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CHRISTENSEN BROTHERS GENERAL ENGINEERING, INC. (1)
Recording Requested By, Recorded in Official Records, Orange County And When Recorded Mail To: Hugh N u en, Clerk Recorder Clerk0 Civ c Cente Pelaza,1P.O.Box 1 88a iiiisiiiiuiiiie�iiriiiiiiiiiiiiiosiiiiiiiiii N� FEE 2 Santa Ana, CA 92702 201400051753210:15 am 12102114 42 416 N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 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 a construction of BROADWAY REHABILITATION — CIVIC CENTER DRIVE TO SANTA o CLARA AVENUE AND BROADWAY AND WASHINTON AVENUE WATER MAIN w IMPROVEMENTS under contract entered into on August 5, 2013, with CHRISTENSEN o BROTHERS GENERAL ENGINEERING, INC., on which contract NORTH AMERICAN ® z SPECIALTY INSURANCE COMPANY is surety. The property on which such work aimprovement was placed is in the City of Santa Ana, County of Orange, State of California, and o described as Project No. 11-6743& 11-6415 located at: BROADWAY. The work improvement on said property was accepted as completed on November 14, 2014. wo CI �YAIySI'A2AMYICIPALCORPORATION by U w Dated: City Engined— Edwin "William" Galvez TITLE VERIFICATION I, the undersigned, say: I am the City Engineer - Edwin "William" Galvez 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 contents of Notice of Completion are true.) THIS NOTICE OF COMPLETION MUST BE RECORDED WITHIN TEN (10) DAYS AFTER COMPLETION REQUEST FOR COUNCIL ACTION CITY COUNCIL MEETING DATE: AUGUST 5, 2013 TITLE: CONTRACT AWARD FOR BROADWAY REHABILITATION FROM CIVIC CENTER TO SANTA CLARA (PROJECT 11-6743) AND BROADWAY AND WASHINGTON AVENUE WATER MAIN IMPROVEMENTS (PROJECT 11-6415) A;��? CIV AN GER RECOMMENDED ACTION CLERK OF COUNCIL USE ONLY: APPROVED AUG _ g 2013 As Recommended) c91j18 ❑ As Amended ❑ Ordinance on 1s' Reading ❑ Ordinance on 2nd Reading ❑ Implementing Resolution ❑ Set Public Hearing For CONTINUED TO FILE NUMBER 1. Award a contract to the lowest responsible bidder, Christensen Brothers General Engineering, Inc., in accordance with the Base Bid totaling $4,302,858.65 for the construction of the Broadway Rehabilitation and Broadway and Washington Avenue Water Main Improvements. 2. Approve the Cost Analysis for a total estimated project delivery cost of $5,163,430.65. DISCUSSION This project has received Council budget and funding approval as part of the City's Capital Improvement Program. Project design is complete and the next step is to construct the improvements. Procurement procedures have been followed as established by the City's Municipal Code and in adherence to the Public Contracts Code. The project was advertised for solicitation of bids, and the recommended action will allow construction to proceed. The City's Pavement Management System identified Broadway from Civic Center Drive to Santa Clara Avenue (Exhibit 1) as a high priority for rehabilitation. The pavement has deteriorated due to weather, age, heavy usage, and poor drainage. Portions of the adjacent curb and gutter, driveway approaches, curb ramps, and sidewalks are either missing or in disrepair and require replacement. Improvements include reconstructing the roadway pavement; replacing damaged concrete curb and gutter, driveway approaches, sidewalk; and constructing new cross gutters. Once completed, these improvements will extend the life of the pavement and enhance the ride quality, surface drainage, and appearance of the street. Other project improvements include replacing deteriorated and undersized water mains on Broadway and Washington Avenue. This work involves installing new water mains, fire hydrants, main gate valves, and water services. Once this project is completed, breaks and leaks Contract Award for Broadway Rehabilitation (Pr. 11-6743) and Broadway and Washington Water Main Improvements (Pr. 11-6415) August 5, 2013 Page 2 associated with the older and deteriorated water mains will be eliminated, and water service capacity and fire protection will be enhanced. The Notice Inviting Bids was advertised on June 10 & 11, 2013, and bids were opened on July 8, 2013. A summary of the bid invitations mailed, bids received, and bid results are as follows: Contractor Participation Data Santa Ana Contractors receiving notices: 15 Contractors requesting bidding documents: 14 Bids received: 6 Bids received from Santa Ana Contractors: 0 Bid Results Summary RANK BIDDER'S NAME LOCATION BASE BID 1 Christensen Brothers General Engineering, Inc. Apple Valley $4,302,858.65 2 Lonerock, Inc. Irvine $4,569,883.00 3 Sally -Miller Contracting, Inc. Brea $4,771,000.00 4 All American Asphalt Corona $5,030,974.00 5 Los Angeles Engineering, Inc. Covina $5,214,016.00 6 Excel Paving Company Long Beach $5,329,910.40 A total of six bids were received and all were deemed responsive, with Christensen Brothers General Engineering, Inc. submitting the lowest responsive bid. Their $4,302,858.65 bid is 9.5 percent higher than the $3,930,100 Engineer's Estimate. A subsequent review of the Engineer's Estimate concluded that night work, which may be required due to the potential impact on traffic, was not accounted for and resulted in a lower estimate. Staff has also begun to notice construction costs trending up associated with greater construction activity. Nonetheless, staff is confident that the current bids are very competitive and that the low bid represents a very good price. ENVIRONMENTAL IMPACT In accordance with the California Environmental Quality Act, this project is exempt from further review. Categorical Exemptions Environmental Review No. 2012-24 was filed for this project. FISCAL IMPACT The Project Cost Analysis (Exhibit 2) determined that the total funds needed to deliver the project are $5,163,430.65. The total cost includes construction administration, testing, and contingencies. Contract Award for Broadway Rehabilitation (Pr. 11-6743) and Broadway and Washington Water Main Improvements (Pr. 11-6415) August 5, 2013 Page 3 Funding for the Broadway Rehabilitation (Pr. 11-6743) is available in the Proposition 1 B — State Local Partnership Program (SLPP) Fund (Account 03017660-66220), Measure M2 Local Fairshare Fund (Account 03217662-66220) and Traffic Congestion Relief HUT Fund (Account 05917663-66220). Funding for the Broadway and Washington Water Main Improvements (Project 11-6415) is available in the Water Utility Capital Projects Fund (Account 06617647- 66301). APPROVED AS TO FUNDS AND ACCOUNTS: Edwin "William" Ga ,�ez' P. E. Francisco Gutierrez Acting Executive Director Executive Director Public Works Agency Finance & Management Services Agency RG/CC Exhibit 1: Project Location Map 2: Cost Analysis 15TH ST TSTH ST M WASHINGTON € HALEBWORTH 10TH CMC CENTER SANTA ANA CIiY COUNCIL. P �l p, AGENDA DATE! AUGUST 45, 21713 U!IL I[ 584145 I SAYY S SANTA CLAAA AVE SUFFALO AVE ij2cm ST im ST in— WASHINGTON i EXHIBIT 1 PROJECT NO, 11-670 BRROADWAAY RD REHABILITATION'. FROM CMC CENTER DR TO SANTA CLARA AVENUE PROJECT NO 11-6416 BROADWAY AND WA9HINGTON' AVENUE WATER MANE IMPROVEMENTS WASHINGTON IMPROVEMENTS FROM SYCAMORE TO MAIN 9T7IEET f FNM ORAiyC 1 O P 3rAr j1y] c COST ANALYSIS PROJECT NO. 116743 AND 116415 BROADWAY REHABILITATION AND BROADWAY AND WASHINGTON AVENUE WATER MAIN IMPROVEMENTS Construction Contract $4,302,858.65 Contract Administration $172,114 Inspection and Testing $129,086 Survey $129,086 Contingencies $430,286 TOTAL ESTIMATED PROJECT DELIVERY COSTS $5,163,430 65 EXHIBIT 2 PROJ. NO. 116743,116415 ADDENDUM NO. ONE CITY OF SANTA ANA PROJECT NO, 11-6743: BROADWAY REHABILITATION -CIVIC CENTER DRIVE TO SANTA CLARA AVENUE AND PROJECT NO. I 1-6415: BROADWAY AND WASHINGTON AVENUE WATER MAIN IMPROVEMENTS PROPOSAL & CONTRACT AGREEMENT BID PROPOSAL TO: CITY COUNCIL OF THE CITY OF SANTA ANA FROM: REQUIREMENT: The undersigned declares that he/she has carefully examined the location of the proposed work, that he/she has examined the Plans and Specifications and read the accompanying instruction to BIDDERS, and hereby proposes to fumish all material and do all the work required to complete the said work in accordance with said plans (if any), specifications and special provisions, for the unit price(s) or lump sum(s) set forth in the following schedule: Item Bid Item Unit Quantity Project No. 11-6743 $Z(it 5 30-66 1. Unclassified Excavation CY 4,390 2. AC Pavement TN 12,820 3. Cold Milling SF 10,400 4. Pulverized Material and Cement- SF 241,900 Treated Base (CTB) 5. Additional I% Cement Content SF 241,900 6. Remove Excess Pulverized Material CY 5,300 7. Pavement Fabric 8. PCC Sidewalk (T=4") 9. PCC Driveway (Residential = 6") 10. PCC Driveway (Commercial = 8") SY 41,100 SF 30,000 Approach SF 18,500 Unit Price Amount I"1. t` $ 5"45" !a $&� iS- $11037, .7"1 exa $$�''�d��1 taco $ ,Z3 $Zli, 57 $ 10975-6,,60 $6G"30 $Z(it 5 30-66 $ B yG.�a �dL P.7LD $ $�C9i=f7,�� Approach SP 5,000 $ 6°5 $ 32a c'o TO BE INCLUDED IN BID PACKAGE BPIof17 PROJ. NO. 116743,116415 ADDENDUM NO. ONE CITY OF SANTA ANA PROJECT NOS. 11-6743 AND 11-6415 PROPOSAL & CONTRACT AGREEMENT BID PROPOSAL, continued Item # Bid Item Unit Quantity Unit Price Amount 11. PCC Alley Apron SF 1,056 $T.5q $�5+6 x'.24 12. PCC Curb Ramp SF 11,100 $ 5a 8 '�' $ (--,L("71-3, 60 13. PCC Curb and Gutter (Type A-2-6) LF 7,000 $ 20, i( % $ i l.7i 7-2-6' oo 14. PCC Curb and Gutter (Type A-2-8) LF 900 $ '21.34 $ 15. PCC Cross Gutter (Arterial) SF 8,200 $ (I,q6$ %' a 2 •�� 16. PCC Catch Basin Local Depression LF 36 $z � 3 $ t L OZ -7, a 17. Root Shave EA 26 42•s0 1 i (lLtl '&o 18. Furnish and Install New Water Valve EA 5 $ ;>65-- 1-7 Is r 925-, ii a Frame and Cover 19. Adjust Manhole Frame and Cover EA 18 $ a > 35- -36 20. Furnish and install Traffic Pullbox EA 14 $ l%;$ i sl, 2-3i. 14 No. 6 21. Furnish and Install Survey Monument EA 20 $�7"g3 $ 2"_7, 7 , 66 22. Furnish and Install 6" PWC Conduit LF 40 $32, 2-2 $ and Caps - Future Use 23. Landscaping LS 1 i Is d ,s $ ° 24. 30 -Day Landscaping Maintenance LS 1 Period 25. Queen Palm - 30" Brown Trunk EA 2 $5;i6Z2, $ )l® 3q'5-129 Height 26. Furnish and Install Traffic Loops Type EA 150 8''06 $ Z1 3' j2 0018',06 E TO BE INCLUDED IN BID PACKAGE BP2of17 CITY OF SANTA ANA PROJECTNOS. 11-6743 AND 11-6415 PROPOSAL & CONTRACT AGREEMENT BID PROPOSAL, continued Item 4 Bid Item Unit 27. Furnish and Install Traffic Loops EA $ $ rl g -,S k°G'. (r Ll Type D Quadracircle $ i7tl.li`/ $ 7 t 2. ' 28, ADA Pedestrian Push Button CA 29. Detector Lead -In Cable LF 30. PCC Parkway Culvert (Type A) EA 31. PCC Parkway Culvert (Type B) EA 32. Furnish and Install Metal Hand Rail LF 33. Furnish and Install CPS Unit EA 34. Temporary Construction Sign EA 35. Signing and Striping LS 36. SWPPP for Risk Level 2 Project LS Project No. 11-6743 Subtotal------------------------- Proiect 11-6415 (Water Main) Schedule 37 8" Class 200, AWWA C900 P.V.C. Water Main 38 12" Class 200 AWWA C900 P.V.G. Water Main 39 8" Class 350 D.I. Water Main 40. 12" Class 350 D.I. Water Main 41. Construct l" Water Service per City Std, Plan 1401 BP3of17 PROJ. NO. 116743,116415 ADDENDUM NO. ONE Quantity Unit Price Amount 63 $ $ rl g -,S k°G'. (r Ll 2 $ i7tl.li`/ $ 7 t 2. ' 1,400 $3 t7 grZ�.14 y1 yj$ GS'G7$ 3[I 47-.�3 2 $3,9_t7.gb 20 $7-9P,i�- $S'r46S. � 3 $C CIg:S- $< q6,6`$ 4 $ 7W.q,) $ t erir'. 1 $ J9a1 la. �6d ISS 2a•as 1 $ L( $ ( Lf � -------------------------- $ ZA s—J6 4lcz < LF 2,940 e 1 _46'D3 e 3g9'61Xi, �)6 LF 6,030 $%--a-1 LF 20 $1Jbg5-,4?$ ,q69• q6 LF 125 sy-I'Maa $Q61965e EA 86 $F�� obi, q6, $ l q it, q gS— TO BE INCLUDED IN BID PACKAGE PROJ. NO. 116743,116415 ADDENDUM NO. ONE CITY OF SANTA ANA PROJECT NOS. 11-6743 AND 11-6415 PROPOSAL & CONTRACT AGREEMENT BID PROPOSAL, continued Item # Bid Item Unit Quantity Unit Price Amount 42. Construct 2" Water Service per City EA 33 $ $ 5� INS-, `�' 43. Std. Plan 1402 8" Resilient Wedge Gate Valve EA 18 $1It( 44. 12" Resilient Wedge Gate Valve LA 16 0 t%51149b, $ v2, qwi, I k? 45. 4" Service Connection Including 4" EA 7 $411;N,_J(' $ 2?1 46. RWGV (Resilient Wedge Gate Valve) 6" Service Connection Including 6" EA 2 $Wr' J•()o RWGV (Resilient Wedge Gate Valve) 47. 6" Service Connection Including 6" EA 1 nn $a�i t q4-S$iSpleJ�f I RWGV (Resilient Wedge Gate Valve 48. and Vault) 4" Fire bine Connection Including 4" EA 11 $ $7d RWGV (Resilient Wedge Gate Valve) 49. 6" Fire Line Connection Including 6" EA 3 RWGV (Resilient Wedge Gate Valve) 50. 8" Fire Line Connection Including 8" EA 3 q RWGV (Resilient Wedge Gate Valve) � �"��$ 1t)(097 %q 51. 10" Fire Line Connection Including EA 2 $ 10" RWGV (Resilient Wedge Crate 52. Valve)/� 12" X 12" Hot Tap Including $r ��• '70 � r r �� Tapping EA 2 $ 53, Sleeve and Valve New Fire Hydrant Assembly, EA 24 $ 7, 1.3 $ /7J/ed 1/' , IQ Including Gate Valve and Lateral Pipe 54, 1" Air Vacuum and Release Valve EA 2 I $L7 lr8/ $r SL•l� 55. Traffic Control, Striping, and LS 1 $ �1010,)o $-Zoe 95Y90 Project Pavement Markings No. 11-6415 Schedule Subtotal ---------------------------------------- $ TO BE INCLUDED IN BID PACKAGE BP4of17 CITY OF SANTA ANA PROJECT NOS. 11-6743 AND 11-6415 PROPOSAL & CONTRACT AGREEMENT BID PROPOSAL, continued Projects 11-6743 and 11-6415 Schedule GRAND TOTAL BID ---------------------- FROJ. NO. 116743,116415 ADDENDUM NO. ONE $gI-�'izIS- 65- * The quantity for this bid item is shown for bid comparison only. This bid ilern shall not be subject to the "25%" limit as stated in Section 3-2 of the Standard Specifications. The actual 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 iters is considered a Specialty Item per Section 2-3.2 of the Standard Specifications. PROJECT NO. 11-6743: BROADWAY BIDDER REHABILITATION -CIVIC CENTER DRIVE TO SANTA CLARA AVENUE AND Pinn C`77/GlS7LNSui/ tyeorp-/a'a-s PROJECT NO. 11-6415: BROADWAY AND WASHINGTON AVENUE WATER MAIN Address 138d� en7corrt re k,� IMPROVEMENTS ^PWA Phone OW aVo - 5a3 G Fax Email 5d�rlQ Ch¢il✓Stn'rIGrS.N:r BIDDER S g ature j (;l M l/ r I , �1� V? a. OA -i CITY OF SANTA ANA PROJECTNOS. 11-6743 AND 11-6415 c TO BE INCLUDED IN BID PACKAGE BP5of17 CITY OF SANTA ANA PROJECT NOS. 11-6743 AND 11-6415 PROPOSAL AND CONTRACT AGREEMENT 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: - Streets, highways including bridge projects; '/2% of the bid or $10,000, whichever is greater - Buildings, parks, or other projects: '/2% of the bid BIDDER proposes to subcontract certain portions of the work to the firms listed below: NAME rRO FhVIN6 CQ. LOCATION 000A,CP PHONE 961, 522- 565o TYPE OF WORK P ,W Aeiof, NAME J)a cae LOCATION PHONE I I ` J `?`1 LI 0 TYPE OF WORK S iv , $' NAME LOCATION PHONE TYPE OF WORK NAME _ LOCATION PHONE NAME �Inu� N t c C n s,osaanc LOCATION ��Ilwa�r,c PHONE (-I,N) 5-12 ^ INFO TYPE OF WORK tmhMOSCNPi $ 25,Sc�o. 00 NAME Ti ra-Vie. 1,o -e5 LOCATION A pie, H i &K4 ) PHONE Its;? TYPEOFWORK (fit $ --700-7 &C) III �W LOCATION _ PHONE TYPE OF WORK NAME LOCATION PHONE 0 TYPE OF WORK $ TYPE OF WORK NAME NAME _ LOCATION LOCATION PHONE PHONE TYPE OF WORK $ TYPE OF WORK /i{.6/Siti7w gar MIS &W -Al 6mumarn , ZVc• Name of Finn Submitting Bid TO BE INCLUDED IN BID PACKAGE BP6of17 CITY OF SANTA ANA PROJECT NOS. 11-6743 AND 11-6415 PROPOSAL & CONTRACT AGREEMENT BIDDER'S STATEMENT BIDDER understands and agrees that this written proposal (or any part thereof specifically designated and accepted by the City of Santa Ana, hereinafter AGENCY) 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 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) days (excluding Saturdays, Sundays and AGENCY'S legal holidays), 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 fuvish 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, that the estimated quantities set forth in the bid schedule are solely for the purpose of comparing bids, and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. All terms contained in the Specifications, the Certification of Non -Discrimination by Contractors, and the Workers' Compensation Insurance Certificate are to be incorporated by reference into this Agreement and are made specifically as part of this bid. Name of Finn e 'HWST A6W V32e)ol4ra$ ('ei✓,c t_ f ja1A1Erre 4tJ& . SSC. Signatr,re of BIDDER Title rogpDMjr (if an individual, so state) TO BE INCLUDED IN BID PACKAGE BP7of17 CITY OF SANTA ANA PROJECT NOS, 11-6743 AND 11-6415 PROPOSAL AND CONTRACT AGREEMENT BIDDER'S STATEMENT continued (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.) LCOV, - C401.f"NSte✓ ,�i C44?F.Q Awarded COUNCIL: on the basis of lowest responsible and responsive 'K ! � bidder in the amount of ve $ 'OVA .3®,2ra r e Date - 20 ATTEST: CLERK OF THE CCOOLFkP IL, APPROVED AS TO FORM: 9e1A0-.Tazi-PA/ CITY ATTORNEY EXECUTIVE DIP PUBLIC WORKS yy o�0 13I OF SANTA ANA: TO BE INCLUDED IN BID PACKAGE BP8of17 CITY OF SANTA ANA PROJECT NOS. 11-6743 AND 11-6415 PROPOSAL AND CONTRACT AGREEMENT CERTIFICATION OF NONDISCRIMINATION BY CONTRACTOR The undersigned contractor or corporate officer, during the performance of this contract, certifies as follows: 1. 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. TO BE INCLUDED IN BID PACKAGE BP9of17 CITY OF SANTA ANA PROJECT NOS. 11-6743 AND 11-6415 PROPOSAL AND CONTRACT AGREEMENT CERTIFICATION OF NONDISCRIMINATION BY CONTRACTOR (continued 7. 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. 8. 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 public works violating this Section is subject to all the penalties imposed for a violation of the Chapter. Signec Title Firm Date `11°%113 C'�R✓ST,L�.✓sE.✓ �¢UsMIL.t U.�E/eW �',�y,�✓g �Qi;.,e6 ^LNLY. TO BE INCLUDED IN BID PACKAGE BP 10 of 17 CITY OF SANTA ANA PROJECT NOS. 11-6743 AND 11-6415 PROPOSAL AND CONTRACT AGREEMENT WORKERS' COMPENSATION INSURANCE CERTIFICATION As required by California Labor Code Section 1860 and 1861, the Contractor certifies as follows: I am aware of the provisions of Section 3700 of the Labor Code, which requires every employer to be insured against liability for worker's compensation or to undertake self-insurance in accordance with the provisions of the Code, and I will comply with such provisions before commencing the performance of the work of this contract. If I, as the Contractor, now or at any time during the course of this agreement, qualify as an employer under California Labor Code Section 3300, unless the hired employee(s) is (are) persons excluded by said Labor Code, I shall furnish the City of Santa Ana with an insurance certificate from my workers' compensation insurance carrier certifying that I carry such insurance and that the policy shall not be canceled nor the coverage reduced except upon thirty (30) days prior written notice to the City of Santa Ana, Signet Title Finn -gjE6 kms— , Date TO BE INCLUDED IN BID PACKAGE BP 11 of 17 CITY OF SANTA ANA PROJECT NOS. 11-6743 AND 11-6415 PROPOSAL AND CONTRACT AGREEMENT The following are the names, addresses, and telephone numbers for three public agencies for which BIDDER has performed similar work within the past two years. 1. 64/rz fjF 60'40moor- _ �Sa �. �^" Sare6aT �c✓k� w.ow r , e r� Name and Address of Owner. F1 Name and Telephone Number of person familiar with project. /, oi/' N26 .63 Srxeer /MeA6yCrAGNT Contract Amount Type of Work Date Completed Name and Address of owner. �" 1 C' Me. t2Ec,.Nim n %4MSnN — f %GU/ 55"i-X17A Name and Telephone Number of person familiar with project. 1`131,005.'30 �;�G1;wo t2�oL��en�+�� ru �S� 1% Contract Amount Type of Work Date Completed 3• 441gjIn. "rALM(aR1.G . GA Name and Address of owner. Name and Telephone umber of person familiar with project. lad qe Reeyoaro kl,"M LANG 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. a1t-JC W¢sr- `s"Anco,lMa — 2323 0"OA114, IJowrrl a316WIJ6s M� Pr17N: Ms. 141hom1 (' 0ya, - ( 40&, MY - 1900 -- Aye Noaxrj dlrvtflekJ QrrA&tT gjcgA±r Z Co - 1175 Noerri /!?a2liNorale Rol 6Vrh Tt- . TTN_ �oNgS - Cg`11� ?,13• iZld TO BE INCLUDED IN BID PACKAGE BP 12 of 17 CITY OF SANTA ANA PROJECT NOS. 11-6743 AND 11-6415 PROPOSAL AND CONTRACT AGREEMENT BIDDER'S STATEMENT_ REGARDING APPRENTICESHIP REOUIREMENTS 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 public work, in the same amount or upon the same basis and in the same manner as the other contractors, except contractors not signatory to the trust agreement shall pay a like amount to the California Apprenticeship Council. Signe( Title Film C,LjR/t7G.ySE.I/ ,i�OD7HGi6S' lxNub. t_'dct-�✓w f 4 i r Date TO BE INCLUDED IN BID PACKAGE BP 13 of 17 CITY OF SANTA ANA PROJECT NOS. 11-6743 AND 11-6415 PROPOSAL AND CONTRACT AGREEMENT NON -COLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY OF SANTA ANA DEPARTMENT OF PUBLIC WORKS In accordance 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 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 above Non -collusion Affidavit is pant of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Non -collusion Affidavit. BIDDERS are cautioned that making a false certification may subject the certifier to criminal prosecution. i J� `�} Signed I U/ If V 1 State of Califhrhia County of 5XW �G2N.g2/J�a/o /Subscribed and sworn to (or affirmed) before me on this y/ day of Q,/ 20[3, by A2?99 �h2/dr.GN%FA/ , proved to me on the basis of satisfactory evidenc�t`o e the person(s) who appeared before me. of Ru ignature Notary Public Seal BP 14 of 17 TO BE INCLUDED IN BID PACKAGE CITY OF SANTA ANA PROJECT NOS. 11-6743 AND 11-6415 PROPOSAL AND CONTRACT AGREEMENT BIDDER'S 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 construction or repair of public work, to give up any part of the compensation to which he/she is otherwise entitled. Signed Title Firm �1,sy�vscN i3oeoryces Cvraa� ✓ccava x^.Va. Date TO BE INCLUDED IN BID PACKAGE BP 15 of 17 CITY OF SANTA ANA PROJECT NOS. 11-6743 AND 11-6415 PROPOSAL AND CONTRACT AGREEMENT CONTRACTOR'S LICENSING STATEMENT The undersigned contractor, or corporate officer, declares under penalty of perjury that the following is true and correct. Contractor's Name: C22,±,vxGv &9607r,Mx-'S 6 rr.*w� i.✓c6e r FT.vc. Business Address: 13RN/ 4",g;"4 .ewr,o , .9�%L' ✓,9//Cr✓_Cii. �d3�� Telephone:9La) )f1y - 9,231, State Contractor's License No. and Class: Expiration Date: Signed: Title: TO BE INCLUDED IN BID PACKAGE BP 16 of 17 CITY OF SANTA ANA PROJECT NOS. 11-6743 AND 11-6415 PROPOSAL AND CONTRACT AGREEMENT PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT 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 k' If the answer is yes, explain the circumstances in the following space. TO BE INCLUDED IN BID PACKAGE BP 17 of 17 MAYOR Miguel A. Pulldo MAYOR PRO TEM Sal Tinajaro COUNCILMEMBERS Vincent F. Sarmiento Michele Martinez Angelic.@ Amezoua P. David Benevides Raman A. Reyna June 25, 2013 ADDENDUM No. ONE CITY OF SANTA ANA PUBLIC WORKS AGENCY M36 20 Civic Center Plaza • P.O. Box 1988 Santa Ana, California 92702 INTERIM CITY MANAGER Kevin O'Rourke CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D,Huizar SUBJECT: PROJECT NOS. 11-6743,116415: BROADWAY REHABILITATION - CIVIC CENTER DRIVE TO SANTA CLARA AVENUE AND BROADWAY AND WASHINGTON AVENUE WATER MAIN IMPROVEMENTS The following changes have been made to Specifications for the subject project: Specifications 1. Pages BP 1 to 5: Replace with the attached pages BP 1 to 5. Changed the type of bicycle loop to type D, added extra loops. 2. Page 29, section 2.22 Loop Defectors and Detector Lead -In Cable: Add the following after paragraph 4: Bicycle loop detectors in vehicle lanes shall be Type D circular 6 foot diameter. 3. Page 39, section 4.02 Project Phasing and Lane Requirements: Replace with the attached section 4.02. 4. Page 16, CEMENT APPLICATION, paragraph 2: Replace with the following: The cement content shall be 6% (six -percent) based on the dry unit weight of the pulverized material. The dry unit weight of the pulverized material shall be determined by California Test 312 (Design and Testing of Classes A and B Cement Treated bases). The Engineer may order an increase or decrease in the specified cement content when conditions warrant such action. For cost estimate purposes, use 130 pounds/cubic foot for the dry unit weight of pulverized material. All other terms and conditions remain the same, FOR THE CITY-� ;AA�ITA ANA S- J Edwin "William" Gale" P.E. City Engineer PROJ. NO. 116743,116415 ADDENDUM NO. ONE 4.02 PROJECT PHASING AND LANE REQUIREMENTS All Intersection work shall be constructed on weekend or night. Segment A between Santa Clara and STA 17 +20: • Phase 1: All work on the west side including curb, gutter, sidewalk and bus pads. Maintain two northbound through lanes at all times. • Phase 11: All work on the east side including curb, gutter, sidewalk and bus pads. Maintain two southbound through lanes at all times. • Work shall be constructed on weekend or night. Segment A between STA 17 +20 and Main Place Drive: • Phase 1: All work on the west side including curb, gutter, sidewalk and bus pads. Maintain two northbound through lanes at all times. • Phase II: All work on the east side including curb, gutter, sidewalk and bus pads. Maintain two southbound through lanes and one northbound through lane at all times. Work shall be constructed on weekend or night. Segment B between Civic Center and Santa Clara: • Phase 1: All work on the west side including curb, gutter, sidewalk and bus pads. Maintain two northbound through lanes at all times. • Phase I1: All work on the east side including curb, gutter, sidewalk and bus pads. Maintain two southbound through lanes at all times. Traffic control plans are required for the above. MAYOR Miguel A. Pulido MAYOR PRO TEM Sal TinaJero COUNCILMEMBERS Vincent F. Sarmiento Michele Martinez Angelica Amezcua P. David Benavides Roman A. Reyna July 2, 2013 ADDENDUM No. TWO CITY OF SANTA ANA PUBLIC WORKS AGENCY M36 20 Civic Center Plaza . P.O. Box 1988 Santa Ana, Carfomia 92702 INTERIM CITY MANAGER Kevin O'Rourke CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D.Huizar SUBJECT: PROJECT NOS. 11-6743,116415: BROADWAY REHABILITATION - CIVIC CENTER DRIVE TO SANTA CLARA AVENUE AND BROADWAY AND WASHINGTON AVENUE WATER MAIN IMPROVEMENTS The following changes and clarifications have been made to Specifications for the subject project: Specifications 1. Page iv, Notice Inviting Bids, paragraph 1. Replace with the following: NOTICE IS HEREBY GIVEN that the City of Santa Ana, California will receive at City Hall -Ross Annex, (M-22), 20 Civic Center Plaza, Santa Ana, California 92701, the Public Works Agency Third Floor Receptionist, (see attached map), on or before the hour of 2:00 p.m. on Monday, July 8"', 2013 2. Page 39, section 4.02 Project Phasing and Lane Requirements: Replace with the attached section 4.02, Clarifications The night and weekend work shall be established at the time of construction based on the need of the businesses and residents. 2. The shift will be 8 hours and shall be established at the time of construction based on the need of the businesses and residents. 3. The contract working days are per Specifications, section 1.14. 4. The work phasing and lane requirements shall be established at the time of construction based on the need of the businesses and residents. Working days and hours are per Section 1.14. All other terms and conditions remain the same. FOR THE CITYOF-SANTA ANA City Engineer PROJ. NO. 116743,116415 ADDENDUM NO. TWO 4.02 PROJECT PHASING AND LANE REQUIREMENTS All Major Intersection work shall be constructed on weekend or night. • Broadway at Civic Center Drive, 10"' Street, Halesworth, Washington Avenue, 17t" Street and Santa Clara Avenue. Segment A between Santa Clara and STA 77 +20: • Phase I: All work on the west side including curb, gutter, and sidewalk. Maintain two northbound through lanes at all times. Work shall be constructed on weekend or night. • Phase II: All work on the east side including curb, gutter, and sidewalk. Maintain two southbound through lanes at all times. Segment B between STA 89+30 and Main Place Drive: • Phase I: All work on the west side including curb, gutter, and sidewalk. Maintain two northbound through lanes at all tunes. • Phase II: All work on the east side including curb, gutter, and sidewalk. Maintain two southbound through lanes and one northbound through lane at all times. Work shall be constructed on weekend or night. Segment C between Civic Center and Santa Clara (midblock): • Phase I: All work on the west side including curb, gutter, and sidewalk. Maintain two northbound tlu-ough lanes at all times. • Phase II: All work on the east side including curb, gutter, and sidewalk. Maintain two southbound through lanes at all times. Broadway and Washington Water Main Improvements project: • Maintain at least one lane in each direction on Broadway from Civic Center to Santa Clara Avenue. • Washington from Flower Street to Broadway can be done per WATCH. Traffic control plans are required for the above. DOCUMENT 00411 BOND ACCOMPANYING BID KNOW ALL BY THOSE PRESENTS: That the undersigned Christensen Brothers General Engineering Inc, as Principal and the undersigned as Surety are held and firmly bound unto the Cily of Santa Ana , a municipal corporation of the State of California (the "City's as obligee, in the penal sum of Ten Percent of Amount Bid Dollars ($1010% ) lawful money of the United States of America, being at least ten percent (10%) of the aggregate amount of said Principal's bid, for the payment of which, well and truly to be made, we bind ourselves, our successors, executors, administrators, and assigns, jointly and severally, firmly by these presents. WHEREAS, the said Principal, is submitting a for Broadway Rehabilitation -Civic Center Drive to Santa Clara Avenue and Broadway and Washington Avenue Water Main Improvements, Project # 11-6743/11-6415, Santa Ana, California THE CONDITION OF THIS OBLIGATION IS SUCH that if the hid submitted by the said Principal, be accepted and the contract be awarded to said Principal, Christensen Brothers General Engineering, Inc, and said Principal shall within a period of Ten (10) calendar days after such award enter into the contract so awarded and provide the required Performance Bond, Labor and Material Bond, insurance certificates and all other endorsements, forms and documents required under document 00200 instructions to Bidders, then this obligation shall he void, otherwise to remain in full force and effect. IN W7NESS WHEREOF, the above bounden parties have executed this instrument this 3rd day of July, 2013 Christensen Brothers General Engineering, Inc. (Corporate Seal) By (Ie Principal North American Specialty Insurance Company Surety By Naom Attomey-in-Fact END OF DOCUMENT BOND ACCOMPANYING 131D 004111 See Attached Aeknowledgmentor Murat Certificate CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT State of Montana County of Yellowstone On July 3, 2013 before me, Debby K. Olds Date Name and Tale of Notary personally appeared Naomi Gerber Name and or Names of Signer(s) Who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand=dofficial see 1.Signature �/� — ag� Notary Public Signature Debby K. Olds OPTIONAL c�gY K•0<D DEBBY K OLDS ypTAHtq�. NOTARY PUBLIC for the _ SEAL : State of Montana Residing at Billings, Martian ,. < ,N��@a' AAV Commission Espiies �6FMQ January 31, 2015 Place Notary Public Seal Above Though the information below is not required by law, it may prove valuable to the persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document Document Date Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner - ❑ Limited ❑ General ❑ Guardian or Conservator Top of thumb D Attorney -in -Fact ❑ Trustee ❑ Other: Signer is representing North American Specialty Insurance Company Number of Pages: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner - ❑ Limited []General ❑ Guardian or Conservator Top of thumb ❑ Attorney -in -Fact ❑ Trustee ❑ Other: Signer is representing NAS SURETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY -'ASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a corporation duly organized and existing under laws of the State of New Hampshire, and having its principal office in the City of Manchester, New Hampshire, and Washington International Insurance Company, a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Schaumburg, Illinois each does hereby make, constitute and appoint: Naomi Gerber Its true and lawful Attorney -in -Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, the following surety bond: Principal: Christensen Brothers General Engineering, Inc. Bond Number: Bid Bond Obligee: City of Santa Ana Bond Amount: See Bond Form Bond Description: Broadway Imhabilitation - Civic Center Dime to Santa Clam Avenueand emadvii,nd Washington Avmec Wmer Main lmarovcmcnti, Proiectall-6743111-(415, Santa Ana, Cmlmmla Provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed the amount of: FIFTY MILLION ($50,000,000) DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington Intemational Insurance Company at meetings duly called and held on the 9`s of May, 2012: "RESOLVED, that any two of the Presidents, any Managing Director, any Senior Vice President, any Vice President, any Assistant Vice President, the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and all contracts of surety, and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached." IN WITNESS WHEREOF, North American Specialty Insurance Company and Washington Intemational Insurance Company have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized officers this 25th day of May 2012. North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Cook ss: On this 25th day of May 20 12 , before me, a Notary Public personally appeared Steven P. Anderson . Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and David M. Layman Vice President of Washington International Insurance Company and Vice President of North American Specialty Insurance Company, personally known to me, who being by me duly sworn, acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. ^ "" l IAL" NcIS S yPublie,Stateoflllinois Donna D,Sklens,Nota Public ommission Expires 10/0(u"1015 Notary s.y I, Jeffrey Goldberg the duly elected Assistant Secretary of North Ameih an.Specialty Insurance Company and Washington Intemational Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company and Washington Intemational Insurance Company, which is still in full force and effect. 'WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 3rd day of July 2013 Jeffrey Goldberg, Vice President & Assistant Secretary of Washington Intemational Insurance Companys, Assistant Seca[ary of North American Specialty Imsumnca Company By Poa�t•WS '& \*\�JQ\A1117V� -OW:.60'OR}fi••V� & F Steven P. Anderson, Senior Vice President of Washingtonlntematlonalln.,mn.Company &Senior Vico Pmsidentot NovtLA criwn Specialtyfnsurance Company tiQQo z, S�L6, un g g: s LE EAL S1973 $a; h'N9M ''0 B ,,q,ON',L\'0 0 1111' Dvd MUyVicsidenoiquon Innuendoes] Insurance C & Vice President ofNorh American Specialty Insurance Company �. m*mn�s IN WITNESS WHEREOF, North American Specialty Insurance Company and Washington Intemational Insurance Company have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized officers this 25th day of May 2012. North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Cook ss: On this 25th day of May 20 12 , before me, a Notary Public personally appeared Steven P. Anderson . Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and David M. Layman Vice President of Washington International Insurance Company and Vice President of North American Specialty Insurance Company, personally known to me, who being by me duly sworn, acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. ^ "" l IAL" NcIS S yPublie,Stateoflllinois Donna D,Sklens,Nota Public ommission Expires 10/0(u"1015 Notary s.y I, Jeffrey Goldberg the duly elected Assistant Secretary of North Ameih an.Specialty Insurance Company and Washington Intemational Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company and Washington Intemational Insurance Company, which is still in full force and effect. 'WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 3rd day of July 2013 Jeffrey Goldberg, Vice President & Assistant Secretary of Washington Intemational Insurance Companys, Assistant Seca[ary of North American Specialty Imsumnca Company CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT 2010 State of California County of SA ra \y4zo ke(i CIVIL CODE § 1189 On --,Z-3 before me, xw sa— wrcbi rir+ sert kr Date Here InName entl itle of the Officer personally appeared Gewvr C�airx�✓S�+✓ Names) of Signers) WITNESS my hand and official seal. Signature: Place Notary Seal Above — re of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(les) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Corporate Officer — Title(s): ❑ Individual ❑ Individual ❑ Partner — ❑ Limited ❑ General Top of thumb hero ❑ Partner — ❑ Limited ❑ General Top of thumb here ❑ Attorney in Fact ❑ Attorney in Fact ❑ Trustee ❑ Trustee ❑ Guardian or Conservator ❑ Guardian or Conservator ❑ Other: ❑ Other: Signer Is Representing: Signer Is Representing: National Notarv.ora - 1 -800 -US NOTARY (1-800-876-6827) Item who proved to me on the basis of satisfactory evidence to be the person(a)—whose name/,.e)-is/wer subscribed to the within instrument and acknowledged to me that ,hetshe/they- executed the same in � SCI)TTIft"ll p*EORV 4isfher/their authorized capacity(les), and that by con"Saba ar lessi pis/her/tttA signature* on the instrument the Noury ipBbIIG • Callfomu amycomon. persona, or the entity upon behalf of which the San 6arnarAiMcounty Ea Il Jul 16.2216 persorp�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: Place Notary Seal Above — re of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(les) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Corporate Officer — Title(s): ❑ Individual ❑ Individual ❑ Partner — ❑ Limited ❑ General Top of thumb hero ❑ Partner — ❑ Limited ❑ General Top of thumb here ❑ Attorney in Fact ❑ Attorney in Fact ❑ Trustee ❑ Trustee ❑ Guardian or Conservator ❑ Guardian or Conservator ❑ Other: ❑ Other: Signer Is Representing: Signer Is Representing: National Notarv.ora - 1 -800 -US NOTARY (1-800-876-6827) Item Company Profile Company Profile Company Search Company Search Results Company Information Old Company Names Agent for Service Reference Information NAIC Group List Lines of Business Workers' Compensation Complaint and Request for Action/Appeals Contact Information Financial Statements PDF's Annual Statements Quarterly Statements Company Complaint Company Performance & Comparison Data Company Enforcement Action Composite Complaints Studies Additional Info Find A Company Representative In Your Area View Financial Disclaimer COMPANY PROFILE Company Information NORTH AMERICAN SPECIALTY INSURANCE COMPANY 650 ELM STREET, 6TH FLOOR MANCHESTER, NH 03101-2524 Old Company Names Effective Date Agent For Service NANCY FLORES C/O CT CORPORATION SYSTEM 818 WEST SEVENTH STREET" LOS ANGELES CA 90017 Reference Information NAIC #: 29874 California Company ID #: 3208-6 Date Authorized in California: 06/30/1989 License Status: FUN LIMITED- Company Type: Property & Casualty State of Domicile: NEW HAMPSHIRE back to top NAIC Group List NAIC Group #: 0181 SWISS RE GRP Lines Of Business The company is authorized to transact business within these lines of insurance. For an explanation of any of these terms, please refer to the glossary. AIRCRAFT" AUTOMOBILE BOILER AND MACHINERY BURGLARY DISABILITY FIRE LIABILITY MARINE PLATE GLASS SPRINKLER SURETY WORKERS' COMPENSATION back to top © 2008 California Department of Insurance Page 1 of 1 https://interactive.web.insiTrance.ca. gov/companyprofile/coinpanyprofile?event—companyP... 7/30/2013 MEMORANDUM TO: David Cavazos City Manager Edwin "William" Galvez Interim Executive Director From: Public Works Agency Date: Mav 16, 2014 Project No. 116743 and 116415 Broadway Rehabilitation and Water Main Improvements Subject: Change Order No. 2 Contractor: Christensen Brothers General Engineering, Inc. 21288 Papago Road Apple Valley, CA 92307 Project Description: Roadway and Water Main Line Improvements Change Order Number: 2 Change Order Total: $494,383.04 Accounting Unit -Account -Activity Number: 11674303028-03017660 11674304028-05917663 11674305028-03217662 11641501028-06617647 JUSTIFICATION Extra Work at Time and Material While potholing the water main and services on Broadway, several utility conflicts were encountered. The water main at STA 14+60, 24+25 and 10+50 (17th Street) was redirected from the original alignment to avoid irremovable obstructions, including an existing stormdrains and active water lines (cylinder main). Also, various unforeseen obstructions were found, which needed to be removed. During the installation process, existing buried concrete pavement was encountered. The material was more difficult to remove then originally proposed and required additional saw cutting or breaking prior to removal. The export of the spoils was hauled to a different plant for further processing and disposal. Additional import material (sand and aggregate base) was needed to fill the void. Other miscellaneous repairs include unmarked sewer laterals, water services and traffic signal conduit. The change order provides compensation for delays associated with production loss. A prior approval was granted on January 6, 2014. (PC0#26;27,28,30,31,32,35,36,37,38,39,40,45,46,48,49,51,54,56,57,58,59,60,61,63,66,67,68,69,70, 72,74,76,77,78 &79). FINAL COST $307,487.98 Project No. 116743 and 11 15 Request for Approval of Change Order No. 2 May 16, 2014 Page 2 of 3 Extra Work at Agreed Price 2. The project phasing was further revised to minimize the impacts to adjacent schools, business owners and residents. The realignment included restriping to accommodate two south -bound lanes and one north -bound lane between Civic Center Drive and Seventeenth Street. Field modifications were made to increase safety, including signage and lane delineation. The change order provides compensation for added traffic control related to the time extension of the project. A prior approval was granted on January 6, 2014. (PCO#22,23,24,68,77 &80). AGREED PRICE $84,172.20 Extra Work at Agreed Unit Prices 3. The proposed pavement structural section was previously revised to incorporate the existing buried concrete pavement in the center lanes. The buried concrete pavement in the outer lanes has to be removed to allow for construction of the water main and curb and gutter. After further field investigations, portions of the outer lanes can remain but require a variable grind. This alternative will reduce costs and help expedite the process. Associated costs in the previous process include additional asphalt concrete and aggregate base. These modifications will not sacrifice the integrity of the pavement, maintaining a design -life expectancy of at least 20 years. The following contract items were deleted or decreased to allow for the change in scope. Item # Bid Item Unit Quantity Unit Price Amount 56 PCC Pavement Removal (6") CY -812.74 $100.67 -$81,815.54 Subtotal -$81,815.54 The following contract items were added to allow for the change in scope. Item # Bid Item Unit Quantity Unit Price Amount 59 Aggregate Base TN 1,000 $49.38 $49,380.00 60 PCC Grind (Variable Width & Thickness) SF 60,000 $2.14 $128,400.00 61 Traffic Signal Conduit LF 330 $20.48 $6,758.40 Subtotal $184,538.40 BID ITEM ADJUSTMENT $102,722.86 Project No. 116743 and 11, 15 Request for Approval of Change Order No. 2 May 16, 2014 Page 3 of 3 ACCOUNTING UNIT COST ANALYSIS CCO Item Number Accounting Unit Accounting Unit Cost Total Amount 1 11641501028-06617647 $336,548.49 $336,548.49 2 11674303028-63017660 $0 $0 2 11674305028-03217662 $0 $0 3 11674304028-05917663 $157,834.55 $157,834.55 Total $494,383.04 CONTRACT COST SUMMARY Original Contract Total $4,302,858.65 Previous Change Orders $284,510 % of Contract 6.61 % Change Order $494,383.04 Increase 11.49% Total CCO to date $778,893.04 Increase 18.10% Contract Total $5,081,751.69 SCHEDULEIMPACT An additional 50 working days will be provided for delays associated with this change order. F re�� /t] Edwin "William" Galve Interim Executive Director Public Works Agency APPROVED AS TO FUNDS AND ACCOUNTS: Francisco Gutierrez n_ Executive Director 6 °` Finance & Management Services Agency PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number Project No. 116743 and 116415— Broadway Change Order Number 2 Rehabilitation and Water Main Improvements Roadway and Water Main Line Improvements To Christensen Brothers General Engineering, 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 COUNCILOR 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 time. Change requested by EXTRA WORK AT TIME AND MATERIAL PUBLIC WORKS AGENCY 1. Water main realignment and removal of obstructions on Broadway per Prior Approval dated January 6, 2014. (PCO#26,27,28,30, 31,32,35,36, 37, 38,39,40,45,46,48,49,51,54,56,57,58,59,60,61,63,66,67,68,69, 7 0,72,74,76,77,78 &79). FINAL COST $307,487.98 EXTRA WORK AT AGREED PRICE 2. Traffic control implementation and safety enhancements on Broadway per Prior Approval dated January 6, 2014. (PCO#22,23,24,68,77 &80). AGREED PRICE $84,172.20 EXTRA WORK AT AGREED UNIT PRICES 3. Revised pavement structural section to incorporate existing buried concrete pavement on Broadway. The following contract items were deleted or decreased to allow for the change in scope. Item # Bid Item Unit Quantity Unit Price Amount 56 PCC Pavement Removal (6") CY -812.74 $100.67 -$81,815.54 Subtotal -$81,815.54 Page 1 of 3 CITY OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number Project No. 116743 and 116415 — Broadway Change Order Number 2 Rehabilitation and Water Main Improvements To Christensen and Water Main Line Im ng, 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. CIT. OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number Project No. 116743 and 116415 — Broadway Rehabilitation Change Order Number and Water Main Improvements Roadway and Water Main Line Improvements To Christensen Brothers General Engineering, 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 $ 494,383.04 By reason of this order the CONTRACT TIME completion will be adjusted as follows: Fifty (50) Working Days We the undersigned . mractor have given careful consideration to the change proposed and hereby agree, if this proposal is approved, that we will provide all equipment, furnish 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 a prices shown above. Accepted, D V Contractor Christensen/Brothers General Engineering, Inc. By Approval recommended by 4P �G c� Date / �/ BLICWORKS AGENCY EXECU EDIRECTOR Approved by Date CITYMANAGER Page 3 of 3 MEMORANDUM To: From: Subject: David Cavazos City Manager Date: November 3, 2014 Contractor: Christensen Brothers General Engineering, Inc. 21288 Papago Road Apple Valley, CA 92307 Project Description: Roadway and Water Main Line Improvements Change Order Number: 3 Change Order Total: $68,915.47 Accounting Unit -Account -Activity Number: JUSTIFICATION Extra Work at Agreed Price 11674303028-03017660 11674304028-05917663 11674305028-03217662 11641501028-06617647 1. While constructing the curb ramps at the NE and SE corners of 10th and Broadway the existing pull boxes were discovered within the limits of the new curb ramps. Upon further investigation, the conduits inside the pull boxes needed to be lowered to allow for the new grade of the pull boxes. Therefore, it was recommended to lower the conduits and adjust the existing pull boxes and pedestrian push buttons to accommodate for the new grade of the curb ramp.(PCO 81) AGREED PRICE $5,775.00 2. While connecting the new water main to the existing water main at the intersection of Washington and Broadway an old wye was discovered at the connection point. The wye intercepted an abandoned main, which is no longer needed. Therefore, the City's Water Department requested to have the wye removed and a new 14” butterfly valve installed (PCO 82) AGREED PRICE $8,799.60 3. While removing the existing pavement at Santa Clara and Broadway an unforeseen old style traffic loop pressure plate was encountered. Consequently, the pressure plate needed to be removed to achieve the design street section. (PCO 85) AGREED PRICE $2,136.76 Fred Mousavipour Executive Director Public Works Agency ^: Q Project No. 116743 and 116415 Broadway Rehabilitation and Water Main Improvements C) Change Order No. 3 ;=c„, Contractor: Christensen Brothers General Engineering, Inc. 21288 Papago Road Apple Valley, CA 92307 Project Description: Roadway and Water Main Line Improvements Change Order Number: 3 Change Order Total: $68,915.47 Accounting Unit -Account -Activity Number: JUSTIFICATION Extra Work at Agreed Price 11674303028-03017660 11674304028-05917663 11674305028-03217662 11641501028-06617647 1. While constructing the curb ramps at the NE and SE corners of 10th and Broadway the existing pull boxes were discovered within the limits of the new curb ramps. Upon further investigation, the conduits inside the pull boxes needed to be lowered to allow for the new grade of the pull boxes. Therefore, it was recommended to lower the conduits and adjust the existing pull boxes and pedestrian push buttons to accommodate for the new grade of the curb ramp.(PCO 81) AGREED PRICE $5,775.00 2. While connecting the new water main to the existing water main at the intersection of Washington and Broadway an old wye was discovered at the connection point. The wye intercepted an abandoned main, which is no longer needed. Therefore, the City's Water Department requested to have the wye removed and a new 14” butterfly valve installed (PCO 82) AGREED PRICE $8,799.60 3. While removing the existing pavement at Santa Clara and Broadway an unforeseen old style traffic loop pressure plate was encountered. Consequently, the pressure plate needed to be removed to achieve the design street section. (PCO 85) AGREED PRICE $2,136.76 Project No. 116743 and 1`,,,415 Request for Approval of Change Order No. 3 November 3, 2014 Page 2 of 3 4. While restriping the street for phase 2 construction on Broadway south of 17th Street, the City's Traffic Section field reviewed and recommended a few modifications to the traffic control at Halesworth, 10th, Washington, and 15th. These modifications increased traffic flow and safety. (PCO86) AGREED PRICE $636.26 5. While placing the new curb and gutter at Santa Clara and Broadway, it was determined that the contract removal limits needed to be increased to eliminate ponding. Therefore it was recommended to remobilize the demolition crew and remove an additional 35 linear feet. (PCO 89) AGREED PRICE $1,585.50 6. After the contractor base paved in the adjacent streets with asphalt at 18tH 20tH and Buffalo, several residents requested to have the streets changed back to the original PCC. Therefore the City's Design Section requested to have the AC removed and replaced with PCC. (PCO 90) AGREED PRICE $25,000 Extra Work at Time and Material 7. While attempting to connect the new 14 -inch water main to the existing at Santa Clara and Broadway, the City's Water Crew, after making several attempts, was unable to sufficiently shut the water down the existing water valves. The City's Water Crew worked diligently for a couple of hours to identify additional valves to achieve a sufficient shutdown. However due to the time of day and the fact that the new valves identified would significantly increase the number of residents without water, it was decided to cancel the work and reschedule after the residents were notified of the expanded shutdown. (PCO 83) FINAL COST $6,476.88 8. While removing and replacing curb ramps, curb and gutter, and sidewalk along Broadway, it was determined at five locations additional work was needed to complete the contract work. At Broadway and Halesworth the flow line needed to be adjusted to eliminate ponding; at Broadway and Washington additional sidewalk needed to be removed and replaced for the new curb ramp; at Broadway and 20th the drive approach needed to be removed and replaced to accommodate egress issues; at Santa Clara and Broadway an existing footing needed to be removed for the new curb ramp; and at Broadway and Washington traffic signal conduits needed to be lowered for the new curb ramp. This work was done on a time and material basis. (PCO 92) FINAL COST $18,505.47 E Project No. 116743 and 11 0415 Request for Approval of Change Order No. 3 November 3, 2014 Page 3 of 3 ACCOUNTING UNIT COST ANALYSIS CO Item Accounting Unit Accounting Unit Cost Accounting Unit Cost Total Amount 1 11674304028-05917663 $5,775.00 $5,775.00 2 11641501028-06617647 $8,799.60 $8,799.60 3 11674304028-05917663 $2,136.76 $2,136.76 4 11674304028-05917663 $636.26 $636.26 5 11674304028-05917663 $1,585.50 $1,585.50 6 11674304028-05917663 $25,000.00 $25,000.00 7 11641501028-06617647 $6,476.88 $6,476.88 8 11674304028-05917663 $18,505.47 $18,505.47 Total $53,638.88 $15,276.48 $68,915.47 CONTRACT COST SUMMARY Original Contract Total $4,302,858.65 % of Contract Adjusted Contract Quantities $ 225,631.01 Increase 5.2% Previous Change Orders $ 778,893.04 Increase 18.1% Change Order 3 $ 68.915.47 Increase 1.6% Total CCO & Adj. Qtys. to date $1,073,439.52 Increase 24.95% Adjusted Contract Total $5,376,298.17 SCHEDULEIMPACT No additional time is warranted. Executive Director Public Works Agency APPROVED AS TO FUNDS AND ACCOUNTS: Francisco Gutierrez Executive Director Finance & Management Services Agency CIT`" OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number Project No. 116743 and 116415— Broadway Rehabilitation and Water Main Improvements Change Order Number 3 To Christensen Brothers General Engineering, 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. Relocate the pedestrian push button and adjust the traffic signal pull box at the NE and SE corners of loth and Broadway as directed per PCO 81. AGREED PRICE $5,775.00 2. Remove an existing 14" Wye and install a new 14" Butterfly valve at Washington and Broadway as directed per PCO 82. AGREED PRICE $8,799.60 3. Demolish, remove, and dispose of an unforeseen traffic loop pressure plate at Santa Clara and Broadway as directed per PCO 85. AGREED PRICE $2,136.76 4. Modify the striping at Halesworth, 10`h Street, Washington, and 15th Street as directed per PCO 86. AGREED PRICE $636.26 5. Remobilize and demolish C&G at Santa Clara and Broadway as directed per PCO 89. AGREED PRICE $1,585.50 6. Remove existing asphalt pavement and replace with 8" PCC at three locations north of 17`h Street, approximately 2000 square feet, as directed per PCO 90. AGREED PRICE $25,000.00 EXTRA WORK AT TIME AND MATERIAL 7. Extra work caused by the inability to provide a proper shutdown of the 14" water main at Santa Clara and Broadway as directed by the City of Santa Ana per PCO 83. FINAL COST $6,476.88 Page 1 of 2 Project Number Project No. 116743 and 116415 — Broadway Rehabilitation and Water Main Improvements CIT' OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Change Order Number To Christensen Brothers General Enaineerina, 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. ID[i5[�i.IF3�7.1\�[�Ixi]i1X:iEyQNIi�YY3�i►�Lf1�pLf:1»iil�L�]]'fCCx�lfi[dilg�[�7L�Hiy1��r�C\�/:fH�:# Unless otherwise stated, rales 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 8. Demolish miscellaneous PCC C&G and Sidewalk, chipping, and conduit work at five locations as directed by the City of Santa Ana per PCO 92. FINAL COST $18,505.47 The compensation both time and cost set forth in this final change order comprises the total compensation due the Contractor, all Subcontractors, and all Suppliers for all change work performed under this contract, including impact on unchanged work. By signing this final change order, the Contractor acknowledges and agrees on behalf of himself, all Subcontractors, and all Suppliers, that the stipulated compensation includes payment for all changed work under this contract, 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 final 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 final 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 $ 68,915.47 By reason of this order the CONTRACT TIME completion will be adjusted as follows: Zero Working Days We the undersigned contractor have given careful consideration to the change equipment, furnish all materials, except as may otherwise be noted above, and payment therefor the prices shown above. Accepted, Dale { _ 3 _ IV Contractor Title ' ., By Approval recommended by 6 4 , Approved by Page 2 of 2 by agree, if this proposal is approved, that we will provide all necessary for the work above specified, and will accept as full Inc. Date Date