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CONTRACT 5171 Public Works Contract CLOSEDAgreement No. 5171 PUBLIC WORKS CONTRACT BETWEEN THE CITY OF EL SEGUNDO AND FS CONTRACTORS, INC. ADA CURB RAMP INSTALLATION (PHASE 11) PROJECT PROJECT NO.: PW 15 -24 COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROJECT NO.: 601718 -15 This CONTRACT is entered into this third day of August, 2016, by and between the CITY Or EL SEGUNDO, a general law city and municipal corporation ( "the City ") and PS Contractors, Incorporated, a California corporation ( "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 fi•om 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; A_ ddenda; 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 Seventy - five Thousand, Eight Hundred Dollars ($75,800) 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. Im Agreement No. 5171 3. TIME FOR PERFORMANCE, . A., The Contractor will frilly complete the Work within Twenty -five (25) 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. 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. I -D -2 Agreement No. 5171 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 frill 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 Stephanie Katsouleas Public Works Director City of El Segundo 350 Main Street El Segundo, CA 90245 (310) 524 -2356 The Contractor Jose Angel Fierros President FS Contractors, Inc. 14838 Bledsoe Street 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. 1 -D -3 Agreement No. 5171 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: & 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 ofthe Contract Documents. I -D -4 Agreement No. 5171 IN WITNESS WHEREOF the parties hereto have executed Ellis contract the day and year first hereinabove written. r, I " E'S' T: Tracy Wea el, City Clerk APPROVED AS TO FORM: MARK D. HENSLEY, City Attorney By: David H. King, Assistant City Attorney Insurance Reviewed by: I-D-5 f,j�e- Angel 4 � iem°c�os, President Contrators, Inc. Taxpayer ID No. Contractor State License No.: Contractor City Business License No.: Agreement No. 5171 LABOR AND MATERIALS BOND ADA CURB RAMP INSTALLATION (PHASE II) PROJECT PROJECT NO.:PW 15 -24 COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROJECT NO.: 601718-15 Bond No. RCB0003506 Bond Fee: Premium Included on Performance Bond F S Contractors, Inc. as principal ( "PRINCIPAL ") and RLI Insurance Company , 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"), are held and firmly bound unto the CITY OF EL SEGUNDO ( "CITY ") in the sum of Seventy -five Thousand Eight Hundred And Nol100THS , which is a minimum one hundred percent (100 %) of the contract, lawful money of the United States; wh ich may be increased or decreased by a rider hereto executed in the same manner as this bond, for the payment of which sum PRINCIPAL and SURETY bind themselves, their successors, and assigns, jointly and severally, by this instrument. This bond is conditioned upon and guarantees payment by PRINCIPAL to contractors. subcontractors, and persons renting equipment; payment by PRINCIPAL and all PRINCIPAL'S subcontractors for all materials, provisions, provender, or other supplies, and equipment used in, upon, for or about the performance of the work contemplated in ADA CURB RAMP INSTALLATION (PHASE II) PROJECT SPECIFICATIONS NO. PW 15 -24 ("Public Project'), the public works contract executed for such Public Project, and for all work or labor of any kind performed for the Public Project. In the case of any default in the performance of the conditions and stipulations of this undertaking, it is agreed that PRINCIPAL or SURETY will apply the bond or any portion thereof, to the satisfaction of any damages, reclamation. assessments, penalties, or deficiencies arising by reason of such default. BOND CONDITIONS 1. PRINCIPAL will construct the public improvements identified in SPECIFICATIONS NO. PW 15 -24 , and the public works contract executed for such Specifications, copies of which is on rile with CITY's Engineering Division ( "Public Project "). Such performance will be in accordance with CITY's plans and profiles ( CITY DRAWING FILE NO. PW 15 -24 ), which are made a part of this bond when said plans and profiles are approved by the City Council and filed with CITY's Engineering Division. 2. PRINCIPAL will pay all contractors, subcontractors, and persons renting Agreement No. 5171 Caroc*,e pursuant to n Civil 0r7 County HEREBY jounty CERTWY THAT Agreement No. 5171 equipment. 3. PRINCIPAL ��zll pay for all materials and other supplies, for equipment used in; on, 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 El Segundo Municipal Code ( "ESMC" ). 5. SURETY, for value received, agrees that no changes, extensions of tune, alteration or modification of SPECIFICATIONS NO. PW 15 -24 , or of the obligation to be performed will in any way affect 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 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; 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 Procedure 995.640 and stating that SURETY's certificate of authority has not been surrendered, revoked, cancelled, annulled, or suspended, or in 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. Agreement No. 5171 SIGNED AND SEALED this 9th day of August A.- 0f:A'J C-1 WWW� �115 P RIN P X11 Vs PRESIDENT pRi'N(1, PAL'S Sl � "1 1� 1�ARY PRINCIPAL's MAILING ADDRESS: F S Contractors, Inc. 14838 Bledsoe Street Sylmar, CA 91342 2016 Maria Rico, Attorney -in -Fact SURETY's MAILING ADDRESS: RU Insurance Company 9025 N. Lindbergh Drive Peoria, IL 61615 NOTE: (1) ALL signatures inust be acknowledged by a notary public. Return one (1) original to City Clerk's Office. (2) Bond shall be effective for one (1) year after acceptance of the job.. reement No. 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 AUG , before me On _. V before Nunez, Not..ry...Putiic �...._W.__— ........_...... Date Here Insert Name and Title of the Officer personally appeared Maria Rico Names) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name() is /aW subscribed to the within instrument and acknowledged to me that f+ /she /t y executed the same in Ws /her /tiYifir authorized capacitypps), and that by Ws /her /t pjr signature(p) on the instrument the person(q), 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 off'ial seal. �, .. „ �,. Signature Bhx „ r� �'i Notary PaubIft . Caftrruoa + Los Ai,igeles County Comm x�)ios Mar 14 2020 l d” kr 'x'�f "PJ tr�x' ';.a ,w r �d✓ 9HSm �� ✓� ✓ of ut l y „9� �"Mf% �� b Place Notary Seal Above OPTIONAL. Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: — Document Date: Number of Pages: Signer(s) Other Than Named Above: „wwwwwwwwwwww,,,, Capacity(ies) Claimed by Signer(s) Signer's Name: ... P. Corporate Officer — Title(s): P Partner — Cj Limited iJ General i Individual K Attorney in Fact I Trustee ❑ Guardian or Conservator �J Other° _..........�.... i . _ Signer Is Representing Signer's Name: �. Corporate Officer — Title(s): ❑ Partner — 1-1 Limited 0 General ❑ Individual Ci Attorney in Fact El Trustee ❑ Guardian or Conservator I.] Other: Signer Is Representing: �_ .... 02014 National Notary Association - www.NationaiNotary.org - 1- 800 -US NOTARY (1 -800- 876 -6827) Item #15907 Agreement No. 5171 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 On August 17, 2016 before me, ROSE MARIE AGUIRRE NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared Jose Angel Ro'o Fierros-- ------- — ----------- -------------------------------------- Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s whose name` is /ard subscrjbed to the within instrumen and acknowledged to me that he /shit executed the same in his/h Moir authorized capacity(i and that b his /h /thei RLI im WAa eal"Pany 9025 N. Lindbergh Dr. I Peoria, IL 61615 Phone: (800)645-2402 1 Fax: (309)689-2036 Know All Men by These Presents: Agreement No. 5171 POWER OF 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 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 Zenizo Margaret Rodriggez, Pietro Micciche Elisabete Salazar, Maria Rico, Lointly or severall in the City of Los Aneeles , 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 $10,000,00,I) A0 ) 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 Vice President with its corporate seal affixed this 24th day of June, eri , 2016. ay ry ,�r re " SUa J Fd / State of Illinois" SShc�H�i��a County of Peoria On this 24th day of June 2016 before mc, as Notary 1'tiblic, personally appeared BartptLW, Davis �n who being. by Inc duly sworn, acknowledged that lie signed the above Power of Attorney Is the ma.foresaid officer of the RJA Insurance Company and /or Contractors Bonding and Insurance Company, and acknowledged said instrument to be the voluantary act and deed of said corporation. Jactlaa one M. Bockler Notary Public ;a "OFFICIAL SEAL" rilA1AAfC+N �� JACQUELINE M. BOCKLER D COMMISSION EXPIRES 01014118 RLI Insurance Company Contractors Bonding and Insurance Company - �F-� A . Barton W. Davis Vice President CERTIFICATE I, the undersigned officer of RLI Insurance Company, and/or Contractors Bonding and Insurance Company, each Illinois corporations, do hereby certify that the 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 Attomey, is now in force. In testimony whereof, I have hereunto set my hand and the scaal of the RLI Insurance Col �ny and/01 C"oa traetors Mr! and Insurance Company tlaa� _ day of " . I RLI Insurance Company Contractors on ing and Ins ranee Company A/ Barton W. Davis Vice President 0449553020212 A0059115 Agreement No. 5171 FAITHFUL PERFORMANCE BOND ADA CURB RAMP INSTALLATION (PHASE II) PROJECT PROJECT NO.: PW 15 -24 COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROJECT NO.: 601718-15 ( "PRIh C1PAL ") F S Contractors, Inc. and RLI Insurance corporation Bond No.RCB0003506 Bond Fee: $1,895.00 Premium Based on Final Contract Amount a incorporated under the laws of the State of .ITmmIllinomismm „mmm...... „m and licensed by the State of California to execute bonds and undertakings as sole surety, as surety ( "SURETY "), are held and firmly bound unto the CITY OF EL SEGUNDO ( "CITY ") in the sum of Seventy -five Thousand Eight Hundred And No /100THS , which is a minimum one hundred percent (100 %) of the contract amount, lawful money of the Un ited States, wh ich may be increased or decreased by a rider hereto executed in the same manner as this bond, for the payment of which sum PRINCIPAL and SURETY bind themselves, their successors, and assigns, jointly and severally, by this instrument. PRINCIPAL or SURETY will apply this bond for the faithful performance of any and all of the conditions and stipulations set forth in this bond, SPECIFICATIONS NO. PW 15 -24 , and the public works contract executed with such Specifications. In the case of any default in the performance of the conditions and stipulations of this undertaking, it is agreed that PRINCIPAL or SURETY will apply the bond or any portion thereof, to the satisfaction of any damages, reclamation, assessments, penalties, or deficiencies arising by reason of such default. BOND CONDITIONS 1. PRINCIPAL will construct the public improvements identified in SPECIFICATIONS NO. PW 15 -24 , a copy of which is on file with CITY's Engineering Division ( "Public Project "). Such performance will be in accordance with CITY's plans and profiles ( CITY DRAWING FILE NO. PW 15 -24 ) which are made a part of this bond when said plans and profiles are approved by the City Council and filed with CITY's Engineering Division. 2. PRNCIPAL's work on the Public Project will be done in accordance with CITY's plans and specifications and with any permit issued by CITY. Should PRINCIPAL fail to complete all required work within the time allowed, CITY may, at its sole discretion, cause all required work to be done and the parties executing the bond will be firmly bound for the payment of all necessary costs therefor. I -E- l Agreement No. 5171 Pursud"t to 99"440 Code of d proWpjre AN ob '. u9$ �v xbi %iRp t pp wp p �� � �� r � dy ON p of Agreement No. 5171 3. PRINCIPAL will guarantee its work against any defective work, labor, or materials on the Public Project for a period of one (1) year following 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 15 -24 or of the obligation to be performed will in any way affect 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 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; B. A certificate issued by the county clerk for the county in which SURETY's representative is located conforming arith California Code of Civil Procedure 4 995.640 and stating that SURETY's certificate of authority has not been surrendered, revoked, cancelled, annulled, or suspended, or in the event that it has, that renewed authority has been granted; and 7. Should PRINCIPAL perform its obligations within the time allowed, PRINCIPAL's obligation will be void upon the acceptance of the performance by CITY; other% ise this obligation will remain in frill force and effect. I -E -2 Agreement No. 5171 SIGNED AND SEALED this 9th (Jay of AU.9 st., 2016 /2k pRi NCI PAL PRESIDENT SECRIYIiy SURETY's-PRE11.7�ENT A Maria Rico, Attorney -in -Fact MILL, 11111.1 = W W-Mi WM V PRINCIPAL's MAILING ADDRESS: SURETY's MAILING ADDRESS: F S Contractors, Inc. RU Insurance Company 14838 Bledsoe treetmmmmmmmmmm 9025 N. Lindbergh Drive Svirnar. CA 91342 Peoria, IL 61615 NOTE: (1) ALL signatures niust be acknowledged by a notary public. Retum olle (1) ori-Mal to City Clerk's Office. (2) Bond shall be effective for one (1) year after acceptance of the job, T-E-3 CALIFORNIA ALL- PURPOSE ACKNOWLEDGMENT Agreement No. 5171 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 Angele��sww ) On . m,.U� �.� fJ._.._.... before me, .— Angel NunezSNotary Public Date Here Insert Name and Title of the Officer personally appeared , -„ „Maria Rico Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person($) whose name( ,S) is/aY6 subscribed to the within instrument and acknowledged to me that lib /she /tHdy executed the same in Ws /her /thffiir authorized capacityogs), and that by Ws /her /tb#jr signature(p) on the instrument the person(q), or the entity upon behalf of which the person(s) acted, executed the instrument. ANGEL NUNEZ Commission # 2146301 Notary Public - California Los Angeles County' M Comm. Ex Ires Mar 14, 2020 Place Notary Seal 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 office eat. 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: „ Number of Pages: Signer(s) Document Date: Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: _.._..._ ............................ ................._............_ O Corporate Officer — Title(s): _....... IT, i:: I Partner — I_- Limited ❑ General Individual W Attorney in Fact L 1 Trustee ❑ Guardian or Conservator 1-1 Other: Signer Is Representing: Signer's Name: n Corporate Officer — Title(s): ❑ Partner — CI Limited ❑ General • Individual ❑ Attorney in Fact • Trustee 1-7 Guardian or Conservator I I Other: Signer Is Representing 02014 National Notary Association - www.NationaiNotary.org • 1- 800 -US NOTARY (1 -800- 876 -6827) Item I15907 Agreement No. 5171 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 On August 17, 2016 before me, ROSE MARIE AGUIRRE NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared Jose Angel Rojo Fierros -------------------------------- — -------- - -- -- -- --------- Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the persono whose name$) is/ subscribed to the within instrument and acknowledged to me that he /she /they executed the same in his /her /their authorized capacity(les)„ and that bb + leis /?,executed the r signatur s) on the instrument the perso K or the entity upon behalf of which the person acts 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 - Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name:. ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: XA',-�IKAVAlf" K� r KX: <XXII 02014 National Notary Association • www.NationalNotary.org • 1- 800 -US NOTARY (1- 800 - 876 -6827) Item #5907 ROSE MARIE AGUIRRE k Commission # 1 39C93� Notary RI.7biiC - California '" Los Angeles County r My Comm t xpfi,(?,s Nov t t 2016 , 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 - Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name:. ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: XA',-�IKAVAlf" K� r KX: <XXII 02014 National Notary Association • www.NationalNotary.org • 1- 800 -US NOTARY (1- 800 - 876 -6827) Item #5907 Agreement No. 5171 PROPOSAL FOR THE ADA CURB RAMP INSTALLATION (PHASE II) PROJECT PROJECT NO.: PW 15 -24 COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROJECT NO.: 601718 -15 Date 12- 20 Company Name: �,, .. 'u ....I___ 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 affect 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 satisfactori ly 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 oraward 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. I -C -1 Agreement No. 5171 EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE BIDDER certifies that in all previous contracts or subcontracts, all reports which may have been due underthe requirements of any agency, State, or Federal equal employment opportunity orders have been satisfactorily filed, and that no such reports are currently outstanding. AFFIRMATIVE ACTION CERTIFICATION 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 DECLARATION 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. 5171 1.911 Ii.Ys" I�IlIJ� ADA CURB RAMP INSTALLATION (PHASE II) PROJECT PROJECT NO.: PW 15 -24 COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROJECT NO.: 601718 -15 n Company Name:,,,_ ? �....W Item Unit Description _ .. Unit No - Item _ Intersection Corner , i'� , Install new McCarthy Ct. / `" I .... ADA Ramp Walnut Ave SW 1 .M. > Install new California St LS 2 _..... .. m ADA Rap �,.. .., i Acacia Ave. . . _ �. NW ...._.. _ .... . I LS Install new Pine Ave. / 3 ADA Ramp Sierra Pl. NE I Install new Pine Ave. / ! 4 NW I 3 Soo ADA Ramp Nevada St. I_,S 3p 5�O new Pine Ave. / 5 DA Ramp Nevada St, NE I Install new Pine Ave. / 6 ADA Ramp Nevada St. SW I Install new Pine Ave. / 7 SE 1 ADA Ram...... p Nevada St. � ....... _, .A...: . Install new Pine Ave. / 8 ADA Ramp Washington_ St NW I Install new Pine Ave. / 9 ADA Ramp Washm ton St. SW I Install new Pine Ave. / 10 ADA Rama Illinois St. NE I Install new California St. / 1 1 ADA Ramp Acacia St NE I Install new California St. / 12 ADA Ramp Acacia St. SW I Install n California St / 13 mp ADA Raw Acacia St. SE I TOTAL BASE BID = $ C) 0 ._ - -- - -___. �.., TOTAL BASE BID WRITTEN IN WORDS: Unit Total Unit LS `" _ LS ) J > LS '.tea 0 � LS 32,00 LS- r LS ! LS 3 Soo I_,S 3p 5�O .so LS . i S 3 5—O LS ._ - -- - -___. �.., TOTAL BASE BID WRITTEN IN WORDS: Agreement No. 5171 I:I I IIY61 :I.01 11 11 11 11 ADA CURB RAMP INSTALLATION (PHASE II) PROJECT PROJECT NO.: PW 15 -24 (CD�BG) PROJECT NO.: 601718 -15 Company Name: _."` _."_'. t ,.... V �, m....m ALTERNATIVE BID ITEMS Item Description Unit Total No Item ... Intersection Corner QTY Unit Price Install new Loma Vista / A 1 ADA Ramp Alley south of NE I LS Palm Ave. _ �Sbo A2 Install new ADA Ramp .. Pepper St. / Walnut Aver NE -i 1 LS A3 Install new ADA Ramp Pepper St. / Acacia Ave. NE I LS a Install new ADA Ramp Pepper St. / Maple Ave. NW 7 LS ® ®..w . AS Install new ADA Ramp Pepper St / Maple Ave NE 1 LS f"aC� � w.,._. _.. m .,.. _ ., ___.. - -___- _._ _..P e ....,.... _. A6 Install new Franklin Ave. / NC 1 LS "m ADA Ramp Sheldon St. a� M Install new Franklin Ave. / A7 ADA Ramp Alley east of NE I I..,S d Concord „C Install new ......... Franklin Ave. / _. _.... A8 ADA Ramp Alley east of NW 1 I,S�� ......W...._...... Concord St. Install new Franklin A / A9 ADA Ramp o. SE....._ l LS t. Concord S t. Install new Franklin Ave. / A10 ADA Ramp Alley east of SW 1 LS ( Concord St. 1 -C -3b Company Name:. _ �..n . .� ._ ..... .:,... ALTERNATIVE BID ITEMS (Continued)__ Item 'Description No. Item Intersection Corner All Install new Illinois St. / NE NW NE SE NW SE SW Agreement No. 5171 SA&C, ADA Ramp Holly Ave. Y Unit Install new Indiana St. / LS Al2 ADA Ramp Holly Ave. �G Alley South of 1 A 13 Install new Grand at LS �. ADA Ramp ._... Lomita . _ _ ....._.. Alley of 1 A14 Install new Grand at . ADA Ramp Lomita Install n.. ew _ Pine Ave. / A.. 15 ADA Ramp Indiana St. - A16 Install new Pine Ave./ ADA Ramp Illinois St. Install new Pine Ave. / A 17 ADA Ramp Indiana St. NW NE SE NW SE SW Agreement No. 5171 SA&C, All work shall be per these specifications and attachments. Prevailing wage rates apply. The City of El Segundo reserves the right to reject any or all bids, to waive any irregularity, and to take all bids under advisement for a period of ninety (90) calendar days. I -C -3c Unit Total Y Unit I LS 1 LS �G 1 LS 1 LS �. 1 LS I LS ��� 6 1 LS S All work shall be per these specifications and attachments. Prevailing wage rates apply. The City of El Segundo reserves the right to reject any or all bids, to waive any irregularity, and to take all bids under advisement for a period of ninety (90) calendar days. I -C -3c Agreement No. 5171 BIDDER'S INFORMATION Company Name: ..... (.omr �m�.�(... 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) p ° u t, State Contractor's License No. and Class --'s S40 Federal Tax Identification Number Original Dale Issued 7 .. Expiration Date The followin g are the names ....t�� � �... �. titles, email addresses, and phone nuinbcrs o all individuals;, lwrn,i members, partners, joint venturers, and /or corporate officers having principal interest in this pr( X)Sllfl .® 1... ��t,I- VvW'fl-ko t k 2 C , The date of any voluntary or involuntary bankruptcy judgments against any principal having all t� m interest in this proposal is as follows: All current and prior DBA's, aliases, and /or fictitious business names for any principal having an interest in this proposal are as I'oilows: Al I N-1 I -C -4 Agreement No. 5171 BIDDER'S INFORMATION (CONTINUED) Company Name: Bidder shall list the name of the person who attended the pre -bid meeting: Name: m Title: I -C -5 Agreement No. 5171 IN WITNESS WHEREOF, BIDDER executes and submits this proposal with the names, titles, hands, and seals of all a forenamed principals this day o f L) 20.1c, BIDDER ( J, V1 C_ ribed and sworn to this ..—day of mm 20. NOTARY PUBLIC I-C-6 Agreement No. 5171 CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202 ® See Attached Document (Notary to cross out lines 1-6 below) ❑ See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) U Signatur6lof Document Signer No. 1 Signature of Document Signer No. 2 (if any) A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of LOS ANGELES Subscribed and sworn to (or affirmed) before me on this 11TH day of JULY —20 16 . by Date Month Year (1) JOSE ANGEL ROJO FIERROS (and (2) -- --- - --- - -- --- - - -- ------ - -- - -- --------- ----- -- ), Name(s) of Signer(s) Seal Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Bid Proposal. Document Date: 07/11/2016 Number of Pages: 01 Signer(s) Other Than Named Above: None. 02014 National Notary Association • www.NationalNotary.org • 1- 800 -US NOTARY (1- 800 - 876 -6827) Item #5910 Agreement No. 5171 PROPOSAL GUARANTEE BID BOND ADA CURB RAMP INSTALLATION (PHASE II) PROJECT NO.: Pw 15 -24 COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROJECT NO.: 601718-15 KNOW ALI, MEN BY THESE PRESENTS that, F S Contractors, Inc. , as BIDDER, and R�,i Ln urance Com�an � , 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 DOLLARS (1 ° , 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 fierce 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 8th _ day of ._.July._, 2016 BIDDER* F S Contractors Inc.,14838 Bledsoe Street Sylmar, CA 91342 (818) 838 -6040 SURETY* RLI Insurance Company 9025 N. Lindbergh h Drive Peoria, IL 61615 (309) 692 -1000 g Elisabete Salazar, Attorney-in-Fact 1800 McCollum Street, L os Angeles, CA 90026 (323) 663 -7814 Subscribed and sworn to this 8th day of Jule„ 2016 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. 5171 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 . . .... ........ . . . . . . ......... . . ................. .......... A notary public or other officer completing this certificate verities 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 Angeles On. before me, -Eublic Date Here Insert Name and Title of the Officer personally appeared Elisabete Salazar . . . ............ . ......... wry LL Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name() is/46 subscribed to the within instrument and acknowledged to me that 1*/she/tHdy executed the same in W/her/ffiffir authorized capacityUps), and that by WP/her/thq)r signature() on the instrument the person(q), 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 eand vial seal. &&4w%A%A Signatur ANGEL n i tt4re of Not i tire of Notary Public Commission # 2146301 Z Zv Notary Public - California Z z i Los Angeles County Place Notary Seal Above ; OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document Description of Attached Document Title or Type of Document: Document Date: Number of Pages: — Signer(s) Other Than Named Above: . Capacity(jes) Claimed by Signer(s) Signer's Name: F3 Corporate Officer — Title(s): I::. j Partner — , Limited L I General F] Individual W Attorney in Fact I Trustee El, Guardian or Conservator F_] Other: Signer Is Representing: . . . ........... . Signer's Name: . . ............. F Corporate Officer — Title(s): ❑ Partner — 1-1 Limited ❑ General * Individual E-j Attorney in Fact * Trustee [I Guardian or Conservator ❑ Other: Signer Is Representing: 02014 National Notary Association • www.NationaiNotary.org • 1-800 -US NOTARY (1-800-876-6827) ltem#5907 RLI ellic .11 RRLL 4"ampla ny 9025 N. Lindbergh Dr. Peoria, IL 61615 Phone: (800)645 -2402 Fax: (309)689 -2036 Know All Men by These Presents: Agreement No. 5171 POWER OF 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 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 Zenizo Margaret Rodriggez, Pietro Micciche Elisabete Salazar Maria Rico jointly or several! 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 ( $1,01000,000.00 ) 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 Vice. PnInicicnt with its corporate seal affixed this 24th day of Ting, 2. AND �,4, on x".10 Lw � tae'' •. R4 ro r,.:4�o1M State of Illinois SSu����� m u County of Peoria On this 24th day of June 2016 before me, a Notary Public, personally appeared Barton W. Davis 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. IM "OFFICIAL SEAL" JACQUELINE M. BOCKLER COMMISSION EXPIRES 01/14118 RLI Insurance Company Contractors Bonding and Insurance Company G/ I Barton W. Davis Vice President CERTIFICATE I, the undersigned officer of Rt.I Insurance Company, and/or Contractors Bonding and Insurance Company, each Illinois corporations, do hereby certify that the 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 testimony whereof, I have hereunto set my hand and the seals of the RLI Insurance Co and/or Contractors Bonding and Insurance Company this day of RLI Insurance Company Notary Public Contractors on ing and Ins rance Company Barton W. Davis Vice President 0449553020212 A0059115 Agreement No. 5171 CONTRACTOR'S LICENSE DECLARATION (Business and Professions Code Section 7028.15) 1. BIDDER'S Contractor's License Number is: `; 9 4, Class No.: a... . 2. The expiration date of BIDDER'S Contractor License is: ... _ _ 20, _ .• 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 3 , at J_...�.� mature t . Typed Name����� Title Company Name (insert City and State where Declaration signed). 1 -C -8 Agreement No. 5171 NON - COLLUSION DECLARATION TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID (pursuant to Cal. Pub. Contract Code § 7106) The undersigned declares: the party making I am the ° � '� �� � �� of . • .....� ._ . ..m e m. � .. .s the foregoing bid. The bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation. The bid is genuine and not collusive or sham. The bidder has not directly or indirectly induced or solicited any other bidder to put in a false or share bid. The bidder has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or to refrain from bidding. 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. Al l statements contained in the bid are true. 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, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof, to effectuate a collusive or sham bid, and has not paid, and wi II not pay, any person or entity for such purpose. Any person executing this declaration on behalf of a bidder that is a corporation, partnership, joint venture, limited liability company, limited liability partnership, or any other entity, hereby represents that he or she has full power to execute, and does execute, this declaration on behalf of the bidder. I declare under penalty of perjury under the laws of the State oft :a ,Ior nia that the foregoing is true, �nC correct and�C that declaration aration is executed oil [date], at [state]." e Dated this day of _.t'V t 201(0. Name Title Signait re I -C -9 Agreement No. 5171 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." r Signature of Bidder: ..,a. �.. .... .... Title:;.. Business Name: Business Address: nµ t -31 4 Z, Telephone Number, � ) � m .. .. l ated this- _ day of 14 20 . I -C -10 Agreement No. 5171 DESIGNATION OF SUBCONTRACTORS ADA CURB RAMP INSTALLATION (PHASE II) PROJECT PROJECT NO.: PW 15 -24 COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROJECT NO.: 601718 -15 Company Name: �-'S, o BIDDER wil l perform the majority ofthe work and proposes to subcontract certain portions ofthe 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: I -C -11 Agreement No. 5171 REFERENCES Company Name:�..�_..'u. ..� . 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 (S) years: Project Title:. " Location: „! S A Name land address of owner Nameland current telephone number of person familiar with project Type of Work: —"A ,- C, Date completed: m ...iN..._.: "I ....r. �" Contract aount. $ 1 Amount of work done by my /our firm under contract $ 3057J,(- "' _ Did your firm have any financial interest in Project? 2, Project Title: 0 t C t Location: VC •. m o. Name and address of owner t................... Name and current telephone number of person familiar with project 11 r. Type of Work: '"S_...� Contract amount $ L....�," Date completed: Amount of work done by my /our firm under contract $ �' 1 Did your firm have any financial interest in Project? --ho I -C -12 Agreement No. 5171 3. Project Title: C,,Ovk.f Location: U S 0 C, QXV rnA��'12,1— v�-Lf n� UdOn OMAV-MO-�rM 0 Name and address of owner c Name and current telephone number of person familiar with project Type of Work: C C 9 \ I � C A-. K I "I J-11 - e In -4 Contract amount : Date completed: Amount of worl< done by my /our firm under contract Did your firm have any financial interest in Project? __ � ""( __ 11 ' ....... . . ...... 4. Project Title - I :),I 1,-' Location: V% -I oos ... . ....... R.- I �6 Lfl Name and address of owner '7- Name and current telephone number of person familiar with project: Type of Work: Contract amount: $ Date completed., -�I ) " 4 (6 — Amount of worl< done by my/our firm Under contract $ Z, 'L I (go Did Your firm have any financial interest in Project? 5. Project Title-, Location:` . ... . ..... o Z( Ir"a Name "a address of ownt-W�Q` P, 9 n I-C-13 Agreement No. 5171 Name and current telephone number of person familiar with project: Type of Work: (OAA (° - ..... "�)k., ��. ( Contract amount $ ° (6 w ,non , a ., Date completed: Amount of work done by my /our firm under contract $',"14 ,, p.. .� 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: . ... W w ' - Z .. ......... G, w� m I -C -14 Agreement No. 5171 BIDDER'S STATEMENT OF PAST CONTRACT DISQUALIFICATIONS ADA CURB RAMP INSTALLATION (PHASE II) PROJECT PROJECT NO.: PW 15 -24 COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROJECT NO.: 601718 -15 Company Name; ... �.at. 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 l 2. If yes, explain the circumstances: 1 Are you registered in accordance with Labor Code § 1725.5 [Note: failure to register requires the City to reject your bid as nonresponsive]? Yes No ❑ ®............ _...., . _ . _... Bidd 's Signat e ot Name (Please P nt) I -C- l 5 Agreement No. 5171 INSURANCE REQUIREMENTS [MUST BE SUBMITTED WITH PROJECT PROPOSAL] ADA CURB RAMP INSTALLATION (PHASE iI) PROJECT PROJECT NO.: PW 15-24, (C MG) PROJECT NO.: 601718 -15 " �. . Company Name:...... ..� ........: 1 . e�....e. � ------------ 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: Type of Insurance Li.in.its, 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 ofthe 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." Date Bid c °r's Sq r�C rre I -C -16 Agreement No. 5171 Worker's Compensation Certification State of California Compliance Form — To be submitted with Bid I certify, by signature below, that I am aware of the provisions of Section 3700 of the California Labor Code which require every employer to be insured against liability for worker's 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. Date: - Project Number:..._^ . Project Name . Company Name:.wa ... .... m.. .. ..:..............._. __m..m..�. _....._.. Address .......�. �..�.�� �� N�.. w.... s..........�..� -...� � ..... �_t... 2` I Y, t Print Name: � �.�..�.. 0. ... . Title: Signature: VI -A -15 Agreement No. 5171 Non - Segregated Facilities Certification Federal Compliance Form — To be submitted with Bid The federally- assisted construction contractor certifies that he /she DOES NOT and WILL NOT: 1. Maintain or provide, for his /her employees, any segregated facilities at any of his /her establishments. Z Permit his /her employees to perform their services at any location, under his /her control, where segregated facilities are maintained. The federally assisted contractor agrees that a breach of this certification is a violation of the Equal Opportunity Clause in this contract. As used in this certification, the term segregated facilities means any waiting room, work areas, restrooms and washrooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, creed, color, or national origin, because of habit, local custom, or otherwise. The federally- assisted contractor agrees that (except where he /she has obtained identical certifications from proposed subcontractors for specific time periods) he /she will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity Clause, and that he /she will retain such certifications in his /her files. NOTE: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001. Date: ®m.. Project Number W V I '� Company _.t... Address: 1 ( Title: .'.. . � IS VI-A-16 Agreement No. 5171 Past Performance Certification Federal Compliance Form — To be submitted with Bid The bidder, proposed sub - contractor, hereby certifies that he /she has, has not, participated in a previous contract or subcontract subject to the Equal Opportunity Clause, as required by Executive Orders 10925, 11114, or 11246, and that he /she has, has not, filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filing requirements. Date: _ �_�„ Project Number: Contract Award: $ Awarding Agency m__. : `) Contractor Name: .Total Number of Employees � Affiliate Company: Title: NOTE: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60- 1.7(b)(1), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60 -1.5 (Generally only contracts or subcontracts of $10,000 or under are exempt). Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60 -1 7(b)(1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the U.S. Department of the Interior or by the Director, Office of Federal Contract Compliance, U Department of Labor gl_�Ist by fn6edl_by; (A) All private employers who are: (1) Subject to Title VII of the Civil Rights Act of 1964 (as amended) with 100 or more employees. (2) Subject to Title VII who has fewer than 100 employees, if the company is owned or affiliated with another company, or there is centralized ownership, control or management so that the group legally constitutes a single enterprise, and the entire enterprise employs a total of 100 or more employees. (B) All federal contractors (private employers), who: (1) Are not exempt as provided for by 41 CFR 60 -1.5 (2) Have 50 or more employees, and a, Are prime contractors or first -tier subcontractors, and have a contract, subcontract, or purchase order amounting to $50,000 or more; or b. Serve as a depository of Government funds in any amount, or c. Is a financial institution, which is an issuing, and paying agent for U.S. Savings Bonds and Notes. VI -A -17 Agreement No. 5171 Notice of Equal Employment Opportunity Federal Compliance Form — To be submitted with Bid TO: kax 0� _ ��_.._......�. (Name of Labor Union WWork rs Rr;gro¢'a,5CnWfive., eta 4 y.. " (Address) Name of Business (Contractor): Project Name dy Project Number: 1 ._ ......_....�' ,� �� tu, ALL. 1 m..�._ _ . -.... — ._ . -. The Undersigned currently holds a contract with involving funds of the U. S. Government, or a subcontract with a prime contractor holding such contract. You are advised that under the provisions of the above contract or subcontract, and in accordance with Executive Order 11246, the undersigned is obligated not to discriminate against any employee or applicant for employment because of race, color, religion, sex or national origin. This obligation not to discriminate in employment includes, but is not limited to the follow: 1. Hiring, placement, upgrading, transfer or demotion; 2, Recruitment, advertising or solicitation for employment; 3. Treatment during employment; 4. Rates of pay or other forms of compensation; 5. Selection for training, including apprenticeship; and 6. Layoff or termination. This notice is furnished to you pursuant to the provisions of the above contract or subcontract and Executive Order 11246. Copies of this notice will be posted by the undersigned in conspicuous places available to employees or applicants for employment. (Pmw N4111w) % (Date) r' (Title) VI-A-18 0 1 �— 0 w (0 -4J CA) D tA 73 0 CD 0 0 0 sv O U) c C) CD D cn (D z Cf) z (Z) cci C) w w 3 (D z w 3 CD Agreement No. 5171 r- 4 0 4. M O -0 0 (n CD CL U) C cr 0 0 0 v > 0- U) 0 Fn cn II > 00 CD M :D C2- CL m 0 3 0' CT O M CD M z Igo Cf) ul 0 Q (D 8 CL E, M C/) c) M U) 0 3 V\ r- 4 0 4. M O -0 0 (n CD CL U) C cr 0 0 0 v > 0- U) II D CD M :D 0 3 0' CT O M CD M z Igo Cf) ul 0 Q (D 8 CL E, M C/) c) M r- 4 0 4. M O -0 0 (n CD CL U) C cr 0 0 n v > II D 3 0' M CD M z Igo Cf) ul 0 Q (D 8 CL E, M c) M U) 0 3 V\ M CD (D r- 4 0 4. M O -0 0 (n CD CL U) C cr 0 0 II D Cf) 8 M C U) M 0 r- 4 0 4. M O -0 0 (n CD CL U) C cr 0 0 Agreement No. 5171 County Lobbyist Certification Los Angeles County Compliance Form — To be submitted with Bid COUNTY LOBBYIST CODE CHAPTER 2.160 COUNTY ORDINANCE NO. 93 -0031 Name of Firm:�..�_��.�_..��. ., .. � ........ .................._. Address: r� °mow �L State: _- .....w. Zip Code: _.. �a.......... ... ..:...... Telephone Number: � R-2 � L � Acting on behalf of the above named firm, as its Authorized Official, I make the following Certification to the County of Los Angeles and the Community Development Commission, County of Los Angeles: 1) It is understood that each person /entity /firm who applies for a Community Development Commission contract, and as part of that process, shall certify that they are familiar with the requirements of the Los Angeles County Code, Chapter 2.160 (Los Angeles County Ordinance 93 -0031) and; 2) That all persons /entities /firms acting on behalf of the above named firm have and will comply with the County Code, and; 3) That any person /entity /firm who seeks a contract with the Community Development Commission shall be disqualified therefrom and denied the contract and, shall be liable in civil action, if any lobbyist, lobbying firm, lobbyist employer or any other person or entity acting on behalf of the named firm fails to comply with the provisions of the County Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into contract with the Los Angeles County and the Community Development Commission, County of Los Angeles. Authorized Official VI-A-20 U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT HUD FORM 4230A REPORT OF ADDITIONAL CLASSIFICATION AND RATE oMB Approval Number 2.501 -0011 (Exp 01/3112010) 1. FROM (name and address of requesting agency) 2. PROJECT NAME AND NUMBrR (� •w S ll, r 1 . o� 3. LOCATION Ow PROJECT (City, County and SlMo) .m__._.._._... _ -- 4. BRIEF DESCRIPTION OF PROJECT 5. CHARACTER OF CONSTRUCTION • - .°� [:1 Building ❑ Residential 1-1 eavy E] Other (specify) [•.Highway if any) _ 7. WAGE DECISION_ EFFECTIVE DAT 6. WAGE DECISION NO. (include modification number, E ❑ COPY ATTACHED ('� 8,. WORK CLASSIFICATION(S) HOURLY WAGE RATES BASIC WAGE FRINGE BENEFIT(S) (if any) uµ(\Loiv, e" A-AMV 1 - ) .. ... ..... _....... ___" .. - ....... ABLE (_r�_...... . ) Pt�IMF CONTRACTOFC (narrate ndclr� � 10, SUBCONTRACTOR /EMPLOYER, IF APPLICABLE name address Y-) ..... W...._ ...... . __..........w_... w.w -_ - Check All That A,,�I/:I ❑ The work to be performed by the additional classification(s) is not performed by a classification in the applicable wage decision F] The proposed classification is utilized in the area by the construction industry, [] The proposed wage rate(s), including any bona fide fringe benefits, bears a reasonable relationship to the wage rates contained in the wage decision. ❑ The interested parties, including the employees or their authorized representatives, agree on the classification(s) and wage rate(s) (j Supporting documentation attached, including applicable wage decision. Check Of e: fJ Approved, meets all criteria. DOL confirmation requested. Lj One or more classifications fail to meet all criteria as explained in agency referral. DOL decision requested. FOR HUD USE ONLY LR2000: ..... ___ , ......_.... ... ...e�.. Agency Representative Date (Typed name and signature) Log in: Log out: one Number 11U0,42XK (8-03) F. R V40U VA1VTJ 1S oBS01 r FF: N Agreement No. 5171 FEDERAL LOBBYIST CERTIFICATION NameofFirm:. Address: - State:.. °..' Zi p Code: ....�- ..._.. Telephone Number: Acting on behalf of the above named firm, as its Authorized Official, I make the following Certification to the U. S Department of Housing and Urban Development and the Community Development Commission, County of Los Angeles. 1) No Federal appropriated funds have been paid by or on behalf of the above named firm to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of and Federal grant, loan or cooperative agreement, and any extension, continuation, renewal, amendment, or modification thereof, and; 2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee or any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with this Federal contract, grant loan, or cooperative agreement, the above named firm shall complete and submit Standard Form -LLL, "Disclosure Form to Report Lobbying ", in accordance with its instructions, and; 3) The above name firm shall require that the language of this certification be included in the award documents for all sub - awards at all tiers (including subcontracts, sub - grants, and contracts under grants, loans, and cooperative agreement) and that all sub - recipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into the transaction imposed by Section 1352 Title 31, U. S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Authorized Official wR M (Conh'actndSubcontrec[oi) o, r (Date) Agreement No. 5171 COMPLIANCE WITH CLEAN AIR AND WATER ACTS (Applicable to federally assisted construction contracts and related subcontracts exceeding $100,000) During the performance of this contract, the contractor and all subcontractors shall comply with the requirements of the Clean Air Act, as amended, 42 USC 1857 et seq., the Federal. Water Pollution Control Act, as amended, 33 USC 1251 et seq., and the regulations of the Environmental Protection Agency with respect thereto, at 40 CFR Part 15, as amended. In addition to the foregoing requirements, all nonexempt contractors and subcontractors shall furnish to the owner, the following: A stipulation by the contractor or subcontractors, that any facility to be utilizes) in the performance of any non exempt contract or subcontract,. is not listed on the List of Violating Facilities issued by the Environmental Protection Agency (EPA) pursuant to 40 CFR 15.20. 2. Agreement by the contractor to comply with all the requirements of Section 114 of the Clean Air Act, as amended, (42 USC 1857c -8) and Section 308 of the Federal Water Pollution Control Act, as amended, (33 USC 1318) relating to inspection, monitoring, entry, reports and information, as well as all other requirements specified in said Section 114 and Section 308, and all regulations and guidelines issued there under. 3o A stipulation that as a condition for the award of the contract, prompt notice will be given of any notification received from the Director, Office of Federal Activities, EPA, indicating that .a facility utilized, or to be utilized for the contract, is under consideration to be listed on the EPA List of Violating Facilities. 4. Agreement by the contractor that he will include, or cause to be included, the criteria and requirements in paragraph (1) through (4) of this section in every nonexempt subcontract and requiring that the contractor will take such action as the government may direct as a means of enforcing such provisions. July 11, 2016 'i 1�ly ADDENDUM NO.1 Agreement No. 5171 to THE CONTRACT DOCUMENTS, SPECIFICATIONS AND PLANS for ADA RAMP INSTALLATION PROJECT NO. PW 15 -24 ATTENTION BIDDERS: The following additions, modifications, and clarifications to the specifications shall be included in, and become a part of, any contract which may be executed for the above project in the City of El Segundo: 1. The bid date and time is still Tuesday, July 12 at 11:00 am 2. Appendix I has been revised to accurately reflect the bid table in I -C -3c. 3. See attached supplement pages As evidence that the BIDDER has read this Addendum, the BIDDER must acknowledge same in the space provided below and submit this Addendum with the Bid Proposal. Failure to provide such acknowledgement shall render the bid as non - responsive and subject to rejection. Signature: �� .. f e., tea�'3 Date: mN° Print Company Name:. °° Page I of I 350 Main Street, El Segundo, CA 90245 -3895 (310) 524 -2300 Fax (310) 640 -0489 Agreement No. 5171 ADA CURB RAMP INSTALLATION (PHASE II) PROJECT PROJECT NO.: PW 15 -24 COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROJECT NO.: 601718 -15 Proposal documents to be completed in full and submitted by the bid opening date and time: A. City Proposal Documents 1. Proposal cover sheet (2 pages) 2. Base and alternate bid tables (3 pages) 3. Bidder's Information Sheets (3 pages) 4. Bid Bond 5. Contractor's License Declaration 6. Non - Collusion Declaration 7. Worker's Compensation Certification 8. Designation of Subcontractors 9. References (3 pages) 10. Bidder's Statement of Past Contract Disqualifications 11. Insurance Requirements B. CDBG Proposal Documents 1. Worker's Compensation Certification 2. Non - Segregated Facilities Certification 3. Past Performance Certification 4. Notice of Equal Employment Opportunity 5. List of Proposed Subcontractors 6. Non - Collusion Declaration 7. County Lobbyist Certification 8. HUD Form 4230A 9. Federal Lobbyist Certification 10. Compliance with Clean Air and Water Acts