of the insurer to mail written notice u[
cancellation imposes no obligation, and to delete the word "endeavor" with regard 0o ally onhcc
provisions.
The City requires ��� Worker's Compensation Coverage with the associated Waiver. 0ut-Of-State
coverage will not be accepted in lieu of the California coverage, beCaLlse the work is being performed in
the State oyCalifornia,
By signing this kxm' the bidder certifies that it has read, understands, and will comply with \hcmo
insurance requirements if it is selected as the City's xunoo\tunt. Failure to provide this insurance will
render the bidder's proposal '`nunrouponoive."
,-
Date
Agreement No. 4898
LABOR AND MATERIALS BOND
REBID OF FY 14/15 CTJRB, GUTTER, SIDEWALK, AN OTHER
CONCRETE IMPROVEMENTS PROJECT
PROJECT NO.: PW 14-16
Mond No. 83604315'
Bond FecAcluded i
Petfwub A I
FS Construction as principal
("PRINCIPAL") and RU Insurance Conipany
inoorporated under the laws of theState of Iflinois and licensed by the State
of California to execute bonds and underwkings as sole surety, as surety ("SURETY"), are held
and firmly bound unto the CITY OF EL SEG UNDO ("Cfl'Y") in the sum of Two Hundrecl
I lou W11(h-Cd j'wcio, 'rwo Dollars and SeveT!
Cents
($229,922.75), lawRil Trkoney ol"the United States, which may be increased or decreased by a
rider hereto exec tited in the same mariner as this bond, for the payment of which sum
PRINCIPAL and SURETY bitidtherriselves, their successors, and assigns, jointly and severally,
by this instrument,
BOND CONDITIONS
2. PRINCIPAL will pay Lill contractors, subcontractors, and persons renting
equipment.
Eff
Agreement No. 4898
3. I"RINICIPAL will pay for all materials and other supplies, for equipment used in.,
oil, for or about the performance of the Public Project, and will pay for all work and labor
thereon.
4. This bond is conditioned upon,and guarantees due compliance with all applicable
law including, without limitation, the F1 Segundo Municipal Code C'ESMC").
5. ST-TRETY, for value received, agrees that no clianges, extensions of i
L Hie,
alteration or modification of SPECIFICATIONS NO. PW 14-16, or of the obligation to be
performed will in any -vvayaflect its obligation on this bond, and it waives notice of any such
change, extension of time, alteration or modification of the contract documents or of the
obligation to be performed.
6. This bond consists of this instrument, the plans and specifications identified
above; and the following "rwo (2) attached exhibits all of which are incorporated herein by
reference:
A. A certified copy of the appointment, power of attorney, bylaws or other
instrument entitling or authorizing the persons executing this bond to do so;
and
B. A certificate issued by the county clerk for the county in which SURETY's
representative. is located conforming with California Code of Civil Procedore
§ 995.640 and stating that SLJRFTY's certificate of atabority has not been
surrendered, revoked, cancelled, annul led, or suspended, or in the event that it
has, that renewed authority has been granted.
7. Should PRINCIPAL perform its obligations within the tirne allowed,
PRINCIPAL's obligation will be void upon the acceptance of the performance by CITY,
otherwise this obligation will remain in full force and effect.
[SIGNATURES ON FOLLOWING PAGE]
UM
Agreement No. 4898
CALIFORNIA ALL- PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California )
County of Los Anqeles )
On � _... /, r • before me, — Trina Lee'Vegam Notary Public
_.... . ___.......,
Date Here Insert Name and Title of the Officer
personally appeared m Fl sa_ te ;.glg7,
- a . .... ....
__ .........__.... ._ _ _ _. ....
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(g) whose name( §) is/aM
subscribed to the within instrument and acknowledged to me that /she/tlWlly executed the same in
NJ$ /her /tYYhr authorized capacity0gs), and that by tMA /her /tPpjr signature(p) on the instrument the person(a),
or the entity upon behalf of which the person(s) 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.
WITNESS my hand official seal
Signature......
Signature, of Notary Public
OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: Document Date:
Number of Pages: . Signer's) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: .
C7 Corporate Officer — Title(s):
1..=1 Partner — i::_1 Limited ❑ General
Cl Individual 5l Attorney in Fact
1 7 Trustee ❑ Guardian or Conservator
D Other:
Signer Is Representing: � ��...� � ....
9 .
Signer's Name:
11 Corporate Officer — Title(s):
• Partner — n Limited 0 General
• Individual lJ Attorney in t=act
• Trustee ❑ Guardian or Conservator
El Other:
Signer Is Re resentin ����
9
02014 National Notary Association • www.NationaiNotary.org • 1- 800 -US NOTARY (1 -800- 876 -6827) Item #5907
R L I CkIC
an RLI Company
9025 N. Lindbergh Dr. Peoria, IL 61615
Phone: (800)645 -2402 Fax: (309)689 -2036
Know All Men by These Presents:
POWER OIA*VTOWYff
RLI Insurance Company
Contractors Bonding and Insurance Company
That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the
approving officer if desired.
That this Power of Attorney may be effective and given to either or both of RLI Insurance Company and Contractors Bonding and
Insurance Company, required for the applicable bond.
That RLI Insurance Company and/or Contractors Bonding and Insurance Company, each Illinois corporations (as applicable), each
authorized and licensed to do business in all states and the District of Columbia do hereby make, constitute and appoint:
Patricia 7enizo, Margaret Rodriguez_ Pietro Mlcciche Fli,cabete Salim r Margarita Lopez. jointly or severally
in the City of Los Angeles ,State of California „ as Attorney in Fact, with full power and authority hereby
conferred upon him/her to sign, execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all bonds,
undertakings, and recognizances in an amount not to exceed Ten Million Dollars
S10,000,000.00 ) for any single obligation.
The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon this Company as if such bond had
been executed and acknowledged by the regularly elected officers of this Company.
RLI Insurance Company and Contractors Bonding and Insurance Company, as applicable, have each further certified that the
following is a true and exact copy of the Resolution adopted by the Board of Directors of each such corporation, and now in force, to -wit:
"All bonds, policies, undertakings, Powers of Attorney or other obligations of the Corporation shall be executed in the
corporate name of the Corporation by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by
such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant
Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds, policies or
undertakings in the name of the Corporation. The corporate seal is not necessary for the validity of any bonds, policies,
undertakings, Powers of Attorney or other obligations of the Corporation. The signature of any such officer and the corporate
seal may be printed by facsimile or other electronic image."
IN WITNESS WHEREOF, RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have
caused these presents to be executed by its respective Vieg eMid nt with its corporate seal affixed this 28th day of MU, 2015.
avlrr;ol
'R ��'u. yl1 ��p'p
�, B51M X57
1�. 17.
e
SE A IL
11
State of Illinois
SS
County of Peoria
On this 28th day of May 1 2015
before me, a Notary Public, personally appeared Roy C. Die , who
being by me duly sworn, acknowledged that he signed the above Power of
Attorney as the aforesaid officer of the RLI Insurance Company and/or
Contractors Bonding and Insurance Company, and acknowledged said
instrument to be the voluntary act and deed of said corporation.
RLI Insurance Company
Contractors Bonding and Insurance Company
Roy C. Die Vice President
L'1/1
CERTIFICATE
I, the undersigned officer of RLI Insurance Company, and/or
Contractors Bonding and Insurance Company, each Illinois
corporations, do hereby certify that [lie attached Power of Attorney is
in full force and effect and is irrevocable,- and furthermore, that the
Resolution of the Company as set forth in the Power of Attorney, is
now in force. In testiniony whereof, I have hereunto set my hand and
the Mcal of the RIAI Insurance t om a y andllal Contractors �
Bonding and Insurance Company this,( �� � da1y��C
RLI Insurance Company
M. Bookid Notary Public Contractors Bonding and Insurance Company
"OFFICIAL SEAL"
.16LIA �� Roy C. Die Vice President
JACQUELINE K BOCKLER
rrr .
da��w COMMISSION EXPIRES 01!14118
0449553020212 A0059115
Agreement No. 4898
SIGNED AND SEALED this 9th day of „ .e pev�qt :2015
-q-
IAL's I J ['S IDENT
PRINCIPAL's SECRETARY
PRINCIPAL's MAILING ADDRESS
FS Construction
14838 Bledsoe St.
Svl mar, CA91342
S 1") IKXKXW
.WAfforney-in-Fact
Elisalbete Salazar
SURETY'S SECRETARY
SURE, TV's MAILING ADDRESS:
-R,Ll Insurance Company
. .. . ........
16150 N Arrowhead Fountains Ctr. Dr #225
Peoria, AZ 85382
NOTE: (1) ALL signatures must be acknowledged by a notary public.
*RcLum oric (1) original to City Clerk's Office.
(2) Bond shall be effective for one (1) year after acceptance of the job
f-F-3
Agreement No. 4898
REBID OF FY 14/15 CURB, GUTTER, SIDEWALK, AND OTHER
CONCRETE IMPROVEMENTS PROJECT
PROJECT NO.: PW 14-16
-1ond No. SSBO43152i!!!
Bond Fee: $4,449.00
Prarnium Based an
Final Contrarl Prk,,e
. ..... —
FS C tru
onsction
. . ..... .. - . . .. . ...... ('PRINCIPAL")
and RLI Insui-aiice Cornpariy
. . ..... . ..... a corporation
incorporated under the laws of the State of Illinois and licensed by the State of
California to execute bonds and undertakings as sole surety, as surety ("SURETY",)y are held and
firmly bound unto the CITY OF EL SEGUNDO ("CITY") in the suin of Two I jidre(VIL
�y
Nine, Thousand. Nine Hui idr( I T ipj
_o r1k S c,
(Ill,
lawfid money of the United States, which may be increased or decreased by a rider hereto
executed in the same manner as this bone!; or the payment o1° which sum PRINCIPAL and
SURETY bind there -iselves; their successors, and ,issigns, jolutly and severally, by this
instrument,
BOND CONDITIONS
2. PRINCTRAL's work on the Public Project will be done in accordance with
CITY" s plans and specifications and with tray permit issued by CITY, Should PRINCIPAL fail to
comploc all required work- within the time allowed, CITY may, at its sole discretion, canse all
required work to be done and the parties executing the bond will be firmly bound for the payment
of all necessary costs therefor.
1 antee its work ngain,-�t any de.1'ective work, labor, or
.-I PTUNCIPAL will guar,
Agreement No. 4898
materials on the Public Project for a period of one (i) year t6ltowinc,!, the Public Project's
completion and acceptance by CITY,
4 This bond is conditioned upon and guarantees due compliance with all applicable
law including, without limitation, the El Segundo Municipal Code ("ESMC"),
5. SURETY, for value received, agrees that no changes, extensions of time,
alteration or modification of SPECIFICATIONS NO. PW 14-16 or of the obligation to be
porrormcd will in any way affc�,-t its obligation on this bond, and it waives lotice of ally suell
change, extensiort of tirne, alteration or modification (if [he contract documents or of the
obligation to be perlbTmed.
6. This bond consists of this instrument; the plan-, and specifications identified
above; and the rollo-wing two (2) attached exhibits all of which are incorporated heroin by
reference.:
A. A certified copy oft e appointinent, power of attorney, bylaws or
other insLrulnent entitling or �atithorizing the persons executing
this bond to do so:
7, Should PRINCIPAT. perform its obligations within the time allowed,
PRTNCIPAf,'s obligation will be void upon the acceptance of the perfol:-mince by CITY,
otherwise this obligation will remain in fal I force and effect.
ON FOLLOWING PACE]
am
SIGNED AND SEALED this 9th
CIPA .'s PRESIDENT
PRINCIPAUs SECRETARY
Agreement No. 4898
day of September
V U rlc"Ll F-y JAV
N
Elisabete Salazar
20 15 .
SURETY's SECRETARY
PRENCIPAL's MAILING ADDRESS: SURETY's MAILING ADDRESS:
FS Construction RLI Insurance Company
- — ------ - - -
14838 Bledsoe St, 16150 N Arrowhead Fountains Ctr. Dr #225
SvI mar
, CA 91342 Peoria, AZ 85382
NOTE, (1) ALL signatures nimt be acknowledged by n notary pubic_
Return one (4) original to City Clerk's Office,
(2) Bond shall be effective for one (1) year after acceptance of thejob.
I-E-3
n-Fact
Agreement No. 4898
CALIFORNIA ALL- PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of Los Angeles
.A a,� before me Trina LeP Vana Nntary Public
On �' Date Here Insert Name and Title of the Officer
personally appeared a_ITElsabete Salazar
Name(s) ofSigner(s) __- .............._ _.___— ,,,,....._n
who proved to me on the basis of satisfactory evidence to be the person() whose name() is/aM
subscribed to the within instrument and acknowledged to me that /she /tHdy executed the same in
W /her /tYi6fir authorized capacityoos), and that by tills /her /opjir signature(p) on the Instrument the person(9),
or the entity upon behalf of which the person(s) acted, executed the instrument.
., A, ,
Place Notary Sea/ Above
I 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 sell _mM.
Srgn ati:ire
Signature o......�
Notary Public
OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: Document Date:
Number of Pages: Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: ...... _ .....
Corporate Officer — Title(s):
D Partner — 1-- Limited C] General
I� Individual R-1 Attorney in Fact
I I Trustee El Guardian or Conservator
0 Other:
Signer Is Representing: g P senting ,...�.�. �.�..���... _...�.
Signer's Name:
C] Corporate Officer — Title(s): µµmw
El Partner — 11 Limited ❑ General
0 Individual ❑ Attorney in Fact
Trustee ❑ Guardian or Conservator
n Other:
g Representing: .
Si ner Is
02014 National Notary Association • www.NationaiNotary.org • 1- 800 -US NOTARY (1- 800- 876 -6827) Item #5907