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PALP INC. DBA EXCEL PAVING COMPANY (4)
Recording Requested By, And When Recorded Mail To: Clerk of the Council,City of Santa Ana Recorded in Official Records, Orange County 20 CivicSantaeAna,, CA 927r rk-Recorder jox 1988 HughIII II III II lguyen, eI II I III II II I I II III NO FEE $ R 0 0 0 8 4 9 4 0 8 0 $ * 2016000299892 3:54 pm 06130116 48 413 N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 11 ;' ' l l" 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 construction of RESIDENTIAL STREET REPAIR FY 14/15 & WILSHIRE AVE. AND BORCHARD AVE. a w WATER o MAIN IMPROVEMENTS under contract entered into on 6/16/2015, with PALP, INC. w DBA EXCEL PAVING COMPANY on which contract FEDERAL INSURANCE COMPANY is w o surety. The property on which such work improvement was placed is in the City of Santa Ana, o County of Orange, State of California, and described as Project No.15-6836 & 15-6452 located at: z SOUTHEASTERN QUADRANT OF THE CITY. The work improvement on said property was a ] accepted as completed on 6/8/2016. o � C0 w C CITY QF— ,j� _ 'A, A MUNICIPAL CORPORATION c741 F y Dated: b ,_;o 16 Prin.'pal Civil Engineer-Tyrone Chesanek Wp TITLE ai a VERIFICATION 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 ` l.1 Vie— 270) "7--"C"'I 6 , at Santa Ana, California (Signature of individual s caring 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: JUNE 16, 2015 111111111111114 CONTRACT AWARD TO CONSTRUCT WATER MAIN IMPROVEMENTS IN WILSHIRE AVENUE AND BORCHARD AVENUE, AND RESIDENTIAL STREET REPAIR, FISCAL YEAR 2014-15 (PROJECTS 15-6452 & 15- 6836) (STRATEGIC PLAN NOS, 6, 1, B & 6, 1, G) CITY MANfj ER RECOMMENDED ACTIONS CLERK OF COUNCIL USE ONLY: APPROVED 0 Jl'+ 1 G 2015 d A$Recommended 23A ❑ As Amended ❑ Ordinance on 1 $' Reading ❑ Ordinance on 2ntl Reading ❑ Implementing Resolution ❑ Set Public Hearing For CONTINUED TO FILE NUMBER Award a contract to Excel Paving Company, the lowest responsible bidder, in accordance with the unit bid prices, totaling $2,468,442, for construction of Water Main Improvements in Wilshire Avenue and Borchard Avenue and Residential Street Repair, Fiscal Year 2014-15, 2. Approve the Project Cost Analysis for a total estimated project delivery cost of $3,332,340. DISCUSSION The recommended contract award will allow for the construction of a new water main in Wilshire Avenue and Borchard Avenue. Water system improvements include fire hydrants, gate valves, water services, and related appurtenances. The contract also includes residential street repairs that were approved in the City's Capital Improvement Program for Fiscal Year 2014-15. These improvements include replacing failed concrete pavement with asphalt pavement and replacing damaged curbs, gutters, sidewalks, cross gutters, and curb ramps. The water main replacements will ensure the safe and reliable delivery of drinking water to area residents, while this phase of the Residential Street Repair Program continues rebuilding neighborhood streets throughout the City by enhancing the ride quality, surface drainage, and appearance of the neighborhoods. The streets selected for repair have been identified by the City's Pavement Management System as high priority streets for rehabilitation and are located in neighborhoods in the southeast quadrant of the city (Exhibit 1). These residential streets have deteriorated due to weather, age, and heavy usage. Replacement of the potable water mains in Wilshire Avenue and Borchard Avenue are also identified as high priorities. Coordinating the construction effort so that the water Contract Award to Construct Water Main Improvements and Residential Street Repair, Fiscal Year 2014-15 June 16, 2015 Page 2 main improvements are completed prior to the roadway repairs is the most effective and efficient way to minimize disruption to area residents. A Notice Inviting Bids was advertised on April 27 and 28, 2015, and bids were opened on May 13, 2015. The following is a summary of the bid invitations and the bids received: Contractor Participation Data Santa Ana contractors receiving notices 18 Contractors requesting bidding documents 28 Bids received 5 Bids received from Santa Ana contractors 0 Bid Results Summary RANK BIDDER'S NAME LOCATION BID 1 Excel Paving Company Long Beach $2,468,442 2 Sully -Miller Contracting Co. Brea $2,610,095 3 Vido Samarzich, Inc. Alta Loma $2,978,810 4 All American Asphalt Corona $3,026,900 5 Minako America Corporation Gardena $3,634,056 A total of five bids were received and all were deemed responsive. Excel Paving Company submitted the lowest responsive bid in the amount of $2,468,442, which is approximately 20 percent lower than the engineer's estimate of $3,050,790. Therefore, staff recommends award of this contract to Excel Paving Company. 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) and Strategy G (develop and implement the City's Capital Improvement Program in coordination with the Community Investment and Deferred Maintenance Plans. Contract Award to Construct Water Main Improvements and Residential Street Repair, Fiscal Year 2014-15 June 16, 2015 Page 3 ENVIRONMENTAL IMPACT In accordance with the California Environmental Quality Act, the recommended actions are exempt from further review. Categorical Exemption Environmental Review No. 2015-48 will be filed for this project. In addition, a Certification of Categorical Exclusion and Statutory Worksheet have been prepared in accordance with the National Environmental Policy Act. FISCAL IMPACT The Project Cost Analysis has estimated project expenditures to be $3,332,340, which includes the construction contract, construction administration, survey and inspection, as well as contingencies (Exhibit 2). Funds are budgeted in the Select Street Construction expenditure accounts for projects 15-6836 and 15-6452 and will be expended in Fiscal Year 2015-16 in the following distribution: Proiec# Account Amount 15-6836 058-17-661-66220 $2,087,627 032-17-662-66220 21,915 059-17-663-66220 406,462 15-6452 066-17-647-66301 816,336 TOTAL. $3,332,340 Public Works Agency FM/EWG/ET Exhibits: 1. Location Map 2. Cost Analysis 3. Construction Contract APPROVED AS TO FUNDS AND ACCOUNTS: Francisco Gutierrez Executive Director Finance & Management Services Agency SANTA ANA 1A CITY COUNCIL RESIDENTIAL STREET REPAIR FISCAL YEARS 2014-2015 I VVI AGENDA DATE: AND WILSMWATER MAIN MROVEM AIRE AVENUE AND RD AVENUE JUNE 16, 2015 (PROJECT 15606 AND 156452) GGB![ �Oae9 nGExt-, PAGE 1 OF 1 COST ANALYSIS PROJECT NOS. 15-6452 & 15-6836: WILSHIRE AVENUE AND BORCHARD AVENUE WATER MAIN AND RESIDENTIAL STREET REPAIR FISCAL YEAR 2014-15 TOTAL ESTIMATED CONSTRUCTION DELIVERY COSTS I $3,332,340 I Exhibit 2 THE REGISTER 625 N GRAND AVE, SANTA ANA, CA 92701 Telephone (714) 796-7000 / Fax (714) 796.6059 .CNS#: 2744774 for filing stamp Only PROOF OF PUBLICATION �FPlO�g,lZ$qyt�' all: Aalle ACelb to 0 (2015.5CC.P.) ' o Is ease . RE'SiP AL s7RfiETsE' State of California.) rd P R-egs2 County of ORANGE )as '�r ^gryE .. r. B HCHMUEVE WATEH AIN IkjPRVEMENTe lihNotice T e: BID- NOTICE INVITING BIDS ..' ,rrs (nrq un k,dcintide a:q 61 ,ty66q - Type: 1 Ara Inoru.6 ahl t t e d 6 or ,ry�+tl4R n, • e orC soot teY, Ad Description:. p - - � 'lir ydrants pgte sVelves; - w ri & h, Ittedd Inviting Bid 15-6836, 15-8452 seNleff .adI - `Aq nonce e Ib e lana IacnILaplLLPgiflhiorath �eicongrete, P Vem With -- - ON fig dOWels asf�hdit Fon' - .IRYa amirentPfabbk"saki, . . I am a citizen of the United States and a resident of the State of California; I am ARRAN, 21adeitlent over thea a of eighteen ears, and not art to or Interested in the above 10admel cur , atdew approach, curb 9 9 Y party 'I@'plps, driveway approQuo entitled )natter. I am the principal clerk of the printer and publisher of the THE -and;,cOnelruggon, of new crossg4Here.,Aelat9d.Wcda REGISTER, a newspaper published in the English language In the city of ariddi A's coptraot, inmudes . SAN7A ANA, county of ORANGE, and adjudged a.newspaper of general .-rponnlzlnu crewa,and equip- circulation as defined b the laws of the State of Californla b the Superior mggt Imp)ehientlng a man - .1 rcNill safety' 'plan, ad Court of the County 'aF ORANGE, State of California, underrate 11/19/1905, - loon util ly ,'covem tragic - Case No � A21046� That the notice, of which the annexed is a printed co has eappas and pavemant mark-, P PYA aunt wooihe EnlllneQcS�u= - been published In aaeh reguier andinkentire issue of weld newspaper old nolo In tlmme Is 13'sR ,ono any supplemenfthereaf on the following dates; to -wit: .. _ _ - Th canfregt"documatd - gbmpplota. el l(�n)caet of%ihr PI 11M - ppecl lcetlona ere avails- - - - §pt at the ,puplla'Wdrj� Ef�bclultsGFnai Flocrf - - p behfer'plata Ross - @A 9antaAnal CaliRrnia 04/2712016, 04/2812015 f 6l , aibr4arr��ce wthe p'ra- - - yla of ih9 Cef ttbrnla }a-: - - G"oda9,'pr§velling wags On - - - - Executed on: 04/28(2p15 Nb -274474# THE ReRl�TER At SANTA ANA, California : _ R-seo IgWI a2 - - certify (or declare) under penalty of perjury that the foregoing is true and correct. - - - - Z�7 loss - - ..'Signature - III 1 �� II �I II �I II II{ VIII I�� III II ' * A 0 0 0 0.0 3.7 4.3 7 7 3 HIt h IIIIIII 111111 {rIIIIIII�IIIIIII�IIIIId IIII�II IIIc NC FEF. ,t$ R 0 0 0 7 S 201585000389 9:24 am 05/13/15 242 304 Z01 0.00 50.00 0.00 0.00 0.00 0,00 OAO 0.00 CITY MANAGER MAYOR Miguel A. Pulido David Cavazos EY MAYOR PRO TEM .; ;,;^ CITY a R, COr al Vincent F. Sarmiento Sonia R, Carvalho CLERK OF THE COUNCIL COUNCIL MEMBERS Angellca Amezcua ..,.chs Marla D. Huizar P. David Benavides Michele Martinez RamanA. Rsyna Sel Tlnajoro CITY OF SANTA ANA jo PLANNING 4 BUILDING AGENCY 20 Civic Center Plaza (M-20) P.O. BOX 1986 • Santa Ana, California 92702 (714) 667-2700 ° Fax (714) 973.1461 www.santa-ana.org NOTICE OF EXEMPTION From the Requirements of the California Environmental Quality Act (CEQA) Fee Exemption per California Government Code Section 6103 To: COUNTY CLERK From: City of Santa Ana Planning & Building Agency County of Orange county 20 Civic Center Plaza M-20 Box Or Santa Ana, CA 92702 Santa Ana, CA 92702 Project Title: RSR 14/15 & Wilshire I Borchard Water Main Date of Approval: 0 6/1 612 01 5 ProjectNumber(s): PWA-2015A31-CIP Project Location: 1 Citywide (Partial) City: Santa Ana County: Orange ER Number: ER -2015-48 Project Description: ppuenltdeWater ed rtanes. Removing existiing locali ed c creepavmetand replacingwith new concrservices and ete pavement Including dowels, asphalt concrete pavement, crack seal, ARAM, replacement of damaged rbs'da,a, Is art Applicant Name: ndy I y, Ity of Santa Ana Applicant Address: 20 Civic Center Plaza, Third floor Ross Annex Santa Ana, CA 92701 POSTED Name of Public Agency Approving Project: City Council Name of Person or Agency Carrying Out Project: Ly, Mindy MAY 13 20'5 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: 9 Categorical Exemption: 15301 (b)(c) Reason(s) Why Project is Exempt From CEQA: Existing Street and Public U'dility HUGH N , CLERK•REGORDER FILED DEPUTY MAY 13 2015 DRANGECO CLERK-REGORDER DEPARTMENT BY: DEPUTY City Contact: Sean Thomas Telephone: (714) 647-5655 Assistant Engineer 5113/2015 Signature: Z� Title: Date: --� SANTA ANA CITY COUNCIL Miguel A. PUIMo Vincent F. fiarrnlento Michela MaNnez Angelico Amezcue P. David 4 Ndea RomanWaardeayna Sal Ward 8 ro Mayor Mayor Pro Tam, Ward 7 Ward Ward3 ro 01 ItM8t9ant Fanaom Mpulldonaenta-ana.org . nta3!ean�_ aorn na 9d9a(d!=at�nanraRR�vn_rdi�sa_�'3JJ— vc�.,.,t„ acne era ��• vine rta a.a aoroA C a(&°'y:-� QB--L-s 5 J®15 CITY OF SANTA ANA 00 CONSTRUCTION CONTRACT PROJECT NO. 15.6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS This CONSTRUCTION CONTRACT is made and entered into this 16 day of Juste 2015, by and between the CITY OF SANTA ANA, CALIFORNIA, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California, hereinafter referred to as "CITY" and Excel Paving Company, hereinafter referred to as "CONTRACTOR". WITNESSETH: The CITY and the CONTRACTOR, for the consideration hereinafter named, mutually agree as follows: CONTRACTOR agrees to perform all the work and furnish all the materials at its own cost and expense necessary to construct and complete in a good and workmanlike manner and to the satisfaction of the City Engineer of the CITY, the Project No. 15-6836: Residential Street Repair FY 14/15 and Project 15-6452: Wilshire Ave, and Borchard Ave. Water Main Improvements identified in and in accordance with the Contract Documents prepared by the City's Public Works Agency and approved by the City Council. 2. The complete Construction Contract consists of the "Contract Documents," as defined by the Standard Specifications for Public Works Construction and which include the following: • ... Notice Inviting Bids •... Instructions to Bidders • ... Bid Proposal • ,.. Bid Bond • ... Contract Forms • ... Contract Bonds • ... General Provisions • ... Special Provisions • ... Technical Provisions •... Project Plans •... Appendices In case of conflict between the Contract Documents, the precedence of documents shall be as established in the Standard Specifications for Public Works Construction. 3, CITY agrees to pay and CONTRACTOR agrees to accept in full payment to complete Project No. 15-6836: Residential Street Repair FY 14/15 and Project 15-6452: Wilshire Ave. and Borchard Ave. Water Main Improvements the sum total amount not to exceed $2,715,286.20, as set forth and identified in the BID PROPOSAL, which is attached hereto and incorporated herein as Exhibit "A". The BID PROPOSAL contains a schedule of unit price(s) or lump sum(s) based on approximate quantities only, and the City does not Page 1 of 3 CITY OF SANTA ANA CONSTRUCTION CONTRACT PROJECT N0, 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND SORCHARD AVE. WATER MAIN IMPROVEMENTS expressly or by implication agree that the actual amount of work will correspond therewith, but reserves the right to increase or decrease the amount of any class or portion of the work or to omit portions of the work as may be deemed necessary or advisable. 4. CONTRACTOR agrees to complete the Project No. 15-6836: Residential Street Repair FY 14/15 and Project 15-6452: Wilshire Ave, and Borchard Ave. Water Main Improvements within the time specified in the Time for Completion of Improvements section of the BID PROPOSAL (Exhibit "A") including commencing construction within the timeframe therein specified after issuance of a Notice to Proceed. The CONTRACTOR will pay, and will require all subcontractors to pay, all employees on the Project No. 15-6836: Residential Street Repair FY 14/15 and Project 15-6452: Wilshire Ave. and Borchard Ave. Water Main Improvements a salary or wage at least equal to the prevailing salary or wage established for such work as set forth in the wage determinations for this work in accordance with applicable State and Federal law. 6. CONTRACTOR shall, after award of this Contract, famish two bonds to be approved by the CITY, one in the amount of One Hundred Percent (100%) of the Contract price, to guarantee the faithful performance of the work (Performance Bond), and one in the amount of One Hundred Percent (100%) of the Contract price to guarantee payment of all claims for labor and materials furnished (Payment Bond). This Contract shall not become effective until such bonds are supplied. to and approved by the CITY. CONTRACTOR shall, prior to the release of the performance and payment bonds or the retention payment, furnish a warranty performance and payment bond equal to at least ten (101/9) percent of the final Contract price or $1,000, whichever is greater (Warranty Bond). CONTRACTOR shall, upon project completion as a condition of project acceptance, furnish a Warranty Payment and Performance bond to be approved by the CITY, in the amount of Twenty -Five Percent (25%) of the Contract price, to warrant the work done under said Contract Agreement against material or quality defects for a period of one year after acceptance by the AGENCY. CONTRACTOR shall, after award of this Contract, furnish Certificates of Liability Insurance and Worker's Compensation Insurance as outlined in the General Provisions, to be approved by the CITY. u Page 2 of 3 CITY OF SANTA ANA CONSTRUCTION CONTRACT PROJECT NO. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS IN WITNESS WHEREOF, the parties hereto have executed this Construction Contract on the day and year first above written. ATTEST: �(, CITY OF SANTA ANA MARIA D. I UIZAR� DAVID CAVAZOS Clerk of the Council City Manager APPROVED AS TO FORM: RECOMMENDED FOR APPROVAL: SONIA R. CARVALHO City Attorney B J se Sandoval \ Fr d Moasavipaur, P.E. ief Assistant City Attorney Executive Director, Public Works Agency CONTRACTOR: Excel Paving Company By.` C e> _ Title:— Q,5 Page 3 of 3 MAYOR Miguel A. Pulldo MAYOR PRO TEM Vincent F. Sarmlento COUNCILMEMBERS Angelica Arrlez oa P. David Benavtdes Michele Martinez Romen Reyni Sal Tinajoro May 7, 2015 `ACobENow No. ONE CITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic center Plaza M-36 • P.O. box 19BB M-36 Santa Ana, Californle 52702 www santa-sna.ora CITY MANAGER David Cavazos CITY ATTORNEY Sonia R, Carvalho CLERK OP THE COUNCIL Maria D. Huizar SUBJECT: PROJECT Nig. 15-6835; Residential Street Repair 14115 and PROJECT NO 15-6452: Wilshire Ave, and Borchard Ave. Water Main Improvements The following changes and clarifications have been made to Specifications for the subject project: Specifications 1. Pages BP 1, 2 & 3 of 17: Replace with the attached SP 1, 2; & 3 of 17. 2. Page 43 Special Provisions: Replace with the attached page 43, 3. Appendix A: Definition of Bid ltems; Replace with the attached Appendix A (9 pages). 4. Appendix K: Quantities for Projects: Replace with the attached Appendix K (1 page) 5. Response to request for information (RFI): Question: The description of bid Item 22, 8 -inch Class 200 AWWA C900 PVC Water Main, includes, "The unit price per linear foot for PVC water main shall include—all related items of work necessary for the water main installation complete In place, backfilled, paved, and tested," The other water line bid items are similar in respect to "paved" and "repair of surface improvements and hardscapes." a, Do the water line bid items include the construction of the 6 -inch thick PCC pavement for the water line trenches? b, Appendix H shows 6 -inch PCCP quantities in the same area as the water line work on Wilshire and Borchard. Are any of these areas in the same place as the water line work? SANTA ANA CITY COUNCIL Mlguol A. Pulldo I Saf'nnaiera i vincanl F 50"Iento I Mlclial¢Mapinea I AW.11oa Amae�a P. David aermvions Roman Reyna Mayor I Mayor Pro Tem, Wanda i Ward I I Ward 2 1 Wards Ward Wald 5 Mpyiydq_0sa la e- n_a,4rp "3'[ja5Yj5 ro a-aL "r i Y.@@[fltla�jQ(Ql@gJJl�3Cls},4L9 mMeri'nazlola t -ane o u i Ap�az—vAamla-ena.oru Q@gy�pyj�§y,�pgpt�-art§,orq RRevna(4sanla aha orp Answer: a) No, the bid items do not include the construction of the 6 -inch thick PCC Pavement for water line trenches. The final PCC paving of the water trenches is included in the bid item 98 of the proposal. b) No, these areas are localized areas on the same street, but are not part of the water main construction. All other terms and conditions remain the same. FOR THE CITY OF SANTA ANA AITEdwin I lam" Gal ;. _. City E meer SANTA ANA CITY COUNCIL, Miguel A. Polido i BaDma.. ! Vffi.nl F, Barmlanlo I MMale MA11noz Angellaa Amen.. 1 P. David Benevides Romon Raynn Mayor Mayor Pro Tam, Ward 1 Werd1 ! Ward 1 Ward3 Ward4 1 Wan15 Bgdo[itl.5�12-agaggr STlna'erofolsanta-ar,a orgVSgl�j,@p ny,[)q s(Pi aana.oYq MM 1' tID digs§pa;p(fy ua„�s8r,�q;ypa gry ! OgigCisfcas®pla-ane am ! R[jgVn sante-ayy@�.op ADDENDUM NO. ONE PROJECT NO. 15-6836 AND 15-6452 CITY OF SANTA ANA PROPOSAL PROJECT NO. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS BID PROPOSAL TO: CITY COUNCIL OF THE CITY OF SANTA ANA p,�Ljl. a4 113A FROM: qgg& �d n�pt' 1 REQUIREMENT: The undersigned bidder declares that they have carefully examined the location of the proposed work, that they have examined the Contract Documents in its entirety and hereby proposes to furnish all material and do all the work required to complete the said work in accordance with said plans (if any) and the specifications for the unit price(s) or lump sum(s) set forth in the following schedule: Item Description Quantities Unit Unit Price Amount 1 Mobilization (Not to Exceed 10% of Total 1 LS Contract) 2 Unclassified Excavation* 300 Cy 3 AC Pavement* 270 TN P � 4 ARHM Pavement* 1,100 TN U1JU 5 Cold Mill* 110,600 SF 6 ARAM* 12,300 SY r 7 Removal of 6" PCC at Various Locations* 3,450 CY 8 Construct 6" PCC with (7 -day) Cure * 3,330 CY�I'I,o � r 9 Crack Seal with Decry Super Gray* 76,200 LF 10 Construct PCC Curb Ramp 3,800 SF 6.' So o , BP -1 of 17 ADDENDUM NO. ONE PROJECT N0. 15-6836 AND 15-6452 CITY OF SANTA ANA PROPOSAL PROJECT NO. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS Item Description Quantities Unit Unit Price Amount 11 Construct PCC Driveway Approach (T=6") 850 SF 6, 12 Construct PCC Curb (B-1) 100 LF 32,' 'LUD 13 Construct PCC Curb and Gutter(A-2-8) 140 LF ® w- 14 Construct PCC Cross Gutter 7,350 SF r 15 Construct PCC Sidewalk 4,800 SF 33000 16 Grind PCC 360 LF 3S. 1 VOW - 17 Root Shave 50 EA - S IWO 18 Adjust Sewer Manhole Frame and Cover 12 EA to Finished Grade �. 19 Furnish and Install Water Valve Frame and 49 EA Cover to Grade rlo a 0ID- 20 Signing and Striping 1 LS 21 Temporary Construction Sign 5 EA 22 8" Class 235 AWWA C900 P.V.C. Water 2,700 LF Main 10 „--2AI ,.,..\__ VW 23 Construct 1" Water Service per City Std. 7 EA Plan 1401 _ 2, 1. 24 12" X 8" Hot Tap Including Tapping Sleeve 3 EA and Valve e- 16 OD _ 25 Fire Hydrant Assembly, Including Gate 7 EA Valve and Lateral Pipe t®ot)D_70 OW _ 26 1" Combination Air Valve 1 EA Still �� 27 Vertical Offset per City Std. Plan 14136 1 EA 4 vi— of 28 8" Resilient Wedge Gate Valve 5 EA LOOM- WOM-29 29 6" Resilient Wedge Gate Valve 1 EA g— I `LIJIJ BP -2 of 17 ADDENDUM NO. ONE PROJECT NO. 15-6836 AND 15-6452 CITY OF SANTA ANA PROPOSAL PROJECT NO. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS Item Description Quantities Unit Unit Price Amount 30 Traffic Loop Detector 3 EA IDD l .- 11I00 31 18" — N3 dowels (with epoxy grouted)* 12,000 EA pnn , TOTAL BASE BID A ' ` The lowest BIDDER shall be selected on based on the lowest responsible total bid. The City reserves the right to award the Base Bid, and any, all, or none of the add -alternate bid items (if any). * The quantity for this bid item is shown for bid comparison only. This bid item shall not be subject to the "25%" limit as stated in Section 3-2 of the Standard Specifications. The actual 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. TIME FOR COMPLETION OF IMPROVEMENTS AND LIQUIDATED DAMAGES The undersigned bidder hereby proposes to complete the Work for the total base bid amount shown above within seventy 70 working days after the commencement date stated in the Notice to Proceed. Furthermore, Project 15-6452 Water Main improvements shall be completed within the first 30 working days and Project 15-6836 may start at the same time as water main improvement, except on Wilshire Avenue and Borchard Avenue. The bidder also proposes to commence construction of the Work within ten (10) days after issuance of a Notice to Proceed, and to continue in a diligent and workman -like manner without interruption, and to complete the construction thereof within the time specified above. The liquidated damages amount in lieu of the amount specified in Subsection 6-9 of the Standard Specifications shall be $4,400 per calendar day if not completed within the first 30 working days for Project 15-64-52 and $4,400 per calendar day if not completed within 70 working days for Project 15-6836. Name of FirmaGFmw„'1r"a��f Signature of BIDDER Title 0,?o BROWN, PRESIDENT (if an individual, so state) BP -3 of 17 CITY OF SANTA ANA PROPOSAL PROJECT N0. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS BIDDER'S STATEMENT BIDDER understands and agrees that this Bid Proposal, Contract Documents and subsequent Construction Contract Agreement shall constitute the entire agreement between BIDDER and the AGENCY only after it has been accepted by the City Council, endorsed by the Clerk of the Council with her signature and official seal noting hereon the action of approval of the Council, signed by the Public Works Agency Executive Director or his/her duly authorized agent, and signed by the City Attorney, denoting his approval of the form of this document, and its execution, and when it or an exact copy of it has been either delivered to BIDDER or deposited with the United States Postal Service properly addressed to the BIDDER with the correct postage affixed thereto. BIDDER further agrees that upon delivery (as defined above) of the accepted agreement he/she will furnish AGENCY all required bonds and certificate of liability insurance within ten (10) business days or the funds, check, draft, or BIDDERS bond substituted in lieu thereof accompanying this proposal shall become the property of the AGENCY and shall be considered as payment of damages due to the delay and other causes suffered by AGENCY because of the failure to furnish the necessary bonds and because it is distinctly agreed that the proof of damages actually suffered is difficult to ascertain; otherwise said funds, check, drafts, or BIDDER'S bond substituted in lieu thereof shall be returned to the undersigned. BIDDER understands that a bid is required for the entire work, the estimated quantities set forth in the bid schedule are solely for the purpose of comparing bids, and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. The BIDDER also certifies that the bid is a balanced bid. In accordance with Section 7028.15 of the California Business and Professions Code, the undersigned certifies under penalty of perjury that the foregoing is true and correct. PIM I& Name of Firm LICEI RALUGCOM MW? Signature of BIDDER 1 Title 01PROWN PRFGRrpW (if an individual, so state) (If a firm or co -partnership, state the firm name and give the names of all individual co-partners composing the firm. If a corporation, state legal name of corporation, and names of President, Secretary, Treasurer and Manager, thereof.) BP -4 of 17 CITY OF SANTA ANA PROPOSAL PROJECT NO. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS CONTRACTOR'S LICENSING and REGISTRATION STATEMENT The undersigned contractor, or corporate officer, declares under penalty of perjury that he/she and all his/her subcontractors are registered with the State of California Department of Industrial Relations (DIR), and that the following is true and correct. Contractor's Name: PALE INC. RBA EXCEL PARING Cf16A ' 2MM AVENUE Business Address: LUNG BEACH, CA W)806 Business E -Mail Address: Telephone: State Contractor's License No. and Class: STATE LIC, 60065g-A- License Expiration Date: CjV2u'-i' tr State Dept. of Industrial Relations (DIR) Registration No.: \DO000 33 State Dept. of Industrial Relations (DIR) ��"" Registration Expiration Date: lV I3® Signed: Title: C,Pe Eft M,PRE ENT CITY OF SANTA ANA PROPOSAL PROJECT NO. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS PREVAILING WAGE COMPLIANCE AND MONITORING STATEMENT Contractor is aware of the requirements of California Labor Code Section 1720, et seq., as well as California Code of Regulations, Title 8, Section 16,000, et seq., ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects. Since the services are being performed as part of an applicable "public works" or "maintenance" project, as defined by the Prevailing Wage Laws, and since the total compensation is $1,000 or more, Contractor agrees to fully comply with such Prevailing Wage Laws. City shall provide Contractor with a copy of the prevailing rates of per diem wages in effect at the commencement of this Agreement. Contractor shall make copies of the prevailing rates of per diem wages for each craft, classification or type of worker needed to execute the services available to interested parties upon request, and shall post copies at the Contractor's principal place of business and at the project site. Contractor shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. The undersigned certifies that the foregoing is true and correct. RYU MU Name of Firm EXCEL PA11MCOMPAW Signature of BIDDER Title C. F. BROWN, PRESIDENT (if an individual, so state) BP -6 of 17 CITY OF SANTA ANA PROPOSAL PROJECT NO. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS OWNERSHIP AFFIDAVIT STATE OF CALIFORNIA ) COUNTY OF ORANGE )SS: CITY OF SANTA ANA ) C.P. BROWN , being duly sworn, deposes and says: ❑ INDIVIDUAL That he/she is the party making the foregoing proposal: ❑ PARTNERSHIP That he/she is a member of the co -partnership firm designated as: and who has been and is duly vested with the authority to make and execute instruments for the co -partnership by: who constitute the other members of the co -partnership. CORPORATION That he is of: PAIP MC PRESIIDENI a corporation which is making the foregoing proposal: F1 JOINT VENTURE That he is of: one of the parties making the foregoing proposal as a joint venture, and the he/she has been and is duly vested with the authority to execute instruments for an on behalf of the parties making said bid who are: that such a bid is genuine and not collusive or sham, and has not in any manner sought by collusion to secure any advantage against the City of Santa Ana or any person interested in the proposed contract, for himself or any other person. Signature of Bidder D,P� BROWN, PRESIDENT Subscribed and sworn to before me this day of Signature of officer ministering Oath (Notary Public) (71 Fh-Lih—nfL-4; MyCh.P�EMCx,PuprHbJiLrFeI1mELsbr3I OCI9'CPcaEtSOl1ift1o;Pr7AnTiYa K�mI'- ! 25, 2l1'ta� BP -7 of 17 20 _ CITY OF SANTA ANA PROPOSAL PROJECT NO. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS :r:• r KNOW ALL PRESENT that, PALP Inc. dba Excel Paving Company , as BIDDER, and Federal Insurance Company , as SURETY, are held and firmly bound unto the CITY OF SANTA ANA, as AGENCY, in the penal sum of Ten percent of the total amount of the bid Dollars ($ 10% ), which is ten percent (105") of the total amount bid by BIDDER to AGENCY for the above -stated project, for the payment of which sum, BIDDER and SURETY agree to be bound, jointly and severally, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas BIDDER is about to submit a bid to AGENCY for the above -stated project, if said bid is rejected, or if said bid is accepted and a contract is awarded and entered into by BIDDER in the manner and time specified, then this obligation shall be null and void, otherwise it shall remain in full force and effect in favor of AGENCY. IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seal this 5th day of May 1 , 20 15 . BIDDER* PALP Inc. dba Excel C.P, BRWVN, PRESIDENT SURE�t �v sworn to before me 20, Signature: Avenue Long Beach, CA 90806 Warren, NJ 07059 Notary Public in and for the County of , State of this �__ day of *Provide BIDDER/ SURETY name, address, and telephone number and the name, title, address, and telephone number of authorized representative. BP -8 of 17 A Notary Public or other Officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached and not the truthfulness, accuracy, or validity of that document. ACKNOWLEDGMENT State of California County of Orange On 05/05/2015 before me, Debra Swanson, Notary Public (insert name and title of the officer) personally appeared Douglas A. Rapp who proved to me on the basis of satisfactory evidence to be the person(id) whose name($) is4wr& subscribed to the within instrument and acknowledged to me that he/eheRhey executed the same in his/ke%4heir authorized capacity(ie*, and that by hisAaaAheir signature(it) on the instrument the person($), or the entity upon behalf of which the person(o) 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. oF. a Dai SV�Ahy9 3N > C��ais�l+n # 99'90919 � - Cx' �� e „ ivUTARYPIIl3LIGCALIFOP..NI,M � Signature (Seal) �"«nc,,y& MY Ophhlt fXP P76V 10,. 2tl1�6 �. Chubb POWER Federal Insurance Company Attn: Surety Department OF Vigilant Insurance Company 15 Mountain View Road Surety ATTORNEY Pacific Indemnity Company Warren, NJ 07059 cr+uss Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY a Wisconsin corporation, do each hereby constitute and appoint Douglas A. Rapp and Timothy D. Rapp of Aliso Viejo, California --------------------------------------------------------- each as their We and lawful Attorney- In- Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or otherwise, bonds and undertakings and other writings obligatory In the nature thereof (other than bail bonds) given or executed in the course of business, and any instruments amending or altering the same, and consents to the modification or alteration of any instrument referred to in said bonds or obligations. In Witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and affixed their corporate seals on this 16th day of December, 2011. Kenneth C. Wendel, Assistant Secretary 7 Norris, Jc, Vice President STATE OF NEW JERSEY ss. County of Somerset On this 16th day of December, 2011 before me, a Notary Public of New Jersey, personallycame Kenneth C, Wendel, to me known to be Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which executed the foregoing Power of Attorney, and the said Kenneth C. Wendel, being by me duly sworn, did depose and say that he Is Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof, that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of the By. Laws of said Companies; and that he signed said Power of Attorney as Assistant Secretary of said Companies by like authority; and that he Is acquainted with David B. Norris, Jr., and knows him to be Vice President of said Companies; and that the signature of David B. Norris, Jr., subscribed to said Power of Attorney is in the genuine handwriting of David B. Norris, Jr., and was thereto subscribed by authorityof said By - Laws and in deponent's presence. .Notarial Seal KATHERINE J. ADELAAR NOTARY PUBLIC OF NEW JFRSFI Nc,, 2316665 COMMission Expires July 16, 2014 r� Notary Public MFyJ�� '--' CERTIFICATION Extract from the By- Laws of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY: "All powers of attorney for and on behalf of the Company may and shall be executed in the name and on behalf of the Company, either by the Chairman or the President or a Vice President or an Assistant Vice President, jointly with the Secretary or an Assistant Secretary, under their respective designations. The signature of such officers may be engraved, printed or lithographed. The signature of each of the following officers: Chairman, President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Assistant Secretaries or Attorneys- in- Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory In the nature thereof, and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached." I, Kenneth C. Wendel, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the "Companies") do hereby certify that (1) the foregoing extract of the By- Laws of the Companies Is true and correct, (ii) the Companies are duly licensed and authorized to transact surety business in all 50 of the United States of America and the District of Columbia and are authorized by the U.S. Treasury Department; further, Federal and Vigilant are licensed in Puerto Rico and the U.S. Virgin Islands, and Federal is licensed in American Samoa, Guam, and each of the Provinces of Canada except Prince Edward Island; and (Ili) the foregoing Power of Attorney is true, correct and in full force and effect. Given under my hand and seals of said Companies at Warren, NJ this 5th day of May, 2015. ,�A1RAyGF tem �,4�ACP �O q`V et'OIANP F�rPP 'I 16 x "arw Yoatr Kenneth C. Werldel, Assistant Secretary IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM, VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER, PLEASE CONTACT US AT ADDRESS LISTED ABOVE, OR BY Telephone (908) 903- 3493 Fax (908) 903- 3656 e-mail: surety@chubb.com Form 15-10. 02258- U (Ed. 5.03) CONSENT 111s CALIFORNIA ALL-PURPOSB-ACKNOWLEDGIMENT CMILCODE 111189 A notary public or other officer completing this certificate verifies only the Identity of the Individual who signed the document to which this certificate Is attached, and not the Mit hfuiness, accuracy, or validity of that document. State of California ) County of- Los Angeles ) On MAY 1. 3 2015 before me, C. Phillips, Notary Public Date Here Insert Name and Title of the Officer personally appeared C. P. Brown Names) of Signer(s) who proved to me on the basis of satisfactory evidence to be the persons) whose name(* isAw subscribed to the within instrument and acknowledged to me that helshoedtbey executed the same in hisftitiildf' authorized capacity(ies), and that by hisMWAtteir signature(s) on the instrument the person(s), or the entity }upon behalf of which the person(s) acted, executed the instrument. w C r'H1911PS 4U�9 M: Nt9961/7 r, Y�2 �`��. Not try nubiicC.alrforni+a a -,;£@»J! LOS ANGi LFS t:OUN7Y '� __w�My Lamy ni. Expires Uct✓"9ri2016!( Place Notary Seal Above I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature . Signature of o ary Public OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Documents Number of Pages: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer - Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator fl Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Tftle(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 0000 01 _n CITY OF SANTA ANA PROPOSAL PROJECT NO. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS LIST OF SUB -CONTRACTORS Section 4100 et. seq. of the Public Contract Code requires listing of all subcontractors with the bid for all subcontract work exceeding the following amount: o Streets, highways including bridge projects: J4% of the bid or $10,000, whichever is greater o Buildings, parks, or other projects: Y2% of the bid Section 1725.5 of the Public Contract Code requires all Subcontractors be registered with the State Department of Industrial Relations (DIR). BIDDER proposes to subcontract certain portions of the work to the firms listed below: Name License DIR Reg. Location Phone Type Of Work Amount $ Name /ak License #/Exp. DIR Reg. #/Exp. License # _ Location _ Phone _ Type Of Work Amount $ Name License #/Exp. DIR Reg. #/Exp. License # Location Phone Type Of Work Amount $ Signature of Bidder C, r. i pOWN, f"f END NT Name License #/Exp. -IUQL� 3 JXA 12.8ij. DIR Reg.#/Exp. O4-10(Y- Location - (Y' Location Phone 0�%o (J609 Type Of Work CQti1G1/dz Amount $ 'I l I QO o X Name License #/Exp. 31 5/20/0 DIR Reg. #/Exp. 'LCO) �O 01� (p lbl1 License # 3 Location Phone Type Of Work Amount $ Name License #/Exp. DIR Reg. #/Exp. License # Location Phone Type Of Work Amount $ BP -9 of 17 CITY OF SANTA ANA PROPOSAL PROJECT NO. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS REFERENCES The following are the names, addresses, and telephone numbers for THREE public agencies for which BIDDER has performed similar work within the past three years. 1. Las G - Name and Address of Owner Name and Telephone Num 514 1141— Contract Amount $I Type of Work Date Completed 2. .0r10Jn ADA o(A 1667 O&I l 611- Name 1rName and Address of owner. N;IaS (2,o--�10 43q zoz Name and Telephone Number of person f miliar vXith project. q, 446, q!n 0vy- a12Zj3 Contract Amount Type of Work Date Completed 3. NaanAddress of owner. \ / WUu, -1I� wn JwN Name and Telephone Number of person familiar with project. 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. �x P SOr 11® VVaMs AwL M BP -10 of 17 CITY OF SANTA ANA PROPOSAL PROJECT NO. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS ADDITIONAL REFERENCES The following are the names, addresses, and telephone numbers for THREE public agencies for which the BIDDER or Subcontractor has performed street rehabilitation, water main improvements, and concrete in the past 5 years. 1. cJn e&n t2 -f= a Aec Name and Address of Owner. WA(akbMEA : ,AAAA), 01006 Yi 5�og Name and Telephone Number of person fame i r with project. �V fr l0 U1,4 Contract Amount Type of Work Date Completed 2. t)I,3 � l-�°�IS Dao► Na a and Address of owner. V�wt 6L6) Name and Telephone Number person familiar with project. Contract Amount Type of Work Date Completed 3. @qaPx Sic ;3 to D �J, R uy- > Ngand Address of own 'ol�,k Name and Telephone Number o person familiar with project. N 5A 201 Cn!�D �C CkyelL � L 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. \40 �o V t V,D �� ci-no BP -11 of 17 CITY OF SANTA ANA PROPOSAL PROJECT NO. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS NON -COLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) 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 ofi 02 AMnlef r 0a Subscribed and sworn to (or affirmed) before me on this day oftj4 ? .j ''i 520__, by 0•P. BROWN , proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me Notary Public Si ature Notary Public Seal FLAIR BP-12 of 17Smm. ExQires Oct. 29, 2016 __ CITY OF SANTA ANA PROPOSAL PROJECT NO. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS NON-DISCRIMINATION CERTIFICATE 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 BP -13 of 17 CITY OF SANTA ANA PROPOSAL PROJECT NO. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS 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. 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. S. 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. Signed: 4 , i"I c,,,®.�./ Title: O.P. BROWN, PREFADENT Au" Firm: -'Xc�l f ,,,. acoom, MAY l �'iMil) Date: BP -14 of 17 CITY OF SANTA ANA PROPOSAL PROJECT NO. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS 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: C � 'k'L—� Title: Co F', BROWN, PRESIDENT Firm r.' 6eP^r Date: MAY "j 1,13 r(05 I: ' Fn'ifll CITY OF SANTA ANA PROPOSAL PROJECT NO. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS 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: PIALP IN&MA Date: BP -16 of 17 CITY OF SANTA ANA PROPOSAL PROJECT NO. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS PUBLIC CONTRACT CODE SECTION 10162 QUESTIONAIRE 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 v If the answer is yes, explain the circumstances in the following space. BP -17 of 17 DESIGNATION/CERTIFICATION OF ASPHALT -RUBBER BINDER APPLICATOR(S) BIDDER proposes to have Asphalt -Rubber BINDER for ARAM (application) applied by: Manhole Adjusting, Inc., 9500 Beverly Rd., Pico Rivera, CA 90660-2135 Name/Address This section shall be completed even if the bidder plans to apply Asphalt -Rubber binder with its own equipment and labor forces. Name above must be the actual company applying the Asphalt -Rubber binder on the roadway. Bidder shall attach to this form copies of all required local air pollution control district or air quality management district final permit to operate (PTO) documents (not temporary, experimental, research, and/or authority to construct (ATC)) which allow the operation of the specific equipment to be used to control emissions during the application of Asphalt -Rubber binder on the roadway (the Application). The Application, in a manner conforming with these project specifications, has been indisputably determined to be in non-compliance with California air quality regulations limiting opacity of emissions, unless a permitted emission control device is used during the Application to directly remove emissions occurring during the Application. It is for that device, which may be described as an air filter, custom air pollution control system, portable air pollution control, opacity control unit, emission control unit consisting of collection hood and 3 -stage oil mist filter system, or other similar description for which a copy of a final PTO must be provided from the local air pollution control district or air quality management district. If the bidder fails to fully complete this portion of the bid and provide the foregoing documentation, the bid is non-responsive and shall be rejected. CERTIFICATION UNDER PENALTY OF PERJURY I certify under penalty of perjury under the laws of the State of California that I have read and understand the requirements contained in this form. I further certify that all information provided in response to this form is true and accurate to the best of my knowledge and belief. Print Name, Title ,L/ HU 1, r 2015 of Bidder Date 912011 DESIGNATIONICERTIFICATION OF ASPHALT-RUBBERAND AGGREGATE MEMBRANE CONTRACTOR AND/OR SUBCONTRACTOR(S) Bidder proposes to have the ARAM installed by: Manhole Adjusting, Inc. This section shall be completed even if the apparent low bidder plans to produce and install ARAM with its own forces. Name of Contractor and/or Subcontractor(s) shall be the actual company(ies) applying the binder and aggregate. For any bid to be considered responsive, performance criteria must be demonstrated on five separate projects performed by the same contractor or subcontractor(s) designated above, and with equivalent aggregate and binder proposed for the ARAM in this bid. Two years shall have elapsed since completion of the ARAM surface on each project and the projects shall be located in Southern California. To be considered a valid representative project, bidder must submit the name of the project, owner agency, agency representative's name and phone number, and a list of streets with limits totaling at least 1 mile (based on full width) in length for each project and the date the project was actually performed. A project will be considered a valid representative project if an asphalt emulsion spray application was originally placed with or without an application of sand, within 15 calendar days of the application of ARAM. Any other cover coat or course on the ARAM will cause the ARAM to be considered invalid as a representative project. ARAM on all projects must show insignificant raveling (loss of rock) and insignificant flushing (binder migration to the surface) at time of inspection by the Agency. Bidder shall verify any proposed representative projects prior to listing a subcontractor with such projects, or the bid will be considered non-responsive. If the Bidder cannot list in the space provided five projects that meet the criteria specified herein that were performed by the proposed ARAM contractor or subcontractor(s), the bid shall be considered non-responsive. V. t. -- _ — ---. Mai 11.2015 2:56PM MRMHl7LE RDJUSTIMG 323-558-8055 P.2 Rear sentative ARAM Prvliect4 Name of Project No, I f�_ J�,� �L�>� U�///, Date Completed .1V4e V --' Agency ��,�;{,!�' Agency Contact QlAk', Phone jt.,�f3JP �a k�* Approx. Length of ARAM(Full Width) .) y)///'AO;-�! Name of Project No, 2 '/JDate Completed Agency �jy%�/(^d��7� {{ Agency Contact Phone �G) �5� ,� 0 Approx. Length of ARAM (Full width) Name of Project No. 3 7]�eL��/P�''/7�� Date Completed „7C,c Agency I �UL%/1A)f) AgeneyContact Phone Approx. Length of ARAM (Full width) /q✓ i Name of Project No. 4 6 %J'•- „! �z 1127611,S-) Date Completed (` Agency �/� Ag'wtcy Contact 1Sl7�r-(�{?j,1Z.6lj�y Phone 07(�� 3�5 � � Approx. Length of ARAM (Full width) 1 « -/ Name of Project No, 5 5��';� .%b/l'/t!%icnli=is%i t� Date CompletedA46+f 11 AgencyF�/�`/ \\ e� bt��Z46t h°'/Yc�� Agency Contact I LkeL 1 /5 Phone . Gt� _ Approx. Length of ARAM (Pull width) _C. PDENT _ MAY � M15 i3lgndture of idder Title De1e END OF CONTRACTOR'S CERTIFICATION OF QUALIFICATION 'Am 4r -f May 11 2015 2tS8PM MANHOLE RDJUgTIINO TMP, 323-558-8055 p.3 hr w 8 South Coast Air Quallty Management District rnat, 1 1'nrI1111No. q 21865 Copley UIIYei, piamond Sar. CA 91765.417 `� �' R•I18G4?5 ";ama'" RNi 7 TO OPERATE nm za�Jr) Legal Owret it) 95994 or Operator: MANHOLE ADJUS'J''INQ, INC x500 BEVERLY RD PICO RfVERA, CA 90660-2135 Equipment Locations VARIOUS LOCATIONS IN SCAQMD Equipment Description a PORTABLE RUBSEk1ZED ASPHALTSPREADFR N0. 2, EQUIPMENT NO, 803, CONSISTING OF: 1, HOLDING TANK, RUBB.ERI%RD ASPHALT BINDER, 3,500 OR 4,500 GALLON CAPACITY, wrnI TWO 300,000 BTU/Hk LPG FUELED BLIRNeRS, AND ONE ASPHALT IZUDOER BINDER SPREADER. 2. C()LLEC'1'ION HOOD NO- 2, 14.6 W. (W I'I'H EXPANDABLE'. WINGS) X 11-5 1.. X 9-5 FI, 3, SIX FILTERSECTIONS, EACH TNR.EE STAGT:OTL MIST' COLI_eCTOR.' 4, EXIIAUS'I' SYSTEM Wi,rHsix HYDRALJLIC POWERI-D BLOWCRS VENTING A 1JOTASPHAL'1' RURBER HINDER SPREADER. Conditions : I. OPCRATION OFTI-IIS J�QL.IIPMI9NT SMALL 31? CCNI:)I.ICTIa) IN ACCORDANCE WITH ALL DATA AND SPECIFICATIONS SUF)MITTT3D WITH THE APPLICATION UNDI3R WI11C:H THIS PERMIT N ISSUED UNLESS OTHERWISE NO'T'ED BELOW. 21 THIS EQUIPMENT SHALL BE PROPERLY MAIN'rAINFD ANI) KEPT IN GOOD OPVRATTNO CONDITION AT ALL TIMHS, 3. THIS EQUIPMENT SHALL BE OPERATED INA MANNER TO MINIMIZE EMISSIONS TNTC) THF: ATMOSPRERF: TO TI -IE MAXIMUM PXTFNT POSSIBLE, 4, THE AIR POLLUTION CONTROI.. SYSTLM SHALL. R117 IN FULL OPERATION WIIENEV ER I11F; SPRIiACJER'I'HAT IS SERVES CS SPRAYING ASPHALT RUBBER BINDER. 51 THE 1.101,DING TANK CO-VER(S) SHALT. REMAIN CLOSED FOR ALL, OPERATIONS EXCEPTDURING CHARGING, 6, A MECHANICAL GAUGU SJIALL SE MAINTAINEn SO AS TO INDICATE. IN INCHES WATER COLUMN,'T'11F. SI'AI'IC PRJ,i$SURF DWFERENTIAI., ACROSS THC FILTER SECTIONS. OWGINAL May 11.2015 2:58PM MANHOLE ADJUSTING INC. 323-558-8055 p.4 rage I South Coast Air Quality Management District veru it No. 21865 Copley Drlve, Dlamond Bar, CA 91765-4178 e.nsaasa PERMIT 70 OPERATE AIN 797+113 7. WHENEVER THIS EQUIPMENT' IS IN OPERATION, TF'3 STATIC PRESSURE DIFFERENTIAL. ACROSS EACH FILTER SECTION SHALL NOT EXCEED 3.1 I'NC'ITES OF WATER COLUMN. S. THE EQUIPMENT OPERATING TEMPERATURE SV IAI,1,, NOT EXCEED 400 DEGREES FAHRENHEIT. 9. THE AMOUNT OF RUBBERIZED ASPHALT BINDER PROCESST.FD BY THIS EQUIPMENT SHALL. NOT EXCEED 6,000 TONS IN ANY ONE MONTH, 10, THE AMOUNT OF PROPANE USED TO FIRE T I JE BURNERS SHALL NOT EXCEED 5,080 GALLONS IN ANY ONE .MONTH. I 1 , RECORDS SHALL BE MAIN'T'AINED TO PROVE COMPLIANCE WITH CONDITIONS NOS, 9 AND 11, THE RECORDS S14ALL 8E KEPT FOR AT LEAST THE LAST TWO YEARS AND MADE AVAILABLE TO DISTRICT PERSONNEL UPON REQUEST, 12, THE OPERATOR SHALL CEASE OPERATION OF THIS .EQUIPMENT IF'f HE VISIBLE EMISSIONS EXCEED TIME LIMIT IN RULE 401, 13. UPON THE FIFTH DAY AFTER PLACEMENT OF THIS EQUIPMENT IN OPERATION AT A SITE, TH E DISTRICT SHALL, 13E NOTIFIED VIA PRONE AT I -877-S 10-6995 OV TI1E EXACT NATURE OF THE PROJECT AS FOLLOWS: A. TI IEPERM ITN UMBEROFTHII PORTABLE EQUIPMENT. B. THF, NAME AN 1) PHONFs NUMBER OF THE CONTACT PERSON, C, 'IT)E LOCATION WHERE 1'Hk: PORT'ABLU EQUIPMENT WILL BE OPERATED, D. THE''GSTIMATED TIME THE PORTABLE EQUIPMENT WILL BE LOCATED AT THESITE, E. DESCRIPTION OF THE PROJECT F. IF LESS THAN 0,25 MILE TO THS. NCARLS'I' SENSITIVE RECEP"FOR, DEFIN50 AS LONG-TERM HEALTH CARE FACILITMS, REHABILITATION CENTERS, CCNVALESCENT CENTERS, RETIREMENT HOMES, R,FSIDENCES, SCHOOLS, PLAYGROUNDS, CHILD CARE+CENTERS, AND ATHLETIC ,FACILITIES. SOURCES OPERATING PORTABLE LSQUIPMGNT PRIMARILY AT A SINOLE FACfLITY PERMI'T'TED UNDER A VARIOUS LOCATIONS PERMITMAY EI.f:CT TO COMPLY WITH AN ALTERNATIVE CONDITION TO NOTIFY THE AQMD ONLY WHEN THE EQUIPMENT IS MOVED OUTSIDE TI IF FACILITY, AS LONG AS IT DOES NOT REMAIN AT ANY ONE LOCATION WITHIN THE FACILITY FOR MORE THAN 12 CONSECUTIVE MONTHS, A FACILITY SHALL RE DEFINED AS ANY SOURCE OR GROUP OF SOURCES OR OTHER AIR CONTAMINAN'r-EMITTING ACTIVITIES WHICH ARE LOCATED ON ONE OR MORE CONTIGUOUS PROPERTIES WITIiIN THE DIST'RICT, IN ACTUAL PHYSICAL CONTACTOR SEPARATED SOLELY BY A PUBLIC ROADWAY OR OTHER PUBLIC RIGHT-OF-WAY AND ARE OWNED OR O,PERATCD BY TI -IE SAME PERSON (OR BY PERSONS LINDER, COMMON CONTROL.) THOSE ELECTING THIS OPTION SHALL ALSO AGRL'R'TO A CONDITION TO MATNTAIN RECORDS DF,'MONSTRATING THAT THE EQUIPMENT DOES N07' RESIDE AT ANY ONE LOCATION WITHIN THE FACILI'T'Y (EXCLUSIVE OF A DESIGNATEI) STORAGE AREA) FOR MORE THAN 12 CONSECUTIVE MONTHS, THESE RECORDS SIIALL BE MADE AVAILABLE TO THE AQMD UPON REQUEST. OkIGINAI. May 11-.2015 2:58PM MANHOLE ADJUSTING INC. 323-558-8055 P.5 p,iu , �N South Coast Air Quaitty Management District ruu,•a 1�':Wm�la 21865 Copley Drive, Diamond Bar, CA 91765-417E3 II141.1„ �. ,pr4.�¢ •rq�'4��iy f' I AIN 217413 PERMIT TO OPERATE 14, THIS EQUIPMENT SHALL No'r RI;MAIN TOIL MORE THAN 12 CONSi:'t,CO MVC MONTHS AT ANY ONE LOCATION IN THE DISTP ICT. THIS PERMIT TOOPERA.TE'R-2186425 SUPERSEDES PERMIT TO OPERATE R-DS6425 ISSUED 5/1612013 NOTICE, IN ACCCRDANQI; WITH RULE 206, THIS PERMIT'1'0 OPERATE ORCOPY SIIALI, OE POSTED ON OR W ITIIIN S METERS OF THE EQUIPMENT. THIS PERMIT DOES NOT AUTHORIZE THE EMISSION OF AIR CONTAMINAN'r5 IN EXCESS OF THOSE ALLOWED 13Y DIVISION 26 OF 711E HEALTH AND SAFETY CODE OF THE STATE OF CALIFORNIA OR TFIE RULES OF THE AIR QUALITY MANACiLMENT DISTRICT. THIS PERMIT CANNOT BE CONSIDERED AS PERMISSION TO VIOLATE EXISTING LAWS, ORDINANCES, REGULATIONS OR STATUTES OI' OTHER GOVERNMENT AGENCIES. EXECUTIVE OFFICER .✓. 11 r a r, �Fd`. By Dorris M.13511uy/13BO1 1 1 /7/2013 ORIGINAL, J W 4 k J W uJ� � IIA e� � EXCEL PAVING CO. 15-6836 & 15-6452 REVIEWED BY: I se G��6 EUNICE HEREDIA (PG 1 OF 7) PALPINC-01 EVELASCO DATE MMIDDttYYY '. A�"✓de2a CERTIFICATE OF LIABILITY INSURANCE 6/23/2015 I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED 13Y THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER The Wooditch Company Insurance Services, Inc. 1 Park Plaza Suite 400 Irvine, CA 92014 NTA T NAME. PpoNE I948 563-9000 PAx A,C Na.Ext:1 ) Alc Na: (949 553-0670 IL ADDRESS: INSURaRS AppORDINO CtlVERADE NAICe NSURRRA: Gid Republic General Ins. Corp 24139 06/0112016 INSURED INSURER B INISURERC: Palp, Inc. dba Excel Paving Company INSURER O: 2230 Lemon Avenue Long Beach, CA 90806 INSURER R: INSURER F: GEN'L AGGREGATE LIMIT APPLIES PER: POLICY a JECT R LOC OTHER: COVERAGES CERTIFICATE NUMBER: REVISION NUMRER: 1 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY FIIAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza POLICY NUMBER MMIDD/TYVV rdbDIYVYYL LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MAGE occua X Al CG50211611 I j O6Po1/2015 06/0112016 EACH OCCURRENCE $ 1,000,000 RENTED PREMISES Do aaou" $ _ 1.00,006 MED EXP Anyone areon) $ 6,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY a JECT R LOC OTHER: ORNERALAGGREGATE $ 2,000,000 PROOUCIS-COMP/OP AGG � 2,000,100 $ A AUTOMOBILELIABILPY X X ANYAUTO ALL OWNED SCHEDULED AUTOS AUT05 I IIREC AUTOC X NON- 'NNEO UTOS A1CA50211511 06/01/2015 06/0112016 COMBINED INOTE IMIT Ea acddanl $ 1,000,000 BODILY INJURY (Parparson) $ BODILY INJU RY(Per ecalden0l$ I' P OP.E den DAMAGE UMBRELLA LIAR EXCESS UAB OCCUR GL11MS-MADE EACH OCCURRENCE S AGGREGATE $ DEO RETENTION$ 3 A WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY ANY PROPRIETORWARTNERIEXECUIIVE YIN CFFICERMEMHER EXCLUDED? � (Mandatory In NH) If yyes, describe undor OE&C PTION OF OPERATIONS helvre N/A 1CW50211512 06101(2015 06101/2016 PER DTFI- X STATUTE E E.L.BACHACCIDEW $ 1,000,000'-: 111.OISEASE.EAEMPLOYE-1 $ 1,000,0001. EL.DISEASE- POLICY LIMIT $ 1,000,006; DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Rema,Ns Eshedule, maybe atlocimd It more space Is required) RE: Excel Job 46260; Residential Street Repalr(15.6836) and Wilshire Avenue and Bosshard Ave Water Main (16-6462). glaip/manual City of Banks Ana, Its officers, employees, agents and volunteers are Included as Additional Insureds as respects General Liability per attached endorsement. This insurance shall apply as Primary and Non -Contributory per attached endorsement. r:FRTIFIr:ATF l4nI DFP PAMr:Fi I ATITIM O 1988-2014 ACORD CORPORATION. All rights reservod. ACORD 26 (2914/01) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES EE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. Ross Annex (M , 2 2) AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 O 1988-2014 ACORD CORPORATION. All rights reservod. ACORD 26 (2914/01) The ACORD name and logo are registered marks of ACORD EXCEL. PAVING CO. 15-6836 & '15-6452 REVIEWED BY, EUNICE HEREDIA (PG 2 OF 7) AGENCY CUSTOMER ID: PALPINC-01 EVELASCO LOC 0; 1 Al d. ADDITIONAL REMARKS SCHEDULE Page 1 of 1 ADDITIONAL REMARKS FOTHIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, RM NUMBER: ACORD 25 FORM TITLE: CertiOaato of Llabllil Insurance Remarks: Cancellation *Except 10 days notice of Cancellation for non-payment of premium, *Should this policy be cancelled before the expiration date, The Wooditch Company will mail 30 (thirty) days written notice to those Certificate Holders which require such action per contract or agreement,* ACORD 101 (2008101) ® 2008 ACORD CORPORATION. All rinhts reserved The ACORD name and logo are registered marks of ACORD AGENGY NAMED INSURED The Wooditch Company Insurance Services, Inc, Polp, Inc, dba Excel Paving Company 2230 Lemon Avenub PouCYNUMEER Long Beach, CA 99006 SEE PAGE 1 CARRIER NAIC CODA SEE PAGE 1 SEE P 1 ADDITIONAL REMARKS FOTHIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, RM NUMBER: ACORD 25 FORM TITLE: CertiOaato of Llabllil Insurance Remarks: Cancellation *Except 10 days notice of Cancellation for non-payment of premium, *Should this policy be cancelled before the expiration date, The Wooditch Company will mail 30 (thirty) days written notice to those Certificate Holders which require such action per contract or agreement,* ACORD 101 (2008101) ® 2008 ACORD CORPORATION. All rinhts reserved The ACORD name and logo are registered marks of ACORD EXCEL PAVING CO. 15-6836 a 15-6452 REVIEWED BY. POLICY NUMBER: AlCG60211611 u +fit. EUNICE HEREDIA (PG 3 OF 7) COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations Where Required By Written Contract Information required to complete this Schedule, if not shown above will be shown In the Declarations. A. Section II — Who Is An Insured is amended to Include as an additional insured the person(s) or orgenization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury' caused, in whole or In part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The Insurance afforded to such additional Insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional Insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional Insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, Including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work' out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 2010 0413 © Insurance Services Office, Inc., 2012 Page 1 of 2 EXCEL PAVING CO. 15-6836 & 15-6452 REVIEWED BY: C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of Insurance: 1. Required by the contract or agreement; or EUNICE HEREDIA (PG 4 OF 7) 2. Available under the applicable Limits Insurance shown In the Declarations; whichever is less. This endorsement shall not increase applicable Limits of Insurance shown In Declarations, of the the Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 EXCEL PAVING CO. 15-6836 & 15-6452 REVIEWED BY: A1CG502'11511 HIS ENDORSEMENT CHANGES T Z�- , � EUNICE HEREDIA (PG 5 OF 7) EASE READ IT ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS nsurance prov WHERE REQUIRED BY WRITTEN CONTRACT, BUT ONLY WHEN COVERAGE FOR COMPLETED OPERATIONS IS SPECIFICALLY REQUIRED BYTHAT CONTRACT. lude as an additional Insured the person(s) or on(s) shown I "property damage" caused, I "your work" at t grated and he °produc pieted operati ded to such addl s required by orded to such add! not be broader t ch you are red by the contract Insurance Sery ided to the addit ed by a contract or agreem pay on behalf Insurance shown I not Increase t EXCEL PAVING CO. 15-6836 & 15-6452 REVIEWED BY: ' EUNICE HEREDIA (PG 6 OF 7) OLD REPUBLIC GENERAL INSURANCE CORPORATION 'CHANGES ADDITIONAL INSURED PRIMARY WORDING SCHEDULE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE REAL) IT CAREFULLY, THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: COMMERCIAL GENERAL QAfdIL17Y COVERAGE FORM Name of Addlfibnal Insured Persons) Or Orgagizatipn(s): As roquuod by wrltton contract. Location(s) of Covered Operations Information required.0 complete this Schedule, Ifoot shown above, will be shown 'Inthe Declarations; The Insurence provided by this endorsomemt Is primary insurance and we will not seek contribution from any other Insurance of a like kind available kb the person or organization shown In the schedule ahove unless the other Insuranas is provided by a contractor othorihon tireparson.or organization shown In tine schedule above for the some operation and job.locaflon. It so, we will sham with that otherlosurenoe by the method described In paragraph 4.o, of Section IVB -Commercial General Liability Conditions. All ofharterrms and conditions remain unchanged, Named Insured Pulp, Inc. dba Excel Paving Company Policy Number A1CG50211511 00/0112015-06/0112016 `Sndursemont No. Polioy Period Endoraerr)ent Enectiva Data: _ 05/01/2015 Producei's Nama: Old Republic Constructlon Insurance Agency Inc, -- ProducerNnYtlhefi �_-��---- AU`rHOR12Ep REPRESENTATIVE CG EN GN 0029 09 06 0510112.016 DATE I EXCEL PAVING CO. 15-6836 8. '15-6452 REVIEWED BY. EUNICE HEREDIA (PG 7 OF 7) ADDITIONAL INSURED ENDORSEMENT Insurance Company 01d Republic General Ins. Com, This endorsement modifies such insurance as is afforded by the provisions of policy #k AICG50211511 relating to the following; 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92702; its officers, ornpioyees, agents and volunteers are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named Insured. 2, With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other Insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The Inclusion of any person or organization as an Insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be canceled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92702, "10 nays Nuked Cencollatlonior Non-payment of Premium (Completion of the feliowing, Including countersignature, Is required to make this endorsement effective.) Effective 06101/16 _ this endorsement form as a part of Policy AlOG50214511 Issued to Palp Inc, dba Excel Paving company __- Named Insured Countersigned by Authorized Representative Attachment B Bond No.8238--533e-87 FAITHFUL BOND FOR 'ERF ORMANCE KNOW AL.L MEN BY T riESE PRESENTS THAT: WHEREAS,The City of Santa Ana,State of California,and PALP Inc.dba Excel Paving Company (hereinafter_designated as'Principe)have entered kite an agreement whercbyPrineipai agrees to install and complete cctrlain designated public improvements,which said agreement, dated entitled Residential Street Repair FY 14/15;Wilshire Ave and Borchard Ave Water Main Improvements is hereby referred to and made a part hereof,and WHEREAS. said Principal is requinxt wider the terms of said agreement to furnish a Blind for Faithful Performance of said agreement NOW,T'l4EREFORE,we,the Principal and Federal.Insurance Company... y, as Surety,_are held and firmly hound unto the City of Santa Ane(hereinafter called"City"),in the penal sum of Two million seven hundred fifteen thousand two hundred eighty six and 20/100 muss ($ 2,715,286.20 ) lawful money of the United States, for the patnient of which sura well and truly to be made, we hindourselves, our heirs.successors,executors and administrators,jointly and severally,thinly by these presents. The condition of this obligation is such that if the above bounded Principal, his or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by,and well and truly keep and perform the covenants, conditions and provisions in the gid agreement and any alteration thereof made as thae it provided, oo his or their part, to be kept and performsri at die Warn and in the:manner therein spec zfiS„ and m all respects according to their true Pant and meaning, and shall indemnify and save harmless City,its offrccers,agents and employees,as therein stipulated,dam this obligation shall become nun and void;otherwise it shall be and remain in full force and effect As part of the obligation secured hereby and in addition to the face amount specified therefor,there shaft be included costs and reasonable expenses and fees, including reasonable attorney's fres, incurred by City in successfully enforcing such obligation,all tole taxed as costs and included in any judgment rendered.. 1 The Surety hereby stipulates and agrees that no change.extensionof thou, alteration,or addition to the terms of the agreement or to the ssvoek to be performed thereunder or the specifications accompanying the sante shall an anywise affect its obligations on this Bond. and it does hereby waive notice of any such change, extension of titan,aiforation or addition to the Dims of the agreement or to the work or to the specifications. IN WITNESS WI- .RFOP.this instrument has been duly exeeuTed by the Principal and Surety above.tamed,en May 214 2015 PRINCIPAL; PALP Inc.dba Excel Paving Company SURETY;Federal Insurance Company (Type Company Name) (Type Company Name): Hs ay Title; PA IDENT---_+fir= DROWN TItI . torxey in Fact c '"aE0(0( V t e BVI Timothy D.Rapp Jam/ Tide: ISM SECRETARY TItIe: !MICHELE E DRAKULICH (Attach adkatowledgementsofboth Principal and Sntety.signaltares) APPROVED AS TO FORM:: r Attorney 2 • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§1189 r - _ _ .. _ d _ _ A notary public or other officer completing this certificate verifies only the identity of the Individual who signed the, document to which this certificate Is attached,and not the truthfulness,accuracy,or validity of that document. State of California ) County of Los Angeles ) On fiket.I nils)1 rh4 (5 before me, C,.. Phillips.; Notary Public Date Here Insert Name and Title of the Officer • personally appeared C.P. Brown and Michele E. Drakulich Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence-to be the person(s) whose name(s) regare subscribed to the within instrument and acknowledged to me that iiiatWthey executed the same in /their authorised capaclty(ies),and that by131i#idt/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. " k°. "„ O.PHILLIPS ° ' <, comm.ux9sev� M WITNESS my hand and official seal. rv+,.._k Notary Public-California ow " *� \ LOS ANGELES COUNTY a " my Comm.Expires Oct.29,2 �t 016I( Signature Sign re of Notary Public Place Notary Seal Above OP77ONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies)Claimed by Signer(s) Signer's Name: Signer's Name: ❑Corporate Officer —Title(s): • ❑Corporate Officer — Title(s): ' ❑Partner — 0 Limited 0 General 0 Partner — 0 Limited ❑General ❑Individual 0 Attorney in Fact 0 Individual 0 Attorney in Fact ❑Trustee 0 Guardian or Conservator 0 Trustee 0 Guardian or Conservator El Other 0 Other: Signer Is Representing: Signer Is Representing: ©2014 National Notary Association•www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange On May 21, 2015 before me, Debra Swanson, Notary Public (insert name and title of the officer) personally appeared Timothy D. Rapp who proved to me on the basis of satisfactory evidence to be the person(* whose name( is/are subscribed to the within instrument and acknowledged to me that he/aisle/they executed the same in his/tier/their authorized capacity{tes), and that by his/hcr/thcir signature( on the instrument the person(*, or the entity upon behalf of which the persons) 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. `y F�� DEBRA SUMMON G7 0� k m COMM. ft 1997119 70 No NOTARY PUOLIC.CALIFORNIA c1 i'dORANGE COUNTY inwsia,Signature 1) I .RL.A>,SEC,A,N, \ (Seal) p, MY COMMEXp.NOV10,2016 C Chubb POWER Federal Insurance Company Attn: Surety Department OF Vigilant Insurance Company 15 Mountain View Road Surety ATTORNEY Pacific Indemnity Company Warren, NJ 07059 CHUBS Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY a Wisconsin corporation, do each hereby constitute and appoint Douglas A. Rapp and Timothy D. Rapp of Aliso Viejo, California each as their true and lawful Attorney-In-Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or otherwise, bonds and undertakings and other writings obligatory In the nature thereof(other than ball bonds)given or executed In the course of business,and any Instruments amending or altering the same,and consents to the modification or alteration of any instrument referred to in said bonds or obligations. In Witness Whereof,said FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and affixed their corporate seals on this 16th day of December, 2011. 7,,,,eic ��& ' - �, Kenneth C.Wende,Assistant Secretary .Norris,Jr.,Vice President STATE OF NEW JERSEY. ' County of Somerset ss. On this 16th day of December, 2011 before me,a Notary Public of New Jersey,personally came Kenneth C.Wendel,to me known to be Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY,the companies which executed the foregoing Power of Attorney, and the said Kenneth C. Wendel, being by me duly sworn, did depose and say that he is Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof,that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of the By-Laws of said Companies;and that he signed said Power of Attorney as Assistant Secretary of said Companies by like authority;and that he is acquainted with David B.Norris,Jr.,and knows him to be Vice President of said Companies;and that the signature of David B.Norris,Jr.,subscribed to said Power of Attorney is in the genuine handwriting of David B.Norris,Jr.,and was thereto subscribed by authority of said By- Laws and in deponent's presence. ,Notarial Seal �.AYF KATHERINE J.ADEIAAR RY�Yr NOTARY PU6UC OF NEW JFRSFI � �OSA� ;' No,2376685 `/7J�/âtPubllo 4 itepw CERTIFICATION Extract from the By-Laws of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY: 'All powers of attorney for and on behalf of the Company may and shall be executed in the name and on behalf of the Company,either by the Chairman or the President or a Vice President or an Assistant Vice President,jointly with the Secretary or an Assistant Secretary, under their respective designations. The signature of such officers may be engraved,panted or lithographed.The signature of each of the following officers:Chairman,President,any Vice President,any Assistant Vice President, any Secretary, any Assistant Secretary and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such power of attorney or cediticate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and'certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached." I,Kenneth C.Wendel,Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY (the'Companies")do hereby certify that (i) the foregoing extract of the By-Laws of the Companies is true and correct, (il) the Companies are duly licensed and authorized to transact surety business in all 50 of the United States of America and the District of Columbia and are authorized by the U.S.Treasury Department;further,Federal and Vigilant are licensed in Puerto Rico and the U.S.Virgin Islands,and Federal Is licensed in American Samoa,Guam,and each of the Provinces of Canada except Prince Edward Island;and (iii) the foregoing Power of Attorney is true,correct and in full force and effect. Given under my hand and seals of said Companies at Warren,NJ this 21st day of May,2015 a 01NA'IY nigy \ S„ 4 cIA . \uNP \Ss,i9;,/ '-..4eW Yo?1.-: G IN'//" Kenneth C.We el,Assistant Secretary IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM,VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER, PLEASE CONTACT US AT ADDRESS LISTED ABOVE,OR BY Telephone(906)903-3493 Fax(908)903-3656 e-mail: surety@chubb.com Form 15-10-022513-U (Ed.5-03) CONSENT Attachment A Bond No.8238-53-87 CONTRACTOR'S PAYMENT BOND KNOW ALL MEN BY THESE PRESENTS,THAT: WHEREAS,the City of Santa Ana, State of California,and PALP Inc.dba Excel Paving Company (hereinafter designated as `Principal") have entered into an agreement whereby Principal agrees to install and complete certain designated public improvements,which said agreement.dated entitled" Residential Street Repair FY 14/15;Wilshire Ave and Borchard Ave Water Main Improvements is hereby referred to and made a part hereof;and WHEREAS,under the terms of said agreement,Principal is required before entering upon the performance of the work,to file a good and sufficient Contractor's Payment.Bond with the City of Santa Ana to secure the claims to which reference is made in Title 3, (commencing with Section 9000) of Part 6 of Division 4 of the Civil Code of the State of California. NOW THEREFORE,said Principal and the undersigned as corporate Surety,are held firmly bound unto the CITY OF SANTA ANA; and all contractors, subcontractors, laborers, materialmen and other persons employed in the performance of the aforesaid agreement and referred to in the aforesaid Civil Code,in the sum of Two million seven hundred fifteen thousand two hundred eighty six and 20/100 DOLLARS(5 2,715,286.20 ), for materials furnished or labor(hereon of ally kind, or for amounts due wider Elie Unemployment.Insurance Act with respect to such work or labor or for any amounts required to be deducted, withheld and paid over to the Franchise "fax Board from the wages of employees of the Principal and his subcontractors pursuant to Section 18806 of the Revenue and Taxation Code, with respect to such work and labor; that said Surety will pay the same in an amount not exceeding the amount hereinabove set forth, and also in case suit is brought upon this Bond,will pay,in addition to the face amount thereof,costs and reasonable expenses and fees,including reasonable attorney's fees,incurred by the City in successfully enforcing such obligation,to be awarded and fixed by the court,and to be taxed as costs and to be included in the judgment therein rendered. IT IS HEREBY EXPRESSLY STIPULATED AND AGREED that this Bond shall inure to the benefit of any and all persons,companies and corporations entitled to file claims Title 3, (commencing with Section 9000) of Part 6 of Division 4 of the Civil Code, so as to give a right of action to them or their assigns in any suit brought upon this Bond. Should the condition of this bond be fully performed,then this obligation shall become null and void, otherwise it shall be and remain infrill force and effect. 1 The Surety hereby stipulates and agrees that no change. extension of time, alteration or addition to the terms of said agreement or the specifications accompanying the same shall in any manner affect its obligations on this Bond,and it does hereby waive notice of any such change, extension,alteration or addition. IN WITNESS WHEREOF, this instrument has been duly executed by the Principal and Surety above named, on May21 , 2015 . PRINCIPAL: PALP Inc.dba Excel Paving Company SURETY: Federal Insurance Company (Type Company Name) (Type Company Name) 1 By: (7 /1 . �/ By.� _.*_-E.. .� .m. 11 „`amu Title: C.P. BROWN aitlei Attorney in Fact P74]SiD'E�➢T g Timothy D.Rapp t CA By: Title: Ta SECRETARY MICHELE E.DRAKULIUH By: Title: (Attach Acknowledgements of both'Principal and Surety signatures) APPROVED AS TO FORM: A. 11, POttomey Payment Bond-P.W.(except subdivisions) 02/13 2 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§1189 A notary public or other officer completing this certificate verifies only the Identity of the individual who signed the document to which this certificate Is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of Los Angeles On before me, C., Phillips, Notary Public Date Here Insert Name and Title of the Officer • personally appeared C.P. Brown and Mic ele E. Drakulich Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) BVare subscribed to the within instrument and acknowledged to me that /they executed the same in iliftlinelltheir authorized capacity(les),and that byl6Tihlfit/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 C.PHILLIPS is true and correct. COMM #1996177 o WITNESS my hand and official seal. t� G's Notary PublicCaIlfornia LL ' d{,�, LOS ANGELES COUNTY ' ' I •' My Comm.Expires Oct.29,2016 Signature Signature Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑Corporate Officer — Title(s): • 0 Corporate Officer — Title(s): 0 Partner — 0 Limited 0 General 0 Partner — ❑Limited 0 General ❑Individual 0 Attorney in Fact 0 Individual 0 Attorney in Fact ❑Trustee 0 Guardian or Conservator 0 Trustee 0 Guardian or Conservator fl Other: 0 Other: Signer Is Representing: Signer Is Representing: 02014 National Notary Association•www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange On May 21, 2015 before me, Debra Swanson, Notary Public (insert name and title of the officer) personally appeared Timothy D. Rapp who proved to me on the basis of satisfactory evidence to be the persona)whose name(e is/are subscribed to the within instrument and acknowledged to me that he/ohc/thoy executed the same in hisA9cr/thcir authorized capacityees•), and that by hislhcr/thcir signature( on the instrument the person(ej, or the entity upon behalf of which the persona) 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. sEw,, iSe fRA S -7=aON i WITNESS my hand and official seal. n"/� p 44. COMM, L 1997119 73 CC; _ NUTAfdYPUBIC•CALIFORNIA lc&KY ''!'$." ORANGE COUNTY Baa 3 agr Inv. MY COMM.EXP.NOV10,2016 . Signature _AL., tii Cuvvrinh (Seal) r Chubb POWER Federal Insurance Company Attn: Surety Department OF Vigilant Insurance Company 15 Mountain View Road Surety ATTORNEY Pacific Indemnity Company Warren, NJ 07059 CHUBS Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY a Wisconsin corporation, do each hereby constitute and appoint Douglas A. Rapp and Timothy D. Rapp of Aliso Viejo, California each as their true and lawful Attorney-In-Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or otherwise, bonds and undertakings and other writings obligatory In the nature thereof(other than ball bonds)given or executed In the course of business,and any instruments amending or altering the same,and consents to the modification or alteration of any instrument referred to in said bonds or obligations. In Witness Whereof,said FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and affixed ttthheirrcorporate seals on this 16th day of December, 2011. C. ------)its...-7...41.1-7/7":------- àJr. Viid? 1✓ &C.Wende, stagry ' gawCB. STATE OF NEW JERSEY r/' County of Somerset ss. On this 16th day of December, 2011 before me,a Notary Public of New Jersey,personally came Kenneth C.Wendel,to me known to be Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY, the companies which executed the foregoing Power of Attorney, and the said Kenneth C. Wendel, being by me duly sworn, did depose and say that he is Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof,that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of the By-Laws of said Companies;and that he signed said Power of Attorney as Assistant Secretary of said Companies by like authority;and that he is acquainted with David B.Norris,Jr.,and knows him to be Vice President of said Companies;and that the signature of David B.Norris,Jr.,subscribed to said Power of Attorney is in the genuine handwriting of David B.Norris,Jr.,and was thereto subscribed by authority of said By- Laws and In deponent's presence. Notarial seal �.Ass KATHERINE 1.ADELAAR !�� NOTARY FUBUC OF NEW 1FRSF1n pr Ijav amNRY y Ne,2316665 g12,____,-/A., r putiv k�' Commission Expires July ih,2014 /YEW ACej CERTIFICATION Extract from the By-Laws of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY: "All powers of attorney for and on behalf of the Company may and shall be executed in the name and on behalf of the Company,either by the Chairman or the President or a Vice President or an Assistant Vice President,jointly with the Secretary or an Assistant Secretary, under their respective designations.The signature of such officers may be engraved,printed or lithographed.The signature of each of the following officers:Chairman,President,any Vice President,any Assistant Vice President, any Secretary,any Assistant Secretary and the seal of the Company may be affixed by facsimile to any power of attorney or to any cerlificate relating thereto appointing Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and'certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached." I,Kenneth C.Wendel,Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY (the°Companies")do hereby certify that (i) the foregoing extract of the By-Laws of the Companies is true and correct, (li) the Companies are duly licensed and authorized to transact surety business in all 50 of the United States of America and the District of Columbia and are authorized by the U.S.Treasury Department;further,Federal and Vigilant are licensed in Puerto Rico and the U.S.Virgin Islands,and Federal Is licensed in American Samoa,Guam,and each of the Provinces of Canada except Prince Edward Island;and (iii) the foregoing Power of Attorney is true,correct and in full force and effect. Given under my hand and seals of said Companies at Warren,NJ this 21st day of May,2015 ,yUNAH.� , MSURAM?� ' vim" °r,• 0� ., Ot � 0jl At1AO `--tale ast,. dinigewit‘ Kenneth C.We el,Assistant Secretary IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM,VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER, PLEASE CONTACT US AT ADDRESS LISTED ABOVE,OR BY Telephone(908)903-3493 Fax(908)903-3656 e-mail: surety@chubb.com Form 15-10-02258-U (Ed.5-03) CONSENT 3a Vtr4 1 �rc.'y`• MEMORANDUM �a n E \-44 • `lr Opt David Cavazos To: City Manager Date: August 4, 2016 Fred Mousavipour, Executive Director From: Public Works Agency Project Nos. 15-6836 & 15-6452; Residential Street Repair FY 14/15 & Wilshire and Borchard Water Main Improvements Subject: Change Order No. 1 CONTRACTOR : Excel Paving Company 2230 Lemon Ave, Long Beach, CA 90806 PROJECT DESCRIPTION: Project Nos. 15-6836 & 15-6452; Residential Street Repair FY 14/15 & Wilshire and Borchard Water Main Improvements CHANGE ORDER NUMBER: 1 CHANGE ORDER AMOUNT: $154,147 ACCOUNTING UNIT-ACCOUNT-ACTIVITY NUMBER: 05817661 -66220- 15683601028 & 06617647- 66220- 15645201028 JUSTIFICATION 1.1 In order to properly repair the pavement on Pullman Street as shown on the construction documents, a deteriorated crossgutter on Pullman Street at Dyer Road was replace; in addition, curbs, sidewalks and two wheelchairs were constructed; pull boxes and pedestrian push button poles also were relocated. (PCO#12) AGREED PRICE = $84,785 1.2 The striping of pavement on Pullman Street at Dyer Road was inadvertently not shown on the construction documents. This change order compensates the Contractor for striping the pavement on Pullman Street. (PCO #11) AGREED PRICE = $1,000 1.3 To ensure that concrete intersections throughout the project get the proper grading before pouring concrete, the Contractor has performed additional survey work. (PCO #8) FINAL COST = $3,067 1.4 Water supply to the property located at 411 West Wilshire was served from an existing mainline on Birch Street. This project will serve the property from the new mainline constructed on Wilshire Avenue. The plans inadvertently did not show the connection from the new water meter to the property. This change order compensates the contractor to extend the water service line behind the new meter to the property. (PCO #2) FINAL COST = $2,200 `� Projects 15-6836 & 15-6452 Change Order No. 1 August 4, 2016 Page 2 of 3 1.5 On patron Street, the Contractor encountered an existing broken water gate valve at Wilshire Avenue; several valves need to be shut down in order to replace the broken valve. To reduce inconvenience to the residents and not to shut down so many valves, the contractor installed a line stop at Parton and Wilshire and replaced the broken valve. (PCO #4) AGREED PRICE = $26,375 , / 1.6 The contractor encountered an abandoned waterline and fittings in the way of tying in the proposed waterline at flower and Wilshire. The Contractor potholed, exposed and removed the abandoned waterline and fittings. (PCO #6) FINAL COST = $24,487 " 1.7 During construction of the waterline, the Contractor hit unmarked utility lines and existing water service at Ross Street which caused flooding of trenches. This change order compensates the Contractor to dry and clean up the flooded trenches. (PCO #9) FINAL COST = $5,530 V, 1.8 Contractor encounter downtime while City crews are trying to shut down existing water valves; in addition, the contractor while trenching concrete streets to install the proposed waterline found rebar in the concrete. This change order compensates the contractor for downtime and dump fee for the rebar. (PCO #7) FINAL COST = $6,703 ✓ ACCOUNTING UNIT COST ANALYSIS CCO Item Accounting Unit Accounting Unit Total Amount Number Costs 1.1 05917663-66220-15683602028 $84,785 $84,785 1.2 05917663-66220-15683602028 $1,000 $1,000 1.3 05917663-66220-15683602028 $3,067 $3,067 1.4 06617647-66220-15645201028 $2,200 $2,200 1.5 06617647-66220-15645201028 $26,375 $26,375 1.6 06617647-66220-15645201028 $24,487 $24,487 1.7 06617647-66220-15645201028 $5,530 $5,530 1.8 06617647-66220-15645201028 $6,703 $6,703 $154,147 Projects 15-6836 & 15-6452 Change Order No. 1 August 4, 2016 Page 3 of 3 CONTRACT COST SUMMARY Amount % of Contract Original Contract Total $2,468,442 Construction Contingency $493,688 Previous Change Orders $-0- - 0.00% Change Order#1 $154,147 Increase 6.24% $2,622,589 SCHEDULE IMPACT Increase hundred and five (105) working days. APPROVED AS TO FUNDS AND ACCOUNTS: I I A ' �-n�}\{�� Fre. Mous-vipour, Executive' .s4,\L aD % -1 _- Director Francisco Gutierrez, Executive Director Pu. is Works Agency Finance & Management Services Agency CITY OF SANTA ANA PUBLIC WORKS AGENCY fF .< CONTRACT CHANGE ORDER Project Number Project Nos. 15-6836 & 15-6452; Residential Street Change Order Number 1 Repair FY 14/15 & Wilshire and Borchard Water Main Improvements To Excel Paving Company Contractor You are hereby directed to make the herein changes from the plans end 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 15-6836: Residential Street Repair FY 14/15 &Wilshire 1.1 EXTRA WORK AT AGREED PRICE Remove existing and construct crossgutter, curbs, sidewalks and two wheelchair ramps; and relocate pull boxes and pedestrian push button poles at Dyer Road and Pullman Street per PCO #12. AGREED PRICE = $84,785 1.2 EXTRA WORK AT AGREED PRICE Install thermoplastic stripping and paint red curb at Dyer Road and Pullman Street per PCO #11. AGREED PRICE = $1,000 1.3 EXTRA WORK AT TIME & MATERIALS Perform additional survey at concrete intersection per PCO #8. TOTAL COST = $3,067 15-6452: Wilshire and Borchard Water Main Improvements 1.4 EXTRA WORK AT TIME & MATERIALS Extend 1" Water Service line on private property at 411 West Wilshire Avenue per PCO #2. TOTAL COST =$2,200 1.5 EXTRA WORK AT AGREED PRICE Install water line stop at Parton St. & Russell Ave. and replace a broken gate valve at Wilshire & Parton per PCO #4. AGREED PRICE = $26,375 Page 1 of 3 ,„ s „.,v 9 CITY OF SANTA ANA ..0 orif PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER 3, i r w`,hti Project Number Project Nos. 15-6836 & 15-6452; Residential Street Change Order Number 1 Repair FY 14/15 & Wilshire and Borchard Water Main Improvements To Excel Paving Company 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 1.6 EXTRA WORK AT TIME & MATERIALS Pothole, expose and remove abandoned waterline and tie-in ACP pipe at Flower and Wilshire per PCO #6. TOTAL COST = $24,487 1.7 EXTRA WORK AT TIME & MATERIALS Clean up flooding trenches at unmarked utility and broken service lines on Ross Street per PCO #9. TOTAL COST = $5,530 1.8 EXTRA WORK AT TIME & MATERIALS Compensate the Contractor for downtime due to unable to shut down existing water valves and dump fee for rebar found during concrete removal for waterline trenching per PCO #7. TOTAL COST = $6,703 Page 2 of 3 �te CITY OF SANTA ANA a ., ', PUBLIC WORKS AGENCY 4 CONTRACT CHANGE ORDER Project Project Nos. 15-6836 & 15-6452; Residential Street Repair Change Order Number 1 Number FY 14/15 & Wilshire and Borchard Water Main Improvements To Excel Paving Company 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 $ 154,147 By reason of this order the CONTRACT TIME completion will be adjusted as follows: One hundred five (105) non- compensatory working days. We the undersigned contractor have given careful consideration to the change proposed and hereby agree,if this proposal is approved,that we will provide all equipment,furnish all materials,except as may otherwise be noted above,and perform all service necessary for the work above specified,and will accept as full payment therefor the prices shown above. Accepted,Date 7-27-16 Contractor Excel Pavin• Company Byf A., Pr:sident C.P. Brown41.11 Xq j°L" / O Approval recommended by a, /- '+ -yam-. P- " • Date�/ 0 1 PUBLIWORKS AGENCY EXECUTIVE DIRECTOR R"ECTOR Approved by t A 1 �pl� Date 2,5/1 YMANAGER Page 3 of 3