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BANNAOUN ENGINEERS CONSTRUCTION CORP.
Recording Requested By, Recorded in Official Records, Orange County And When Recorded Mail To: Hugh Nguyen, Clerk-Recorder Clerk of the Council,City of Santa Ana II�III III IIII�I �IIIIII I IIII�I! IIIILII I III III II NO FEE 20 Civic Center Plaza,P.O.Box 1988 I f I 1f Santa Ana,CA 92702 * $ R 0 0 0 8 0 1 4 8 4 3 $ 2015000624560 11:09 am 12/09/15 276 416 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 i T 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, r California, 92701, is the owner of the property hereinafter described, that said owner has caused a construction of 2014-2015 OMNIBUS CONCRETE REPLACEMENT CONTRACT under contract entered into on 9/2/2015, with BANNAOUN ENGINEERS CONSTRUCTOR CORP., x on which contract SURETEC INSURANCE COMPANY is surety. The property on which such owork improvement was placed is in the City of Santa Ana, County of Orange, State of o z California, and described as Project No.15-6824 located at: VARIOUS LOCATIONS. The work aimprovement on said property was accepted as completed on 11/20/2015. a a v CITY O A, A MUNICIPAL CORPORATION o by �- U a Dated: l Za t S Princigdl Civil Engineer-Tyrone Chesanek TITLE pG U 0. W R; V ` RIFICATION I, the undersigned, say: I am the City Engineer - Edwin "William" Galves 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-/� �,e_ v' t at Santa Ana, California (Signature of in Mdual swearing that the 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: SEPTEMBER 2, 2014 TITLE: CONTRACT AWARD FOR 2014 -2015 OMNIBUS CONCRETE REPLACEMENT PROJECT (PROJECT NO. 156824) J CITY MANAGER RECOMMENDED ACTION CLERK OF COUNCIL USE ONLY: SEP 2 ZM4 APPROV,EEDD ET `ED Recommended j 07 ❑ As Amended ❑ Ordinance on 15' Reading ❑ Ordinance on 2ntl Reading ❑ Implementing Resolution ❑ Set Public Hearing For CONTINUED TO FILE NUMBER 1. Award a contract to Bannaoun Engineers Constructors Corporation, the lowest responsible bidder, in accordance with its bid in the amount of $424,875, for the construction of the 2014- 2015 Omnibus Concrete Replacement project. 2. Approve the Cost Analysis for a total estimated project delivery cost of $481,186. 3. Authorize the City Manager to execute change orders in an amount not to exceed the total authorized contingency of $8,091. DISCUSSION The Omnibus Concrete Replacement project provides for high priority street repairs, which include replacing damaged and deteriorated concrete sidewalk, curbs, gutters, cross gutters, wheelchair ramps, driveways approaches, and concrete pavement at various locations throughout the City. The work will be performed on an as- needed basis. Bid procedures have been followed as established by the City's Municipal Code and in adherence to the Public Contracts Code. The Notice Inviting Bids was advertised on July 18 and 21, 2014; bids were opened on August 8, 2014. The following is a summary of the bid invitations mailed and received, and the bid results: Contractor Participation Data Santa Ana contractors receiving notices 13 Contractors requesting bidding documents 15 Bids received 5 Bids received from Santa Ana contractors 1 Contract Award for Omnibus Concrete Replacement Project September 2, 2014 Page 2 Bid Results Summary RANK BIDDER'S NAME LOCATION BID 1 Bannaoun Engineers Constructor Corp. Chatsworth $424,875 2 El Camino Construction & Engineering Corp. Long Beach $492,945 3 Moalej Builders, Inc. Sherman Oaks $540,550 4 Unique Performance Construction, Inc. Anaheim $699,240 5 Hardy & Harper, Inc. Santa Ana $763,530 Five bids were received and deemed responsive, with Bannaoun Engineers Constructors Corporation submitting the lowest responsive bid. Their bid amount of $424,875 is within one percent of the Engineer's Estimate of $420,215. STRATEGIC PLAN ALIGNMENT Approval of this item supports the City's efforts to meet Goal #6 Community Facilities & Infrastructure, Objective #1 (establish and maintain a Community Investment Plan for all City assets), Strategy B (equitably maintain existing streets and associated assets in a state of good repair so they are clean, safe and aesthetically pleasing for all users). ENVIRONMENTAL IMPACT In accordance with the California Environmental Quality Act, the recommended actions are exempt from further review. Categorical Exemption Environmental Review No. 2014 -74 was filed for this project. FISCAL IMPACT The estimated total delivery cost of this project is $481,186, which includes construction administration, inspection, testing, survey and contingencies (Exhibit 1). Funding is available to cover costs in the following funds: Traffic Congestion Relief -HUT (Account No. 05917663 - 66220, $271,186), Federal Clean Water Protection Enterprise (Account No. 05717640 - 62300, $160,000), Water Systems Maintenance (Account No. 06017641- 63001, $10,000), Sanitary Sewer Service (Account No. 05617640 - 63001, $10,000), and PRCS Facilities Maintenance (Account No. 01113260- 62320, Activity 10200801102, $30,000). Contract Award for Omnibus Concrete Replacement Project September 2, 2014 Page 3 Edwin "William" G Interim Executive Public Works Aqe py1 / Gerardo Mouet Executive Director Parks, Recreation and Community Services EWG /KW Exhibit 1: Cost Analysis APPROVED AS TO FUNDS AND ACCOUNTS: ACNZ-,� I :;X Francisco Gutierrez Executive Director Finance & Management Services Agency IYK- Exhibit 1 FUNDING ANALYSIS PROJECT NOS. 156824 CONTRACT AWARD FOR 2014 -2015 OMNIBUS CONCRETE REPLACEMENT CONTRACT Construction Contract $424,875 Contract Administration $19,288 Inspection and Testing $28,932 Contingencies $8,091 TOTAL ESTIMATED CONSTRUCTION COSTS $481,186 THE REGISTER 625 N GRAND AVE, SANTA ANA, CA 92701 Telephone (714) 796 -7000 / Fax (714) 796 -6059 PROOF OF PUBLICATION State of California County of ORANGE Notice Type: BID - NOTICE INVITING BIDS Ad Description: Omnibus Concrete Rapt FY 14/15 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 clerk of the printer and publisher of the THE 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 dale 11/19/1905, 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: 07/19/2014, 07121/2014 Executed on: 07/21/2014 At SANTA ANA, California I certify (or declare) under penalty of perjury that the foregoing is true and correct. 00 eb 4641 III * A ".a ' ."t, I I II II VIII I I I I II II 4 8 7 3 4 7 a cN O Q� ct'4 a c p U to U a .� U- 0 > . U c UNv'o a `o u U v Q N H Y D7 C w V 0 0 V N Q t 4 U O C � � 3 C � � W Ol L C U O m C C N m C a) E w u t7 V' co CD r N � U G U U o �CL s u C 0 O c � US r- O N tf' O N '7 O O :V ri 0 N a a) 0 dYd ' U5 u ¢ 9 14 iD;1 1.5'7� MAYORi Miguel A. Pulido MAYOR PRO TEM Sal Tinajero COUNCIL MEMBERS Angelica Amezcua P. David Benavides Michele Martinez Roman A. Reyne Vincent F. Sarmlento 4 S .aw CITY OF SANTA ANA PLANNING & BUILDING AGENCY 20 Civic Center Plaza (M -20) P.Q. BOX 1988. Santa Ana, California 02702 (714) 657 -2700 • Fax (714) 913.1481 wvay.sanla- ana.org CITY MANAGER David Cavazos CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Hulzar Mml ORANGE COUNTY CL CORDER OEPARTh1EPn BY: _ _0EPUTY 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: 2014.2015 Omnibus Concrete Rep Date of Approval: 09/02/2014 ProjectNumber(s): PWA -2014- 977 -CIP Project Location: City: Santa Ana Project Description: Applicant Name: 1 Citywide (Partial) County: Orange ER Number: ER- 2014 -74 Replacement of damaged and deteriorated concrete sidewalk, curbs, gutters, cross gutters, wheelchair ramps, driveways approaches and concrete pavement at various locations throughout the City. Monica Suter , City of Santa Ana Applicant Address: City of Santa Ana, 20 Civic Center Plaza SANTA ANA, CA 92702 Name of Public Agency Approving Project: City Council Name of Person or Agency Carrying Out Project: Suter, Monica 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: Q Categorical Exemption: 15301(c) Reason(s) Why Project is Exempt From CEQA: Repair /maintenance of existing public Infrastructure City Contact: Sean Thomas Signature: ��-° Title: Recorded in Official Records, Orange County Hugh Nguyen, Clerk - Recorder �� I II II ��III��I IIII IIII �� NO FEE *$ R 0 0 0 6 8 8 4 9 4 0$ 2014850006861:37 pm 08107/14 281 304 201 OAO 50.00 0.00 0.00 0.00 0.00 0.00 0.00 Telephone: (714) 647 -5655 Assistant Engineer Date: 8/7/2014 •� s AUG 0 7 2014 HUGHNGUYRN, RECORDER SANTA ANA CITY COUNCIL DEPUTY BY.—- µ- ,.,-- _,__ Miguel A. Pulido Sal Thomism Vincent F. Sarmlenle Mlchale Martinez Angelica Amezcua P. David Benavides Roman Rayon Mayor Mayor Pro Tam, Ward 8 Ward 1 Ward 2 Ward 3 Ward 4 Ward 5 MPui'do&nsama- ana.om STinaieroCdaanta-ana.prg VSarmiento(&santeana. orb. MMadiinezfo] santa •a(la<glgppQL@z�ge(rg5.anta -nna nro.DBanavida& s ig,.gnggre.RRavnaQsaata- anaorb SANTA ANA �A CITY OF SANTA ANA PINA PUBLIC WORKS AGENCY 20 CIVIC CENTER PLAZA PBW WOWS AOENGY CITY HALL - ROSS ANNEX SANTA ANA, CA 92701 PROJECT NO. 15 -6824 2014 -2015 Omnibus Concrete Replacement Contract PREPARED UNDER THE SUPERVISION OF: _ ""' N0,.48591 rs re+J * FWP 6/30/16 7/21/2014 Jr� C'IV1�- Monica M. Suter R.C.E. 48591 Date \ or v! THE PLANS AND SPECIFICATIONS ARE AVAILABLE AT NO CHARGE IN PORTABLE DOCUMENT FORMAT (PDF) ON A COMPACT DISK (CD) ONLY PROJECT COORDINATION AND SERVICES: BID SUBMITTALS: UNDERGROUND FACILITIES: CITY HALL ROSS ANNEX 4TH FLOOR RECEPTIONIST, (M -43) FIRE DEPARTMENT (714)647.5100 DESIGN: POLICE DEPARTMENT (714)8344801 ENGINEERING (PUBLIC WORKS AGENCY) (714)647 3 013 PUBLIC WORKS AGENCY (CITY YARD) (714)847 -3380 LANDSCAPE (RECREATION B COMMUNITY SERVICES) (714)5714219 PUBLIC WORKS AGENCY (TRAFFIC SIGNALS) (714)647-5619 CONSTRUCTION ENGINEERING: RECREATION& COMMUNITY SERVICES (MAINTENANCE) (714)S71 4212 PUBLIC WORKS INSPECTOR (714)847 -6074 PUBLIC WORKS AGENCY (WATER AND SEWER) (714)647x360 CONTRACTADIAMISTRATOR (714)6473074 TIME WARNER (714)903-0337 PERMITS AND INSPECTIONS DEPARTMENTS: SOUTHERN CALIFORNIA EDISON COMPANY 18004224133 BUILDING INSPECTOR (7:3a.8;30 AMKS:304:30 PM) (714)6474w6 SOUTHERN CALIFORNIA GAS COMPANY 14 0 0 4 2 241M ELECTRICAL INSPECTOR (7:304:M AMR3:304:30 PM) (714)647 -6800 AT&T TELEPHONE COMPANY: (714) 2 3 9 416 6 PLUMBING INSPECTOR (7:30-8= AMN3:304:30 PM) (714)647.6600 (7:00 AM -5:00 PM)MONDAY - FRIDAY 14004224133 SOUTHERN PACIFIC TRANSPORTATION COMPANY (909)3419060 WEEKENDS, HOLIDAYS, AND EMERGENCIES 14004214600 SANTA FE RAILROAD COMPANY (909)386-0000 GREAT WESTERN RECLAMATION (TRASH COLLECTION) (714)566 -7761 ORANGE COUNTY TRANS. AUTHORITY (BUS 9ERNCE) (714)6384330 TABLE OF CONTENTS PROJECT NO. 15 -6824 2014 -2015 Omnibus Concrete Replacement Contract ITEM PAGE Tableof Contents ............................................................................................. ............................... i NoticeInviting Bids ....................................................................................... ............................... iii Map of City Hall; Directions to Bid Opening ................................................ ............................... iv Instructions to BIDDERS on Executing Proposal and Contract Documents ............................................................................. ............................... v PROPOSAL AND CONTRACT AGREEMENT Bid Proposal ........................... List of Sub - contractors........... BIDDER'S Statement ............. Certification of Nondiscrimination by Contractor .......... ............................... Workers' Compensation Insurance Certification ............ ............................... References....................................................................... ............................... BIDDER'S Statement Regarding Apprenticeship Requirements .................. Non - Collusion Affidavit ................................................. ............................... BIDDER's Statement Regarding "Anti- Kickback" Requirements ................ Contractor's Licensing Statement ................................... ............................... 1.00 SPECIAL PROVISIONS - General 1.01 Definitions ............................ ............................... 1.02 Standard Specifications ........ ............................... 1.03 Time of Completion ............. ............................... 1.04 Liquidated Damages ............ ............................... 1.05 Award and Execution of Contract ....................... 1.06 Emergency Information .................................. ............................... 1.07 Plans & Specifications .................................... ............................... 1.08 Work by City Forces Because of Nonperformance by Contractor 1.09 Labor Standards Provision .............................. ............................... 1.10 Apprenticeship Standards ........ 1.11 Contract Bonds ......................... 1.12 Liability Insurance ................... 1.13 Utilities ....................................... ............................... 1.14 Working Day .............................. ............................... 1.15 Contractor's Equipment and Facilities ...................... 1.16 Licenses and Permits .................. ............................... 1.17 Clean-up & Dust Control ........... ............................... 1.18 Public Convenience and Safety . ............................... 1.19 State Division of Industrial Safety Permits ............... 1.20 Payment ...................................... ............................... 1.21 Subcontracting ........................... ............................... 1.22 Survey ........................................ ............................... 1.23 Markup ....................................... ............................... ...... BP -1 ...... BP -7 ...... BP -8 .... BP -10 .... BP -12 .... BP -13 .... BP -14 .... BP -15 .... BP -16 .... BP -17 .. 2 ........................ 2 ........................ 2 ............. 2 3 3 ................... 4 ................... 4 ................... 5 ................... 5 ................... 6 ................... 6 ................... 7 ................... 7 ................... 7 ................... 8 ................... 9 ITEM PAGE 1.24 Temporary Steel Plate Bridging ............................................................. ............................... 10 1.25 Retention ................................................................................................ ............................... 11 2.00 SPECIAL PROVISIONS - Construction 2.01 Rock Products ........................................................................................ ............................... 12 2.02 Relative Compaction Tests .................................................................... ............................... 12 2.03 Construction Survey Staking ................................................................. ............................... 12 2.04 Earthwork ............................................................................................... ............................... 12 2.05 Subgrade Preparation ............................................................................. ............................... 13 2.06 Asphalt Concrete .................................................................................... ............................... 13 2.07 Concrete Curbs, Gutters, Sidewalks, Cross Gutters, Curb Ramps, and Driveways ............ 14 2.08 Portland Cement Concrete Pavement Construction ............................... ............................... 16 2.09 Landscaping and Irrigation Repair ............................................................ .............................18 2.10 Root Shaving .......................................................................................... ............................... 18 2.11 Adjustment of Surface Utilities to Grade ............................................... ............................... 18 2.12 Traffic Striping & Pavement Markings ................................................. ............................... 20 2.13 Stamped Concrete .................................................................................. ............................... 21 2.14 Decorative Sidewalk .............................................................................. ............................... 21 2.15 Interlocking Concrete Pavers ................................................................. ............................... 22 2.16 Top Soil Class A .................................................................................... ............................... 22 2.17 Brick Pavers ........................................................................................... ............................... 22 2.18 PCC Grinding ......................................................................................... ............................... 22 2.19 Monument Tiles ..................................................................................... ............................... 23 2.20 Erosion Control Plan ................................................................................. .............................23 2.21 Automatic Retractable Screen (ARS) and Connector Pipe Screen (CPS) .. .............................23 2.22 Concrete Filled Steel Bollard .................................................................... .............................24 2.23 Concrete Bollards ( Square) .................................................................... ............................... 24 2.24 Precast Wheel Stops ............................................................................... ............................... 24 2.25 ADA Truncated Domes ......................................................................... ............................... 25 2.26 Concrete Planters ................................................................................... ............................... 25 3.00 SPECIAL PROVISIONS - Speed Humps & Raised Crosswalk 3.01 Scope of Work .............................................................................................. .............................23 3.02 Sprayable Thermoplastic (Thin Mil) ........................................................... .............................24 3.03 Raised Pavement Markers ( RPMs) .............................................................. .............................24 3.04 Signs .............................................................................................................. .............................24 3.05 Payment ......................................................................................................... .............................26 4.00 SPECIAL PROVISIONS - Traffic Diverters, Monument and Monument Sign 4.01 Traffic Diverters and Monument and Monument Sign .............................. .............................27 APPENDICES A - Improvement Standard Plans B - Sample Bonds & Sample Certificates of Insurance C - Santa Ana Recycling Requirements D - Traffic Diverter and Monument E - Concrete Filled Steel Bollard F - Miscellaneous Details NOTICE INVITING BIDS 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 Thursday. August 7th, 2014 sealed bids and/or proposals for: PROJECT NO. 15 -6824: 2014 -2015 OMNIBUS CONCRETE REPLACEMENT CONTRACT Notice is hereby given BIDDERS that in accordance with the provisions of the California Labor Code, not less than the prevailing rate of per diem wages for each craft or type of worker and mechanic needed to execute the contract in the locality in which the work is to be performed, and not less than the general prevailing rate of per diem wages for holiday and overtime work as determined by the Director of Industrial Relations of the State of California shall be paid to all workers employed. Each bid shall be accompanied by cash, a cashier's or certified check payable to the City of Santa Ana, or bid bond issued by a corporate surety, for an amount not less than ten percent (10 %) of the aggregate of the bid, as a guarantee that the BIDDER will enter into the proposed contract if the same is awarded to him. THE SIGNATURE OF THE BIDDER ON THE BID BOND MUST BE NOTARIZED. The City Council reserves the right to reject any or all bids. The successful BIDDER must possess or obtain a valid California Class "A" Contractor's license prior to the scheduled award date of this contract. Substitution of securities for any monies withheld by the City of Santa Ana to ensure performance is allowed in accordance with the Public Contract Code. Complete electronic sets of the Plans and Specifications will be furnished upon application at the Public Works Agency counter, First Floor, 20 Civic Center Plaza, Ross Annex, Santa Ana, California 92701. Plans and Specifications are available in portable document format (PDF) on a compact disk (CD) only. There is no charge for the Plans and Specifications on CD. PWA Counter Business Hours are 9:00am to 4:00pm, Monday thru Thursday and alternating Fridays (such as July 25, 2014). Call the PWA Projects Information Lane at 714 - 647 -5680 for availability of CDs. To request a CD by mail, the Contractor must submit an email request to sarmour(a�santa- ana.org and provide the following information: Company name, mailing address, phone number, FedEx account, and email Subject heading: CD Request for Project 15 -6824: 2014 -2015 OMNIBUS CONCRETE REPLACEMENT CONTRACT Checks are no longer accepted. Addenda will be issued by email to those who received CDs directly from the Public Works Agency. DO NOT CALL PURCHASING DIVISION REGARDING PUBLIC WORKS AGENCY PROJECTS. iii it IV R W # ' ,ws aR 1 a} INSTRUCTIONS TO BIDDERS ON EXECUTING PROPOSAL AND CONTRACT DOCUMENTS PROJECT NO. 15 -6824: 2014 -2015 Omnibus Concrete Replacement Contract The proposal shall be correctly executed and submitted in accordance with the Notice Inviting Bids. The Proposal shall contain the legal name and address of the BIDDER and any SUBCONTRACTORS to be used. If the BIDDER is a corporation, it is important to state the appropriate officers. The Proposal shall be made a part of the entire contract, and accuracy is essential. Proposals shall be enclosed in a sealed envelope plainly marked on the outside, "SEALED BID FOR PROJECT NO. 15 -6824: 2014 -2015 Omnibus Concrete Replacement Contract IN THE CITY OF SANTA ANA - DO NOT OPEN WITH REGULAR MAIL." Proposals may be mailed, with return address, or delivered by messenger. However, it is the BIDDER'S own responsibility to ensure delivery of the proposal to the office of the City Hall -Ross Annex, 20 Civic Center Plaza, Santa Ana, California 92701, the Public Works Aaency Third Floor Receptionist, prior to the bid - opening hour stipulated in the Notice Inviting Bids. Late proposals will not be considered. CONTRACT AGREEMENT The contract agreement is included in the project contract documents. The contract agreement is to be completed and signed by the BIDDER and returned, with the proposal, to the City of Santa Ana c/o Public Works Agency. BIDDER is to place the complete and correct business name in the appropriate location. After a careful reading and understanding of the terms and conditions of the contract, the BIDDER shall sign the document using the legal firm name, business address, telephone number and email, and designate the type of business involved. ACCEPTANCE AND NOTIFICATION Upon award of contract by the City Council, the successful BIDDER will be notified of award and requested to furnish appropriate bonds and insurance certificates. Bonds and certificate of liability insurance shall be submitted to the City of Santa Ana (AGENCY) within ten (10) days after notice of award. After the AGENCY receives and approves bonds and certificates of liability insurance, the AGENCY will send to the successful BIDDER a copy of the fully executed Contract Agreement. WITHDRAWAL OF PROPOSAL A proposal may be withdrawn with a written request signed by the BIDDER. Such requests must be delivered to the AGENCY'S Public Works Agency Executive Director prior to the bid - opening hour stipulated in the Notice Inviting Bids. Proposals may not be withdrawn after said hour without forfeiture of the proposal guarantee. The withdrawal of the proposal will not prejudice the right of the BIDDER to submit a new proposal, providing there is time to do so, or to submit a new proposal for rebidding the same project. SUBMISSION OF BIDS: AGREEMENT TO ASSIGN In accordance with Section 4552 of the Government Code, the BIDDER shall conform to the following requirements: in submitting a bid to a public purchasing body, the BIDDER offers and agrees that if the bid is accepted, it will assign to the purchasing body all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 USC Sec. 15) or under the Cartwright Act [Chapter 2 (commencing with Section 16700) of Part 2 of Division 7 of the Business and Professional Code], arising from purchases of goods, materials, or services by the BIDDER for sale to the purchasing body pursuant to the bid. Such assignment shall be made and become effective at the time the purchasing body tenders final payment to the BIDDER. PRIOR TO BID The BIDDER shall be held to have examined the Plans and Specifications, visited the project site and fully informed himself/herself as to all existing conditions and limitations involved in the work. The BIDDER shall have included in the contract price a sufficient sum to cover all items, either labor or materials, that are required or implied for a complete project as shown on the Plans and described in the Specifications and other contract documents. REVIEW OF BIDS The AGENCY will check each bid item Unit Price and Amount for all bids submitted. In case of a discrepancy between the correct product of the Unit Price multiplied by the Quantity and the Amount entered by the BIDDER, the correct product shall prevail. In case of a discrepancy between the correct sum of the individual Amounts and the total Bid entered by the BIDDER, the correct sum shall prevail. If a Unit Price is not legible or is missing, the Amount for that contract bid item shall be divided by the Quantity to arrive at the Unit Price. If both the Unit Price and the Amount of the Contract bid item are left blank or are illegible, the entire Bid shall be rejected. More than one proposal from an individual, firm, partnership, corporation, or combination thereof under the same or different names will not be considered. Reasonable grounds for believing that any individual, firm, partnership, corporation or combination thereof is interested in more than one proposal for the work contemplated may cause the rejection of all proposals in which such individual, firm, partnership, corporation, or combination thereof is interested. If there is reason for believing that collusion exists among the BIDDERS, any or all proposals may be rejected. Proposals in which the prices obviously are unbalanced may be rejected. LABOR DISCRIMINATION Attention is directed to Section 1735 of the Labor Code, as added by Chapter 643, Statutes of 1939, which reads as follows: "No discrimination shall be made in the employment of persons upon public works because of the race, religious creed, color, national origin, ancestry, physical handicap, medical condition, marital status, or sex of such persons except as provided in Section 1420, and every contractor for Public Works violating this Section is subject to all penalties imposed for a violation of the Chapter." A copy of the Certification of Nondiscrimination by Contractors, as provided with this Specification, shall be executed by BIDDER and submitted with his /her Proposal and Contract. vi LICENSE REOUIREMENTS In accordance with Section 7028.15(e) of the Business and Professions Code, a licensed contractor shall not submit a bid to the public agency unless his or her contractor's license number appears clearly on the bid, the license expiration date is stated, and the bid contains a statement that representations made therein are made under penalty of perjury. Any bid not containing this information or a bid containing information, which is subsequently false, shall be considered non - responsive and shall be rejected by the public agency. Format for this statement is shown in Section BP, Proposal and Contract Agreement. In accordance with the Section 3300 of the California Public Contract Code, the Agency has determined that the BIDDER shall possess a license in the classification specified in the Notice Inviting Bids. BOND Each bid shall be accompanied by cash, a cashier's or certified check payable to the City of Santa Ana, or a bid bond issued by a corporate surety, for an amount not less than ten percent (10 %) of the aggregate of the bid and ALL bid alternates, as a guarantee that the BIDDER will enter into the proposed contract if the same is awarded to him. Any bid submitted without any of the above shall not be considered. THE SIGNATURE OF THE BIDDER ON THE BID BOND MUST BE NOTARIZED. DISCREPANCIES AND MISUNDERSTANDINGS BIDDERS shall satisfy themselves by personal examination of the work site, Plans, Specifications, and other contract documents (and by any other means as they believe necessary) as to the actual physical conditions, requirements, and difficulties under which work must be performed. No BIDDER shall at any time after submission of a proposal make any claim or assertion that there was any misunderstanding or lack of information regarding the nature or amount of work necessary for the satisfactory completion of the job. Any errors, omissions, or discrepancies found in the Plans, Specifications, or other contract documents shall be called to the attention of the AGENCY and clarified prior to the submission of proposals. The BIDDER shall submit a complete bid package. All unit prices and products of unit prices multiplied by the quantities shall be filled out by BIDDER. Failure to fulfill these requirements or to submit a completed bid package will render the bid irregular and will result in its rejection by the AGENCY. INTENT OF BID PROPOSAL The purpose of this Bid Proposal is to obtain a Prime Contractor to enter into a contract with the AGENCY to complete the work shown on the Plans and described in the Specifications. Since job locations cannot be determined at this moment, unit prices shown in bid schedule shall be used for each job order. The minimum amount for each job order shall be $10,000; however, each job order may include replacement of many small areas of concrete scattering at different locations of the City. For each job order, specific locations throughout the City will be given to the Contractor. For job orders involving emergency concrete repair on time and material basis, the minimum for each job order shall be $5,000. vii The Agency reserves the right to increase or decrease the amount of any quantity shown and /or delete any item from the contract without any adjustment for overhead and profit. ADDENDA The effect of all addenda to the Contract Documents shall be considered in the bid package. Before submitting his/her bid, each BIDDER shall inform himself/herself as to whether or not addenda have been issued. It is the BIDDER's responsibility to notify the AGENCY regarding receipt of addenda, if any. BID PROTEST Any bid protest must be submitted in writing to Executive Director of Public Works, City of Santa Ana, 20 Civic Center Plaza M -21, Santa Ana, CA 92701 before 5:00 p.m. of the 5th business day following bid opening. Bid protests sent via mail or overnight carrier must be received by the AGENCY by 5:00 p.m. of the 5th business day following bid opening in order to be deemed timely. Hand delivered protests must be provided to the receptionist in the City Hall Annex/Public Works Counter on the first floor of the City Hall Annex. a. The initial protest document shall contain a complete statement of the basis for the protest. b. The protest shall refer to the specific portion of the document, which forms the basis for the protest. c. The protest shall include the name, address and telephone number of the person representing the protesting party. d. The party filing the protest shall concurrently transmit a copy of the initial protest document and any attached documentation to all other parties with a direct financial interest, which may be adversely affected by the outcome of the protest. Such parties shall include all other BIDDERS or proposers who appear to have a reasonable prospect of receiving an award depending upon the outcome of the protest. The AGENCY shall announce at bid opening who such parties shall be. e. Should a written bid protest be filed in a timely fashion, a protest hearing shall be held before the Executive Director of Public Works or designee on the 10th business day following bid opening at 10:00 a.m. in the conference room on the fourth floor of the City Hall Annex at 20 Civic Center Plaza, City of Santa Ana, Santa Ana, California 92701. All interested parties may appear and offer testimony at this bid protest hearing. Formal rules of evidence shall not apply at this hearing, nor shall testimony under oath be required. The burden of proof shall be on the party submitting the protest to demonstrate that the staff s determination of proposed low BIDDER is arbitrary and capricious, or unsupported by substantial evidence in the record. f. All BIDDERS are advised that if you challenge the AGENCY's award of contract in court, you may be limited to raising only those issues you or someone else raised at the public hearing described above, or in written correspondence delivered to the Executive Director of Public Works at, or prior to, the public hearing. g. The Executive Director of Public Works or designee will issue a written decision to the City Council on the protest, which shall also be promptly provided to all interested parties. If the Executive Director of Public Works or designee determines that a protest is frivolous, the party originating the protest may be determined to be irresponsible and that party may be determined to be ineligible for future contract awards. viii h. The procedure and time limits set forth in this paragraph are mandatory and are the BIDDER's sole and exclusive remedy in the event of Bid protest and failure to comply with these procedures shall constitute a waiver of any right to further pursue the bid protest, including filing a Government Code Claim or legal proceedings. ix CITY OF SANTA ANA PROJECT NO. 15 -6824: 2014 -2015 Omnibus Concrete Replacement Contract PROPOSAL & CONTRACT AGREEMENT BID PROPOSAL TO: CITY COUNCIL OF THE CITY OF SANTA ANA FROM: o r� ri a o to n r1 os a n t cr s ns c' rs �or(�oro° °ort 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 furnish 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 Unit Price Amount MAINTENANCE 00 1. Unclassified Excavation CY 200 $ (S — $�3 p( 2. Construct AC Pavement TN 250 00 $ /50_ ao $-31507 3. Remove and Construct 4" PCC SF 8,000 $ AS CIO $ 40, CC-0 PO Sidewalk 4. Remove and Construct PCC Curb and LF 500 02 $ 1{0 _ n $ 201` Gutter (A -2 -6) —92 on 5. Remove and Construct PCC Curb and LF 850 $ 45 $ 38, Z50 Gutter (A -2 -8) 6. Remove and Construct PCC Curb (B -1) LF 550 $ 3S`° $ 2��w 7. Remove and Construct PCC Curb SF 10,500 eo $ inn eo $ fo' 3, 066 _ Ramp 8. Remove and Construct 6" PCC SF 700 00 $ Driveway 00 �_ 9. Remove and Construct 8" PCC SF 1,600 $ $ 60 Driveway 10. Remove and Construct PCC X- Gutter SF 900 $ lb°t 00 $ 6fcco BP 1 of 17 CITY OF SANTA ANA Project No. 15 -6824: 2014 -2015 Omnibus Concrete Replacement Contract PROPOSAL & CONTRACT AGREEMENT BID PROPOSAL, continued Item # Bid Item Unit Quantity Unit Price Amount 11. Remove and Construct 8" PCC SF 800 $ /O oe ' $ R'am w ` Pavement 12. Remove and Construct 12" PCC Bus SF 3,400 5'0 $ 8 " 00 $ 2A 1004 Pad 13. PCC Grinding LF 150 $ GS $ 7 0 14. Root Shave EA 100 $ $ 3,sba 15. Paint Red Curb LF 300 $ 3 w $ 6100' 16. Remove and Construct Stamped SF 300 ao $ /O – ao $ 73, Ofd ` Concrete 17. Remove and Construct Decorative SF 300 00 $ /0 $ 310ct>` Sidewalk 18. Remove and Construct Brick Pavers SF 300 $ 12— $ 3,606- 19. Furnish and Install Water Valve Box EA 5 $ �ZS6 $ 2 /ZS�' Frame and Cover to Grade 20. Adjust Manhole Frame and Cover to EA 5 eo $ 65'0 w $ 3, ZSO Grade 21. Adjust Pull Box to Grade EA 10 bo $ 250 on $ 25 6-6 22. Furnish and Install No. 6 Pull Box EA 10 $ ( Oil $ 9,000– 23. Concrete Steel Filled Bollard (include EA 16 00 $ 2– 5"b_ -to $ 4,CT)o 2 coats of paint) 24. Install Concrete Bollards (Square) EA 16 ao $ 0 ..v $ 000v 25. Furnish and Install Monument Tiles EA 8 00 $ 3 p0— w $ Zi 40 BP2of17 CITY OF SANTA ANA Project No. 15 -6824: 2014 -2015 Omnibus Concrete Replacement Contract PROPOSAL & CONTRACT AGREEMENT BID PROPOSAL, continued Item # Bid Item Unit Quantity Unit Price Amount 26. Concrete Planters EA 16 00 $ 750 M $ 42,0r 27. Interlocking Concrete Pavers SF 300 00 $ 5 — °O $ 4 5c)o 28. Furnish and Install Class A Topsoil CY 15 co $ 600 w $ /,500— TRAFFIC 29. Construct Speed Hump 30. Construct Raised Crosswalk 31. Repair Traffic Diverter (per Appendix D) 32. Repair Monument and Monument Sign (per Appendix D) 33. Repair and /or Replace Monument Sign Only (per Appendix D) 34. Install Traffic Sign and ,Post 35. Install ADA Truncated Domes (Cast - in- ,Place) 36. Install Precast Wheel Stops 37. Install Striping STORM DRAIN FACILITIES 38. Construct PCC Parkway Culvert (Type A) EA 10 $ 1000 EA 1 $ h 200 le EA 1 $ 3,500 $ ti 600` $ 6, 2C0 wo $ eo ao EA 1 $ 2rS00 $ 2.560 EA 1 $ 5,000 $ Si ®bJM EA 6 $ 300 $ /, 800tl` 0o ee EA 6 $ , $ 0o po EA 20 $ 60 — $ 1200e —7 LF 100 $ 2 GO $ 250 00 00 EA 1 $ 4/00— $ /m BP3of17 CITY OF SANTA ANA Project No. 15 -6824: 2014 -2015 Omnibus Concrete Replacement Contract PROPOSAL & CONTRACT AGREEMENT BID PROPOSAL, continued Item # Bid Item Unit Quantity Unit Price Amount 39. Construct PCC Parkway Culvert (Type B) EA 1 rro $ w $ /, 200 40. Reconstruct Reinforced PCC Catch Basin Top Slab EA 1 $ /, &ey $ 11 6co (W =7') 41. Reconstruct Reinforced PCC Catch Basin Top Slab EA 1 13? $ 3AW to $ 3_ CCO (W =14') 42. Reconstruct Reinforced PCC Catch Basin Top Slab EA 1 Co $ 4,Cb6 to- $ 4, L560 (W =21') 43. Construct PCC Catch Basin Inlet and Depression EA 1 00 $ 6 COO °= $/,000 (W =7') 44. Construct PCC Catch Basin Inlet and Depression EA 1 00 $ 1,500— eo $ t, '90t)— (W =1.4') 45. Construct PCC Catch Basin Inlet and Depression EA 1 ao $ 2,6CO co $ 2, Oco (W =21') 46. Furnish and Install Catch Basin Screen Insert ARS EA 1 $ I& $4000 _ 47. Furnish and Install Catch Basin Screen Insert CPS EA 1 co $ /,Q66— o? $ 48. Repair Catch Basin Screen Insert ARS EA 1 e_o $ 500 00 $ 5oc> 49. Repair Catch Basin Screen Insert CPS EA 1 a� $_93 ate- eu $ GOO — 50. Furnish and Install Formed Steel Catch Basin Face EA 1 co $ 4500— 00 $ 600 Plate 51. Furnish and Install Formed Steel Catch Basin EA 1 Protection Bar Assembly w /Anchor, Hanger and Bolts BP4of17 CITY OF SANTA ANA Project No. 15 -6824: 2014 -2015 Omnibus Concrete Replacement Contract PROPOSAL & CONTRACT AGREEMENT BID PROPOSAL, continued Item # Bid Item Unit Quantity Unit Price Amount 00 .o 52. Furnish and Install Cast Iron Catch Basin EA 1 $ ,SOO � $ SCOT Manhole Cover and Frame wBolts — Non Traffic (Clear Opening — 22 ") mo ao 53. Furnish and Install Cast Iron Junction Chamber EA 1 $ /,OeO $ /, OOD Manhole C & F wBolts — Traffic (Clear Opening — 23.5 ") ao � 54. Furnish and Install Cast Iron Junction Chamber EA 1 $ 4 (,C0 — $ , 600 Manhole Cover and Frame w/Bohs — Traffic (Clear Opening — 36 ") mo 55. Adjust PCC Junction Chamber Manhole — Grade EA 1 $ $ /, 800 Rings and Collar ro eo 56. Furnish and Install Ductile Iron Catch Basin EA 1 $_�,_6d0 $1,600— Inlet Grate and Frame — Non Traffic (Rectangular) in v_ 57. Furnish and Install Ductile Iron Catch Basin EA 1 $/,660 $ 4C00 Inlet Grate and Frame — Traffic and Bicycle (Rectangular) BP5of17 CITY OF SANTA ANA Project No. 15 -6824: 2014 -2015 Omnibus Concrete Replacement Contract PROPOSAL & CONTRACT AGREEMENT BID PROPOSAL, continued TOTAL BID Srve -o y Avg c4ol I uws The lowest responsible bidder based on the TOTAL Bid shall be selected. However, the City reserves the right to limit the contract award amount up to the available funding limit. NOTE: QUANTITIES IN BID SCHEDULE ARE SHOWN ONLY FOR BID COMPARISON. PROJECT NO. 15 -6824 2014 -2015 Omnibus Concrete Replacement Contract ov BIDDER Firm 13arx1r1Arou,n main eers �n� ' Gov �roi�•i ov, � Address si61 L' kal-SW OA, CA 91311 Phone (81g BIDDER -775-0040 Signature s BP6of17 CITY OF SANTA ANA Project No. 15 -6824: 2014 -2015 Omnibus Concrete Replacement Contract 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; '' /a% of the bid or $10,000, whichever is greater - Buildings, parks, or other projects: '' /z% of the bid BIDDER proposes to subcontract certain portions of the work to the firms listed below: NAME Su or - "Ior Pa" g Mowk¢ -g g LOCATION Cyprcss, PHONE "71 _,MS TYPE OF WORK sj,.`pinq $ 76,T0` NAME LOCATION PHONE TYPE OF WORK $ NAME LOCATION PHONE TYPE OF WORK $ NAME LOCATION PHONE TYPE OF WORK $ NAME LOCATION PHONE TYPE OF WORK $ NAME LOCATION PHONE TYPE OF WORK $ NAME LOCATION PHONE TYPE OF WORK $ NAME LOCATION PHONE TYPE OF WORK $ NAME LOCATION PHONE TYPE OF WORK NAME LOCATION PHONE TYPE OF WORK Name of Firm Submitting Bid' 8,,xnn0.uwn F- ny ;nCarsCo»s6-mleA- scope �+O- mN.ev� Signature of BIDDER ~ BP7of17 R CITY OF SANTA ANA PROJECT NO. 15- 6824: 2014 -2015 Omnibus Concrete Replacement Contract 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 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, 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. NameofFirm 50- rer%CLO x F-r)al'InrerS Consl- rs �rPfl� ®cove Signature of BIDDER O Title- Jvytai (if an individual, so BP8of17 CITY OF SANTA ANA Project No. 15 -6824: 2014 -2015 Omnibus Concrete Replacement Contract 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.) Lam`,&, MiKkce:L_j t reggurer`, Wahl K,SicaV-iavnl Monomer Awarded d -�, of COUNCIL: on the,basis.of owest responsible nd responsive i bidder in the amountof ATTEST: CLERK OF THE C` Oi INC L ACCEPTED FOR THE CITY OF SANTA ANA: EXECUTIVE DIRECTOR PUBLIC WORKS AGENCY BP9of17 CITY OF SANTA ANA Project No. 15 -6824: 2014 -2015 Omnibus Concrete Replacement Contract 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. BP 10 of 17 CITY OF SANTA ANA Project No. 15 -6824: 2014 -2015 Omnibus Concrete Replacement Contract 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 Stars. 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. Signed C f�K Title -PreslJen (I-- Firm FXXnyNGOtAn �/a ✓PprrAH en Date augt tA 0 6, 2 0 14 BP 11 of 17 CITY OF SANTA ANA Project No. 15 -6824: 2014 -2015 Omnibus Concrete Replacement Contract 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. Signed Title 1 Firm Date BP 12 of 17 CITY OF SANTA ANA Project No. 15 -6824: 2014 -2015 Omnibus Concrete Replacement Contract 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. 2. '`+C.Y 0; Arno, 20 c ioc- C��ker Plaza . Saww�a fin^ eAWz Name dnd Address of Owner. Mr, Qv- xnpLo Ga.-G0, 7/1- Name and Telephone Number of person familiar with project. 22(5 t757 s�G Gonwe vK a o eym;,c anoeus ® Z7 2,m6Z Contract Amount Type of Work Date Complete Name and Address of owner.' MV' ®e$1 ^ (&[� cyr 2 562 -2.71- 3188 Name and Telephone Number of person familiar with project. 207,361611° Mixcllancous Conc. CtL Ranwvs ©3 /ZI 12-olZ Contract Amount Type of Work Date Completed 3. C%�nj ®1= CasiEt MtSat -i 7 FA:,v- VY1we . C05, M.eSa -, CA' 17Z6Z8 Name And Address of owner. _1 Mv. Jv-a +11G 5ct-iiC-1ieZ "764 - -7574 - G ZZ.2 Name and Telephone Number of person familiar with project. Z-17,403 �s Mtr,a,- Gorw�t� R � wtA- o BIOS" /2013 Contract Amount Type of Work o,..k Mkc Ct Date Completed The following are the names, addresses, and telephone numbers of all brokers and sureties from whom BIDDER intends to procure insurance and bonds. - - i 1615b7 Ve,,%Jcur . TarZanca, " 01356 �uarcTeC- -1�y15WI -ante Cn,ICo.My 512 - 73Z -Oo 6M °1737 Greer L F� ;1� a;,l. SL4L 32-o . A- ',n - FXJ$ %Sq BP 13 of 17 CITY OF SANTA ANA Project No. 15 -6824: 2014 -2015 Omnibus Concrete Replacement Contract PROPOSAL AND CONTRACT AGREEMENT BIDDER'S 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 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. Signed Title k Firm Qp�y�no��u.n Ana Irvelrs e-0#?S rC"rS CDrO4!0eod On Date c7P3fo6�Zr� /4 BP 14 of 17 CITY OF SANTA ANA Project No. 15 -6824: 2014 -2015 Omnibus Concrete Replacement Contract 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 part 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. Signed State of California County of Subscribed and sworn to (or affirmed) before me on this day of , 20_, by , proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. Notary Public Signature Notary Public Seal BP 15 of 17 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT 5,0 Rlw4y STATE OF CALIFORNIA Couni Los Ancie-tes On 0810(0l(2014 beforeme, Mt �e-tr NI)k Date Here rserl Name and Title of the O leer personally appeared who proved to me on the basis of satisfactory evidence to be the person(&) whose name* is/a4;& subscribed to the within instrument and acknowledged to me that he/&4@A4W executed the same in his/14944eir authorized capacity(406), and that by his/keg4ke4 signature(e4 on the instrument the person(i4, or the entity upon behalf of which the person4o) 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. Signature of Notary P/11�,-� 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: —L\t—ori - Cc 11wd. arx ------ A�t,=taA, L Document Date: 091061?-ON —Number of Pages: 0 n e(A)— Signer(s) Other Than Named Above: Capacity(les) Claimed by Signer(s) Signer's Name: CDyy-ic&--%- KaLtcF— ❑ Individual ("'Corporate Officer — Title(s): 1pne ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is RepresentiDg: Signer's Name: ❑ Individual ❑ Corporate Officer -- Title(s): i Partner - -- ❑ Limited ❑ General Attorney in Fact Trustee Guardian or Conservator Signer Is Representing: CITY OF SANTA ANA Project No. 15 -6824: 2014 -2015 Omnibus Concrete Replacement Contract 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 I Firm IL:�ayi r- ta.00A'" ZYi�I iClr'2.rS C-- OnSA"�'Ll r IAVS cor4E�ora ,Ai ova Date 0(51061Z-,014 Zc] /4 BP 16 of 17 CITY OF SANTA ANA Project No. 15 -6824: 2014 -2015 Omnibus Concrete Replacement Contract 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: ( ✓Q/�Y�R�LCni19 Zvi Cfvs L®�cC (OILS Carpl�r+ ion Business Address: Telephone: E31(5 —'775 —©o State Contractor's License No. and Class: BO7°Z9 A/B 4CZ1 Expiration Date: iYO✓ern�cr 3/ Z © /S' Signed: Title: -A '-e- 5�,cleL BP 17 of 17 " _• KNOW ALL MEN BY THESE PRESENTS, that we Bannaoun Engineers Constructors Corporation as principal, hereinafter called the "Principal," and SURETEC INSURANCE COMPANY, 9737 Great Hills Trail, Suite 320, Austin, Tx 78759, as surety, hereinafter called the "Surety," are held and firmly bound unto City of Santa Ana as obligee, hereinafter called the Obligee, in the sum of Ten Percent (10 %) of the Amount Bid by Principal for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the principal has submitted a bid for Project No. 15 -6824 2014 -2015 Omnibus Concrete Replacement Contract. NOW, THEREFORE, if the contract be timely awarded to the Principal and the Principal shall within such time as specified in the bid, enter into a contract in writing or, in the event of the failure of the Principal to enter into such Contract, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. PROVIDED, HOWEVER, neither Principal nor Surety shall be bound hereunder unless Obligee prior to execution of the final contract shall furnish evidence of financing in a manner and form acceptable to Principal and Surety that financing has been firmly committed to cover the entire cost of the project; and PROVIDED, FURTHER, unless the bid documents require that bid security remain in effect for a longer period of time, Surety shall have no liability hereon if a contract for the bid amount is not awarded to Principal within 60 days of the date hereof. SIGNED, sealed and dated this 5th day of August, 2014. Bannaoun Engineers Constructors Corporation (Principal) a BY: TITLE: �Y Gsiolt rtC SureTec Insurance Company r BY: ,�- id , ttore`7C ney -in -Fact SureTec Bid Bond Form Rev 1.1.06 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA Countyof - -L.OS krw4eles On QeVQk1Z614 beforeme,_- MIC.kelr csr OLAq P"lir, Date Here sert Name and Title of the vfi personally appeared l_J M a4- _ (- la L.00t: Capacity(ies) Claimed by Signer(s) Signer's Name: lJn' 014– M�a6 ❑ Inc ividual Corporate Officer — Title(s):T✓ eS i A e A ❑ Partner —❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Represent'&q 13AnnAAltn l Orp. Signer's Name ❑ Individual ❑ Corporate Officer —Title(s): ❑ Partner - - - ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Name(s) of Signor(s) -- who proved to me on the basis of satisfactory evidence to M E i ETYEMEEIAN be the person(&) whose name(c, is /are. subscribed to the within instrument and acknowledged to me that he /she✓ ll Commiaeton Ar 1975083 executed the same in his /heckJaeir authorized capacity(ies), Notary Pubtle - Callfornia Le and that by his /heW#taeis signature(s4 on the instrument the Los Angeles County person(&), or the entity upon behalf of which the person(} My Comm, Expires A r 14.2010 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 Signature of Notary Pi OPTIONAL O 7 p^9 -per IONAL 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 ggnt p ^ Title or Type of Document: ,8 -- Document Date: 0 81061 Z Of¢ Number of Pages: C)rt e Signers) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: lJn' 014– M�a6 ❑ Inc ividual Corporate Officer — Title(s):T✓ eS i A e A ❑ Partner —❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Represent'&q 13AnnAAltn l Orp. Signer's Name ❑ Individual ❑ Corporate Officer —Title(s): ❑ Partner - - - ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: ACKNOWLEDGMENT State of California County of Los Angeles On AUG 052014 before me, Christopher John Rizzotti Notary (insert name and title of the officer) personally appeared David Noddle 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 capecity(ies), and that by his /her /their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and o ici seal. �f'�° �o�� AY PUdu� cry F 1 6n s-fi` LO &AdGELJA O IY CC) JA aJ p,9y Comm Expres NUARY 17 ?019 Signature (Seal) PoAN:_51 0010 SnreTec Insurance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURFTEC INSURANCE COMPANY (the "Company "), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint David Ncddle its true and lawful Attorney -in -fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for: Five Million and 00/100 Dollars ($5,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney -in -Fact may do in the premises. Said appointment shall continue in force until 1013V2015 and is made under and by authority of the following resolutions of the Board of Directors of the Suri Insurance Company: Be it Resolved that the President, any Vice - President, any Assistant Vice- President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s) -in -Fact to represent and act for and on behalf of the Company subject to the following provisions: Atiorney-in -Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attomey -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20 of April, 1999) In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal to be hereto affixed this 21 st day of March, A.D. 2013. SURETEC INSURANCE COMPANY tiffv.�c . ..o By: `w CO .i_ John i0�Jr, sid ent State of Texas as: I / ,rl County of Harris a' On this 21st day of March, A.D, 2013 before me personally came John Knox Jr, tome known, who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said Company; and that he signed his time thereto by like order. �,sw + "xe4, JACQUELYN MAblic O ` Notary Public v 11/1 State of Texas " °'r e My Comm. 15 /18 /2otr Jacq elynMaldonado,NotaryPublic My commission expires May 18, 2017 I, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a hue and correct copy of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. Given under my hand and the seal of said Company at Houston, Texas this day of AUG 052014 _ , A.D. )Bre t Beaty, Assistant ecretaty Any instrument Issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 812 -0800 any business day between 8:00 am and 5:00 pm CST. 9NSURt RiSS A4'8 "tiT4IDING COVERAGE NMC' Mk NSURER I(tc cIal T TtI,. 1453 6NSURERE . • 4:tRkD BA tl i'pp E eDC19'iEDECLIYI .C1gineei"E+ Constructors y MURER C Corporation R0, Box 16599 tNSURFR D, I�EIv dy Hills CA 90209-2352 ME I RE z e; _�_O_V A__GES CERTIFICATE NUMB, E W REVISION hd4Jl : TIOS !CY TO CERi FY THAT THE"? (""(" ?6,IUE.s OF ENSUi•AivCE LISTED BEi < %M HAVE BEEN 4, SC4ED TO "HE, MG1RED hiAPviED ABOVE +'OR THE, P i.Cf. T r��k!:4"�:EC:� ", INUCAIrED, NOY 'r1r8T8°VSTdLNDMCI ANY RFa „Y AREM mN TEaRIVI OR t:;t:1NEAT'ION OF ANY (,FriFAC; v OR i THE'R DOCUMENT WITH RESPECT TO M@CF1 THIS CE RIDFICA.? E'. fAA"Y BE 6SUE,0 OR MA)” r'ks" R 1 "AK THE M iURAN E" AFFORDED BY TEE, I "C,iG,.l+w ES f.IP!iSC 4YB :9 HEREIN is suBjEnc r V) AU, THE l E"E' MS K: XCL.W.BCaFC3C S AND C.;f: N l[T°3eJNS C)F „NE.CH POUCHES. 6.E1'w)H S lI tCiiTN MAY HAVT B9 _`E..N RhE:[EU A D BY PAA0 C L.e"A6PA9S. MR -.. ADOL SURA TYPE Cif" IhdStbNdRA.hNC.E IMORk '4' VCt .. POUC.Y EF €- POI 6C'E EX LI Mk TS .............._.�.�___PCkW. 6C"f N33t! C4f eC.._. _ ....m_L4+fiAA6C12Lyi n '2Mfat Cl yLy]fY%.,.._.w._. ...,.,,.._,._._ ,....,_............_._.,_,...........,.,.__ .,.,_,._.__.........,.„....,._. A GENERALUAk3UTY V 883- 1464 "Ii /112014 11 /Y1201w EACH 0,1,,,CuRRENCE S1,0C)('e.t'00 f`ONI,M R6.,P L GENERAL w4AB4,J( Y DAMAGE 10 KF 41 PREMISES (Fa. wrrdwm, i.EI.:nNlr'l -MAI����F A 0<I ,f. R Ar9asD d.XP (Ap,y o per o,,Y E b,C,)0p ) _ PERSONAL &ACA, trva V,0' ,S,000,t010 fFE Pdf A,taF'A i,_GAIC ,.,EMe eA. #PUE1,,i PHR 14kt, "/ J,7 s `, „; 1C 4b <1a "Ih €�;e A;,C00,COO '` 4 ai f "Y 1 1MR _„ �E ��..Y(I Ty 1�,Aw, R.... AMETO MOBILE LBABILtTY IE fA;Ar fi VI f2(1, 14 1 1'12CY 5 ac tL <t E)ClC).C),7fI _ A t ,,"Y'0M, "..,ID t;H EPAi A P 1) bOMLY t 4.,uff /`a u, 1 E.1714 T "L A07 OO f A A UMBRELLA U AB N LC C Y Y 88314647 1 'f. !,,2014 11"V-01fi A1. GC, . , k�Ra VA 'S5,000,000 EXCESS LIAS CL, W 4%h AIX` 4- d,.,(. r�t, .`re'a1rya ya ixm (xCc D,ED f lE= N T h,f. ...,.....,., � .... .,._ ................ __,m., "r _ WORKERS COMPENSAT4 N x TEO r t� Arf AND EMPLOYE R ' LIAEUY Ce fI.4 { P(!E %Rf e }E^ /W `FARM YIe Yd i d ...; "G1 Y!✓4 (.., R' / A, i -.. �. t ?� l3 )1t;,�;:Y''1 L.,r`0'7 S QMandatory In Niid .. .. ._ @. ,tP :I ra(eL .Y P •V, ;)1 C e @`, r t'7i Pt.FAr! "ION OV 4 1°E A t, N +,r;€ ). IB P e f� t r tl _ ' I P E✓ESCREG 1 EoP'q OF OP:. Pr$niE$ NS I E_OrE:,+"+u�I•MYINS iVEHICL ES EAtt IX"h A,Cf"&RD 101, Add',Iifl #ona l I4'a*RRark%..rvt,Elti.f ukA i� mar ,I" ac" N kw "quil'lmfi L,ertificaTte PTolcici is iltckLrdM -d as an Additional Insured wider (,or rLnescia Gr,r ea n,,,d Llaoikty pcAi(;y per endorsement +: G 2(1 '100 'Q 11, attad'Ie d ' *&ibge E to eETmipany appmai, §ART: Driveway or Sft$E:"a"•_alk work 3E€"M"fQ',irined for 2014-2015 Ortii'9Vi;us CC1tl`1f, etC replzwenB ent Contract, job #1 5- 6824 'This is <.6. CIi'E9, A„Eto r(.?i i1I;;PE„r 'ri9Yf.3 supersedes es 4E" e One is%jr;:' d 1OK31 /2014'. EANl AOL)N ENGIREERS' ORP. PROJECT 156824 7CNS'TRUCTORS REVIEWED ESP EUNIC;E HEREDIA (PG. 1 of 3) RTtFICA TE HOLDER CANCELLATION fARE SIICEULD, ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 4:MRAIlOrk DATE. THEREOF, NOME WILL BE EAELAIERED 6N I., >y of Santa fA, €'1„) ACCORDANCE Ml H "P"H POLICY PROVISIONS, 20 Civic Plaza-Russ Jm Yu "d EPI,a Aria t.,yy 92 701 19882010 ACORD CORPORATION, AiR rights rrYservEdrt. A,C ORD a (2010/0 5) The ACORi:D W "ir' rie and IC%a:Io are reg¢ steredt marks of A"4CORD 1 3108 - 1 -01 -207 4 POLIG(FUMBEFF 8831.4547 CG 20 1 OR 12 11 'THIS ENDORSEIAE04T CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDII&NAL INSURED -- OWNERS, LESSEES OR CONTRACTORS (WITH LIMITED COMPLETED OPERAINNS COVERAGE) T,irs rmd%a Ymmanc, providrx,l thcfalfuwl y COMMERCiAL GlEr, ERAL 1_1A81[JT_"eC()VFRAGE PAR T' 8US1NFSS0Wt,4FRS C'0VERA(.,7E FORf\4 NAME OF,PERSON OR ORGANIZATIOfr� Any powson or mgwirzatio,i rur to whah tt,r, r1arricol, irrsiAnsd is obhgaed' by a virt,w o' ,-,3 Written uorr"' ai" 'o Picwide, 'hal is afforded c�y thin poky. Where mpAed by conxacL Te alhem Mds emlJoyees cbrevoi, sQwManes pwthers, successors panaT& Mwkvis arorritec,,s, surveyors ar,d enqineerg '.'ire incf.ked as adrhYnad ins,ireds All other entities Ir,cLi dirrp t,,ut not hrriited to z'kr:)ents, vrslun'.eers, .)( rvari,,s w par1rw0psrare ir,cl ,de d, as raddirk..anal insareds 0 reqWmd by cmxaM only, veen aNkg wqW1 Pt e course a')d ,'.;cope o4 he dxies mid supwvow! hy Te p6mary IM nddiwral in sired 4 an Owrier CantroHed Insarence. Pmqlran" is involvel the coverage p,,,.) es o of - sit a Only. I the ptapose rd I'VIS eidorserienn is Or bd purpmes rarely tei in txiverage apoes. V %iiC7 k Fr IC RE--.D,. (Se,,.fior if) 'y 1:5, sechoi is arnerded to wdAe m wi ins,jrc',,,d t 3 pursot, or, coga,liza.ron, wi"Ilin 'hc', scapo of the vahling abov ;ut i),fly t"( t�i("' extort rh")" ,,>cfsort or hod HaWin hw your acts at wassons ;q Rw cojme of NoiH wok' W Mat penon or orgnniza',i(.',n (,:jr S you The froduls oper,,,,"rtbv hwat" pa' dmi of HT pAny coveage as impeco the additioral insmed Ams rT apply ,o work ir;voivi�ig col G el'arrrd In p@cpc�-'Ifr"s 1"t "cwcV"o tor ('� QWwWral ucupancv (ot,iur arr:)ara,iu;I ,�-.;f Tys coasu Qxs mat HIM to openatio,o,;" provi�,'Ie,.' tea Jis v%Q,, vo�wvp sry iqht & remvep. when reTwed My Nn."e; r ' th;"n), 'N�-, rnay Person co viii {r ?a smVc of CG 20 IOR 12 11 tI _ ,alr`yrig ia,'fguagc,, abi=, because of payriwils vas riake Or VqLry, Ve job bcathn rNs: No Mr un Suan of Wide of lr,e nanied ii,f.z.t.ired or soy 1001-19U0,JS St,�'EO trerSO 7,ie type ')f work perfornred rnust 1.Ie that as �IescriUed twdei classifications it t, e CGL Coverage Pan Dedaraho,-is Wier, t,*i erdofsernert nppl e',; 'an"I ort'en reqwreo by mqMn noTraiN, mxi onawTe as jra attordeid %i, t,"i�z ge,iciefl ka,,Jhty p,',,Iicy Is, pork nwy Minne and Soar insurarce shall Nz cad ,,,ess :'find sf,ah 'irot ccrftnr),,iIp to t1he insxwmr'� afforded by Jhs erd use men� xa ucpicy� i'ls�' ran'�;i; r'c" "'rpplr/ ti"; warroge" or "peman,':0 at,d ',idvertjsirg rlxy adfig cy S Ev, arisvecK ergineei's cm sxveyars rerderrq or fabon m reMs w,,,y gKolesMonal ser0ces. YK011, 0,, fL,,,jJjr-q L,r c( ,'ipprovc," wap"'�' dosgr's sir g drawings Md SPEXASWIS WK! 2 irsp,,.cficj,) of SITIewn] WOW, r" C. IDATE ,g BANNAOUN ENGIE'L---IF?'C,C)?S'rF°i'(JCTORS CORP, PROJECT 15-6824 REVIEWED BY: EUNICE HEREDIA (PG 2 of 3) Page I o X11. CERTHOLDER COPY 0 RO, BOX 8192, PLEASANTON, (,',A 94588 n" �s us to certffV that we have issut-, z a valid tlkrrkers Compensation insurance pokey in a fofrn app ovefj r)}, the CafiNxnia insurance Cwnrnzss�cfner �,o the efnp�oyer nampd ba'sOvr( for thi- Peal ry Period mcitcated Thls pohcy 's riot sut)ject to canceflalion by Ch,- Fund excePt w-.xw 30 da°'s advance vvnt r) noljc�r- to the en'iplt,) er. We wifl also gWe YOU 30mays advarice rfotxe shouid the Policy be canceik,,d pinor to iIs ncrrnaE expwaticwf, This certificate ot insurance rs not an insurance pahcy and does not arnend, extend or aaer the coverage affordpd by the po;foy bsted herem. Notvviltislanding any requiren-wa, te,rn of, conditiorl of any contraclt or other docurrofW with respect to whrch Viis certtficate of triswance may be ISSUed or U't which if may pertain, the ri!,,urance af9'orded by the pohcy doscribed herem fs subjec, to aft the ,.errns, oxcf ions, and concittions, of su& paGicy. Awthctr5ie,d Representatwe fi'r'es dent and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS. $1,000,000 PER OCCURRENCE, ENDORSEMENT #0015 ENTITLED ADDITIONAL INSURED EMPLOYER EFFECTIVE 2014-11-01 IS ATTACHED TO AND FORMS A PART OF THIS POLICY, NAME OF ADDITIONAL INSURED: CITY OF SANTA ANA ENDORSEMENT #1600 - MALOOF, OMAR P,S T - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS" NOTICE EFFECTIVE 11-01-2011 IS ATTACHED TO AND FORMS A PART OF THIS POLICY, BANNAOUN ENG1K,Ef7F'C STRUCTORS CORP PROJECT 15-6824- REVIEWED BY EUNICE HEREDIA (PG. 3 of 3) BANNAOUN ENGINEERS CONSTRucrORS CORP PO BOX 16599 BEVERLY HILLS CA 90209 SC (REV,7 20 kw PRINTED : 02-10 2015