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HomeMy WebLinkAboutINTERNATIONAL LINE BUILDERS, INC. (2) Recording Requested By, Recorded in Official Records, Orange County And when Recorded Mail To: Hugh Nguyen, Clerk-Recorder City of Santa Ana,Public Works Agency M22 �IIII '�II I III II ��I IIII I II II I I I IIIII II��III III III III 20 Civic Center Plaza,P.O. Box 1988 + I + I I NO FEE Santa Ana,CA 92702 * $ R 0 0 1 3 6 9 4 6 7 1 $ * 2022000158259 2:24 PM 04/26/22 340 414A N 12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.000.000.00 0.00 THIS SPACE FOR COUNTY RECORDERS USE ONLY !_ NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN that the undersigned City of Santa Ana, California, a municipal corporation, with the address of City Hall, 20 Civic Center Plaza, Santa Ana, California, 92701, is the owner of the property hereinafter described, that said owner has caused q construction of EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION under contract entered into on May 19, 2020, with International Line Builders, on which contract w LIBERTY MUTUAL INSURANCE COMPANY & TRAVELERS CASUALTY AND o SURETY COMPANY OF AMERICA is surety. The property on which such work improvement o z was placed is in the City of Santa Ana, County of Orange, State of California, and described as c Project No. 17-6894 [HSIPL-5063 (171)1 located at: INTERSECTION OF EUCLID STREET a o w AND HAZARD AVENUE. The work improvement on said property was accepted as completed 0 on FEBRUARY 11 2022. Wo w E~ CITY OF SANTA ANA,A MUNICIPAL CORPORATION B o � Y U � Dated: Acting City E neer—Jason Gabriel ------------------------- TITLE -------------------------- VERIFICATIOI 1, the undersigned, say: I am the Acting City Engineer—Jason Gabriel of the City of Santa Ana, California; I executed the foregoing Notice of Completion acting on behalf of the owner of the property therein described; I make this verification on behalf of said corporation by authorization of the City Council of the City of Santa Ana; I have read said notice and know the contents thereof; and I declare under penalty of perjury that the facts therein stated are true. Executed on 2/� , at Santa Ana, California Acting Ci Engineer—Jason Gabriel THIS NOTICE OF COMPLETION MUST BE RECORDED WITHIN TEN(10)DAYS AFTER COMPLETION Ay JUN 19 2020 O:(Z) PW.4 GYY4 OAZf- CITY OF SANTA ANA CONSTRUCTION CONTRACT PROJECT 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION [HSIPL-5063(171)] This CONSTRUCTION CONTRACT is made and entered into this 10 day of May, 2020 by and between the City of Santa Ana, California, a charter city and municipal corporation organized and existing under_ the Constitution and laws of the State of California (hereinafter "CITY"), and Infemational Line Builders, -Inc. (hereinafter "CONTRACTOR"). `IJIIl1l►1�7`I�'� The CITY and the CONTRACTOR, for the consideration hereinafter named, mutually agree as follows: 1. CONTRACTOR agrees to perform all the work and famish all the materials at its own cost and expense necessary to construct and complete in a good and workmanlike manner and to the satisfaction of the City Engineer of the CITY, the Euclid Street at Hazard Avenue Signal Modification Project (hereinafter referred to as the "WORK OF IMPROVEMENT') identified in and in accordance with the Contract Documents prepared by the City's Public Works Agency and approved by the City Council. 2. The complete Construction Contract consists of the "Contract Documents" as defined by the Standard Specifications for Public Works Construction and which include the following: • Notice Inviting Bids • Information to Bidders • Bid Proposal • Bid Bond • Contract Form • Contract Bonds • General Provisions * Special Provisions - • Technical Provisions and Project Plans • Community Workforce Agreement • Appendices In case of conflict between the Contract Documents, the precedence of documents shall be as established in the Standard Specifications for Public Works Construction. 3. CITY agrees to pay and CONTRACTOR agrees to accept in full payment to complete the WORK OF IMPROVEMENT the sum total amount not to exceed Two Hundred Fifty-five Thousand Six Hundred Twenty Dollars and No Cents ($255,620.00), as set forth and identified in the BID PROPOSAL, which is attached hereto and incorporated herein as Exhibit "A." The BID PROPOSAL contains a schedule of unit price(s) or lump sum(s) based on approximate quantities only, and the City does not expressly or by implication agree that the actual amount of work will correspond therewith, but reserves the right to increase or decrease the amount of any class or portion of the work or to omit portions of the work as may be deemed necessary or advisable. MV.o4,oirzon Page 1 of 4. CONTRACTOR agrees to complete the WORK OF IMPROVEMENT within the time specified in the Time for Completion of Improvements section of the BID PROPOSAL (Exhibit "A") including commencing construction within the timeframe therein specified after issuance of a Notice to Proceed. The CONTRACTOR will pay, and will require all subcontractors to pay, all employees on the WORK OF IMPROVEMENT a salary or wage at least equal to the prevailing salary or wage established for such work as set forth in the wage determinations for this work in accordance with applicable State and Federal law. 6. If applicable, the CONTRACTOR shall adhere to the CITY'S Community Workforce Agreement (CWA), a pre -hive collective bargaining agreement, which establishes the labor relations policies and procedures for CONTRACTOR to follow in the crafts persons employed to complete the WORK OF IMPROVEMENT as more fully described in the CWA. The CWA may be found on the City's website at: littD://www.santa-ana.orsi/Dwa/docuiiients/CWA.t)d I 7. CONTRACTOR shall, after award of this Contract, furnish two bands to be approved by the CITY, one in the amount of One Hundred Percent (100%) of the Contract price, to guarantee the faithful performance of the work (Performance Bond), and one in the amount of One Hundred Percent (100%) of the Contract price to guarantee payment of all claims for labor and materials furnished (Payment Bond). This Contract shall not become effective until such bonds are supplied to and approved by the CITY. 8. CONTRACTOR shall, prior to the release of the performance and payment bonds or the retention payment, furnish a warranty performance and payment bond (Warranty Bond). Said Warranty Bond shall also be required as a condition of project acceptance. For projects up to Five Hundred Thousand Dollars ($500,000), the Warranty Bond amount shall be the greater of Ten Thousand Dollars ($10,000) or Twenty Percent (20%) of the final contract price. For projects above Five Hundred Thousand Dollars ($500,000), the Warranty Bond amount shall be the greater of One Hundred Thousand Dollars ($100,000) or Ten Percent (10%) of the final contract price. 9. CONTRACTOR shall, after award of this Contract, furnish Certificates of Liability Insurance and Worker's Compensation Insurance as outlined in the General Provisions, to be approved by the CITY. Page 2 of 3 IN WITNESS WHEREOF, the parties hereto have executed this Construction Contract on the day and year first above written. ATTEST: CITY OF SANTA ANA DAISY GOMEZ KRfSTINE RIDGE Clerk of the Council City Manager APPROVED AS TO FORM: SONIA R. CARVALHO CONTRACTOR: City Attorney International Lin�ildcrs. Inc. By:. JdANFUNK Assistant City Attorney FOR APPROVAL: NABIL SABA, PE Executive Director Public Works Agency William Davenport President Page 3 of 3 City of Santa Ana Euclid street at Hazard Avenue Signal Modification (17-6894 (HSIPL 5063(171))), bidding on February26, 2020 2:00 PM Bid Results Bidder Details Vendor Name International Line Builders, Inc Address 3955 Temescal Canyon Road Corona, CA 92883 United States Respondee Omar Echeverri Respondee Title PreConsWction Manager Phone 951-682-2982 Ext. Email Omar.Echaverd@ilbinc.com Vendor Type CADIR License# 782516 CA DIR Bid Detail Bid Format Electronic Submitted February 26, 2020 1 A5:51 PM (Pacific) Delivery Method Bid Responsive Bid Status Submitted Confirmation # 203383 Ranking 0 Respondee Comment Buyer Comment Attachments File Tlde Proposal Ownership Affidavit Bid Bond Non -Collusion Affidavit Line Items Type Item Code UOM Section 1 1 Mobilization LS 2 Traffic Signal Modification at Euclid St and Hazard Ave LS 3 OTT Opticom EVP System at Euclid & Hazard LS File Name Proposal (Signed).pdf Ownership Affidavit (Signed).pdf Bid Bond (Signed).pdf Non -Collusion Affidavit (Signed).pdf Qty Unit Price 1 $12,000.00 1 $84,511.00 1 $10,017.00 PlanerBids, hit. Page 1 Printed 04/1512020 EXHIBIT A File Type General Attachment Ownership Affidavit (Notary Public) - REQ Original Hard Copy Submittal in Addition Bid Bond Guaranty (Notary Public) - REQ Original Hard Copy Submittal in Addition Non -Collusion Affidavit (Notary Public) - REQ Original Hard Copy Submittal in Addition Line Total Comment '.. $12,000.00 $84,511.00 $10,017.00 City of Santa Ana page z Euclid Street at Hazard Avenue Signal Modification (17-6894 (HSIPL 5063(171))), bidding on February 26, 2020 200 PM Panted 04/1512020 Bid Results EXHIBIT A Type Item Code UOM oty Unit Price Line Total Comment 4 Install 4" PVC per plan '.. LF 360 $41,00 $14,760,00 5 Install New or Replace Existing No. 6 Pull Box EA 7 $566.00 $3,962.00 6 Install New or Replace Existing No. 6E Pull Box EA 1 $886.00 $886.00 7 24 Strand SMFO Cable LF 1000 $2,00 $2,000.00 8 IP Communication System LS 1 $12,458,00 $12.458.00 '.. '.. 9 Construct ADA Curb Ramp Per Plan SF 1243 $26.00 $32,318.00 10 Pothole for Utility Not Shown EA 6 $589.00 $3,534.00 11 Pothole for U0111y for Traffic Signal Pole Locations EA 2 $220.00 $440.00 12 Furnish and Install Temporary Overhead Wiring LS 1 $5,706.00 $5,706.00 13 Signing and Striping LS 1 $54,621.00 $54,621.00 .' 14 Furnish and Install Type E Traffic Loop Detector (with DLC)' EA 10 $482.00 $4,820.00 15 Furnish and Install Type D Traffic Loop Detector (with DLC)' EA 6 $511,00 $3,066.00 16 Furnish and Install Type Q Traffic Loop Detector (with DLC)' EA 1 $521.00 $521.00 17 Labor Agreement Oversight LS 1 $10,000.00 $10,000.00 Subtotal $255,620.00 Add Alternative One 18 Install Video Dection System at Euclid Street $ Hazard Avenue '.. LS 1 $28,794.00 $28,794.00 Subtotal $28,794.00 Base Bid Asterisk Notes per P-2 of Specifications - NOT part of Base Bid Calculation City of Santa Ana Page 3 t Euclid Street at Hazard Avenue Signal Modification (17-6894 (HSIPL 5063(171))), bidding on February 26, 2020 2:60 PM Printed 0M15/2020 Bid Results EXHIBIT A Type Item Code UOM Oty Unit Price Line Total Comment - 19 '=The quantity for this bid item is shown for bid comparison only. This bid item shall not be subject to the "25%" limit as stated in Section 3-2 of the Standard Specifications. EA 0 $8,407.00 0 Subtotal 0 Total $284,414.00 Planel Bids. hte- CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION EXHIBIT A FEDERAL PROJECT NO: HSIPL 5063 (171) amount for this item will be dictated by the actual quantity used, and the Agency reserves the right to increase or decrease the quantity of this item accordingly. t This bid item is considered a Specialty Item per Section 2-3.2 of the Standard Specifications. TIME FOR COMPLETION OF IMPROVEMENTS AND LIQUIDATED DAMAGES The undersigned bidder hereby proposes to complete the Work for the total base bid amount shown above, within number (80) working days after the commencement date stated in the Notice to Proceed. The liquidated damages amount, in lieu of the amount specified in Subsection 6-9 of the Standard Specifications, shall be S400.00 per calendar day. Name of Firm International Line Builder's, Inc. Signature of BIDDER Title (If an individual, so state. If a ftrrtr or co -partnership, state the firm name and give the names of all individual co-partners composing the firm. If a corporation, state legal name of corporation, and names of President, Secretary, Treasurer and Manager, thereof) P-3 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) BID PROPOSAL TO: CITY COUNCIL OF THE CITY OF SANTA ANA FROM: International Line Builder's, Inc. REQUIREMENT: The undersigned bidder declares that they have carefully examined the location of the proposed work, that they have examined the Contract Documents in its entirety and hereby proposes to furnish all material and do all the work required to complete the said work in accordance with said plans (if any) and the specifications for the unit price(s) or lump sum(s) set forth in the following schedule: Item Description Qty Unit Unit Price Amount I Mobilization 1 LS $I%660.00 $ 1'&,000.00 2 Traffic Signal Modification at Euclid St and Hazard Ave 1 LS $ P4,511. 00 $ e4,$1l . 00 3 GTT Opticom EVP System at Euclid & Hazard 1 LS $101 D1'+. 00 $ 10101-I•. 00 4 Install 4" PVC per plan 360 LF $.41_00 $14,14JO.00 5 - - Install New or Replace Existing No. 6 Pull Box - - 7 EA $ 5ULJ-00 - $ 5, lt-e -00 6 Install New or Replace Existing No. 6E Pull Box 1 EA $�tp.QQ $ gyp, D0 7 24 Strand SMFO Cable 1000 LF $ 'a%.00 $ -a•, 000.00 8 IP Communication System 1 LS $la,tag�.00 $ 12,LjCfa•00 9 Construct ADA Curb Ramp Per Plan 1243 SF $ -,)p,QO $3'd,3tt�• 00 10 Pothole for Utility Not Shown 6 EA $5j2A.00 $ 3, <j5 q.00 I I Pothole for Utility for Traffic Signal Pole Locations 2 EA $ r3 a0. DO $ u0. t)U 12 Furnish and Install Temporary Overhead Wiring I LS $ Gj,+W. Do $ SjoLp.00 13 Signing and Striping 1 LS $5t4, UM.60 S 5L4, LM •00 P-1 ofP-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) Item Description Qtv Unit Unit Price Amount 14a Furnish and Install Type E Traffic Loop 10 EA $ q 9Ja-.U() $ LI Qj 30. 00 Detector (with DLQ* l4b Furnish and Install Type D Traffic 6 EA $ 011.00 $ 3,ULPLQ. 00 Loop Detector (with DLQ* 14c Furnish and Install Type Q Traffic 1 EA $".©U $ 5a .00 Loop Detector (with DLQ* 15 Labor Agreement Oversight I LS $ 10,000 $ 10,000 TOTAL BASE BID $ a 55, Lra-U .00 ADD ALTERNATIVE ONE Item Description Unit Unit Price Amount 16 Install Video Detection System 1 LS $ab,"ti3Ot) $'a TOTAL BASE BID + ADD $ a QlLi ,141q .00 ALTERNATIVE ONE The lowest responsible bidder shall be selected based on the Total Base Bid. The City reserves the right to award the Base Bid, and any, all, or none of the add -alternate bid items (if any). The quantity for this bid item is shown for bid comparison only. This bid item shall not be subject to the "25%" limit as stated in Section 3-2 of the Standard Specifications. The actual P-2 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) amount for this item will be dictated by the actual quantity used, and the Agency reserves the right to increase or decrease the quantity of this item accordingly. f This bid item is considered a Specialty Item per Section 2-3.2 of the Standard Specifications. TIME FOR COMPLETION OF IMPROVEMENTS AND LIQUIDATED DAMAGES The undersigned bidder hereby proposes to complete the Work for the total base bid amount shown above, within number (80) working days after the commencement date stated in the Notice to Proceed. The liquidated damages amount, in lieu of the amount specified in Subsection 6-9 of the Standard Specifications, shall be $400.00 per calendar day. Name of Firm International Line Builder's, Inc. Signature of BIDDER Title Aana_lci 4,2taf - (If an individual, so state. If a firm or co -partnership, state the firm name and give the names of all individual co-partners composing the firm. If a corporation, state legal name of corporation, and names of President, Secretary, Treasurer and Manager, thereof.) P-3 ofP-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) BIDDER'S STATEMENT BIDDER understands and agrees that this Bid Proposal, Contract Documents and subsequent Construction Contract Agreement shall constitute the entire agreement between BIDDER and the AGENCY only after it has been accepted by the City Council, endorsed by the Clerk of the Council with her signature and official seal noting hereon the action of approval of the Council, signed by the Public Works Agency Executive Director or his/her duly authorized agent, and signed by the City Attorney, denoting his approval of the form of this document, and its execution, and when it or an exact copy of it has been either delivered to BIDDER or deposited with the United States Postal Service properly addressed to the BIDDER with the correct postage affixed thereto. BIDDER further agrees that upon delivery (as defined above) of the accepted agreement he/she will furnish AGENCY all required bonds and certificate of liability insurance within ten (10) business days or the funds, check, draft, or BIDDERS bond substituted in lieu thereof accompanying this proposal shall become the property of the AGENCY and shall be considered as payment of damages due to the delay and other causes suffered by AGENCY because of the failure to furnish the necessary bonds and because it is distinctly agreed that the proof of damages actually suffered is difficult to ascertain; otherwise said funds, check, drafts, or BIDDER'S bond substituted in lieu thereof shall be returned to the undersigned. BIDDER understands that a bid is required for the entire work, 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 BIDDER also certifies that the bid is a balanced bid. In accordance with Section 7028.15 of the California Business and Professions Code, the undersigned certifies under penaltye erjury that the foregoing is true and correct. Name of Firm International Line B Ider's, Inch Signature of BIDDER Title Earnest Brown - (If an individual, so state. If a firm or co -partnership, state the firm name and give the names of all individual co-partners composing the firm. If a corporation, state legal name of corporation, and names of President, Secretary, Treasurer and Manager, thereof.) P4 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGINAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) CONTRACTOR'S LICENSING AND REGISTRATION STATEMENT The undersigned contractor, or corporate officer, declares under penalty of perjury that he/she and all his/her subcontractors are registered with the State of California Department of Industrial Relations (DIR), and that the following is true and correct. Contractor's Name: International Line Builder's, Inc. Business Address: 3955 Temescal Canyon Road Corona, CA 92883 Business E-Mail Address: Omar.Echeverri@ilbinc.com Telephone: (951) 682-2982 State Contractor's License No. and Class: 782515 A-C10 License Expiration Date: 08/31/2020 State Dept. of Industrial Relations (DIR) Registration No.: 1000007032 State Dept. of IndusOpD elations (DIR) Registration Expiratie: 06/30/2020 Signed: Title: Earnest Brown- President So Cal Div. P-5 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) PREVAILING WAGE COMPLIANCE AND MONITORING STATEMENT Contractor is aware of the requirements of California Labor Code Section 1720, et seq., as well as California Code of Regulations, Title 8, Section 16,000, et seq., ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects. Since the services are being performed as part of an applicable "public works" or "maintenance" project, as defined by the Prevailing Wage Laws, and since the total compensation is $1,000 or more, Contractor agrees to fully comply with such Prevailing Wage Laws. City shall provide Contractor with a copy of the prevailing rates of per diem wages in effect at the commencement of this Agreement. Contractor shall make copies of the prevailing rates of per diem wages for each craft, classification or type of worker needed to execute the services available to interested parties upon request, and shall post copies at the Contractor's principal place of business and at the project site. Contractor shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. The undersigned certifies that the f regoing 1s true and correct. Name of Firm Signature of BIDDER Title Earnest Brown- President So Cal Div. (if an individual, so state) P-6 ofP-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) OWNERSHIP AFFIDAVIT STATE OF CALIFORNIA ) COUNTY OF ORANGE ) SS: CITY OF SANTA ANA ) Earnest Brown- President So Cal Div. , being duly swum, deposes and says: ❑ INDIVIDUAL That he/she is the party making the foregoing proposal: ❑ PARTNERSHIP That he/she is a member of the co -partnership firm designated as: and who has been and is duly vested with the authority to make and execute instruments for the co -partnership by: who constitute the other members of the co -partnership. ® CORPORATION That he is of: 1:rl ttrvu. a corporation which is making the foregoing proposal: ❑ JOINT VENTURE That he is of: International Line Builder's Inc. one of the parties making the foregoing proposal. as a joint venture, and the he/she has been and is duly vested with the authority to execute instruments for an on behalf of the parties making said bid who are: that such a bid is genuine and not collusive or sham, and has not in any manner sought by collusion to secut any advantage against the City of Santa Ana or any person interested in the proposed contraC =any other person. Signature of Bidder Subscribed and sworn to before me thi day of �0 _ At-, 41-mo-w-'cl Signature of er Administering Oath (Notary Public) P-7 of P-39 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 Riverside Subscribed and sworn to (or affirmed) before me on this M_ day ofT;P—hpt a . 20 20 . by Earnest Brown proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. ARENDA MCKINNEY Koury Public - Glilornia ■■ Riverside County f _ Commission r 2Z73125 " My Comm. Expires Feb 12. 1023 (Seal) SignatureEJi, CF�I4-Lc.rrriPrt CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) KNOW ALL PRESENT that, International Line Builders. Inc. , as BIDDER, and Liberty Mutual Insurance Company , as SURETY, are held and firmly bound unto the CITY OF SANTA ANA, as AGENCY, in the penal sum of _ Ten Percent of Amount Bid Dollars ($ 10% ), which is ten percent (10%) of the total amount bid by BIDDER to AGENCY 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 AGENCY 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 AGENCY. IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seal this 26th day of February 2020. SURETY* brv. Subscribed and sworn to before me Kelly Nicole En hauser this 26th day of february 2020. , KELLY NICOLE ENGHAUSER Signature: Notary Public -Minnesota Notary Publ c i d for the C ty of Hennepin State of Minnesota * Provide BIDDER/ SURETY name, address, and telephone number and the name, title, address, and telephone number of authorized representative. "Willis Towers Watson Midwest, Inc. 8400 Nonnandale Lake Blvd., Suite 1700, Bloomington, MN 55437 Phone:763-302-7170 P-8 of P-39 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 Riverside On t7 „a�rl, a0?fli before me. Brenda McKinney, Notary Public (insert name and title of the officer) personally appeared Earnest Brown, President So Cal Div. who proved to me on the basis of satisfactory evidence to be the person(r) whose name(-&) isfare- subscribed to the within instrument and acknowledged to me that he/sheft" executed the same in his/herftheir authorized capacity(ies). and that by his/#lerkheir signature(&) on the instrument the person(&). 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 m hand and official seal. BRENDAMNotary Public California y NanryPublic INNEYnia Riverside Counry [_ Commission; 2228125 My Camm. Expires rob 19. 2023 Signature (Seal) This Power of Attorney limits the acts of thou named herein, and they have no authorlly to bind the Company except In the manner and to the extent herein slated. Liberty Liberty Mutual Insurance Company `OkMutual. The Ohio Castle Insurance Company Cerdkcale No: 8202635-190003 SURETY West Ameripn Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insunew Company is a corporation duty organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duty organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (heroin collectively called the'Companiesl, puhannt to and by ini oriy herein set forth, does hereby name, constitute and appoint, Blake S. Bohlig. Brian D. Carpenter, Kelly Nicole Enghauscr, Heather R. Goedtet Michelle Halter. Jessica Hof. Nicole Langer. Craig Olmstead. Laurie Pnrp all of the city of Bloomington state Of Minnesota each individually if them be more than one named, its toe and lawful altomey+n-fact to make, execute. seal, acknowledge and deliver, for and on cis behalf as surely and as its act and deed, any and all undertakings, bonds, recrgnizances and other surety obligatimis, in pursuance of these presents and shall be as binding upon the Companies as it they have been duly signed by the president and attested by the secretary of the Companies in their awn proper persons. IN WITNESS WHEREOF, this Power of Aeomey has been subscribed by an authorized officer in official of the Companies and the corporate seals of the Companies have been affixed thereto this 21st dayof November , 2019 . Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company /4q 0(90 By' 7 n:,an u r..e„ ss On this 21 st dayof November , 2019 before me personally appeared David M. Carey, who acknowledged himsef to be the Assistant Secretary of Liberty Mutual Insurance Company, The Ohio Casualty Company. and West American Insumnce Company, and that he, as such, being aufwnzed so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. I have hereunto subscribed my name and affixed my notarial Hal at King of Prussia, Pennsylvania, on the day and year fin; above written P45T ZP eE m�unFq C� OMMONWEALTI OF PENNSYLVANW O l= y OF NWUI5B01 tereaa Peeb'N, Ndary Public Upper MamnTwp., Mo,xpvrery Cwmry � J/// BY: ���7[� J /� ('/[ ,, J _I— Pastdla, Notary Public �N�c Mmmaer. pmnanrma N a,p, asxw,z�,ee area This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West Amencim Insurance Company which resolutions are now in full forte and effect reading as follows: ARTICLE IV- OFFICERS: Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in wntihg by the Chairman or the President, and subject to such limitation as the Chairman or the President may pescribe, shall appoint such attomeysdn-fact as may be necessary to act in behalf of 0he Corporation to make; execute, seal, acknowedge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall have NII power to bind the Coryorabon by their signature and exewtion of any such instruments and to allac h thereto the seal of the Corporation. When H executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney -in -fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers grunting such power or authority. ARTICLE )(III - Execution of Contracts: Section 5. Surety Bonds and Undertakings. Any officer of the Company auhonzed for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman a the president may prescribe, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recngnizances and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and exewtion of any such instruments and to attach thereto the seal of the Company. When H executed such instruments shall be as binding as f signed by the president and attested by the secretary. Certificate of Designation -The President at the Company, acting pursuant to the Bylaws of the Company. authorizes David M. Carey, Assistant Secretary to appoint such attomeys-in- fact as may be necessary to act on behalf of the Company to make, execute, seal, aclawwledge and deliver as surety any and all undertakings, bonds, recognizances and other surety Obligations. Authorization - By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretaryof the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the Hine force and effect as though manually affixed. 1, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Ubery Mutual Insurance Company, and West Amedcen Insurance Company do hereby cendy that the original power of anomey of which the foregoing is a NII, true and collect copy of the Power of Attorney executed by aid Companies, is in NII force and effect and has not been revoked. _ IN TESTIMONY WHEREOF, I have hereuhd set my hand and affixed the seals of said Companies this 26th dayof February , 2020 . � \Nabq' '`tY INSU N 1NSUq - _ 0 1919 r, z 1991 r�'� - d� �+cxus°+D! S��FUNvaw�D�O ♦ '+puwh' ! By. 6zy . but ''tut . k� w3,N a kN+ Renee C. Llewellyn, Assistant Secretary CMS-128MLW000[CvyMCMWurA_MoI8 " CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) LIST OF SUB -CONTRACTORS Section 4100 et. seq. of the Public Contract Code requires listing of all subcontractors with the bid for all subcontract work exceeding the following amount: o Streets, highways including bridge projects: %% of the bid or S 10,000, whichever is greater o Buildings, parks, or other projects: 1/2% of the bid Section 1725.5 of the Public Contract Code requires all Subcontractors be registered with the State Department of Industrial Relations (DIR). BIDDER proposes to subcontract certain portions of the work to the firms listed below: Name W, 7"Ff;'G Name WP40. License #/Exp. 6}}(y9lD1 02�71$1a1 8� License #/Exp. 83 n }it 05 J Imo_ DIRReg.#/Exp. �Oppta_ 0}SIQI a?130�rt� DIRReg.#/Exp. IppDOILo}� 1*(nilaq?ia- Location Lai4jyJjoUWletrlq,r[,OLuytye, Location Ql}y/�p��pLn+QIJPXJtd{aY350$ Phone I>ul)9}4-Ito10 LA "1?rSUG Phone tri6i) 1ei�t-�3�a Type Of Work S4ny,14 0 jt¢Iptny Type Of Work luoorl;�rtc.O Teti rt__� __ Amount $ J0150.00 Amount $ Name ssr, &l fltt:.I'W0-IN(,. License #/Exp. I of d I bi 0351 Marl DIR Reg. #/Exp. 100000It0I0t cuiLcJ'aa- License # NIA Location 1,938 r, VmWla Art XA!3% tl4 Phone (.180M}. g06LP CM01 3 Type Of Work ICI; Amount $ 3&Q330.06 Name At &A-myan Asd-tot1), License #/Exp. }0}31 U11 1512a DIR Reg. #/Exp. jpO 2 pel_1, License # NIA Location ?,o.6aj aeJ cANgytLn cragA Phone (ole,�l)'}3L0--4uoo Type Of Work " I4cs Amount 0 0 (, t l 1 Signature of Bidder Name License #/Exp. DIR Reg. #/Exp. License # Location Phone Type Of Work Amount $ Name License #/Exp. DIR Reg. #/Exp. License # Location Phone Type Of Work Amount $ P-9 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) The following are the names, addresses, and telephone numbers for THREE public agencies for which the BIDDER has performed similar work within the past three years. l • City of Ontario 303 East B Street Ontario, CA 91764 Name and Address of Owner. Mauricio Diaz (951) 395-2000 Name and Telephone Number of person familiar with project. $248,570.00 Traffic Signal Modifications 11/30/2019 Contract Amount Type of Work Date Completed 2. _City of Riverside 3900 Main Street Riverside, CA 92522 Name and Address of owner. Gary Hironimus (951) 826-5377 Name and Telephone Number of person familiar with project. $1,967,698.83 Street Light Relocation 04/30/2018 Contract Amount Type of Work Date Completed 3. City of Anaheim 200 S Anaheim Blvd Anaheim CA 92805 Name and Address of owner. Robert Palaelogus (714) 765-5169 Name and Telephone Number of person familiar with project. $599,286.95 Street Light Relocation 10/31/2018 Contract Amount Type of Work Date Completed The following are the names, addresses, and telephone numbers of all brokers and sureties from whom BIDDER intends to procure insurance and bonds. Willis of Minnesota 8400 Normandale Lake Blvd., Suite 1700 Bloomington MN 55437 Heather Goedtel (763) 302-7159 Nicole Langer (763) 302-7214 P-10 ofP-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) ADDITIONAL REFERENCES The following are the names, addresses, and telephone numbers for THREE public agencies for which the BIDDER or Subcontractor has performed similar work in the past five years. 1 • Whiting -Turner 2520 Commerce St Suite 150 Irvine CA 90062 Name and Address of Owner. Name and Telephone Nun $1,988,327.00 Contract Amount of person familiar with project. Street Lighting, Site Electrical, Traffic Signal Type of Work 04/30/2018 Date Completed 2. City of Alhambra 111 S First St Alhambra CA 91801 Name and Address of owner. Robert Bias (626) 703-9013 Name and Telephone Number of person familiar with project. $670,780.96 Streetlight Conversion 08/30/2017 Contract Amount Type of Work Date Completed 3. Griffith Company 4756 Mission Blvd Montclair CA 91762 Name and Address of owner. Jill Kiefer (909) 270-5040 Name and Telephone Number of person familiar with project. $3,441,059.84 Streetlight Installation Contract Amount Type of Work 03/13/2016 Date Completed The following are the names, addresses, and telephone numbers of all brokers and sureties from whom BIDDER intends to procure insurance and bonds. P-11 ofP-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) NON -COLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the BIDDER declares 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, comtived, 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. Note: The abovgNon-ollusion Affidavit is part of the Proposal. BIDDERS are cautioned that rn! se certific-on may subject the certifier to criminal prosecution. Signed State of California County of Subscribed and sworn to trnted) before me on this day of 20by proved to me on the basis of satisfactory evidence to be the person(s) who appeare ore me S e � �'f"G1 tJ'lpzl . Notary Public Signature Notary Public Seal P-12 of P-39 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 Riverside Subscribed and sworn to (or affirmed) before me on this 2-I_ day of 20 20 . by Earnest Brown President So Cal International Line Builder's, Inc. proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. BRENDA MCRINNEY Notary Public dC California Riverside ersiCounty Commission 9 2...... 28 t 25 01. y Comm. Expves Feb 19. 2023 (Seal) Signature �r�C%� CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) NON-DISCRIMINATION CERTIFICATE The undersigned contractor or corporate officer, during the performance of this contract, certifies as follows: The Contractor shall not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. The Contractor shall take affirmative action to ensure that applicants are employed, and that employees are treated during employment without, regard to their race, color, religion, sex, or national origin. Such action shall include, but not be limited to, the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The Contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. 2. The Contractor shall, in all solicitations or advertisements for employees placed by or on behalf of the Contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. 3. The Contractor shall send to each labor union or representative of workers with which he/she has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the Contractor's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 4. The Contractor shall comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. 5. The Contractor shall furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his/her books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation, to ascertain compliance with such rules, regulations, and orders. 6. In the event of the Contractor's non-compliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, the contract may be canceled, terminated, or suspended in whole or in part and the Contractor may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Execution Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law. P-13 ofP-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) The Contractor shall include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontract or purchase order as the administering agency may direct as means of enforcing such provisions, including sanctions for noncompliance; provided, however, that in the event the Contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency, the Contractor may request that the United States enter into such litigation to protect the interests of the United States. Pursuant to California Labor Code Section 1735, as added by Chapter 643 Stats. 1939, and as amended, no discrimination shall be made in the employment of persons upon public works because of race, religious creed, color, national origin, ancestry, physical handicaps, mental condition, marital status or sex of such persons, except as provided in Section 1420, and any contractor of publi or violating this Section is subject to all the penalties imposed for a violation of the Ch ter. Signed: - � �cu \I --' Title: Earnest Brown- President So Cal Div Firm: International Line Builder's Inc. Date: 02/26/2020 P-14 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) STATEMENT REGARDING APPRENTICESHIP REQUIREMENTS The undersigned BIDDER is familiar with the requirements of Section 1777.5 of the State Labor Code regarding employment of apprentices, and understands that contractors on contracts exceeding $30,000 or 20 working days shall: 1. Apply to the joint apprenticeship committee administering the apprenticeship standards of the craft or trade in the area of the site of the public work for a certificate approving the contractor under the apprenticeship standards for the employment and training of apprentices in the area or industry affected. 2. Employ the number of apprentices or the ratio of apprentices to journeymen stipulated in the apprenticeship standards. 3. Contribute to the fund or funds in each craft or trade in which he/she employs journeymen or apprentices on the pu is work, in the same amount or upon the same basis and in the same manner as the othe,contactors, except contractors not signatory to the trust agreement shall pay a like amoun�tlh pprenticeship Council. Signed: u Title: Earnest Brown- President So Cal Div. Firm: International Line Builder's, Inc. Date: 02/26/2020 P-15 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) STATEMENT REGARDING "ANTI -KICKBACK" REQUIREMENTS The undersigned is submitting this proposal for performing by contract the work required by these bid documents, agrees to comply with the Copeland "Anti -Kickback" Act (18 USC 74) as supplemented in the Department of Labor regulations (29 CFR, Part 3). This act provides that each contractor or subcontractor shall be prohibited from inducing, by any means, any person employed in the constru r repair of public work, to give up any part of the compensation to which he/she is otherwi e eptitled. Signed: Title: Earnest Brown- President So Cal Div. Firm: International Line Builder's, Inc. Date: 02/26/2020 P-16 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) PUBLIC CONTRACT CODE SECTION 10162 OUESTIONNAIRE In conformance with Public Contract Code Section 10162, the BIDDER shall complete, under penalty of perjury, the following questionnaire: Has the BIDDER, any officer of the BIDDER, or any employee of the BIDDER who has a proprietary interest in the BIDDER, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No X If the answer is yes, explain the circumstances in the following space P-17 of'P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) BIDDER'S STATEMENT REGARDING REQUIRED FEDERAL CONTRACT PROVISIONS (FORM FHWA-1273) The undersigned, is sut bid documents, agrees 1273) as shown in the Signed this proposal for performing by contract the work required by these Ply with the required Federal Contract Provision (Form FHWA- c of the S cial Provisions of this project. Title Earnest Brown- President So Cal Div. Finn International Line Builder's, Inc. Date 02/26/2020 P-1 S of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder International Line Builder's, Inc. proposed subcontractor hereby certifies that he has X , has not _, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has 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 filling requirements. 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.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. 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 Federal Highway Administra Corr r by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Signed Title Earnest Brown- President So Cal Div. Firm International Line Builder's, Inc. Date 02/26/2020 P-19 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conforniance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has i , has not ,�C been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. I/ Signed Title Earnest Brown- President So Cal Div. Firm International Line Builder's, Inc. Date 02/26/2020 P-20 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) PUBLIC CONTRACT CODE SECTION 10232 STATEMENT In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to Signed Title Earnest Brown- President So Cal Div. Firm International Line Builder's, Inc. Date 02/26/2020 P-21 atP-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) TITLE 49 CODE OF FEDERAL REGULATION PART 29 DEBARMENT AND SUSPENSION CERTIFICATION The bidder under penalty of perjury, certifies that except as noted below, he/she or any person associated therewith in the capacity of owner, partner, director, officer, manager: is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; has not suspended, debarred, voluntarily excluded, or determined ineligible by any federal agency within past three years; has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space Exceptions will not necessarily result in denial of award, but will be considered in determining bidder's responsibility. For any exception noted above, indicate below to whom it applies, initialing agency, and dates of action. Note: Providing false information may result in criminal prosecution or administrative sanctions. The above certificati is part of a Proposal. Signing this Proposal on the signature portion thereof shall also constitute. signature o is Certification. Signed Title Earnest Brown- President So Cal Div. Firm International Line Builder's, Inc. Date 02/26/2020 P-22 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) NON -LOBBYING CERTIFICATION FOR FEDERAL AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influence or attempting to influence 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 any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriate funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal 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 undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. 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 this 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. The prospective particip t a� agrees by submitfing his or her bid or proposal that he or she shall require that theZngua of this certification be included in all lower tier subcontracts, which exceed $100,000 find th all sucbMb-recipients shall certify and disclose accordingly. Signed Title Earnest Brown- President So Cal Div. Firm International Line Builder's, Inc. Date 02/26/2020 • Standard Form LLL may be obtained from Caltrans and FHWA offices. P-23 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) DISCLOSURE OF LOBBYING ACTIVITIES DISCLOSURE OF LOBBYING ACTIVITIES Aappred by OLE Complete this torn to disclose lobbying activities pursuant to 31 U.S.C. 1352 DUMM46 See reverse for public burden disclosure. 1 _ Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract a- bidfoffenapplicabon a. initial filing b. grant b. initial award b_ material change a cooperative agreement c. post -award For Material Change Only: d. ban Year quarter e. ban guarantee date oflaw report f. loan insurance 4. Name and Address of Reporting Entity: 5_ C Reporting Entity in No_ 4 is a Subawardee, Enter Name ❑ Pram Cl abowwwow, and Address of Priume: Tier . it known: C sional District. iflrnown: congressional District. ifknown: 6. Federal DeparfinentlAgency: y. Federal Program Name/Description: CFDA Number, ifappTocable: S_ Federal Action Humber, iknown: 9. Award Amount, if known: S 10. a. Name and Address of Lobbying Entity b. Individuals Perforw ng SsrNees (kncbd W address if (if individual. last name. frrst name. Mf): dMemnikom No. f0a) (last name. fist name, M11: Conl'niJ>mrl r SF411AF 11. AmodM of Payment (check aA Curt apply): 13. Type of Payment (check all that apply): S ❑ Paso ❑ poetic -a ❑ a re aanr ❑ b. arr4ePe an ❑ a cummimon 12. Form of Payment (dmecle ay that apply). ❑ a reran ❑ a caeMgrd be ❑ G sNcpG spay: nature ❑ a. dwerred value ❑ t. athK apeery: U. Brief Description of Services Performed or to be Performed and Dates) of Service, including offreer(s), employee(s), a Mernber(s) contacted, for Payment Indicated in Ream 17: / 1 atad+Cpm MINdr, r 5F411A At .! 15. Continuation S s SF41 LA attached: Lj Ys m•«w� Mawr e.yn r. Mn ..Mnd M F er U a e C:� ature: .i.. -- Print Nan,.: EaYnest Brown cow. +r rev... wwr.a w... n u e c pax ry Title: President So Cal Div. •bwwwy b web N �v w1 N «e.welw b r•Y1c Nee0m ..,.........r N..w.e Pwm�e vr« ��w....,w....aa•>or.....�....naas« Telephone No.:(951)682-2982 Date: 02/26/20 Federal Use Only: AYICnHd b lad Rlprpelrlld+ "San %,b Fbnn 111 . 7471 P-24 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) INSTRUCTIONS FOR COMPLETION OF SF-LL. 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P-25 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) EXHIBIT 12 B BIDDER'S LIST OF SUBCONTRACTORS (DBE AND NON -DBE).— PART I PART The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1 A54 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Loral Assistance Procedures Manual Exhibit 12.8 and NON -DBE) Exhibit 12-B Bidder's List of Subcontractor (DBE and Non -DBE) Part 1 As of March I, 2015 Contractors (and sub -contractors) wishing to bid on public works contracts shall be registered with the State DI\'IYlna of Industrial Relations and certified to bid on Public Works contracts. Please register at: hlipc-/hm wv� dr capov/Public.WorkS/Contractor-RPPistratlon.hinll In accordance with Tide 49. Section 26.11 of the tote of Federal Regulations, and Section 4104 of else Public Contract Code of the State of California, as amended, the following information is required for each sub -contractor who will perform work amounting to more than one half of one percent (0.5%) of the Total Base Bid or S 10.000 (whichever is greater). Photocopy this form for additional firms. Federal Project Number: HAPL15OU5.0 W Subcontractor Name and Location line Item L Desaipton Subcontract Amount percentage of Bid Item Sub- contracted Contractor License Number DRE (y/N) DBE Cen Number Annual Gross Receipts DIR Re Number Name: lJ r s(yhl✓ly S �y�s � ',L D-eJ 0In J .I G^ nr� t7•r,l ✓6 la ,70 [�.y •I.t -ps„ Cl TT V USY N r' .) ❑ <$I million <$S million City. Stale: C,M .n/. ' s� Vp•~, C-a vT 'rW. IV��VT� <510million _ <515 million Ageofiirm ls. Name h.11 V 1,, 1 A�Il.tbl � C! L�N�l p�� ff3r TJ•Je"� 4510 r rQ �pl�sl V _ r 1V �Iq ❑ <S1 minion IN City.State: Cq&clrly` ,LJ`I J <55 minion ❑ <510 million I 1t�Q <$15millnn Age of Firm: rs. Name: Gf �s If -I11� 'Ulv(:,Q . 1 }l41103, �df p/ 'Its FO -1� C;>U 4-() 3 N N/4 / ❑ <$1 million ASPho11i- City. state: ��t '��roy�� ��n frm"I A, fA <$S million <SlSr illion �00�(� 615 matron eof Firm yes. Name' � n `1%IQQ•J(�1 (,Y1rr�+' vi- CID /)1 L �1 q 0 (� p, 1;3jJi I y �r�•F :I✓�l ❑ Qi million DLQreck DW yIA 'hI Stale: llf✓I J aiv"iticky (f4 $S million IQO00110} <Slo million O Age of firm. rs fFlrmi 2y Name: ❑ <$I million City, slate: <$5 million <510 million <535 million Age of Firm: yes. xame: <51 mllllon City, state: <$5 million ❑ <Slo million <515 million e of firm: rs. Distribution: 11 Original -cowl Agency File 2) Copy -Dot w/ nwaro racaage Page 1 of 2 January 2019 P-31 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) EXHIBIT 12-B BIDDER'S LIST OF SUBCONTRACTORS(DBE AND NON -DBE) — PART II PART II The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title 49, Section 26 of the Code of Federal Regulations. Photocopy this form for additional firms. Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors (DBE and NON -DBE) Exhibit 12-B Bidder's List of Subcontractor (DBE and Non -DBE) Part 2 In accordance with Title 49. Section 26 of the Code of Federal Regulations, the Bidder shall list all subcontractor who provided a quote or Pid but "ere not selected to participate as a subcontractor on this project. Photocopy this form for additional firms. Federal Project Number: Subcontractor Name and Location lane Item B Description subcontract Amount Percentage of Bid Item Sub. contracted Contractor license Number DBE )Y/N) DBE Cart Number Annual Gross Receipts DIR Reg Number Name:9 rs IV, /1 �J �•C Faq, qol y 4007" .�✓,� ✓s rt fJl /T <51 Mallon <SS million City. State: T`�G" LA�'rM� r , Ln IQ'xmoju <$10million ❑ <$lS million ARe of Firm: ya, Namef-6f 61WIC" VI UVV11 l �y� 'Y✓F dI r'I � �0 t5� N I A 1 ��()Cn I.O � N' A ❑ cSl million ❑ <55 million city, Nate: CA"ec"ar 04 ) <510 million ❑ 635 million ARe of firm: cos. Name: ❑ <$1 million <SS million City, State: ❑ 410 million ❑ <$1S million ARe of Flrm: Va. Name: ❑ <SS million ❑ 45 million City, State: LJ cS10 milllon <$35 million Afeaf Firm: Va. Name ❑ b1 million ❑ <55 million Gtv. State. <Slo million 615 million ARe of Firm: Va. Name <$1 million <S5 million City, State <$10 million <515 million r of firm: �. Distribution: l) Original -Local Agency File 2) Copy-DLAE w/Award Package Page 2 of 2 January 2019 P-32 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) PROMPT PAYMENT OF FUNDS WITHHELD TO SUBCONTRACTORS The undersigned, is submitting this proposal for performing by contract the work required by these bid documents, certify to comply with the following: The agency shall hold retainage from the prime contractor and shall make prompt and regular incremental acceptances of portions, as determined by the agency, of the contract work, and pay retainage to the prime contractor based on these acceptances. The prime contractor, or subcontractor, shall return all monies withheld in retention from a subcontractor within 30 days after receiving payment for work satisfactorily completed and accepted including incremental acceptances of portions of the contract work by the agency. Federal law (49CFR26.29) requires that any delay or postponement of payment over 30 days may take place only for good cause and with the agency's prior written approval. Any violation of this provision shall subject the violating prime contractor or subcontractor to the penalties, sanctions and other remedies specified in Section 7108.5 of the Business and Professions Code. These requirements shall not be construed to limit or impair any contractual, administrative, or -judicial remedies otherwise available to the prime contractor orb co ractor in the event of a dispute involving late payment or nonpayment by tl�e prime ontractor, deficient subcontract performance, or noncompliance b .#_su ontractor. Signed Title Earnest Brown- President So Cal Div. Finn International Line Builder's Inc. Date 02/26/2020 P-33 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) EXHIBIT 16-B — SUBCONTRACTING REQUEST Local Assistance Procedures Manual Exhibit 16-B CONTRACrORNAME _. COUNTY ROUTE International Line Builder's Inc. Orange Count BusmEsS ADDRESS CONTRACTNUMBER 3955 Temescal Canyon Road 17-6894 CITY AND STATE ZIPCODE FEDERAL -AID PROJECT NUMBER Corona CA 92883 HSIPL 5063 171 A. SUBCONTRACTOR B. BIDITEM C. PERCENTAGEOF D. SUB Lmm RCERTIFIED F. DESCRIBE WORK G. DOLLAR AMOUNT (Name. Bwe Address. Phone) NUMBERS) BID ITEM AT BID TIME DBE WHEN LEA THAN BASEDONTHEBID SUBCONTRACTED 100% OF WORK IS AMOUNT SUBCONTRACTED 8U -fa..+ L'' �i" ITCLl 13 i��o Yes No d Yes No ,J1ynlny '4 t�,�So.vo llclo ❑ El rt�ipl�� -ra'I IW1U" t-lt4j-V V �qny 6, Lna 14,1 IL1b 1L1u Lis N o Yes No Yes No d L(iUYDJ a 9j30. 00 4-IN)ti-j}-y55Lv E4 ❑ ❑ AtI4N,—Vvari,(fpn tzle4nct, LA IF I t �1,13 pl�� ° Ye No Yes No G r LC a-+4103.0 0 �151 -�tcov El El Zn�ld& Dw�E >W111" e4VV2eJICit,- I ��ho Yes No Yes No i D eFiC.}1Gr" �t ( T,(�UU.DO 0151 5 a3 a- Eld ❑ D¢,lltnv�+ Yes No Yes No ❑ ❑ ❑ ❑ Yes No Yes No ❑ ❑ ❑ El I certify that: • The Standard Provisions for labor set forth in the contract apply to the subcontracted work. • If applicable, Form F IW 73 of the Special Provisions has been inserted in the subcontracts and should be incorporated in any to er-ti subcontract. Written contracts have been executed for the above noted subcontracted work. _ This section is to be completed by the resident engineer 1. Total of bid items ]i Z Contractor must perform with own forces (line 1 X contract req. %) $ 3. Bid items previously subcontracted (taken from previously approved 16-B) $ 4. Bid items subcontracted (this request) $ 5. Total bid items subcontracted (line 3 plus 4) 6. Balance of work contractor to perform (line 1 minus 5) Approved RESIDENT ENGINEERS SIGNATURE Dg1ti wpy ,.nu,vuvun. vny�nao-e.onaaaor a.opy-neooenr engineer wpy-unto-smantu>mes>+neocatc+iJ �ptcTenv or fax to(916) 324-1949 Page 1 of 2 January 2018 P-34 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) Local Assistance Procedures Manual Exhibit 16-B Subcontracting Request INSTRUCTIONS FOR COMPLETING SUBCONTRACTING REQUEST FORM All first -tier subcontractors must be included on a subcontractor request. Before subcontracting work starts, the contractor will submit an original CEM-1201 for approval according to the Standard Specifications. After approval, the RE returns the original to the contractor and complete the remaining distribution as listed on the bottom of the form. D. If subcontractor was listed at bid time per the Fair Practices Act, check yes, otherwise check no. E. If subcontractor is a certified DBE contractor, check yes, otherwise check no. F and G. When a portion of an item is subcontracted, describe the portion and show the percentage of the bid item and value. - G. When an entire item is subcontracted, show the full bid item value. THIS FORM IS NOT TO BE USED FOR SUBSTITUTIONS OF SUBCONTRACTORS AND UDBE, DVBE OR SMALL BUSINESS ENTITIES. Page 2 of 2 January 2018 P-35 ofP-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) DIFFERING SITE CONDITIONS The undersigned, is submitting this proposal for performing by contract the work required by these bid documents, certify to comply with the following: a. Contractor's Notification Promptly notify the Agency's Engineer if you find either of the following conditions: I. Physical conditions differing materially from either of the following: • Contract documents • Job site examination 2. Physical conditions of an unusual nature, differing materially from those ordinarily encountered and generally recognized as inherent in the work provided for in the Contract Include details explaining the information you relied on and the material differences you discovered. If you fail to promptly notify the Engineer, you waive the differing site condition claim for the period between your discovery of the differing site condition and your notification to the Engineer. If you disturb the site after discovery and before the Engineer's investigation, you waive the differing site condition claim. b. Engineer's Investigation and Decision Upon your notification, the Engineer investigates job site conditions and: 1. Notifies you whether to resume affected work 2. Decides 0 the condition differs materially and is cause for an payment, or both Signed Title Earnest Brown- President So Cal Div. Firm International Line Builder's, Inc. Date 02/26/2020 P-36 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) BIDDER'S CERTIFICATE OF COMPLIANCE REGARDING "BUY AMERICA" REQUIREMENTS FOR STEEL OR MANUFACTURED PRODUCTS The undersigned, is submitting this proposal for performing by contract the work required by these bid documents, certify to comply with the "Buy America" requirements of Section 165 of the Surface Transportatio istance Act of 1982 and as shown in the special provisions of this project. /1 Signed Title Earnest Brown- President So Cal Div. Firm International Line Builder's Inc. Date 02/26/2020 P-37 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) NEPA COMPLIANCE FOR FEDERAL AID CONTRACTS The undersigned, is submitting this proposal for performing by contract the work required by these bid documents, certify to comply with the Categorical Exemption/Categorical Exclusion Determination Form including and not limited to the National Environmental Policy Act (NEPA) requirements and ron ental commitments found in the appendix of the Contract Documents a of this project. r\ Signed Title Earnest Brown- President So Cal Div. Firm International Line Builder's, Inc. Date 02/26/2020 P-38 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) TMP COMPLIANCE FOR FEDERAL AID CONTRACTS The undersigned, is submitting this proposal for performing by contract the work required by these bid documents, certify d 'cTply with the Traffic Management Plan (TMP) commitments found in the appendix of the Ca�:ict Documents of this project. Signed Title Earnest Brown- President So Cal Div. Firm International Line Builder's, Inc. Date M26/2020 P-39 of P-39 ORANGE COUNTY REGISTER 2190 TOWNE CENTER PL, ANAHEIM, CA 92806 Telephone (714) 796-7000 f Fax (714) 796-6059 PROOF OF PUBLICATION (2015.5 C.C.P.) stale of California ) County of ORANGE ) ss Notice Type: BID - NOTICE INVITING BIDS Ad Description: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION I am a citizen of the United States and a resident of the State of California; I am over the age of eighteen years, and not a party to or Interested in the above entitled matter. I am the principal dark of the printer and publisher of the ORANGE COUNTY REGISTER, a newspaper published in the English language in the city of SANTA ANA, county of ORANGE, and adjudged a newspaper of general circulation as defined by the laws of the State of California by the Superior Court of the County of ORANGE. State of California, under date 1111911905, Case No. A21046. That the notice, of which The annexed is a printed copy, has been published in each regular and entire Issue of said newspaper and not In any supplement thereof on the following dates, to -wit: 0210512020, 02/12/2020 Executed on: 02/12/2020 AI SANTA ANA,CA I certify (or declare) under penalty of perjury that the foregoing Is true and correct. EMU II IIII IIIIIII II CNS#: 3338988 This 5paca nar la,y alarm arty Recorded it `ficial Records, Orange County Hugh Nguye,., Clerk -Recorder 11 $11II II III11�1II1111 11IIII 111111111111111111 NO FEE *$ R 0 0 0 8 2 8 9 6 3 1$ 201685000335 8:46 am 04/12/16 323 304 Z01 0.00 50.00 0.00 0.00 0.00 0.00 0.00 0.00 MAYOR Miguel A. Pulido - ,-s-.- a' CITY MANAGER MAYOR PRO TEM David Cavazos CITY ATTORNEY Vincente Sarmiento Sonia R. Carvalho COUNCIL MEMBERS Angelica Amezcua _ - ` _± - CLERK OF THE COUNCIL P. David Benavides Maria D. Huizar Michele Martinez Roman A. Reyna Sal Tinajero CITY OF SANTA ANA PLANNING 8 BUILDING AGENCY 20 Civic Center Plaza (M-20) P.O. BOX 1988 . Santa Ana, California 92702 (714) 667-2700 - Fax (714) 973-1461 vWAv.santa-ana.org NOTICE OF EXEMPTION From the Requirements of the California Environmental Quality Act (CEQA) Fee Exemption per California Government Code Section 6103 To: COUNTY CLERK From: City of Santa Ana County of Orange Planning & Building Agency P.O. Box 238 20 Civic Center Plaza M-20 Santa Ana, CA 92702 Santa Ana, CA 92702 Project Title: Euclid Street at Hazard Avenue Signal Modification Date of Approval: 07/05/2016 Project Number(s): PWA-2016-370-CITY Project Location: 1 Citywide (Partial) City: Santa Ana County: Orange ER Number: ER-2016-39 Project Description: Construction to install protected, left turn arrows for east and west directions at Euclid Street and Hazard Avenue. Applicant Name: Zdenek Kekula, City of Santa Ana Public Works Agency Applicant Address: 20 Civic Center Plaza M-43 SANTA ANA, CA 92702 Name of Public Agency Approving Project: City Council Name of Person or Agency Carrying Out Project: Exempt Status: ❑ Ministerial (Sec. 15268) ❑ Declared Emergency (Sec. 15269 (a)) ❑ Emergency Project (Sec. 15269 (b through e)) ❑ General Rule (Sec. 15061(b)(3)/(5)) ❑ Statutory Exemption: 10 Categorical Exemption: 15301(c) Reason(s) Why Project is Exempt From CEQA: Kekula, Zdenek APR 12 2016 HUGH NGUYEN,,CLEE�RK-RECORDER BY: AA DEPUTY APR 12 2016 ORANGE COUNTY CLERK•RECORDER DEPARTMENT BY: ryI A— DEPUTY 15301(c) consists of the operation, repair, maintenance or minor alteration of existing public facilities such as streets, sidewalks, gutters, bicycle and pedestrian trails. City Contact: Zdenek Kekula Telephone: (714) 647-5606 Signature: � Title: wV CYcG Vim. Date: L1 Z1 SANTA ANA CITY COUNCIL Miguel A. Pulido Vincente Sarmiento Michele Martinez Angelica Amezcua P. David Benavides Roman Rayne Sal Tinajero Mayor Mayor Pro Tem, Warr! t Ward 2 Ward 3 Ward 4 Ward 5 Ward 8 MPulida(o)santa-anon VS t (a! t MMartinez(o)s t AAme ro ta- Dg tl oa t - q RRevna(&sama- ST' Cq)., ta- CITY OF SANTA ANA PROPOSAL PROJECT NO:=.-d 7-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) KNOW ALL PRESENT that, Alfaro Communications Construction, Inc. , as BIDDER, and Endurance Assurance Corporation , as SURETY, are held and firmly bound unto the CITY OF SANTA ANA, as AGENCY, in the penal sum of _ Ten Percent of the Total Bid Amount Dollars ($ 10 % of Total Bid Amount) which is ten percent (10%) of the total amount bid by BIDDER to AGENCY 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 AGENCY 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 AGENCY. IN WITNESS WHEREOF the parties hereto have set their n es, titles, hands, and seal this 21st day of February , 20 20 BIDDER* G Alfaro Communications Construction, Inc. SURETY* Endurance sura ce Corp r f James W. Moilanen, Attorney-in-F; Subscribe d sworn to before me this day of 120. Signature: Notary Public in and for the County of See Attached California Notary Acknowledgement , State of * Provide BIDDER/ SURETY name, address, and telephone number and the name, title, address, and telephone number of authorized representative. Bidder: Alfaro Communications Construction, Inc. 15614 S. Altantic Ave., Compton, CA 90221 Surety: Endurance Assurance Corporation 1221 Avenue of tiie Americas, New York, NY 10020 T: 415-500-5028 Agent: The Bond Exchange and Insurance Agency 24800 Chrisanta Dr. Suite 160, Mission Viejo, CA 92691 949-461-7000 P-8 of P-39 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 Orange On February 21, 2020 before me, Robyn R. Kargari , Notary Public, Date Insert Name of Notary exactly as It appears on the official seal personally appeared James W. Moilanen sE "'Free ROBYN R. KARGARI fFJ Ji 'm COMM. # 2296844 :t1 y P r NOTARY PUBLIGCALIFORNIAORAGE Y COUNTY N °gtwo MY 0 MN XP, JULY 13 3023 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 an Icial se Signatur inna Place Notary Seal Above So ry ilic obyn R. Kargan OPTiONAL Though the information below is not required by law it may prove valuable to persons relying on the document and could prevent fraudulent removal anti reattachment of the form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer —Title(s):_ ❑ Partner El Limited ❑General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: Number of Pages: Signer's Name: _ ❑ Individual ❑ Corporate Officer—Tltle(s): _ ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator Other: Signer is Representing: w POWER OF ATTORNEY 1043 KNOW ALL BY THESE PRESENTS, that Endurance Assurance Corporation, a Delaware corporation, Endurance American Insurance Company, a Delaware corporation, Lesson Insumneo Company, a Texas corporation, and/or Bond Safeguard Insurance Company, a South Dakota corporation, each, a'Company" and collectively, "Sompo International," do hereby constitute and appoint: YUNG T. MULLICK, JAMES W. MOILANEN, IRENE LUONG, P. AUSTIN NEFF, EMILIE GEORGE estrus and lawful Attorneys) -In -Fact to make, execute, seal, and deliver for, and on its behalf as surety or co -surety; bonds and undertakings given for any and all purposes, also to execute end deliver on its behalf as aforessid renewals, extensions, agreements, waivers, consents or stipulations relating to such bonds or undertakings provided, however, tha ,to single bond or undertaking so made, executed and delivered shall obligate the Company for any portion of the penal sum thereof in excess of the sum of TEN MILLION nnlivro ($10,000,000.00). Such bonds and undertakings yor said purposes, whon duly executed by said attorney(s)-in-fact, shall .te binding upon tha Company as fully and to the same extent as if signed by the President of the Company under its corporate seal attested by its Corporate Secretary. This appointment is made under and by authority of certain resolutions adopted by the sole shareholder of each Company by unanimous written consent effective the 16th day of June, 2019, a copy of which appears below under the heading entitled "Certificate", This Power of Attorney is signed and sealed by facsimile under and by authority of the following resolution adopted by the sole shareholder of each Company by unanimous written consent ediec5ve the 15th day of June, 2019 and said resolution has not sinew been revalued, amended or repealed: RESOLVED, that the signature of an individual named above and the seal of the Company may be affixed to any such power of attorney or any certificate relating thereto by facsimile, and any such power rd attorney at certificate bearing such facsimile signature or seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to wl rich it is at4achod. IN WITNESti VVHg1IE.0 °, and- Corr:pany has caused this instrument to be signed by the follnmiag officers, and its corporate seal to be affixed this 16s, day of June, 2019. Endurance American In are c,eYipp Ry. f 8) Richard AppeG,"Pdt.,Aenior Counsel 'eor in V,PDF btu'. V. ��F 2n3 Na M'. IvP:i :ot DL-LAWARE,.��"�`R t U� ... w •,,,,,- ,ACKNOWLEE On this 15r` day of June, 2019, Uefore me, personally came the above signatories knows of the Companies; and that hn axncidod said instrument on behalf of each Compamr by CERTIF( I, the undersigned Officer of each Company, DO HEREBY CERTIFY that 1. That the original power of attorney of which the foregoing is a copy was duly executed or behralf of each Company and has not since been revoked amended or modified; that the undersigned has compared the foregoing copy thereof with the original power of attorney, and that the same is a true and correct copy of the original power of attorney and of the whole thersof, 2. The following am, resolutions v.;hich were adopted by the sole shareholder of ouch Company': y unanimoux varitten consei t effective June 15, 2019 and said resolutions have not since been revoked, amended or modified: "RESOLVED, that each of the individuals named below is authorized to make, execute, seal and dolive' f• em:I or, bohni; cf the Company any and all bonds, undertakings or oblinations in surety or W-surety with others: RICHARD M. APPEL, BRIAN J. BEG38, CHRIS I C•NHER DONEIAN, SHARON L. SIMS, CHRISTOPHER I... SPARRO, MARIANNE L. WILBERT ; and be it further RESOLVED, that each of the individuals named above is authorized to appoint attorneys -in -fact for the purpose of making, executing, sealing and delivering bonds, undertakings or obligations, in surely or co -surely for and on behalf of the Company." 3. The undersigned further cartif!es that the above resolutions are true and correct copies of the resolutions as so recorded and of the whole thereof. IN WITNESS WHEREOF, I have herounto set my hand and affixed the corporate seal this 21st ----..day of February 2020 Dames t e`Se iem:y NOTICE. UU^S. TRL--ASURY QEPARTMENT'S OPFICH )ELF( _N ASSETS C01v R0L-LACl No coverage is provided by this Notice nor can it be construed to replace any provisions of any surety bond or other surety coverage provided. This Notice providas Information concerning possible Impact on your surety coverage due to directives issued by OFAC. Please read this Notice carefully. The Offers of Foreign Assets Control (OFAC) administers and enforres aanMions policy, based an Presidentia! de*Aerations of "national emergency". OFAC has identified and listed numerous foreign agents, dent organizations, terrorists, terrorist organizations, and narcotics traffickers as'Specially Designated Nationals and Blacked Persons". This list can be loomed on the United States Tn.ocury a wr: baea hops;/wppntrenauY..gobvesourcece_at-er an,iQns/,`IIN-Lix.j. In accordance with OPAC regulations, if it is determined that you or any other person or entity claiming the banaiits of any coverage has violated U.S. sanctions law or Ise Specially Designated National and Blocked Person, as identified by OFAC, any coverage will be considered a blocked or frozen Contracf inlaJ pro-nsions of any coverage provided are Immediately subjectto OFAC. When a surety bond or other form of surety coverage is considered to be such a blocked 01 irm:%n: Cnrtraet, ao paymants nor premium refunds may be made without authorization tram OFAC. Other limitations on the premiums and payments may also apply. Any reproductions are void. Surety Claims Submission: 1_axpn4lafrgAr mlI-r_niptratinn¢sc;npo-Irr4l.com Telephone: 615-663-9500 Mailing A.ddrosc: Sompo Intornatlonat; 12690 Lebanon Road; Mount Julleq TN 37122-2870 No. 5082.3 STATE OF CALIFORNIA DEPARTMENT OF INSURANCE SAN FRANCISCO Amended Certificate. of Authority THIS I& To CERTIFY that, pursuant to (lie Insurance Code of the State ofCalifvrnia; Endurance Assuranee Corporation of Delaware, organized under the laws of Delaware, subject to its Articles of incorporationor other fundamental organizational documents; is hereby authorized to transact within this State, subject to provisions of diis Cart#lorue, the following classes of hisurance: Fire, Marine, Surety, Disability, Plate Glass, Liability, Workers' Compeusationr Common Carrier Liability, fluffier and Machinery, Burglary, Credit, Sprinkler, Team and Vekiele, Automobile;.Aircraft, and iuliscellaneous as such classes are now or mqy hereafter be dined in the :.Insurance Laws of the State of Gall brnia,: THIS CERTIFICATE Is expressly conditioned upon the holder hereofnow,andheregjter being in full compliance with all, and not in violation of any, t y"Ass applicable laws and lawful requirements made under€ uthorh y of the.laws of the State of CaI1 ornta as longas such laws or requirements are ineffectamf applicable, and as such laws and requirements now are, or may het'inear be changed oramended IN WITNESS WHEREOF, effecittre as of the 2314 day of August, 2n16 I have hereunto set my hand and caused my of vial sea{ to be affixed this2Yedgy afAis itsi, 20I6 Dave Jones Insurance emohlasfoner AAA BY Catol Fxair for Joel Laucher ChisfDep,ey Qualgieation with the 900retany of statetrtust be awounplished as required by the California Corporations Codeifeumptlyaft. issuance 01his Certfleato ofAuthsrlty, Eallae to do so Will be aviotation of lnsurmee Code section 701 mid wtll be grounds ft revoking this Codficnee ofAudiorby pauauant to the OVe11211[s made is the application therefor and Ole wnditions contained heroht. CALIFORNIA CERTIFICATE OF 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 02/21/2020 before me, Cindi Esmeralda SantaMaria Castillo (here insert name and tide of the officer) personally appeared Hugo Alfaro who proved to me on the basis of satisfactory evidence to be the personV) whose name() isfaresubscribed to the within instrument and acknowledged to me that he/sh@A4ey executed the same in his/her/r r authorized capacity(ies), and that by his/herfthefr signature on the instrument the person(s), 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. Signature Cindi Estneralda Santamada Castillo Comm. #2200339 z Notary Public •California o z' v Los Angeles County 1 My Comm. Expires June 5, 2021 i eap Optional Information Although the information in this section is not required by law, it could prevent fraudulent removal and reattachment of this acknowledgment to an unauthorized document and may prove useful to persons relying on the attached document. Description of Attached Document The preceding Certificate of Acknowledgment is attached to a document titled/for the purpose of City of Santa Ana Proposal Bid Bond Project No. 17-6894 Euclid St at Hazard Ave Project# HSIPL - 5063,(171) containing pages, and dated The signer(s) capacity or authority is/are as: ❑ Individual(s) ❑ Attorney -in -Fact President Corporate Officers) ritletsl ❑ Guardian/Conservator ❑ Partner - Limited/General ❑ Trustee(s) ❑ other. representing: Name(y) of Person(sl or Entity0es) Signer is Representing Method of Signer Identification _ Proved to me on the basis of satisfactory evidence: O form(s) of Identification ❑ credible witnesses) Notarial event is detailed in notary journal on: Page # Entry # Notarycontact: (323)495-6782 ❑ Additional Signer(s) ❑ Signer(s) Thumbprinds) Is Copyright 2007 2016 Notary Rotary, Inc PO Box 41400, Des Moines, IA 50311-0502 All Rights Reserved item Number 101772. Please contact your Authorised Resellei to purchase copies of this form. CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) NON -COLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the BIDDER declares 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, panne hip, company association, organization, bid depository, or to any member or agent thereof t�ffectuate a collusive or sham bid. Note: The above Non llu i it is part of the Proposal. BIDDERS are cautioned that making a f its le c r m y subject the certifier to criminal prosecution. Signed State of C ifornr I County of�Lgs�Q�Q, ubscribed and orn(}}to (or affirmed) before me on this2l day of ()Z 202, by proved to me on the basis of satisfactory evidence to be the person(s) who a0pearea before me :� Cindi Esmeralda Santamaria Castillo _ Comm. fl2200339 p '�;i_ ,� '''.'�� � Notary Pu61ic California o s Los Angeles County �,, hfy Comm. Expires June 5, 2021 a Public Signature Notary Public Seal P-12 ofP-39 CALIFORNIA CERTIFICATE OF ACKNOWLEDGMENT A notarypublic or other officer completing this certificate verifies only the Identity of the Indrvtdual 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 02/21/2020 before me, Cindi Esmeralda SantaiMaria CastLo (here insert name and tide of the officer) personally appeared Hugo Alfaro who proved to me on the basis of satisfactory evidence to be the person(A whose name( is/3sesubscribed to the within instrument and acknowledged to me that he/sheAhey executed the Same in hisA4e*A4!A +r authorized capacity(ies), and that by hisAwoA"r signature(,a'ion the instrument the persony,, or the entity upon behalf of which the persony 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. CindiEsrferaldaSantam:2021] Comm. NaryPuCaLos Angeles CoSignature M Comm.ExresJu (Seal) L. Optional Information _ Although the information in this section is not required by law, it could prevent fraudulent removal and reattachment. of this acknowledgment to an unauthorized document and may prove useful to persons relying on the attached document. Description of Attached Document The preceding Certificate of Acknowledgment is attached to a document titled/for the purpose of City of Santa Ana Non Collusion Affidavit Project No 17-6894 Euclid St at Hazard Ave Project# HSIPL - 5063,(171) containing pages, and dated The signer(s) capacity or authority is/are as: ❑ Individual(s) ❑ Attorney -in -Fact President r Corporate Officer(s) allele) ❑ Guardian/Conservator ❑ Partner - Limited/General ❑ Trusteets) ❑ other: representing: Names) of Persons) or Entityhes) Signer is Representing Method of Signer Identification Proved to me on the basis of satisfactory evidence: Q rormis) of identification Q credible witness(es) Notarial event is detailed in notary journal on: Page # Entry # Notary contact: (323) 495-6782 ❑ Additional 5igner(s) ❑ 5igner(s)Thumbprint(s) 0 Copyright 2007 2DIis Notary Rotary, Inc To Boa 41400. Des Moines. IA 50311 0507 All Rights Reserved Item Number 101772 please contact your Authorized Reseler to purchase copies of This form. CITY OF SANTA ANA PROPOSAL PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) OWNERSHIP AFFIDAVIT STATE OF CALIFORNIA ) COUNTY OF ORANGE ) SS: CITY OF SANTA ANA ) Hugo Alfi m , being duly sworn, deposes and says: ❑ INDIVIDUAL That he/she is the party making the foregoing proposal: ❑ PARTNERSHIP That he/she is a member of the co -partnership firm designated as: and who has been and is duly vested with the authority to make and execute instruments for the co -partnership by: who constitute the other members of the co -partnership. CORPORATION That he is of President of Alfaro Communications Construction,fnc a corporation which is making the foregoing proposal: ❑ JOINT VENTURE That he is of. - one of the parties making the foregoing proposal as a joint venture, and the he/she has been and is duly vested with the authority to execute instruments for an on behalf of the parties making said bid who are: that such a bid is genui a and not collusive or sham, and has not in any manner sought by collusion to secure any v n against the City of Santa Ana or any person interested in the proposed contract, for hpl s � a y other person. Signature and stworn'fo before me this 2 i ° i day o n2Ct / 202� A--\ /\ of officer Administering Oath (Notary Public) ��Cindi Esawalda Santamana Castillo Comm. #22003.. z • ® Notary Public California z Los Angeles County M Comm. Expires June 5, 2021 P-7 of P-39 CALIFORNIA CERTIFICATE OF 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 02/21/2020 personally appeared before me, Cindi Esmeralda SantaMaria Castillo (here insert name and tide of the officer) Alfaro who proved to me on the basis of satisfactory evidence to be the person() whose name(l) is/aisesubscribed to the within instrument and acknowledged to me that he/sfie #wy- executed the same in his/herAheif authorized capacity(es ,, and that by his/rer}Opeir signature(Z) on the instrument the persona); or the entity upon behalf of which the personviacted, executed the instrument. 1 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. Cindi Esmeralda Santamada Castillo Comm. #2200339 z ! Signature6 �, m Notary Public -California o z Los Angeles County M Comm. Ez re5 June 5, 2021 ' (Seal) 1, Optional Information Although the information in this section is not required by law, it could prevent fraudulent removal and reattachment of this acknowledgment to an unauthorized document and may prove useful to persons relying on the attached document. Description of Attached Document The preceding Certificate of Acknowledgment is attached to a document titled/for the purpose of City of Santa Ana Proposal Ownership Affidavit Project No 17-6894 Euclid St at Hazard Ave Project# HSIPL - 5063,(171) containing pages, and dated The signer(s) capacity or authority is/are as: ❑ Individualfs) ❑ Attorney -in -Pact President X1 Corporate Officers) ❑ Guard ian/Conservator ❑ Partner - Limited/General ❑ Trustee(s) ❑ Other: representing: Names) of Person(sl o1 EntiIyge,) Signer is Representing Method of Signer Identification Proved to me on the basis of satisfactory evidence: O form(s) of identification Q credible witness(es) Notarial event is detailed in notary journal on: Page # Entry # Notary contact: (323) 495-6782 Other ❑ Additional Signer(s) ❑ Signer(s)Thumbprint(s) 0 Copyright 2007 W016 Notary Rosary, Inc PO Box 41400, Des Mimes, IA 50311 0507 All Rights Reserved item Number 101772 Please contact your Authorized fieselle, to purchase copies of this form. CITY OF SANTA ANA Bond No. 190045266/107249015 BONDS PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) PAYMENT BOND KNOW ALL MEN BY THESE PRESENTS that International Line Builders, Inc. as CONTRACTOR, and Liberty Mutual Insurance Company & Travelers Casualty and Surety Company of America , a corporation, organized and existing under the laws of the State, and duly authorized to transact business under the laws of the State of California, as SURETY, are held and firmly bound unto the City of Santa Ana, as AGENCY, in the penal sum of Two Hundred Fifty Five Thousand Six Hundred Twenty and 00/100 Dollars ($ 255,620.00 ), which is 100 percent of the total contract amount for the above stated project, for the payment of which sum, CONTRACTOR and SURETY agree to be bound, jointly and severally, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas CONTRACTOR has been awarded and is about to enter into the annexed Contract Agreement with AGENCY dated May 19, 2020 for Project No. 17-6894, Euclid Street at Hazard Avenue Signal Modification [HSIPL-5063(171)] if CONTRACTOR or any subcontractor fails to pay for any labor or material of any kind used in the performance of the Work of Improvement to be done under said Contract Agreement, or fails to submit amounts due under the State Unemployment Insurance Act with respect to said labor, SURETY will pay for the same in an amount not exceeding the sum set forth above, which amount shall insure to the benefit of all persons entitled to file claims under the State Code of Civil Procedures; provided that any alterations in the work to be done, materials to be furnished, or time for completion made pursuant to the terms of the contract documents shall not in any way release either CONTRACTOR or SURETY, and notice of said alterations is hereby waived by SURETY. IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seal this 26th day of May ,20zo . Liberty Mutual Insyrfbice ComgiKy, 175 Berkeley Street, Boston, MA 02116, Phone: (617) 357-9500 & Heather R. Willis Towers Watson Midwest, Inc., 8400 Normandale Lake Blvd, Suite 1700, Bloomington, MN 55437, Phone: 763-302-7159 Subscribed and sworn to before me, Nicole Lamiger this 26th day of May 12020 .xa ;; e;. NiCO?PC4-, Signature: = Jan 3 12023 Notary Public in e County of Hennep n State o esota Rate of premium on this bond is $ 4.70 per thousand. Total amount of premium charge is $ 1,201 To be filled in by Surety *Provide CONTRACTOR /ADMITTED SURETY name, address, and telephone number and the name, title, address, and telephone number of authorized representative. 2of3 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 Riverside On A o!4 � �, aO�U before me. Brenda McKinney, Notary Public (insert name and title of the officer) personally appeared W ij h c4& 1 .0 mEnpL, 43e", rnM who proved to me on the basis of satisfactory evidence to be the person(64whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/hey executed the same in his/heFAheiF authorized capacity(tes). and that by his heFA eir signature(r) 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. BRENOA MCKINNEY WITNESS my hand and official seal. Notary Public - Califonia Riverside CountyE 22781 Commission C 2278125 My Comr. Ezpi. es Feb 19, 2023 Signature (Seal) oLiberty Mutual, SURETY This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY Certificate No: 8202635-190003 KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively railed the 'Companies), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Blake S. Bohlig, Brian D. Carpenter, Kelly Nicole Engbauser, Heather R Goedtel, Nfichelle Halter, Jessica Hoff, Nicole Langer, Craig Olmstead, Laurie Pflug as or me city or Bloomington stare or Minnesota Seen individually d mere be more than one named its true and lawful attomeyAn-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as 9 they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 21st day of November , 2019 . Liberty Mutual Insurance Company Y Ixap d 1NSUgq The Ohio Casualty Insurance Company "a°W,R9y oP °o"pOWr yc West American Insurance Company (9(0(9 °b r1g `°n1919aoas1991coo, 7/h+xr^ D3 Y Mprpx> D "yam// flaui,IM f:aroe Aecielani Cerrolnry State of PENNSYLVANIA County of MONTGOMERY ss On this 21st day of November , 2019 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the therein contained by signing on behalf of the corporations by himself as a duly authorized officer. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. PAST 9P F' oNW F� COMMONWEALTH OF PENNSYLVANIA Notarial Seal OF Teresa Pestella, Notary Public Upper Marion Twp., Montgomery Cuunty By: C VP� My Commission Expires March 28, 2021 Mambec PenroyNaniaAssocla0on ofNolariea This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are new in full force and effect reading as follows: ARTICLE IV —OFFICERS: Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such aftorneys41n-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, reoognizances and other surety obligations. Such attomeys-in-fact, subject to the limitations set forth in their respective powers of affomey, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attomey-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE All — Execution of Contracts: Section 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in wdfing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attomeys-in-fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attomeys-in- fact as may be necessary to act on behalf of the Company to make, execute, seal, acnowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 26th day of May , 2020 . tV INSU a 1NSU J�°"r°x+>� �P°°pPO��tin (0(90 OQ � Fa m Q: 3 Fo to 1979 W a a 1991 0 � "++r vs'" da rs '"O�^"" as By: Renee C. Llewellyn,Assistant Secretary LMS-12873 LMIC OCIC WAIC Mulb Co 062018 Travelers Casualty and Surety Company of America Travelers Casualty and Surety Company TRAVELERS J St. Paul Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the "Companies"), and that the Companies do hereby make, consfitute and appoint Heather R. Goedtel of Minneapolis, Minnesota, their true and lawful Attomey-in-Fact to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 3rd day of February, 2017. State of Connecticut By: City City of Hartford ss. Robert L. Raney, Se or Vice President On this the 3rd day of February, 2017, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. In Witness Whereof, I hereunto set my hand and official seal. e,rer My Commission expires the 30th day of June, 2021 7As �'(1W W� �. • .gA�to • Marie C. Tetreault, Notary Public This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, which resolutions are now in full force and effect, reading as follows: RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attomeys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her; and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attomeys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attomeys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, do hereby certify that the above and foregoing is a We and correct copy of the Power of Attorney executed by said Companies, which remains in full force and effect. Dated this 26te day of May , 2020 CN°wyry a a: a �awrrow, a rr Kevin E. Hughes, Assistant Secretary To verify the authentidty if this Power ofAttomey, pimse call us at I-BV&421 38Bo. Please refer to the above -named Attorney-in-Factand the details of the bond to which the power is attached. CITY OF SANTA ANA Bond No. 190045266/107249015 BONDS PROJECT NO.: 17-6894 EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION FEDERAL PROJECT NO: HSIPL 5063 (171) FAITHFUL PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS that International Line Builders, Inc. as CONTRACTOR, and Liberty Mutual Insurance Company & Travelers Casualty and Surety Company of America a corporation, organized and existing under the laws of the State, and duly authorized to transact business under the laws of the State of California, as SURETY, are held and firmly bound unto the City of Santa Ana, as AGENCY, in the penal sum of Two Hundred Fifty Five Thousand Six Hundred Twenty and 00/100 Dollars ($ 255,620.00 ), which is 100 percent of the total contract amount for the above stated project, for the payment of which sum, CONTRACTOR and SURETY agree to be bound, jointly and severally, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas CONTRACTOR has been awarded and is about to enter into the annexed Contract Agreement with AGENCY dated May 19, 2020 for Project No. 17-6894, Euclid Street at Hazard Avenue Signal Modification [11SIPL-5063(171)] if CONTRACTOR faithfully performs and fulfills all obligations in the performance of the Work of Improvement to be done under said Contract Agreement in the manner and time specified therein, then this obligation shall be null and void, otherwise it shall remain in full force and effect in favor of AGENCY; provided that any alterations in the obligations or time for completion made pursuant to the terms of the contract documents shall not in any way release either CONTRACTOR or SURETY, and notice of such alterations is hereby waived by SURETY. IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seal this 26th day of May , 20 20 . CONTRACTOR Liberty Mutual Insurance Company, 175 Subscribed and sworn to before May 20 20 . Signature: Notary Public ikfand Wthe County of Street, Brsston, MA 02116, Phone: (617) 357-9500 & ;a One Tower Square, Hartford CT 06183, Phone: (8 Heather R. Goedtel, Attm vd, Suite 1700, Bloomington, MN 55437, Phone: 763 r¢er , this 26th NICOLE CATHERIN%LA.NGER <.cJ NoavPnb.c N,; ,., n.. ep.. My Comm zlon Eal xpires Jan 31, 2023 day of Rate of premium on this bond is $ 4.70 per thousand. Total amount of premium charge is $ 1,201 To be filled in by Surety *Provide CONTRACTOR /ADMITTED SURETY name, address, and telephone number and the name, title, address, and telephone number of authorized representative. 1 of 3 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 Riverside On UcA 1-.`AtaCi before me. Brenda McKinney, Notary Public (insert name and title of the officer) personally appeared Mill i a" 1NaJenpoa. 22ai n- who proved to me on the basis of satisfactory evidence to be the person(&} whose name(s) ish"e- subscribed to the within instrument and acknowledged to me that he/she/#Hey executed the same in his/hen4heif authorized capacity(ies). and that by his/4en #%* 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. BRENDA MCKINNEY Notary Public - California Riverside County Commission 5 2278125 ra cmy Comm. Expires Feb 19. 2027 > Signature (Seal) ftLiberty Mutual® SURETY This Power of Attorney limits the ads of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY Certificate No: 8202635.190003 KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company Is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Blake S. Bohlig. Brian D. Carpenter, Kellv Nicole Enghauser, Heather R- Goedtel, Michelle Hatter, Jessica HofT Nicole Langer, Craig Olmstead, Laurie Pflug, all of the city of Bloomington state of Minnesota each individually if there be more than one named, its true and lawful attorneyin-fad to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 21st day of November 2019 . Liberty Mutual Insurance Company (0(00 omsUqThe Ohio Casualty Insurance Company �yc�Pa°oNP°W„Q'!�mWeesst American Insurance Company �d$oa e 1991 a' B `y�DY MCIPN•� 9M + hd Y' n.a;n M ram° eegiem°r c�rgmm of MONTGOMERY ss On this 21st day of November , 2019 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. 5p PAST COMMONWEALTH OF PENNsriVANIA F?tiax �eilY Notarial Seal OF Teresa Pastella, Notary Public /y Upper Marion Twip.Twp.. Monlgomery County By: voa`pa My Commission Eaplms March 28, 2021 eresa Pastella, Notary Public Member, PenrwwaniaA dauw allownes This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV —OFFICERS: Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attomeys-in-fad, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attomeys-in-fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attomey-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII — Execution of Contracts: Section 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attomeys-in-fad, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attomeys-In-fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certficate of Designation —The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attomeys-in- fad as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Companys Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby codify that the original power of attorney of which the foregoing is a full, hue and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 26th day of May , 2020 . C)(ajY INSLq3°°wPpW>�`9ynP1919gx w o�I'hgMPS� D$Ht . he'd N 1NSUq' 1991 a By: re,� xolxx>ad1:� Renee C. Uewellyn, Assistant Secretary M • F LMS-12873 LMIC OCIC WAIC Mulfi C° 082018 Travelers Casualty and Surety Company of America Travelers Casualty and Surety Company TRAVELERS J St. Paul Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Heather R. Goecitel of Minneapolis, Minnesota, their true and lawful Attomey4n-Fact to sign, execute, seal and acknowledge any and all bonds, mcognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 3rd day of February, 2017. State of Connecticut City of Hartford as. By:< "Robert L. Raney, Se or Vice Vice President On this the 3rd day of February, 2017, before me personally appeared Robert L Raney, who acknowledged himself to be the Senior Vice President of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. In Witness Whereof, I hereunto set my hand and official seal. Atl'1) My Commission expires the 30th day of June, 2021Marie C. Tetreault, Notary Public This Power of Attomey is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Travelers Casualty and Surety Company of America, Tmvelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, which resolutions am now in full force and effect, reading as follows: RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attomeys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, mcognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her; and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attomeys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Pourer of Attorney orto any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attomeys-in-Fad for purposes only of executing and attesting bonds and undertakings and otherwritings obligatory in the nature thereof, and any such Power of Attomey or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of the Power of Attomey executed by said Companies, which remains in full force and effect. Dated this 26th day of May , 2020 Goo !✓ r. Kevin E. Hughes, Assistant Secretary To verify the autrentrily if this Power ofAtdorney, please hall us at 1-800-421 3880. Please refer to the above -named Attorvre"n-factand the details of the bond to which the power is attached. CITY OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number Project No. 17-6894; Euclid Street At Hazard Avenue Signal Change Order Number 1 Modification — Federal Project # HSIPL-5063(171) To International Line Builders Inc. Contractor You are hereby directed to make the herein changes from the plans and speclflcatlons or do the following described work not included in the plans and spaciFlcations on this contract. NOTE: THIS CHANGE ORDER IS NOT EFFECTIVE UNTIL APPROVED BY THE CITY COUNCIL OR CITY MANAGER. Unless otherwise stated, rates for rental of equipment cover only such time as equipment is actually used and no allowance Wit be made for idle time. Change requested by PUBLIC WORKS AGENCY EXTRA WORK AT AGREED PRICE 1. To compensate the contractor to provide a temporary traffic signal pole in order to utilize the existing traffic pole location since existing utilities obstructed planned location per PCO #1 dated July 1, 2021. TOTAL AGREED PRICE = $8,795.00 Page 1 of 2 CITY OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number Project No. 17-6894; Euclid Street At Hazard Avenue Signal Change Order Number 1 Modification — Federal Project # HSIPL-5063(171) To International Line Builders, Inc. Contractor You are hereby directed to make the herein changes from the plans and specifications or do the following described work not included in the plans and specifications on this contract. NOTE: THIS CHANGE ORDER IS NOT EFFECTIVE UNTIL APPROVED BY THE CITY COUNCIL OR CITY MANAGER. Unless otherwise stated, rates for rental of equipment cover only such time as equipment is actually used and no allowance will be made for idle time. Change requested by PUBLIC WORKS AGENCY The compensation both time and cost set forth in this change order comprises the total compensation due the Contractor, all Subcontractors, and all Suppliers for all work performed per this change order, including impact on unchanged work. By signing this change order, the Contractor acknowledges and agrees on behalf of himself, all Subcontractors, and all Suppliers, that the stipulated compensation includes payment for all work contained in this change order, plus all payment for interruption of schedules, extended field overhead, home office overhead, profit, delay, and all impact, ripple effect or cumulative impact on all other work under this Contract. The signing of this change order constitutes full mutual accord and satisfaction for all changes and work performed on this project, and that the time and cost paid per this change order constitutes the total equitable adjustments owed the Contractor, all Subcontractors, and all Suppliers for all work performed on this project. The Contractor on behalf of himself, all Subcontractors, and all Suppliers agrees to waive all rights, without exception or reservation of any whatsoever to file any further claim related to this project. TOTALCOSTTHIS CHANGE ORDER: DECREASE $------_---- -- INCREASE $ 8,795.00 By reason of this order the CONTRACT TIME completion will be adjusted as follows: 3 non-compensable working days We the undersigned contractor have given careful consideration to the change proposed and hereby agree, if this proposal is approved, that we will provide all equipment, furnish all materials, except as may otherwise be noted above, and perform all service necessary for the work above specified, and will accept as full payment therefor the prices shown above. Accepted, Date Z f Contractor International Line Builders, Inc. �lfii.✓ /-,1*riJ By Title Approval recommended by 4 "' Date �'t7/Iso's r1:17e76;E!5- LIC WORKS AGENCYEXECUTIVE DIRECTOR Approved byDate % CITYMANAGER Page 2 of 2 CITY OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number Project No. 17-6894; Euclid Street At Hazard Avenue Signal Change Order Number 1 Modification — Federal Project # HSIPL-5063(171) To International Line Builders, Inc. Contractor You are hereby directed to make the herein changes from the plans and speclflcations or do the following described work not included in the plans and specifications on this contract. NOTE: THIS CHANGE ORDER IS NOT EFFECTIVE UNTIL APPROVED BY THE CITY COUNCIL OR CITY MANAGER, Unless otherwise stated, rates for rental of equipment cover only such time as equipment is actually used and no allowance will be made for idle time. Change requested by PUBLIC WORKS AGENCY EXTRA WORK AT AGREED PRICE 1. To compensate the contractor to provide a temporary traffic signal pole in order to utilize the existing traffic pole location since existing utilities obstructed planned location per PCO #1 dated July 1, 2021, TOTAL AGREED PRICE = $8,795.00 Page 1 of 2 CITY OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number Project No. 17-6894; Euclid Street At Hazard Avenue Signal Change Order Number 1 Modification — Federal Project # HSIPL-5063(171) To International Line Builders, Inc. Contractor You are hereby directed to make the herein changes from the plans and specifications or do the following described work not included in the plans and specifications on this contract. NOTE: THIS CHANGE ORDER IS NOT EFFECTIVE UNTIL APPROVED BY THE CITY COUNCIL OR CITY MANAGER. Unless otherwise stated, rates for rental of equipment cover only such time as equipment is actually used and no allowance will be made for idle time. Change requested by PUBLIC WORKS AGENCY The compensation both time and cost set forth in this change order comprises the total compensation due the Contractor, all Subcontractors, and all Suppliers for all work performed per this change order, including impact on unchanged work. By signing this change order, the Contractor acknowledges and agrees on behalf of himself, all Subcontractors, and all Suppliers, that the stipulated compensation includes payment for all work contained in this change order, plus all payment for interruption of schedules, extended field overhead, home office overhead, profit, delay, and all impact, ripple effect or cumulative impact on all other work under this Contract. The signing of this change order constitutes full mutual accord and satisfaction for all changes and work performed on this project, and that the time and cost paid per this change order constitutes the total equitable adjustments owed the Contractor, all Subcontractors, and all Suppliers for all work performed on this project. The Contractor on behalf of himself, all Subcontractors, and all Suppliers agrees to waive all rights, without exception or reservation of any whatsoever to file any further claim related to this project. TOTAL COST THIS CHANGE ORDER: DECREASE $ INCREASE $ 8,795.00 By reason of this order the CONTRACT TIME completion will be adjusted as follows: 3 non-compensable working days We the undersigned contractor have given careful consideration to the change proposed and hereby agree, it this proposal is approved, that we will provide all equipment, furnish all materials, except as may otherwise be noted above, and perform all service necessary for the work above specified, and will accept as full payment therefor the prices shown above. AccepteContractor Internnaabonal Line Builders, Inc. By Title Approval recommended by �'� 1 �,` r"! h Date �ll�`LUZ.t USLIC WORKS AGENCYIXECCUUT_NE DIRECTOR % Approved by £ Date �/�iJ ki/ CITYMANAGER Page 2 of 2 CITY OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number Project No. 17.6$94; Euclid Street At Hazard Avenue Signal Change Order Number 1 Modification — Federal Proiect # HSIPL-5003 171 To International Line Builders, lrrg,„ Contractor You are heroby directed to make the heroin changes from the plans and specl8oallons or do the following described work not Included in the plans and specifications an this contract. NOTE: THIS CHANGE ORDER I$ NOT EFFECTIVE UNTIL APPROVED BY THE CITY COUNCIL OR CITY MANAGER, Unless otherwise staled, rates for rental of equipment cover only such time as equipment is actually used and no allowance will be made for Idle Ilme. Change requested by PUBLIC WORKS AGENCY gXMAWORK AT AGREED PRICE 1. 7o compensate the contractor to provide a temporary traffic signal pole in order to utilize the existing traffic pole location since existing utilities obstructed planned location per PGO #1 dated July 1, 2021. TOTAL AGREED PRICE = $8,795.00 Page 1 of 2 CITY OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number Project No. 17-6894; Euclid Street At Hazard Avenue Signal Change Order Number 1 Modification — Federal Project # HSIPL-5063(171) To International Line Builders, Inc. Contractor You are hereby directed to make the herein changes from the plans and specifications or do the following described work not Included in the plans and specifications on this conImL NOTE: THIS CHANGE ORDER IS NOT EFFECTIVE UNTIL APPROVED BY THE CITY COUNCIL OR CITY MANAGER. Unless otherwise stated, rates for rental of equipment cover only such time as equipment is actually used and no allowance will be made for idle time. Change requested by PUBLIC WORKS AGENCY The compensation both time and cost set forth in this change order comprises the total compensation due the Contractor, all Subcontractors, and all Suppliers for all work performed per this change order, including impact on unchanged work. By signing this change order, the Contractor acknowledges and agrees on behalf of himself, all Subcontractors, and all Suppliers, that the stipulated compensation includes payment for all work contained in this change order, plus all payment for interruption of schedules, extended field overhead, home office overhead, profit, delay, and all impact, ripple effect or cumulative impact on all other work under this Contract. The signing of this change order constitutes full mutual accord and satisfaction for all changes and work performed on this project, and that the time and cost paid per this change order constitutes the total equitable adjustments owed the Contractor, all Subcontractors, and all Suppliers for all work performed on this project. The Contractor on behalf of himself, all Subcontractors, and all Suppliers agrees to waive all rights, without exception or reservation of any whatsoever to file any further claim related to this project. TOTAL COST THIS CHANGE ORDER: DECREASE $----- -------- INCREASE $ 8,795.00 By reason of this order the CONTRACT TIME completion will be adjusted as follows: 3 non-compensable working days We the undersigned contractor have given careful consideration to the change proposed and hereby agree, if this proposal is approved, that we will provide all equipment, furnish all materials, except as may otherwise be noted above, and perform all service necessary for the work above specified, and will accept as full payment therefor the prices shown above. Accepted, Date ' 2% Contractor Intemational Line Builders, Inc. By 1 Title ��00 �A. Approval recommended by �I ���kN% h Date l�lzi`ser2'I PUBLIC WORKSAGENCY EXECUTIVE DIRECTOR n Approved by �Qr Date —1 24 7 i7Z— CITYMANAGER Page 2 of 2 CITY OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number Project No. 17-6894; Euclid Street At Hazard Avenue Signal Change Order Number Modlfin2finn_ucin, onnnu�. To International Line Builders, Inc. Contractor You are hereby directed to make the herein changes from the plans and specifications or do the following described work not included in the plans and specifications on this contract. NOTE: THIS CHANGE ORDER IS NOT EFFECTIVE UNTIL APPROVED BY THE CITY COUNCIL OR CITY MANAGER. Unless otherwise stated, rates for rental of equipment cover only such time as equipment is actually used and no allowance will be made for Idle time. Change requested by PUBLIC WORKS AGENCY EXTRA WORK AT AGREED PRICE 1. To compensate the contractor to provide additional striping in order per revised striping plane per PCO #2 dated September 24, 2021, TOTAL AGREED PRICE = $3,925.95 Page 1 of 2 CITY OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number Project No. 17-6894; Euclid Street At Hazard Avenue Signal Change Order Number Modification — Federal Project # HSIPL-5063(171) To International Line Builders, Inc. Contractor You are hereby directed to make the herein changes from the plans and specifications or do the following described work not included in the plans and specifications on this contract. NOTE: THIS CHANGE ORDER IS NOT EFFECTIVE UNTIL APPROVED BY THE CITY COUNCIL OR CITY MANAAM Unless otherwise stated, rates for rental of equipment cover only such time as equipment is actually used and no allowance will be made for idle time. Change requested by PUBLIC WORKS AGENCY The compensation both time and cost set forth in this change order comprises the total compensation due the Contractor, all Subcontractors, and all Suppliers for all work performed per this change order, including impact on unchanged work. By signing this change order, the Contractor acknowledges and agrees on behalf of himself, all Subcontractors, and all Suppliers, that the stipulated compensation includes payment for all work contained in this change order, plus all payment for interruption of schedules, extended field overhead, home office overhead, profit, delay, and all impact, ripple effect or cumulative impact on all other work under this Contract. The signing of this change order constitutes full mutual accord and satisfaction for all changes and work performed on this project, and that the time and cost paid per this change order constitutes the total equitable adjustments owed the Contractor, all Subcontractors, and all Suppliers for all work performed on this project. The Contractor on behalf of himself, all Subcontractors, and all Suppliers agrees to waive all rights, without exception or reservation of any whatsoever to file any further claim related to this project. TOTAL COST THIS CHANGE ORDER: DECREASE $--------------- INCREASE $ 3,925.95 By reason of this order the CONTRACT TIME completion will be adjusted as follows: one non-compensable working day. We the undersigned contractor have given careful consideration to the change proposed and hereby agree, if this proposal is approved, that we will provide all equipment, furnish all materials, except as may otherwise be noted above, and perform all service necessary for the work above specified, and will accept as full payment therefor the prices shown above. Accepted, Cat 3 �y 2 Contractor International Line Builders, Inc. By //�'A "'/• Title �W�'0y Approval recommended by t� l----.�f u 4 lid Date � 14 -2-- ' PUBLIC WORKS AGENCYEXECUTIVE DIRECTOR Approved by GEDate G% CI ANAER ' Page 2 of 2