CONTRACT 4998 Public Works Contract CLOSEDAgreement No. 4998
PUBLIC WORKS CONTRACT
BETWEEN
THE CITY OF EL SEGUNDO AND
RAMONA INC.
WATER MAIN IMPROVEMENT AT CENTER, MAPLE AND WALNUT
PROJECT NO.: PW 16 -02
This CONTRACT is entered into this 16th day of March, 2016, by and between the
CITY OF EL SEGUNDO, a general law city and municipal corporation ( "the City ") and
laror�aa Inc. a. Calml'tmn�a Cor roratio9, ( "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 One
Milli V "I "liree 1-luridred Eh)[i1v I m oht °I "housand Three 1-lutidred Dollars ($1 £ 300,00) 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.
A. The Contractor will fully complete the Work within Eighty -Five (85) working
days (the "Contract Time. ")
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Agreement No. 4998
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:
i, 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.
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.
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
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Agreement No. 4998
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 Cijy
Public Works
The Contractor
City of El Segundo
Ramona Inc.
350 Main Street,
302 N. First Ave. Suite 1
El Segundo, CA 90245
Arcadia, CA 91006
Attn: Lifan Xu
Attn: Michael Grbavac
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.
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.
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Agreement No. 4998
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. 4998
IN WITNESS WHEREOF the parties hereto have executed this contract the day and
year first hereinabove written.
CIT" EL UNDO RAMONA INC.
Greg Ca nter tl w p9� iP/T
City M er '
APPROVED AS TO FORM:
MARK D. HENSLEY, City Attorney
By:
Karl H. Berge
Assistant City Attorney
Insurance Reviewed by:. t
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Taxpayer ID No. 7 3 -1 71.2 .9-0
Contractor State
License No.: RS-0,O
Contractor City Business
License No.: 3 7a 60
Agreement No. 4998
WATER MAIN DMPR0VEA4BNTAJ CENTER, MAPLE AND WALNUT
PROJECT NO.: PW 16-02
Bond No. 1000901785
Bond Fee: $12.828.00
and U.S. Sciecialtv Insurance COMDanv a corporation
incorporated under the laws oythe State of �� and li�����z���mf
(�m\iforniubuexccn¢� bonds and undertakings usoo]e surety, as surety ("SURETY^). are field and
firmly bound unto the CITY OFBI.SBGl/NT}O(^'ClT`/'`)in the sum nf
One Million Three Hundred EiqhtV Eiqht Thousand Three Hundred & DOLLARS,
|uvvfu| co8ucy of the United States, nvbiob may be increased or deuccumod by a rider borcLo
executed in the auoue manner as this bond, for the payment of which nuno PE(iy4C|l,/\L and
SURETY bind tbo/DSo|voa' their *uuccse0oy, and assigns, Jointly and ucvcoz}/y, by this
BOND CONDITIONS
2. 96kDHClP/kL'a work on the PnbboProject will be done in accordance with
CITY's plans and specifications and with any permit issued by CITY, Should PR[NCf PAL. fail
to complete all required work within the time allowed, CITY may, at its sole discretion, cause al I
required vvodc to be done and the parties executing the bond will be 6unlv bound for the
payment ofall necessary costs therefor.
3 P6ONClP/\I' will guarantee its work against uny defective work, labor, or
oj
materials on the Public Pro1ject for a period of one (1) year following the Public Pr 'ect s,
l-E->
Agreement No. 4998
completion and acceptance by CITY.
4. This bond is conditioned upon and guarantees due C01111111aflCe 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 16-02 or of the obligation to be
performed will in any way al.fect its obligation on this bond, and it waives notice of any Such
change, extension of time, alteration or niodification 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 two (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;
7. Should PRINCIPAL perform its obligations within the time allowed,
PRINCIPAL's obligation will be void upon the acceptance of the performance by CITY;
otherwise this obligation will rernain in full force and effect.
[SIGNATURES ON FOLLOWING PAGEI
am
Agreement No. 4998
SIGNED AND SEALED thim_t6th_ day of March 2V1G .
Ramona Inc. ----
' ' G | Company
—
P l�ESlDBNT
11�1 ��PAL,uSE'CRETARY
PRINCIPAL's MAILING ADDRESS:
'Foot
8DR2TY`sSECRET6RY
Inc. SURETY's MAILING ADDRESS:
Surety
8U2N. First Ave. Ste. 1 18OUE. Lambert Rd. #210
Arcadia, CA010OG Brea, CAQ2821
NOTE: (1) ALL� signatures must beockonw|cducdbyu notary public.
Return one (1) original to City Clerk's Office.
(2) Bond shall hc effective for one (i) year after acceptance o[ the job.
Agreement No. 4998
POWER OF ATTORNEY
AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY
UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY
_KNOW -ALL MEN BY THESE PRESENTS: That American Contractors Indemnity Company, a California corporation, -Texas
Bonding Company,- an assumed name of American Contractors Indemnity Company, United States Surety Company, a Maryland--
corporation and US. Specialty Insurance company, a Tekas corporation (collectively, the "Companies "), do by these presents make,
constitute and appoint:
Frank Morones of Brea, California
its trite and lawful Attorney(s)-in-fact, each in their separate capacity if inore than one is milled above, with full power and authority
hereby conferred in its name, place and stead„ to execute, „, acknowledge and deliver any and all bonds, recognizance s, undertakings
or other instruments or contracts of suretyship to include riders, amendments, and consents of surety,, providing the bond
penalty does not exceed ”" "Ten Million* * * ** Dollars ($ * *10„000 „0100.00 ** ).
This Power of Attorney shall expire without further action on December 20, 2017. This Power of Attorney is granted under and by
authority of the following resolutions adopted by the Boards of Directors of the Companies:
Be it Resolved, that the President, any Vice - President, any Assistant Vice- President, any Secretary or any Assistant Secretary shall be and is hereb)_vestedmith full
power and °uuthorrty_°to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subjectm the_folfowtng
__pro_visions:_ _
=Attorney -in -Fact may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and deliver -any and allyborids
recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any and all consents for the release of retained
percentages and/or final estimates on engineering and construction contracts, and any and all notices and documents canceling or terminating the Company's liability
thereunder, and any such instruments so executed by any such Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected
by the Corporate Secretary.
Bxt Res nth a signature of any authorized officer and seal of the Company heretofo -re=or=_ hereafter _affixed to W power of attorney or =any certificate relating -__
ereee o WacsilfiWaa any power of attorney or certificate bearing facsimile signature or facsimile sa.a =shall he yd� binding upon the Company with respect to- _ any bond or undertakiripap undertaking-p which it is attached„
IN WITNESS WHEREOF, The Companies have caused this instrument to be signed and their corporate seals to be hereto affixed, this
1 st day of December, 2014.
AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY
Corporate Seals UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY
n in xcawon�hara� yn'i ri �,
, t By:
�,SEFT.fa. 1990 ✓� "b
ME
�t '� ''
Daniel P. Aguilar, Vice President
err,rnr nully m ,� C9� �'�'�tr� '� nrr a�uiraw�'t�'
nnrniuva�
A notury 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.=
of Los Angeles SS:
On this 1st day of December, 2014, before me, Maria G. Rodriguez -Wong, a notary public, personally appeared Dan P. Aguilar, Vice President of American
Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Specialty Insurance Company who proved to me on
the basis, of” satisfactory evidence to be the person whose ?name is subscribed to the within instruirient and acknowledged to me that he executed the Mme in
his uuthotizcd capacity, and that by his signature on the instrtnnenrthe person, or the entity upon behalf of which the poison acted, executed the instninienC
I certify under PENAUT"Y OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.
WITNESS my hand and official scab.
(MARIA G, ROt7t OU Y
Commission # 2019771
Signature (Seal) si Notary publlC . California zz
LOS Angeles County
Cttu . Ex fas DOC: 20 2017
1`, Michael Chalckson, , Assistant Secretary of American Contractors Indemnity C"otnpany, Texas Bonding Company, United States Surety Company
and U.S. Specialty Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by
said Companies, which is still in full force and effect; furthermore, the resolutions of the Boards of Directors, set out in the Power of Attorney are in
full force and effect.
In Witness hereof, I have hereunto set illy hand and affixed the seals of said Companies at Los Angeles, California this �_ day
I° r"
,M41 tltl�R
�y ,7�t5'abaPtt'e'°d'$1L�aWW,,
Corporate Seas a �1 a IP` "f Michael Chalekson Assistant
tM1 Mf VPN �Y
wk a � Secretary
aErr zs ,999 eroya �„ n4� f �'
Bond No r " s
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Agreement No. 4998
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189
. . . . .......... . ... ......... ...
A notary public or other officer Gornpleting this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfUlneSS, accuracy, or validity of that document.
,State of California
County of Orange
On before: me,,L-.-C,la.r.k Notary Public
—,,,.
Here Insert Name and Title of the Officer
personally appeared Frank Morones
Narrie(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the persori(s) whose narne(4) is/efe
subscribed to the within instrument and acknowledged to me that heft executed the same in
authorized capacity(i�). and that by � signature(s) on the instrument. the person(s),
or the entity upon bohatf of which the person(e) acted, execute. d thc4. instrument.
Place Notary Seat Above
OPTIONAL
Though this secticin is optional, completing this information can deter alteration of the document or
fraudulent reattochment of this form to On vaintonded documont.
Description of Attached Document
Title or Type of Document Document Date'.
Nuifter of Pages: Signer(s) Other Than Narned Above: --- ---
Capacity(ies) Claimed by Signer(s)
Signer- s Name:
Corporate Officer — Title(s):
Limited 'General
Partner —
Individual X. Attorney in Fact
Trustee Guardian or Conservator
Other.
Signer Is Representing:
Signer's Name:
Corporate Officer — Tltle(s):
Partner -- I-- Limited
General
Individual
Attorney in Fact
Trustee -.'Guardian or Conservator
Other: . .... . .....
Signer Is Representing.,
N,14. w IR"
(02014 National Notary Association - www.NationalNotary.org -1 -800- UISS NOTARY (1- 800 -87r -6827) ltem#5907
Agreement No. 4998
CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT
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
On March 24, 01' before me,
Public,
Date
;personally appeared
Nu Huvnh
(here insert name and title of the officer)
Mladen Grbavac and Dusanka Grbavac
Notary
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is /are
subscribed to the within instrument and acknowledged to me that he /she /they executed the same
in his/her /their authorized capacity(ies), and that by his/her /their signature(s) on the instrument
the person(s), 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 and official seal.
d
Jr iL a
Signature: _.... �' (Seal)
OPTIONAL
!Description of Attached Document
'Title or Type of Document: .., ....
Document Date: _ Other:
Lr"
rr
Number of Pages:
ttiV�,t�1N4/,1)aima @�,,�I, _w (,.�msfmah�ir�, C9arlMgl .. p ,9,swg,ia;l;wa4�,aatItShia�rdru
State of California
County of Orange
Agreement No. 4998
HUGH NGUYEN PROPERTY RECORDS
BIRTH AND DEATH RECORDS
CLERK - RECORDER MARRIAGE LICENSES /RECORDS
PASSPORTS
CER71 IFICAT1 � OIL A mirrED SURETY Y INS I .ER
Certificate pursuant to 995.640(a) Code of Civil Procedure
FICTITIOUS BUSINESS NAMES
NOTARY REGISTRATION
ORANGE COUNTY ARCHIVES
9��
I, Hugh Nguyen, County Clerk- Recorder of the County of Orange, State of California, in and for
said County, DO HEREBY CERTIFY THAT U.S S eclal Insut -ance Comnany has been
issued a Certificate of Authority as an Admitted Surety Insurer by the State of California
Insurance Commissioner who authorized the Insurer to transact Surety Insurance in the State of
California and that based on the records in this office, that authority has not been surrendered,
revoked, cancelled, annulled or suspended.
In Testimony Whereof, I execute this certificate and have hereunto set my hand and affixed the
seal of said County this 161h day of March, 2016.
Hugh Nguyen, Orange County Clerk- Recorder
(Purple Seal)
DWce Cuevas, Deputy Clerk- Recorder
NORTH COUNTY BRANCH OFFICE ORANGE COUNTY SOUTH COUNTY BRANCH OFFICE
HISTORIC DOWNTOWN FULLERTON HALL OF RECORDS LAGUNA HILLS CIVIC CENTER
201 N. HARBOR BOULEVARD 12 CIVIC CENTER PLAZA, ROOM 101 24031 EL TORO ROAD
FULLERTON, CALIFORNIA 92832 SANTA ANA, CALIFORNIA 92701 LAGUNA HILLS, CALIFORNIA 92653
(714) 834 -2500 • FAX (714) 834 -2675 ♦ WWW.00RECORDER.COM • WWW.00ARCHIVES.COM
Agreement No. 4998
LABOR AND MATERIALS BOND
WATER MAIN IMPROVEM ENT ATCENTER, MAPLE AND WAI-.,N[J'I'
PROJECTNO.: Pik 16-02
Ramona, Inc,
Bond No. 1000901785
Bond Fee: Included in Performance Bond
("PRINCIPAI.") and U.S. Specialty Insurance Company a
col-poration
BOND CONDITIONS
2. PRINCIPAL will pay all contractors, subcontractors, and persons I-ClItill.i-I
eqviipment.
M
Agreement No. 4998
3, PRINCMALwi I I pay for all materi a Isand0therSUpplieS, for equipment used in.
on, for or about the performance of the Public Pro . feet, 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 El SC(YLInd0 MUMCipat Code. Ode ("ESMC).
5. SURETY, for value received, agrees that no changes, extensions of tinge.
alteration or modification of SPECIFICATIONS NO, PW 16-02, or of" the obligation to be
performed Nvill in any way affect its obligation on this bond, and it walves notice of any raid)
change. extension of tirne, alteration or modification of the contract dOCUrrionts or of" the
obligation to be performed.
6, This bond consists of this instrument; the plazas and specifications identified
above-, and the following TWO (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 CXCCLIting this bond to (to so;
and
13. A certificate issued by the county clerk for the County in which SURETY's
representative is located conforrinna with California Code of Civil Procedure
§ 995,640 and stating that SURETY's certificate of authority has not been
surrendered, revoked, cancelled, annulled, or suspended, or III the event that
it has, that renewed authority has been granted.
7. Should PRINCIPAL perform its obligations within the time 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 PAGEJ
SIGNED AND SEALED this 11116th_ clay of
Ramona, Inc. __
INCIPAL's PRISIDENT
iden-Grbavac;
11,"VINCIPIAL's SECRETARY
Dusanka Grbavac
PRINCIPAL's MAILING ADDRESS:
R.q m n nq Inc..
302 N. First Ave., Ste. 1
Arcadia, CA 91006
Agreement No. 4998
March _,2016
U 1 f urance Company
SURETY's PRESIDENT
Frank Morones, Attorney -in -Fact
SURETY's SECRETARY
SURETY's MAILING ADDRESS:
CalWest Surety
1800 E Lambert Rd.- #210
Brea, CA 92821
NOTE: (1) ALL signatures must be acknowledged by a notary public.
Z- I I
Return one (1) original to City Clerk's Office.
(2) Bond shall be effective for one (1) year after acceptance of the jot).
I-F-3
State of California
County of Orange
Agreement No. 4998
HUGH NGUYEN
CLERK - RECORDER
CERTIFICATE OF ADMITTED SURETY INSURER
Certificate pursuant to 995.640(a) Code of Civil Procedure
PROPERTY RECORDS
BIRTH AND DEATH RECORDS
MARRIAGE LICENSES /RECORDS
PASSPORTS
FICTITIOUS BUSINESS NAMES
NOTARY REGISTRATION
ORANGE COUNTY ARCHIVES
I, Hugh Nguyen, County Clerk- Recorder of the County of Orange, State of California, in and for
said County, DO HEREBY CERTIFY THAT U.S Specialty Spccialty 1,usurance Compagy has been
issued a Certificate of Authority as an Admitted Surety Insurer by the State of California
Insurance Commissioner who authorized the Insurer to transact Surety Insurance in the State of
California and that based on the records in this office, that authority has not been surrendered,
revoked, cancelled, annulled or suspended.
In Testimony Whereof, I execute this certificate and have hereunto set my hand and affixed the
seal of said County this 161h day of March, 2016.
Hugh Nguyen, Orange County Clerk - Recorder
A--
Duke Cuevas, Deputy Clerk- Recorder
(Purple Seal)
a�
NORTH COUNTY BRANCH OFFICE ORANGE COUNTY SOUTH COUNTY BRANCH OFFICE
HISTORIC DOWNTOWN FULLER TON HALL OF RECORDS LAGUNA HILLS CIVIC CENTER
201 N. HARBOR BOULEVARD 12 CIVIC CENTER PLAZA, ROOM 101 24031 EL TORO ROAD
FULLERTON, CALIFORNIA 92832 SANTA ANA, CALIFORNIA 92701 LAGUNA HILLS, CALIFORNIA 92653
(714) 834 -2500 • FAX (714) 834.2675 • WWW.00RECORDER.COM ♦ WWW.00ARCHIVES.COM
Agreement No. 4998
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT GIVIL CODE § 1189
P't A,<xx & ''Y x —��Xv—c 'kX Ck,
.0u, "Am "e , , , � , , , , c - �e X, , ,
$exv - �c x, x'cex', x, cu-�"w UK'
. .. ........
A notarypublic or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of Orange,,,
On, before me, L. Clark, Notary Public
Date Here Insert Name and Titte of the Officer
personally appeared Frank Morones
. . . .... . . .................. . . . —
Narne(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person() whose name(&) is/a.fe
subscribed to the within instrument and acknowledged to me that hefty executed the same in
his/h&54heit" authorized capacity(ieR); and that by Nsl� signature(5) on the instrUrnent the person(s),
or the entity upon behalf of which the person(4s) acted, executed the instrurnent.
I., CLARK
Commission # 1996834
Notary Public - California
Los Angeles County
2
Place Notary: Seal Above
I certify under PENALTY OF PERJLJRY under the laws
of the State of California that the foregoing paragraph
is true and rarrect,
WITNESS my hand and official seat.
Signature .. ...... . .. .
Signature of Notary Public
OPTIONAL
Though this section is optional, completing this information can deter afteration of the document or
frati(Yulent rcattachment of this form to -an urfintendod docurnont.
Description of Attached Document
Title or Type Of DOCUrnent: Document Date:
Number of Pages: signer(s) Other Than Named Above�
Capacity(ies) Claimed by Signer(s)
S,iq
ner's Name:
Corporate officer cer — -itle(s):
Partner — Limited General
Individual X,1 Attorney in Fact
Trustee Guardian or Conservator
Other:
Signer Is Represpnting: ... ..... .. ... _ ....... . ..... ... ..
Signer's Name:____
-7 Corporate Off loer — -Title(s)*
'
Partner — F General
-
Individual
:'Attorney in Fact
Trustee Guat dian or Conservator
Other:
. ..... . . .......... .
Signer Is Representing:
"4% m,
oz
(02014 National Notary Association - wvmt.Nationa)Notary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907
Agreement No. 4998
POWER OF ATTORNEW
AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY
UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY
KNOW ALL MEN BY THESE PRESENTS; That .American Contractors Indemnity Company, a California corporation, °Texas -
Bonding Company, an assumed name of Affierican Contractors Indemnity Company, United States Surety Company, aMaryland
corporation and U.S. Specialty Insurance Company, a Texas corporation (collectively, the "Companies "), do by thes6 presents make,
constitute and appoint:
Frank Morones of Brea, California
its true and lawful Attorney(s)-in-fact, each in their separate capacity if more than one is named above, with Rill power and authority
hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recogn:i ance,s, undertakings
or other instrinnents or contracts of suretyship to include rider's, amendments, and consents of surety, providing the bond
,penalty does not exceed * * ** * *Tcn Million * **'* ** Dollars ( * *IIl�O'00,000,04i **
This Power of Attorney shall expire without further action on December 20, 2017. This Power of Attorney is granted under and by
authority of the following resolutions adopted by the Boards of Directors of the Companies:
Be it Retrolsee'l that the President, any Vice - President, anyjWstantXice- President, any Secretary or any Assistant Secretary shall be and is hereby vested -with full
power and authority =to appoint anyone or m�ifalile persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subjc fo the following,
previsions:
-_ _- Attorney -in =Fact maybe given full power� uthar� f6 ends he name of and on behalf of the Company, to execute, acknowledge and deliver, any andilFbonds,
recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any and all consents for the release of retained
percentages and/or final estimates on engineering and construction contracts, and any and all notices and documents canceling or terminating the Company's liability
thereunder, and any such instruments so executed by any such Attorney -in -Fact shall be binding upon the Company as if signed by the President and scaled and effected
by the Corporate Secretary.
Bit Resolved,, there signature of any authorized officer and seal of the Company heretofore or hereafter affixed toAny power of attorney or any certificate - relating -_
ther�o by faQsimjW a_nd any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Cornpany with _respect to= —
any -
lany bond or undertakin(o which it is attached,
IN WITNESS WHEREOF, The Companies have caused this instrument to be signed and their corporate seals to be hereto affixed, this
1 st day of December, 2014.
AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY
Corporate Seats UNITED S "rA "I "k Iw SURE,TY COIk^I.IIANY U.S. SPECIALTY INSURANCE COMPANY
arliari4aNecur aa,+, t�d''��BC1lAMyY
xaaronmm %i
dP tih b W 4PtlF
�wurrr sty A" �
sevcza,nsom w z By:�
o
�a 44i'
w sY Y Daniel P. Aguilar, Vice President
NserWiauuai"HawAr ruauaan vy4'�,.v�rgr11'y„w
r
A•:notary public or tither officer completing this certificate verifies only the identity of the individual who signed the
doetnnem to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
Slane ol`Californiri
Co unity of Los Angeles SS: -
On this 1st day of December, 2014, before me, Maria G. Rodriguez -Wong, a notary public, personally appeared Dan P. Aguilar, Vice President of American
Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Specialty Insurance Company who proved to me on
the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the saaine in
his authorized capacity, and that by his signature on the instillorient =the person, or the ontity upon behalf of which the person acted, executed the Inslruli cm,
I certify under PI NALTY Cl- PERIUItY tinder the laws of the State or California that the foregoing paragraph is: true and correm
WITNESS my hand and official scat.
WlklllA G. lltltll PtltNlit- 1fY'ClNG
Si ature Seal �ahx Commission #I 2049771
gn (Seal) Notary Public . California
Los Angeles County 2:'
mee
' Cornrn, tt tE 20, 2017 t
1, Michael Chalekson , Assistant Secretary of American Contractors Indemnity Company, Te tas Bonding Company, United States -Surety Company
and U.S. Specialty Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by
said Companies, which is still in full force and effect; furthermore, the resolutions of the Boards of Directors, set out in the Power of Attorney are in
full force and effect_
In Witness Wl
of acs
Corporate Seals
I have hereunto set my hand and affixed the seals of said Companies at Los Angeles, California this _ day;
Bond No t 1
Agency No. 17501
h4M Arypp „' 141,g �py4y Rfl diwSl+p
�Z k0
�i.. aenlrayu''.
}µY 411114dYf1, flu .... ar�auy �
�.. „r
IS
i l Michael Chalekson, Assistant Secretary
kayrd�rauMwwrw,n�'�
Agreement No. 4998
CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT
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 1
On March 24, 20118 before me,
Public,
Date
personally appeared
Nu Huvnh
(here insert name and title of the officer)
Mladen Grbavac and Dusanka Grbavac
Notary
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is /are
subscribed to the within instrument and acknowledged to me that he /she /they executed the same
in his/her /their authorized capacity(ies), and that by his/her /their signature(s) on the instrument
the person(s), 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 and official seal.
r
Signature: r (Seal)
OPTIONAL
Description of Attached Document
Title or Type of Document:
Document Date:
Other:
L7""'NU HUYNH
Commission # 2108086
Notary Public - California
Los Angeles County
M coma x aims 1 t)t i
-
of Pages:
tll, . la, itglc � ,,Jw it;l Vii„ by NV,-y Cj4jj'Caf i iiA 911111115
Agreement No. 4998
PROPOSAL
FOR THE
WATER MAIN IMPROVEMENT AT CENTER, MAPLE AND WALNUT
PROJECT NO.: PW 16 -02
Date -010640 ] 93 20 1,G
Coinpa�ry blame: Oil rto :..r
TO THE CITY OF EL SEGUNDO:
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.
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE
I -C -1
Agreement No. 4998
BIDDER certifies that in all previous contracts or subcontracts, all reports which may have been
due under the requirements of any agency, State, or Federal equal employment opportunity orders
have been satisfactorily filed, and that no such reports are currently outstanding.
AID FIII 1!IATIVE ACTION CEIITIFICAT'ION
BIDDER certifies that affirmative action has been taken to seek out and consider minority business
enterprises for those portions of the work to be subcontracted, and that such affirmative actions
have been fully documented, that said documentation is open to inspection, and that said
affirmative action will remain in effect for the life of any contract awarded hereunder. Furthermore,
BIDDER certifies that affirmative action will be taken to meet all equal employment opportunity
requirements of the contract documents.
NONCOLLUSION AFFIDAVIT
BIDDER declares that the only persons or parties interested in this proposal as principals are those
named herein; that no officer, agent, or employee of the City of El Segundo is personally
interested, directly or indirectly, in this proposal; that this proposal is made without connection to
any other individual, firm, or corporation making a bid for the same work and that this proposal is
in all respects fair and without collusion or fraud.
I -C -2
Agreement No. 4998
BID SCHEDULE
WATER MAIN IMPROVEMENT AT CENTER, MAPLE AND WALNUT
PROJECT NO.: PW 16-02
Company Name: RA-Mt2AjA TA)C.,
ITEM
[NO.
1
2
. ....... — -
DESCRIPTION
Mobilization/Demobilization
Traffic Control, Public Safety and
Convenience
UNIT
LS
LS
QTY
1
1
UNIT
PRICE IN
FIGURES
$
goo-
$
. ........ . .....
AMOUNT
$_2 5 1 —1111""Y
Utility Potholing
2-1000—
............
2-1 coo -
3
LS
1
Bracing and Shoring
00 0_
$ 00D_
4
LS
1
Temporary High-Line Piping System
LS
1
Construct 8-inch Ductile Iron (Class
LF
853
52) Water Main including all Fittings
and Appurtenances, Trench
6
Excavation, Pipe Bedding, Trench
$
$
Backfill, Trench Resurfacing, and
Temporary and Permanent Traffic
Striping and Markin-qs
Construct 10-inch Ductile Iron (Class
LF
2,184
52) Water Main including all Fittings
and Appurtenances, Trench
7
Excavation, Pipe Bedding, Trench
$
Backfill, Trench Resurfacing, and
Temporary and Permanent Traffic
Stripinq and Markinqs
Remove Existing 6-inch Water Main
LF
1,264
and Construct 10-inch Ductile Iron
8
(Class 52) Water Main in same
$ i'91:51'91X_
alignment including all Fittings and
Appurtenances, Trench Excavation,
Pipe Bedding, Trench Backfill, Trench
I-C-3a
Agreement No. 4998
I -C -3b
Resurfacing, and Temporary and
Permanent Traffic Striping and
Markings
Install 8 -inch Main Line Gate Valve
EA
6
9
and Adjustable Valve Box
$ _
$ i
Install 10 -inch Main Line Gate Valve
EA
15
10
and Adjustable Valve Box
$ ���0°
$�
Construct Fire Hydrant Connection
EA
8
complete including Hydrant Lateral, all
Fittings and Appurtenances, Hydrant,
11
Gate Valve, Trench Excavation, Pipe
$
,
Bedding, Trench Backfill, Trench
_12-
Resurfacing, and Temporary and
Permanent Traffic Striping and
Markings
Construct 1 -inch Water Service
EA
124
Connection, Remove Existing Meter,
Install New Meter, and Connect to
Existing Customer Service including,
all Fittings and Appurtenances,
f f l
99, w
12
Trench Excavation, Pipe Bedding,
$
$
Trench Backfill, Trench Resurfacing,
and Temporary and Permanent Traffic
Striping and Markings, Repair Existing
Landscape / Hardscape / Concrete In
Kind
Furnish new 3/4 inch and 1 inch,
�I
13
smart meters for bid item #12 as
LS
1
$80,000
$80,000
determined by existing condition and
by the Enqineer.
Connect New Water Main to Existing
EA
1
Service including 10 -inch x 4 -inch Tee
in New Water Main at 21+08+/ -
Center Street, all Fittings and
14
Appurtenances, Trench Excavation,
Pipe Bedding, Trench Backfill, Trench
Resurfacing, and Temporary and
Permanent Traffic Striping and
Markinqs
Install Air Relief Valve Connection
EA
3
Complete including, all Fittings and
15
Appurtenances, Trench Excavation,
Pipe Bedding, Trench Backfill, Trench
Resurfacinq, and Temporary and
I -C -3b
Agreement No. 4998
16
Permanent Traffic Striping and
Markings
Connect to Existing Water Main
including all Pipe, Fittings and
Appurtenances, Trench Excavation,
Pipe Bedding, Trench Backfill, Trench
Resurfacing, and Temporary and
Permanent Traffic Striping and
Markings, Removal of Interfering
EA
13
$o
Portions of Existing Pipe and Valves,
and Cut and Abandon Existing Water
Main(s) and Valve(s)
Abandon Existing Fire Hydrant
EA
8
Complete including Removal of
Hydrant and Piping, Trench Backfill,
17
Trench Resurfacing, Construction of
$ 1
Concrete Plugs, Restoration of
Sidewalk and /or Landscaping
Alternative
Bid Items (Determined by the City on
as- needed
basis)
Miscellaneous Water Improvements
18
LS
1
$100,000
$100,000
Type l Slurry m Gutter to
SF
160,000
�� 0
19
Gutter in project area
G
$
$
TOTAL BID ITEM ITHROUGH 19
_ $ �b -
TOTAL BID WRITTEN IN WORDS: O%1e IVA1\-\w -Thr. --" vl'tot tfA
I -C -3c
(BLANK PAGE)
I -C -3d
Agreement No. 4998
Agreement No. 4998
BIDDER'S INFORMATION
Company Name:..
BIDDER certifies that the following information is true and correct:
Form of Legal Entity (i.e., individual, partnership, corporation, etc.)
If corporation, State of Incorporation (i.e., California) .......... _. ' 11r ,+L
Business ® TAI C_ .
Address 30 1 /L S -/N & /C' /U'14 V C ��.........�
Telephone No......(61 0 13
Facsimile No. ( 2 mmmmmm m l
State Contractor's License No. and Class q A
Original Date Issued �„ Expiration Date 30b-
The following are the names, titacs, addresses, and phone numbers of all individuals, firm
members, partners, joint venturers, and/or corporate officers having principal interest in this
proyp�fosal1l:y ry 3/ py y 7 y
3�' - p
A'*:.i. d":l...e��.d..• ° r ""', _d..l ,IW"4 S '°. ,d' "''""w ..., .9au . /.:.. t, i`.. ,mP.. ,5�..,. .� �' K . " t3
The date of any voluntary or involuntary bankruptcy judgments against any principal having an
interest in this proposal is as follows:
N c;
All current and prior DBA's, aliases, and /or fictitious business names for any principal having
an interest in this proposal are as follows:
I -C -4
Agreement No. 4998
BIDDER'S INFORMATION (CONTINUED)
Company Name: )l
Bidder shall list the name of the person who attended the mandatory pre -bid job walk:
Name: _AV''
LL
I -C -5
Agreement No. 4998
IN WITNESS WHEREOF, BIDDER executes and submits this proposal with the names, titles,
hands,
and seals of all a forenamed principals this 2 3 4 day of _, 20j,�.
BIDDER
Subscribed and sworn to this day of , 20_.
NOTARY PUBLIC
I -C -6
Agreement No. 4998
CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT
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 1
On 2/23/2016 before me, Nu Hunh
Public,
Date
personally appeared
(here insert name and title of the officer)
Dusanka Grbavac
otary
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is /are
subscribed to the within instrument and acknowledged to me that he /she /they executed the same
in his/her /their authorized capacity(ies), and that by his/her /their signature(s) on the instrument
the person(s), 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 and official seal..
Signature; (Seal)
dM
Description of Attached Document
Title or Type of Document:
Document Date;
Other:
OPTIONAL
Le NU UU°'M"WH
Commis :Ion #t 2
Notsm PuNNo - Cs
�7;
C Los C
Number of Pages:
Agreement No. 4998
PROPOSAL GUARANTEE
BID BOND
WATER MAIN IMPROVEMENT AT CENTER, MAPLE AND WALNUT
PROJECT NO.: PW 16 -02
KNOW ALL MEN BY THESE PRESENTS that,
Ramona, Inc. , as BIDDER, and
U.S. Specialty Insurance Company , as SURETY, are held and finely bound unto the
City of El Segundo, in the penal sum of Ten Percent of Amount Bid DOLLARS
($ 10% of amount Pid , 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, if said 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
5th day of February 22016
BIDDER* Ramona, Inc.
e wreste
PO Box 660219
Arcadia CA 91066 355 1360
SURETY* U.S. SReclaltv Insurance Com, an
Frank Morones, Attorney -in-Fact
601 S. Figueroa St , #. 1600
Los Anqeles, CA 90017 (714) 784 0053
Subscribed and swom to this day of _ , 20
NOTARY PUBLIC
*Provide BIDDER/SURETY name, title, address and telephone number and the name, title,
address and telephone number for authorized representative.
I -C -7
Agreement No. 4998
POWER OF ATTORNEY
AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY
UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY
KNOW ALL MEN BY THESE PRESENTS: That American Contractors Indemnity Company, a California corporation, Texas
Bonding Company, an assumed name of American Contractors Indemnity Company, United States Surety Company, aMaryland
corporation and U.S. Specialty Insurance Company, a Texas corporation (collectively, the "Companies "), do by these presents make,
constitute and appoint:
Frank Morones of Brea, California
its true and lawful Attomey(s) -in -fact, each in their separate capacity if more than one is named above, with full power and authority
hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings
or other instruments or contracts of suretyship to include riders, amendments, and consents of surety, providing the bond
penalty does not exceed * * * ** *Ten Million * * * * ** Dollars ($ * *10 „000,000.00 ** ).,
This Power of Attorney shall expire without further action on December 20, 2017. This Power of Attorney is granted under and by
authority of the following resolutions adopted by the Boards of Directors of the Companies:
Be it Resolved, that the President, any Vice_ - President, any Assistant Vice - President, any Secretary or any Assistant Secretary shall be and is hereby vested with full
power and authority to appoint any one or more suitable persons as Attorney(s) -in -Fact to represent and act for and on behalf of the Company subject to the following
provisions:
Attorney -in -Fact may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and deliver, any and all bonds,
recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any and all consents for the release of retained
percentages and /or final estimates on engineering and construction contracts, and any and all notices and documents canceling or terminating the Company's liability
thereunder, and any such instruments so executed by any such Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected
by the Corporate Secretary„
Be it Resr)lvod that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating
thereto by,fiacsitnife and any power of attorney or certificate bearing facsimile signature or facsimtlt seal shall be valid and binding upon the Company with respect to
any bond oruMertaking to which it is attached.
IN WITNESS WHEREOF, The Companies have caused this instrument to be signed and their corporate seals to be hereto affixed, this
1 st day of December, 2014.
AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY
Corporate Seals (1NITFD TA'TE a $I)RF't"Y COMPANY U.S. SPECIALTY INSURANCE COMPANY
naZinia y ",''`{B "Up'�, `,74h �h�q td'�d�r 40�k5wxsrY y;w
�r-"! wCORPDRATEO Vim. ��P is 5 . By:
9EPT 2 190 "'a
Daniel P. Aguilar, Vice President
to r sus +” I " �rrt %
ar0 NN,,5 ��� � "� 4,1M
A notary public or other officer completing this certificate verifies only the identity ortlte;individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity ofthat document.
State ofC alifornia
County of Los Angeles SS:
On this 1st day of December, 2014, before me, Maria G. Rodriguez -Wong, a notary public, personally appeared Dan P. Aguilar, Vice President of American
Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Specialty Insurance Company who proved to me on
the basis of satisfactory evidence to be the person whose name k =subscribed to the within instrument and acknowledged to me that he executed the same in
his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.
WITNESS my hand and official seal. ��
Falaa RIA th fI0l1IIItIIIE2•tiW0NG
Commission # 2019711
Signaature� i (Seal) �q�,+� Nottify PUbliC -- California
LOS Angola County
Comm, 1ir" Dec 20 2017
I, Michael Chalekson , Assistant Secretary of American Contractors Indemnity Company, Texas Bonding Company, United States Surety Company
and U.S. Specialty Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by
said Companies, which is still in full force and effect; furthermore, the resolutions of the Boards of Directors, set out in the Power of Attorney are in
full force and effect.
In W i cress Whereof, I have hereunto set my hand and affixed the seals of said Companies at Los Angeles, California this "day
of u a a Y.
Corporate Seals�,�,,,
,,�yy+''jjj � xconPOn+sEO r�y'�
BondBondA rota � M AA � +9EPi 231990
Y ,.n!' Y
Agency No. 1701kr rod
�qq �x
�L
00"
,,,00INea4+ �y l w ink IY
aY a� n m
Michael Chalckson, Assistant Secretary
�r
Agreement No. 4998
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189
Is
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
. .... . ... .... . ... . ...... ...... ..... _
State of California
County of Orange_ - . ...... . . ...... . ... .............. ____
On 01 (a before me,
� 1111-1 � .......... ...
Date
pargonally appeared Frank Morones
L. Clark, Notary Public
--- ------------ - -
Here Insert Name and Title of the Officer
Name(s) of Signer(s)
who proved to rne of) the basis of satisfactory evidence to be the person(s) whose, narne(&) is /are
subscribed to the within instrument and acknowledged to me that he/sheAhe) executed the same In
his/hei4#.He'f authorized Gapacity(ime,).,
and that by signature(s) on the instrument the person(),
or the entity UpOrl behalf of which the person(e) acted, executed thc4 instrument.
Place Notary Seal Above
I certify under PENALTY OF PFRAJRY under the laws
of the State of California that the foregoing paragraph
is trtip anti correct.
WITNESS my hand and official seal,
Signature,,
Signature of Notary Public
OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or
fraudufcnt rcattinchment of thhs form to an unintendod docutrient.
Description of Attached Document
Title or Type of Document..... .......... . ....... .. ...... Document Date,
Number of Pages', Signer(s) Other Than Named Above: __ -1. 1
Capacity(ies) Claimed by Signer(s)
Signer's Name,______
Corporate Officer . . . ....
Partner Limited '.General
Individual X Attorney in Fact
Trustee
Guardian or Conservator
J
tither
Signer Is Representing: ....... . . ...... . . ......... .
Signer's Name:
corporate Officer — -Title(s);
Partner Limited . J General
Individual F-1 Attorney in Fact
Trustee :. Guardian or Conservator
Other:
Signer Is Representing:
4 �YVX�
01 MINIZ (11 It
2014 National Notary Association - www.Nationa]Notary.org - 1 -800-LiS NOTARY (1- BOO -.876 -6827) [terra #5907
L CLARK
Commission iv 1
N ary Public California
OIL"os
Angeles
My Comm Expires N, 2016,
ov2�8
Place Notary Seal Above
I certify under PENALTY OF PFRAJRY under the laws
of the State of California that the foregoing paragraph
is trtip anti correct.
WITNESS my hand and official seal,
Signature,,
Signature of Notary Public
OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or
fraudufcnt rcattinchment of thhs form to an unintendod docutrient.
Description of Attached Document
Title or Type of Document..... .......... . ....... .. ...... Document Date,
Number of Pages', Signer(s) Other Than Named Above: __ -1. 1
Capacity(ies) Claimed by Signer(s)
Signer's Name,______
Corporate Officer . . . ....
Partner Limited '.General
Individual X Attorney in Fact
Trustee
Guardian or Conservator
J
tither
Signer Is Representing: ....... . . ...... . . ......... .
Signer's Name:
corporate Officer — -Title(s);
Partner Limited . J General
Individual F-1 Attorney in Fact
Trustee :. Guardian or Conservator
Other:
Signer Is Representing:
4 �YVX�
01 MINIZ (11 It
2014 National Notary Association - www.Nationa]Notary.org - 1 -800-LiS NOTARY (1- BOO -.876 -6827) [terra #5907
Agreement No. 4998
CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT
notary public or other officer icermcompleting this certificate verifies only the identit y 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 Lays Art ekes }
On 2/23/2016 before me, Nu Hu nh Notary
Public,
Date (here insert name and title of the officer)
personally appeared Dusanka Grbavac
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is /are
subscribed to the within instrument and acknowledged to me that he /she /they executed the same
in his/her /their authorized capacity(ies), and that by his/her /their signature(s) on the instrument
the person(s), 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 and official seal.
Signature; " t (Seal)
OPTIONAL
Description of Attached Document
Title or Type of Document:
Document Date:
Other:
� .. ,d� 19�) .: k m...�_ 992 -555 � i'� Y ,_ tQ.9 1.'?%l i ))'�IsA IlLt
Number of Pages:
war NIEMEN,
Agreement No. 4998
CONTRACTOR'S LICENSE DECLARATION
(Business and Professions Code Section 7028.15)
1. BIDDER'S Contractor's License Number is:
Class No.:.
2. The expiration date of BIDDER'S Contractor License is:
3. BIDDER acknowledges that Section 7028.15(e) of the Business and Professions
Code provides as follows:
"A licensed contractor shall not submit a bid to a public agency unless his or her
contractor's license number appears clearly on the bid, the license expiration date
is stated, and the bid contains a statement that representations herein are made
under penalty of perjury. Any bid not containing this information, or a bid
containing information which is subsequently proven false, shall be considered
non - responsive and shall be rejected by the public agency."
The undersigned declares, under penalty of perjury, that the representations made
by the undersigned in this bid proposal are true and correct.
Executed on 12Z 3 20 16, at
' °8_LlI (insert City and State where Declaration signed).
�' 'S nature
s 46' 8 0 V '
_ �._.� ................ ...�.. ..... _. ...........
.
Typed Name
V,
Title
. . . . . . . . . . .... . . ............ . - . . . . . .
Company Name
I -C -8
Agreement No. 4998
NON - COLLUSION AFFIDAVIT
TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID
State of California )
) ss.
County of 1_0s AtJ6)ELi7-,5
being first duly sworn, deposes and say that he or- she is
of rJA , -LtJ C „
the party making the foregoing bid that the bid is not made in the interest of, or on behalf of, any
undisclosed person, partnership, company, association, organization, or corporation; that the bid
is genuine and not collusive or sham; that the BIDDER has not directly or indirectly induced or
solicited any other BIDDER to put in a false or sham bid, and has not directly or indirectly
colluded, conspired, connived, or agreed with any BIDDER or anyone else to put in a sham bid,
or that anyone shall refrain from bidding; that the BIDDER has not in any manner, directly or
indirectly, sought by agreement, communication, or conference with anyone to fix the bid price
of the BIDDER or any other BIDDER, or to fix any overhead, profit, or cost element of the bid
price, or of that of any other BIDDER, or to secure any advantage against the public body
awarding the contract of anyone interested in the proposed contract; that all statements contained
in the bid are true; and further, that the bidder has not, directly or indirectly, submitted his or her
bid price or any breakdown thereof, or the contents thereof, or divulged information or data
relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company
association, organization, bid depository, or to any member or agent thereof to effectuate a
collusive or sham bid.
Signature
vt rJIL 'IVA C
Typed Name
�w
I -C -9
RA M rs fJA , 7AJ C_
Name of Bidder /Company Name
Date
e.p 2
Agreement No. 4998
WORKER'S COMPENSATION CERTIFICATION
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 3700 of the Labor Code which require every
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 before commencing the performance of the work of this contract."
Signature of Bidder:
0/
Z ....
�-
__..
Title:
Business Name: ) i') ° "I
Business Address: °- Lz (27 4f i
Telephone Number: /
Dated this .2 3" day of ��r �,. ��� , 20�.
I -C -10
Agreement No. 4998
DESIGNATION OF SUBCONTRACTORS
WATER MAIN IMPROVEMENT AT CENTER, MAPLE AND WALNUT
PROJECT NO.: PW 16 -02
Company Name:
BIDDER will perform the majority of the work and proposes to subcontract certain portions of the
work which are in excess of one -half of one percent (1/2 of 1 %) of the bid and to procure
materials and equipment from suppliers and vendors as follows:
Name of
Sub-
Description of
Subcontractor
contractor
portion of
License
Work
Estimated
Number
Address
Subcontracted
$ Amount
7i
'r'
S, 6
0 , us
. . . ......................
i -c- 11
Agreement No. 4998
REFERENCES
Company Name: )W-OnAIA - -Mx//- .
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:
Project Title: VJA tL, M-AV A qNAConr&,-,J -r we r
V
Location: 7" 4: L2LZI
CITZ 6_7' -ALHAI)IR"
Namdand'address of owner
Name and current telephone number of person familiar with project
Gojuy(KitcT � "J)uclr'Lr, rko'Al k)01rV',14 ,I -
Type of Work: � k I " Wh-(zp- z&ca &1,11vrc7-(oV
Contract amount:$ -570,9.40' Date completed: TA) e
. .... ................ . . .
Amount of work done by my/our firm under contract $ 70, 916, X ...........
Did your firm have any financial interest in Project? . .......... . ............ _ ......................................
2. Project Title: pn)njl� �LL�$O Q'j`z; C L
Location: MrhA UiJ-b MDUA,-rAiAl 171L,, Lt,) ,d-VL5, VAJ2-7MA)
/I (' -.-7 - CL-
C P �VtrN DMA 6 L;,-- A J -,')n P- A II q 1 '74 /
Name rid Address of owner
Name and current telephone number of person familiar with project
Type of Work:
Contract amount: $ . . . !q... 6 �ko Date completed:
. .... . . ..
Amount of work done by my/our firm under contract $ l 6TO
Did your firm have any financial interest in Project?
I-C-12
3
4
Project Title: 7/') VL 0 P, rA V,?, /U 14� U7A-7Z,'L11AJ6-
Location:
'A .166 'a..
Agreement No. 4998
501 TRA216247-10tl -4T 1)),9A,7,7,A-r,1L)) , 6j± Ile9_614 Q
Name and address of owner
Nam and current telephone number of person familiar with project
Type of Work:
Contract amount: $-..J.7S ..j 3 6, Date completed: 711
Amount of work done by my/our firm under contract $ 1-79, /3 L . .......... --
Did your firm have any financial interest in Project?
Project Title:
Location: UIDI--,AJ+A 0A AAVDvAlE
6-� v 2-
Nam dand
It X-Alu
K;—m'e- and
dress of owner
Type of Work:
-3 / 0 Ll 3 6
ihone number of person familiar with project:
Contract amount: $ T.2 2 Date completed:
Amount of work done by my/our firm under contract $ /.2 2 1, -M f,
Did your firm have any financial interest in Project?
5 Project Title:
Location:
Name and address of owner
I-C-13
Agreement No. 4998
Name and current telephone number 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?
Bidder may attach additional reference pages if necessary.
The following are the names, addresses, and telephone numbers for all brokers and sureties from
whom BIDDER intends to procure insurance bonds:
_..7 '" 4 - M.�-
I -C -14
Agreement No. 4998
BIDDER'S STATEMENT OF
PAST CONTRACT DISQUALIFICATIONS
WATER MAIN IMPROVEMENT AT CENTER, MAPLE AND WALNUT
PROJECT NO.: PW 16 -02
Company Name: - R,4 M 0 AJ A. TW C_
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 lJ'
2. If yes, 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 non - responsive]?
Yes Ell" No L�
idder's Signature
dEQM/knl e" „
Name (Please Print)
I -C -15
Agreement No. 4998
INSURANCE REQUIREMENTS
[MUST BE SUBMITTED WITH PROJECT PROPOSAL]
WATER MAIN IMPROVEMENT AT CENTER, MAPLE AND WALNUT
PROJECT NO.: PW 16 -02
Company Name: ,fir J - C-
To be awarded this contract, the successful bidder must procure and maintain the following types of
insurance with coverage limits complying, at a minimum, with the limits set forth below:
y e of lnst:trance Limits
Commercial general liability: $2,000,000
Business automobile liability: $1,000,000
Workers compensation: Statutory requirement
Commercial general liability insurance must meet or exceed the requirements of ISO -CGL Form No. CG
00 01 11 85 or 88. The amount of insurance set forth above must be a combined single limit per
occurrence for bodily injury, personal injury, and property damage for the policy coverage. Liability
policies must be endorsed to name the City, its officials, and employees as "additional insureds" under
said insurance coverage and to state that such insurance will be deemed "primary" such that any other
insurance that may be carried by the City will be excess thereto. Such endorsement must be reflected on
ISO Form No. CG 20 10 11 85 or 88, or equivalent. Such insurance must be on an "occurrence," not a
"claims made," basis and will not be cancelable or subject to reduction except upon thirty (30) days prior
written notice to the City.
Insurer will agree in writing to waive all rights of subrogation against the City, 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 01 06 92, including
symbol 1 (Any Auto).
The Consultant must furnish to the City duly authenticated Certificates of 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 time to
time. Insurance must be placed with admitted insurers with a current A.M. Best Company Rating
equivalent to at least a Rating of "A:VII." Certificate(s) must reflect that the insurer will provide thirty
(30) day notice of any cancellation of coverage. The Consultant will require its insurer to modify such
certificates to delete any exculpatory wording stating that failure of the insurer to mail written notice of
cancellation imposes no obligation, and to delete the word "endeavor" with regard to any notice
provisions.
The City requires California Worker's Compensation Coverage with the associated Waiver. Out -of -state
coverage will not be accepted in lieu of the California coverage, because the work is being performed in
the State of California.
By signing this form, the bidder certifies that it has read, understands, and will comply with these
insurance requirements if it is selected as the City's consultant. Failure to provide this insurance will
render the bidder's proposal "nonresponsive."
z' ... . .......
....
Date
I -C -16
Agreement No. 4998
END PROPOSAL SECTION
I -C -17