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HomeMy WebLinkAboutKDC, INC. DBA DYNALECTRIC Recording Requested By, And When Recorded Mail To: Recorded in Official Records, ©range County Clerk of the Council,City of Sant Ana Hugh Nguyen, Clerk-Recorder ) 20 CivicCenter P.O.70Box 19$$ ll I IIII IIII IIIII IIII I III II I ICI IIII III I III NO FEE Sant * $ R 0 0 0 9 3 5 7 4 0 5 S 2017000254066 2:59 PM 06/20/17 63 413 N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 e `t' f 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 Safe Routes to School Enhancements at Monte Vista Elementary under contract U entered into on October 18, 2016, with KDC Inc., dba Dynalectric, on which contract Travelers ce va Casualty and Surety Company of America & Federal Insurance Company is surety. The property coC on which such work improvement was placed is in the City of Santa Ana, County of Orange, o z State of California, and described as Project No. 16-6873 located at: Monte Vista Elementary. A The work improvement on said property was accepted as completed on June 2, 2017. Cw G CITY OF S A, A MUNICIPAL CORPORATION ry 0 by Dated: l4 f �' �� Principal C' it Engineer-Tyrone Chesanek TITLE O = VERIFICATION I, the undersigned, say: I am the City Engineer - Edwin "William" Galvez of the City of Santa Ana, California; I executed the foregoing Notice of Completion acting on behalf of the owner of the property therein described; I make this verification on behalf of said corporation by authorization of the City Council of the City of Santa Ana; I have read said notice and know the contents thereof; and I declare under penalty of perjury that the facts therein stated are true. Executed on , at Santa Ana, Californi (Signature of indivi I swearing that the contents of Notice of Completion are true.) THIS NOTICE OF COMPLETION MUST BE RECORDED WITHIN TEN(10)DAYS AFTER COMPLETION REQUEST FOR COUNCIL ACTION CITY COUNCIL MEETING DATE: OCTOBER 18, 2016 TITLE: AWARD CONTRACT TO KDC INC., DBA DYNALECTRIC, FOR CONSTRUCTION OF GRANT -FUNDED SAFE ROUTES TO SCHOOL ENHANCEMENTS AT MONTE VISTA ELEMENTARY (PROJECT NO 166873) (STRATEGIC PLAN NOS. 6, 1B & 1G) CtTY MA AGE RECOMMENDED ACTION CLERK OF COUNCIL USE ONLY: APPROVED OCA 18, 201b Ed As Recommended, 23 8 © As Amended [] Ordinance on 1't Reading Ordinance on 2nd Reading [] Implementing Resolution © Set Public Hearing For CONTINUED TO FILE NUMBER 1. Award a contract and authorize the City Manager and Clerk of the Council to execute a construction contract to KDC Inc., dba Dynalectric, the lowest responsible bidder, in accordance with the base bid in the amount of $332,234 for the term beginning upon execution of the contract and ending upon project completion, for the Safe Routes to School Enhancements at Monte Vista Elementary, subject to nonsubstantive changes approved by the City Manager and the City Attorney. 2. Approve the Project Cost Analysis for a total estimated project delivery cost of $411,658, which includes the contract bid amount, administration, inspection and testing, and an authorized contingency of $33,224. DISCUSSION The recommended actions are needed for the City to proceed with the installation of traffic safety enhancements on City streets adjacent to Monte Vista Elementary School (Exhibit 1). The improvements include left turn arrows on McFadden Avenue at Raitt Street, and bulb outs on Monte Vista Avenue at Townsend Street to narrow the street. Once completed, these improvements will increase school-age pedestrian safety while promoting more walking. A Notice Inviting Bids was advertised on September 23, 2016 and September 30, 2016; bids were opened on October 10, 2016. The following is a summary of the bid invitations made and the bids received: Contract Award For Safe Routes to School Enhancements for Monte Vista Elementary October 18, 2016 Page 2 Contractor Participation Data Santa Ana contractors receiving notices 9 Contractors requesting bidding documents 13 Bids received 5 Bids received from Santa Ana contractors 0 Bid Results Summary RANK BIDDER'S NAME LOCATION BID 1 KDC Inc. dba Dynalectric Los Alamitos $332,234.00 2 DBX, Inc. Temecula $332,701.00 3 Belco Elecnor Electric Chino $336,205.00 4 California Professional Engineering La Puente $344,108.00 5 1 PTM General Engineering Riverside $405,945.00 A total of five bids were received and all were deemed responsive. KDC Inc. dba Dynalectric submitted the lowest responsive bid in the amount of $332,234 (Exhibit 2). Based on the bid analysis and a contractor's reference check, staff recommends awarding the construction contract to KDC Inc. dba Dynalectric, in the amount of $332,234 (Exhibit 3). 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 (e.g., neighborhood streets, traffic improvements, park facilities, bike master plan, etc.). ENVIRONMENTAL IMPACT In accordance with the California Environmental Quality Act, the recommended actions are exempt from further review. Categorical Exemption Environmental Review No. 2014-151 was filed for this project. Contract Award For Safe Routes to School Enhancements for Monte Vista Elementary October 18, 2016 Page 3 FISCAL IMPACT As indicated in the Cost Analysis (Exhibit 4), the estimated total construction delivery cost of this project is $411,658, which includes construction, contract administration, inspection, testing, and an authorized contingency of $33,224. Funding is available in the Active Transportation Program Fund (Account No. 14817613-66220, Project 166873) and Measure M2 Local Fair Share Fund (Account No. 03217662-66220, Project 166873) for expenditure in Fiscal Year 2016-17. A r A-0-� re Mousavipour Executive Director Public Works Agency FM/EWG/TC/MO EXHIBITS: 1. Location Map 2. Bid 3. Construction Contract 4. Cost Analysis APPROVED AS TO FUNDS AND ACCOUNTS: :�-Az Nxt 1S n1'� Francisco Gutierrez Executive Director Finance & Management Services Agency B A Mi Tr an SANTA ANA City Council project No. 16-6873: Safe Routes to School PWA ■ Agenda Date Enhancement for POBLIC WORMS AGENCY October 18, 2016 Monte Vista Elementary Exhibit 1A i� f I x. .i I x 11, 1 z {� t i Y r F,. V' 'Ahfl rAt!H City Council Project No. 16-6873 Safe Routes i■ ■ Agenda [late to School E hance Enhancement for October 18, 20716 1 Monte x. .i {� t I Wit. R4 yc V' 'Ahfl rAt!H City Council Project No. 16-6873 Safe Routes i■ ■ Agenda [late to School E hance Enhancement for October 18, 20716 1 Monte L wii- 4 R4 yc j " YI k } V' 'Ahfl rAt!H City Council Project No. 16-6873 Safe Routes i■ ■ Agenda [late to School E hance Enhancement for October 18, 20716 1 Monte or I I 1e City Council Agenda Date �Qd e.1e2om � R4�l 2+�5@�am bSchool Enhancement for Monte Vista Elementary Exhibit IC (� �* or I I 1e City Council Agenda Date �Qd e.1e2om � R4�l 2+�5@�am bSchool Enhancement for Monte Vista Elementary Exhibit IC CITY OF SANTA ANA EXHIBIT 2 PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) BID PROPOSAL TO: CITY COUNCIL OF THE CITY OF SANTA ANA FROM: KDC Inc., dba Dynalectric REQUIREMENT: The undersigned bidder declares that they have carefully examined the location of the proposed work, that they have examined the Contract Documents in its entirety and hereby proposes to furnish all material and do all the work required to complete the said work in accordance with said plans (if any) and the specifications for the unit price(s) or lump sum(s) set forth in the following schedule: Item Description Qty Unit Unit Price Amount Traffic Signal Modification at McFadden Ave and Rain Street 1 LS $ 7317gS`' $ %3I "79J__ 2 GTT Opticom Emergency Vehicle Preemption System✓ 1 LS $ f 4 `t ��� $ �� J 3 Install 2" PVC Conduit Per Plan* 100 LF $ 1/ $ 4 Install 3" PVC Conduit Per Plan * 2075 LF $ $ 5 Install 4" PVC Conduit Per Plan * 400 LF 6 Install No. 6 Pull Box * 13 EA $' 7Z ! _, $ l 1177 w 7 Install Traffic Signal Loop Detector (Type E Loop) 21 EA $ -;, $ J/ 8 Install Bicycle Loop Detector ('Type D Circular Loop) 12 EA $ 32.2 J $ sJ✓ �P, J.....- 9 24 Strand S"MFO Cable 3800 LF $ '0,770- r770._.10 10 Fusion Splice 1 Strand SMFO 96 EA $ $ l I IP Communication System 1 LS $ ca o ` $ a! cx�)CP —' 12 Signing and Striping 1 LS $ $�� 13 ConstnctOPCCSidewalk 1,740 SF $�$ 1'• lam"' �lPi 35�� P-1 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATFL- 5063(163) Item 1)everlption Qty Unit Unit Price Amount 14 Construction PCC Curb Ramp 1260 SF $ $ 15 AC Pavement 30 TN $ 2-36 $ 16 Pothole For Utilities Not Shown on Plans 10 EA $ �w�� $ 17 Pothole For Traffic Signal Equipment Utility Conflicts 4 EA $ $ 18 Unclassified Excavation * 130 CY $ $ n I9 PCC Curb and Gutter (Type A-2-8) 200 LF $ $ 20 PCC Driveway Approach (Commercial) 400 SF $ /4/— $ 21 Temporary Overhead wiring 1 LS $ s $ 22 Crosswalk Drainage System 1 LS$^ry $ P-2 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) TOTAL BASE BIll i <? > c! The lowest responsible bidder shall be selected based on the total base bid. The City reserves the right to award the Base Bid, and any, all, or none of the add -alternate bid items (if any). * The quantity for this bid item is shown for bid comparison only. This bid item shall not be subject to the "25%" limit as stated in Section 3-2 of the Standard Specifications. The actual 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. This bid ;item is considered a Specialty Item per Section 2-3.2 of the Standard Specifications. TIME FOR COMPLETION OF 1MPROVFMENTS AND LIQUIDATED DAMAGES The undersigned bidder hereby proposes to complete the Work for the total base bid amount shown above, within 80 (eighty) working days after the commencement date stated in the Notice to Proceed. The liquidated damages amount, in lieu of the amount specified in Subsection 6-9 of the Standard Specifications, shall be $1,000 per calendars ay. Name of Firm KDC Inc., dba D Signature of BIDDER Title William B. Davenport, Exec. V KFO, Trees. (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.) "Please See Attached P-3 of P-17 WRITTEN CONSENT OF THE SOLE DIRECTOR AND SOLE SHAREHOLDER OF KDC INC. Pursuant to sections 307(b) and 603 of the General Corporation Law of the State of California, and in lieu of annual meetings of the sole Shareholder and of the sole Director of ICDC Inc.,. a California corporation ("the Corporation"), the undersigned sole Shareholder and sole Director of the Corporation do hereby consent to, and adopt, the following resolutions: RESOLVED, that the sole Director, pursuant to the Bylaws of the Corporation, does hereby fix the number of directors of the Corporation at one director; and RESOLVED, that R. Devin Matz be and he hereby is, elected by, the sole Shareholder of the Corporation, the sole Director of the Corporation for a term of one year or until his successor shall have been elected and qualified or his earlier resignation or romoval. RESOLVED, that all acts, contracts and agreements on behalf of the Corporation made, taken or authorized by the sole Director and the officers of the Corporation since the date of the last meeting of, or written consent in lieu thereof by, the sole Shareholder of the Corporation are hereby adopted, approved and ratified by the sole Shareholder. RESOLVED, that the following named persons be, and each hereby is, elected, by the sole Director, to the respective office indicated opposite such person's name below to serve as such until the next annual meeting or until their respective successor is elected and qualified or such officer's earlier resignation or removal: Officer Name Michael J. Parry R. Kevin Matz Joseph C. McCormick William B. Davenport Dusty Lord Wayne Gantt Matthew Thornton Susan Henri Mark M, Porto DATE: April 4, 2016 R. Kevin Matz, Di tot Title Chief Executive Officer, President Vice President Asst, Vice President and General Counsel CFO, Executive Vice President and Treasurer Secretary Vice President Vice President — General Superintendent Assistant Secretary Assistant Secretary SOLE SHAREHOLDER: Dyn Specialty Contracting Inc, By: R. Kevin Matz, Mee Presi ent CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENFIACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATFL- 5063(163) 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 'boards and certificate of liability insurance within ten (10) business days or the funds, cheek, 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 finds, 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. Name of Firm KDC Inc., dba Dynalectric Signature of BIDDER Title William S, Davenport, Exec. VP, CFO, Trees. (Ir 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.) "*Please See Attached P-4 of P-17 WRITTEN CONSENT OF THE SOLE DIRECTOR AND SOLE SHAREHOLDER OF XDC INC, Pursuant to sections 307(b) and 603 of the General Corporation Law of the State of California, and in lieu of annual meetings of the sole Shareholder and of the sole Director of KDC Inc., a California corporation ("the Corporation"), the undersigned sole Shareholder and sole Director of the Corporation do hereby consent to, and adopt, the following resolutions: RESOLVED, that the sole Director, pursuant to the Bylaws of the Corporation, does hereby fix the number of directors of the Corporation at one director; and RESOLVED, that R. Kevin Matz be and he hereby is, elected by, the sole Shareholder of the Corporation, the sole Director of the Corporation for a term of one year or until his successor shall have been elected and qualified or his earlier resignation or removal. RESOLVED, that all acts, contracts and agreements on behalf of the Corporation made, taken or authorized by the sole Director and. the officers of the Corporation since the date of the last meeting of, or written consent in lieu thereof by, the sole Shareholder of the Corporation are hereby adopted, approved and ratified by the sole Shareholder. RESOLVED, that the following named persons be, and each hereby is, elected, by the sole Director, to the respective office indicated opposite such person's name below to serve as such until the next annual meeting or until their respective successor is elected and qualified or such officer's earlier resignation or removal: Officer Name Title Michael J. Parry Chief Executive Officer, President R. Kevin Matz Vice President Joseph C. McCormick Asst. Vice President and General Counsel William B. Davenport CPO, Executive Vice President and Treasurer Dusty Lord Secretary Wayne Gantt Vice President Matthew Thornton Vice President —General Superintendent Susan Henri Assistant Secretary Mark M. Porto Assistant Secretary DATE: April 4, 2016 R• Kevin Matz, Di for SOLESHAREHOLDER: Ayn Specialty Contracting Inc. R. Devin Matz, oe Presi ent CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) 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: KDC Inc., dba Dynalectric Business Address: 4462 Corporate Center Dr., L.os Alamitos, CA 90720 Business E -Mail Address: bdavenport@dyna-la.com Telephone: 714-828-7000 State Contractor's License No, and Class: 550173 A, C10 License Expiration Date: 12/31/2016 State Dept. of Industrial Relations (DIR) Registration No.: 1000001129 State Dept. of Industrial R4ExecCFO, Registration Expiration Dat06/30/2017 Signed: Title: William B. DavenpTrees. P-5 of P-17 CITY Or SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENI-IACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) PREVAILING WAGE COMPLIANCE AND MONITORING STATEMENT Contractor is aware of the requirements of California Labor Code Section 1720, ct 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 matte 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 %ic and correct. Name of Firm KDC Inc., dba D' Signature of BIDDER / Title William B. Davenport, Exec. ExeVP (if an individual, so state) Treas. P-6 of P- 17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) OWNERSHIP AFFIDAVIT sTATr OF CALIFORNIA ) COUNTY OF ORANGE ) SS: CITY OF SANTA ANA ) William B. Davenport, Exec. VP, CFO, Treas_ _ being duly sworn, deposes and says: ❑ INDIVIDUAL That he/sire is the party making the foregoing proposal: ❑ PAR'I'NERSIIIP That he/she is a member orihe co -partnership firm designated as: and who has been and is duly vested with the authority to make and execute instruments Cor the co -partnership by: who constitute the other rnembers orthe eo-partnership. ®CORPORA'rION That he is of KDC Inc., dba Dynalectric a corporation which is making the foregoing proposal: ❑ JOINT VENTURE That he is or-, one or the parties making the knegoing proposal as a joint venture, and the he/she has been and is duly vested with the authority to execute instruments for an on behall`of the panties making said bid who are: that such a bid is genuine not collusive or sham, and has not in any manner sought by collusion to secure any r antage against the City of Santa Ana or any person interested in the proposed contract, for In self or any other person. Signature o udder Will B. Davenport, Exec. VP, CFO, Treas. Subscribed and sworn to before me this day of Signature of officer Administering Oath (Notary Public) P-7 of P-17 20 **Please See Attached Jurat CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202 tft&=A�102111=1= S"S'fiM.S�kYi:r fztCNxu ,5- + C2;.^EfES"SS .`C'a"�A�4^" 54 �%£.." `' ',t`YCCY sKZL'M%ii`GdSd`..L419'1'dF`i. 'di.`�3ffi3 ❑ See Attached Document (Notary to cross out lines 1-6 below) I I See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) Signature of Document Signer No. 8 Signature of Document Signer No. 2 (if any) A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange KRISTEN RENEE CZUPRYN Commission # 1996022 z i � n Notary Public - California z z Orange County n M Comm. Expires Nov 2s, 201 Subscribed and sworn to (or affirmed) before me on this _ 7th day of _October -1 20 16 by Date Month Year (1) William U. Daven orf (and Name(s) of Signers) proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. Signator -f Signature of ary Public Seal Place Notary Seal Above OPTIONAL Though this section is optional, completing this Information can deter alteration of the document or fraudulent reattachment of this form to an unintended document Description of Attached Document Title or Type of Document: Owneishlp Affidavit Number of Pages: _ Signar(s) Other Than Named Above: Document Date: _ 10-7-16 '�..•t2R�'Tr�'"-"T.-l`US'CX?Y%6F'J`R%�i`&G't%Y`.C`W'!-[i"�X 4'R�2N-''�"r..G.<lLK�'Y �"E%£`Ln�"Y=.ZtP.�)U"v>f�i%(i`Y_ti"�'-Z'.�'X=L"s"Z%f.`E:`W'V.%fi2'.l`:%i`L 02014 National NotaryAssociation • www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5910 CITY OIC SANTA ANA PROPOSAL PROJECT NO.: 1.6-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) BID BOND KNOW ALL PRESENT that, as BIDDER, and _—Travelers Casualty and Surety Company of America _ , as SURETY, are held and firmly bound unto the CITY OF SANTA ANA, as AGENCY, in the penal sum of _ Ten Percent of the Amount Bid Dollars ($10°/n of Amt. Bid ), which Is ten perceat (10%) of the total amount bid by BIDDER to AGENCY for the above -stated project, for the payment of which sum, BIDDER and SURETY agree to be bound, jointly and severally, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas BIDDER is about to submit a bid to AGENCY for the above -stated project, if said bid is rejected, or if said bid is accepted and a contract is awarded and entered into by BIDDER in the manner and time specified, then this obligation shall be null and void, otherwise it shall remain in full force and effect in favor of AGENCY. IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seal this _Ath _. day of October -12016, BIDDER* SURETY* Travelers Casualty_and Surety Company of America One Tower Sguare�Hartford, CT 061 S3 (7321321-5600 Rita Sagistan o, Attorney -f Fact Alli ant Insurance Services, Inc., $33 Earle Ovington Blvd, Suite 700, Uniondale, NY 11553 Subscribed and sworn to before me DnnnaMarieXis.sans this 4th day of 2016. 00NNAMAR19 A MISSANe Notary Public,01 State Now York Signature cue No.K16297783 Qualified in Nassau County Notary Public in and for the County of ___tiCommission Expires March 3, 2019assau ___ , State of New York * Provide BIDDER/ SURETY name, address, and telephone number and the name, title, address, and telephone number of authorized representative. P-8 ofP-17 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1199 0A:tt..x^.&'..C:e 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-----,.,. 10'7-16 .^__ before me,_Kristen Czupryn, Notary Public _ Date Here Insert Name and Title of the, Officer personally appeared William 13- Name( s) of Signers) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. KRISTEN RENEE CZL1pRYN WITNESS my hand and official seal. Ur Commission ix 1996022Notary Nbhu Californiaa�y Orange County �" Signator e morn az.Enq . w1°Y 25 2016 k signature of Not 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: Bid Bond„ Document Date: 104-16 Number of Pages: _ 1Signer(s) Other Than Named Above: Capacity(les) Claimed by Signer(s) Signer's Name: William B. Davenport GSI Corporate Officer -- Title(s):.Fxer VP & CFO _ ❑ Partner — ❑ Limited ❑ General ❑ Individual 11 Attorney in Fact Trustee f.1 Guardian or Conservator ❑ Other: Signer Is Representing: KDC Inc. dba By alectric___ Inc. dba KDC System_s._ ___ Rita Sagistana _ is Name: _ ni Corpo Officer — Title(s): 0 Pa tner — 'ted ❑ G LJ Individual 1 in Fact Trustee Guardian or ❑ Other _____ r Is Representing: 92014 National Notary Association - www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item tt5907 92014 National Notary Association - www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item tt5907 WARNING: 'THIS IS INVALID WITHOUT AW POWER OF A'I"FORNEY TRAVELERS J Farmington Casualty Cmnpan'v St, Paid Mercury Insurance Company Fidelity raid Guaranty Insnranee Company Travelers Casualty and Surety Cnnapaily Fidelity and Guaranty insurance under diel s, in'. Travelers Casualty and Surely Company of America St. Paul Fire, and ovlaldia Insurance ConpunyUrdtttl States Miley and Guaranty Company St. Paul Guardian Insurance Company At'lorney-In Fact NO, 229701 Cod ideate, No. 006912623 KNOW ALL MLN BY THESE' PRESENTS: That Farminilton Casualty Company, St. Paid fire and Murine hnamun:e Company, St. Paul Guardian himitanrce Company, SL Paul Mercury Insurance Company, Travelers Camattty and Surely Company 'Imyclers Casualty anal Surely Company of Arlie ica. and Unliml States Fidelity and Gu a airy Company are evaporations [luly organaxc[I andel the laws of [h Since ill Conn necrnt, that f of lin and Guai.lnly Insurance Company is a corp(maion duly rn,.atived under the taws of the Saute of low,, anti that Fidelity and Guatamty Insurance Lnderwt iter,, Inc_ is a corporation duly org.a'rrcd under the haws of (be State of Wisconsin (herein collectively called the "Companies'), Had that Iia Companies do hereby make, eorimituae and appoint Thomas Bean, Rita Sagistano, Gerard S. Macholz, Susan Lupski, Robert T. Pe irson, Camille Maitland. George O. Brewster, Colette R. Chisholm, Vincent A. Wilsh, Lee Fcrrucci, Desiree Cardlin, Nelly Renchiwich, and Mia Woo -Warren Of the City of UJQndale „- Sate of. _ New York 11a13r vue and law fat Auouic vas) -In -Fact, tach set then sep Irnc capacity d more than one is named aboveio sign, execute., seal and aCkilmvedge am,sad all bonds, iuognirances conditional undenakings and other writings obli mtory In the nature thereof oil behalf of tate Companies in (heir busiucns of ALIal atcung lilt, fidelity of persons. :uatranicv:inc the pvitornumce of contracts and executing or gmarnntechag bonds all(] undertakbag., required or peemina[I in any actions or proceedings allowed by law. r; IN WITNESS WHIEREOF, ate Companies have caused this imt...tlent ser be signed ;aid their carpmute seals ser be hcrem atFtza[I, this _- 2Sdi dayof- Ally . 2016 ....__ y Farmington Casualty Company ridelih' and Guaranty Insnraneli Company Fideflty and Guanmly linnitunce Underwriters, tile. St. Paul Fire and Marine Insurance Cnapory St. Pad Guardian Insurance CGnnpta y SL Patti Mercury Insurance Company 'travelers Casualty mid Surety Company Travelers Casualty and Surety Company of Ameriea U nitLd States IrideQty rill(] Guaranty Company agM1 .b."i+�wt„ �'cUtY,typr a3' 6 P NCfAa1XUaN 1 ^ t t moan s 3 rQ- I v a x 9 1977 r, 1t a tPiirrnnp rival 5 ++rtu s� glean. > SER.i.� coxa. �� '�F car:u ='l nese��,d �y nw ✓ D .S §` ,..,A" it,ts,,.r,✓'f �... °,..✓ rot " Aar w: b �r''»4,100 State of Connecticut Ciic of Hartford ss. JJ '/ Roloq 1.. Rana,, Senior Vita President On This the 29th _ tiny if_ilil2016 , befaa vie personals appuuad Robert L Rnncy, who ao(enovi ledged himself to be alta Savior Vice President of F'arminion Ciecuatty Company Fidelity and Guaranry brsurnncc ('o nintny. Fidelity and Gontmxy ingarIDCC Uodenvrnccs, lac -St. Peal Mon and Marine Insurance Company, St. Patti Guaidlan Insurance Company, St. Pard A4erca}' huunmce Compan).'Trmodcrs C:wualty and Surau Company, Travelers Cnsuahy mid Surety Company of America, sad United State, Fidelity and Guamnpy Company, and that he as such, being authorized m to do, c-xvcated the foregoing monument for the purposes thereon condoned by signing on behalf' of the cotpor2tions by himself it, a duly authorised ofi'icer In Witness Whereof, I hereunto set my haul and official seal. biv Commission expires the 30111 day of.funm 2021. '& Ail61tG 'b" 56440-5-16 Printed in U.S.A. \Itis ('f t rah \nun -Public --- TRAVELERS CASUAJ TY AND SURETY COWANY Or AMERICA HAJIT]TORD, CT, 06183 AT rOTSNEY-aN-PACT nSTITICATION PRBNCITAL'S ACKNOIYLEDGhfENT--IP A CORPORATION Stale oFNcw York, County of On Hit$ day of '20 , befors me torsionally spptarad lomeknown,who, being byme dulyswom, deposes and says: That he7she rashim in the City of , that ha7340 is dla of - flit corpomUon described in and which executed the within instrumanl; that hetsha knows the $eal of Sold corporallont that the seat Mutual] to said hla nconl is such continuous neat; that It was sa opined by order of the Board of Directors of said carpomllon, and that he/she sipped hlOW name thereto by like order, Slate of New York, County of PRINCIPAL'S ACKNOWLIMCNIENT—If INDCVBDUAL OR PIItM MW Coors day or ,20 , before me personatly nppcarod to me known to be (the individual) (one of flit Snn of ) described In and who saturated the wilbin instrument, and he/she Wercapoa duly acknowledged to at that Wshe encauted Dm soma (as the am and dead of said fins). SURETY CONIPANY'S ACKNONYLEBGMIENT Smltaf New Yeek, Couayof Nassau )IL OR Wis 4t11 dnyof October ,.2016befommepcoonmly up cited Rita Sagistan0 , to me known, who, being by me dulyswvarn, did depose and soy: That he/she resides In the County of Nassau, NY that heliho is Allamay-in-Fact of TWUYELERS CASUALTY AND SURETY COAR'ANY OR AMERICA, the cooperation described in and which bxecufed the within instrument: Brat he/she knows Use corporate nod of said Company; that the real ftMxeJ to sold Instrument Is such corporate such and U1at he/she signed sold instrument is Alicmeydn-Fact by authority of the Heard el'Diorelors ofsaid Company, and oRiant did Ndle r depose and say Wet the Supwiniondont of Discuss" of Use Shite of New Ymk has, puns ural to Chapter 612 at the Laws of the Slate of Naw York for the year 1939, constituting ahaptcr 23 of the Consolidating laws of the SIMa of'Nsw York m tho insurance Law &s amended, Issuer] to TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA hishor c4riifecala thal said Company Is qualified to become and be an6eplad W surety or suaramar on all bonds, undotakings, recognizances, guaranties, and other o ill no requht l or permitted by law; and thus such cadidcate has not been revoked. ll a IA _ A >_ Secorlims onrried At $7,695,598 In the above statement are deposited with public aulhodtles, as required by law TRAVELERS CASUALTY AND SURETY COMPANY OFAMERICA GONNAMARIIC A KISSANE Hanford, Connecticut 06161 Many puhllD, State of New Yuck FINANCIAL STATEMENT AS OF DECEMBER 31, 2015 No. 01KI62MB3 QUallifleAS FILED WITH THC INSURANCE DEPT. Of THE 5TA'�R. OF NEW.YORK Commission� IEnp1RD3 Marcssau h � 2018 CAPITAL STOCK $ 6,400,000 _ ASSETS LIABILITIES A SURPLUS CASHANDINVEOTEDCASH S ,M.M,551 UNEARNED PREMIUMS $ 562,837,466 BONDS 3,sn0,672,638 LOSSES 79.5,72071 STOCKS 24E,B0,111 tOOBAIi,25STMENT WENSES 278,9001166 INVESTMENT INCOME DURAND ACCRUED 43.006,720 COMMISSIONS 56,296,314 OTHER INVERTED ASSETS 3XIIAR76 TAXES.LICENSES ANU iE-E5 19,981,717 FREMIUM"'ANCE3 260,990,813 OTHRRENPENSES 30,463,867 14ETDET'ERRED TAX ASSET 05.751,126 CURRENT FEDERAL AND FOREIGN INCOMETAXES 14,16susto REINSURANCE RECOVERABLE 22,632,866 RRMrLTANCES AND ITEMS NOT ALLOCATED 4,685,722 SECURITIES LENDING REINVESTED COLLATERAL ASSETS 11,778,176 AMOUNTS WITHHELD I RETAINED BY COMPANY FOR OTHERS 33,059,653 RECEIVABLES FROM PARaNT, SUOSIOIARIES AND AFFILIATE 26,359,432 R67ROACRVE REINSURANCE RESERVE ASSUMED 698,144 GrHERAWETS 6,685,097 POLK YHOLDER DIVIDENDS 5,060,101 PROVISIONFOR REINSURANCE 3,831,304 ADVANCE PREMIUM 1,372,415 PAYABLE FOR SECURITIES 8,0001060 PAYABLE FOR recusurh7S LENDING 11,772,176 CEOW RONSURANCB NET PREMIUMS PAYABLE 26,0.75,326 ' ESOMAT LIABILITY 684,921 GTHERACCRUED EXPNSES AND LIABILITIES i 5350 ' TOTAL LIABILITIES 2001,00 IMI WITAL STOCK S 8,400,OW PND IN SURPLUS 433.805,700 QUIET BURF'LUs9._... 457,]17 Q_A_ _ 71V-95271-11 TOTAL SURPLUS TO FGLICYHOLPPRS i 2.l 99764 TOTALASSEI3 3 4,184,007,702 TGrALLIABILITIES&SURPLUai_d�d,',760., Secorlims onrried At $7,695,598 In the above statement are deposited with public aulhodtles, as required by law CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCIIOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) LIST OF SUB -CONTRACTORS Section 4100 et. seq, or 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: 1/2% of the bid or $10,000, whichever is greater o Buildings, parks, or other projects: ''/2% of the bid Section 1725.5 of the Public Contract Code requires all Subcontractors be registered with the State Department of Industrial Relations (DIR). BIDDER proposes to subcontract certain portions of the work to the firms listed below: Name S41nir/fSc'J /Et<- C Name License #/Exp. %/7572v 3 DIR Reg. #/Exp. 10600 Location (jy gha6v Phone %/q' y5'-2 �a Type Of Work Amount S Name License DIR Reg License Location Phone Type Of Amount Name f'k-c e License 4/Exp. DTR Reg. #/Exp. License # A- Location L,- Phone 540- Type Of Work Amount S7 Signature of License #/Exp. 7 DIR Reg. #/Exp. Location Phone Type Of Work Amount $ Name License #/Exp, DIR Reg, #/Exp. License # Location Phone Type Of Work Amount S Name License #/Exp. DIR Reg. #/Exp. License # Location Phone Type Of Work Amount S B. Davenport, Exec. VP, CFO, Trees. P-9 ofP-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCIIOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) REFERENCES The following are the names, addresses, and telephone numbers for THREE public agencies for which the BIDDER has performed similar work within the past three years. j, "Please See Attached Name and Address of Owner. 2. 3. Name and Telephone Number of person familiar with project. Contract Amount Name and Address of owner. Type of Work Name and Telephone Number of person familiar with project. Date Completed Contract Amount Type of Work Date Completed Name and Address of owner, 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. Alliant Insurance Services, Inc. 333 Earle Ovington Blvd„ Ste. 700 Uniondale, NY 11553-3610 Rita Sagistano 516-414-8900 P-10 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) ADDITIONAL REFERENCES The following are the names, addresses, and telephone numbers for THREE public agencies for which the BIDDER or Subcontractor has performed similar work in the past five years. I, "Please See Attached Name and Address of Owner. 2. Name and Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed Nance and Address of owner. Name and Telephone Number of person familiar with project, Contract Amount Name and Address of owner. Type of Work Name and Telephone Number of person familiar with project. 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Ma0Nn4 i 1 ' 0. 6haMNlon I f' 1 I I I I 1 I I i f 1 I f i j. I I r i I ! I i i I i j i 1 1 i I w kW Dynal ® eynaBClric _ MY tk9Ct711 RMnplay 1-082rAlpo C 0072bnua LreAwnitos, CA 60784,2630 Phone: 711828,700 Fm 714101.2586 Bidder's Experience and Qualifications Project Name/Number: Cerritos Ave. Widening Prosect #81 Project Description: Sitlnal modifrcati0n and street lighting Approx. Construction Date: From: x$014 To: 4/2014 Agency Name: City of Cvpress Contact Person: arren Williams Telephone: (951) 377:87a1 Original Contract Amount: (,g54 Final Contract Amoum:__ $4a pM_ If Final Amount is different from original, please explain (change orders, extra work, etc): _.---SaeriEaC11.�C:nrtk'aotoc,A.dded Qio_na to ,ih® ar�nra Did you file any claims against the Agency? Did the Agency lice any claims against you/Contractor? If yes, briefly explain and indicate outcome of claims:Na LAS 2 ProjectName/Nuntber: Soto+Al2gzar ProjectDeseription: Tra '�jgOga,tjjicr3(��ns Approx. Construction Data: From: _ 12013 To: —. 22= Agency Name: City of LOs Angeles !USC Contact Person: Marisa Morgan Telephone: (323) 442.3721 _ Original Contract Amount: $59 970 Final Contract Amount., --$26,395 1 mWdynadaxom If Final Amount is different from original, please explain (change orders, extra work, etc.): Change order for purchasing signal gear, controller and poles (not part of original scope) Did you file any claims against the Agency? Did the Agency file any claims against you/Contractor? If yes, briefly explain and indicate outcome of claims: No Project Name/Number: Highway Safety Improvement Program Project Description:_4_new alone and 1 left tum __ Approx, Construction Date: From: ;,1901 3To: Agency Name: City of Los Angeles ContaetPerson: M t,� Talaa Telephone: 213 305-1312 Original Contract Amount;_ f3Bfi„7 35 Final Contract Amoun1:__$,05A&a5 If Final Amount is different from original, please explain (change orders, extra work, etc,): —Ch araga-®rders to cove+-unit-p»c+taros t4ratixataed-frcariginal gtuatatities Did you file any claims against the Agency? Did the Agency file any claims against you/Contractor? If yes, briefly explain and indicate outcome of claims: __ Na a. 4 Project NamelNumber: 2012-2013 Traffic Signal Rehabllitahon #52.23 Project Description: Roadwork and signal rnodirlcatipn Approx. Construction Date: From: _ 212013 To: 6!2013 Agency Name:_ C of NewDort Beach Contact Person:—AMM-StyClair Telephone: (945) 283-7489 Original Contract Amouru: $20s saZ _ Final Contract Amount:-119?,8 If Final Amount is different from original, please explain (change orders, extra work, etc,); -->Larisunes iu quanti#ies nn items r Did you file any claims against the Agency? Did the Agency rile any claims against you/Contractor? If yes, briefly explain and indicate outcome of claims: __ No _. No�S Project Name/Nutnber: W mington ATSAC NQLE1907 000) Project Description:__Signals strc+et lights fiber _ Approx. Construction Date: From 6!2011 _ To: !12/2013 Agency Name: City of Los Attgeles Contact Person:_ Moises DelGadg_ Tel Original Contract Amount -_V 94 0056 _ Final Contract Amount:--Wlz0 62 If Final Amount is different from original, please explain (change orders, extra work, etc.): Change orders and extra wurk Did you file any claims against the Agency? Did the Agency file any claims against you/Conuactor? If yes, briefly explain and indicate outcome of claims: _,(fig ___ NQ, 6 Project Name/Number:_.pajniversel Pedestrianddge._ Project Description:, Lighting Approx. Construction Date: From: 4/2014 To: 112016 Agency Name: Griflltlt Company o/nLps Anaetes Metropolitan Transit Authority Contact Person: Telephow— f71j �01-Q(l�j Original Contract Amount:_$g24 580 _ Final Contract Amount: I inkotsitt•i..mgoing If Flnal Amount is different from original, please explain (change orders, extra work, etc.): Did you file any claims against the Agency? Did the Agency file any claims against you/Contractor? If yes, briefly explain and indicate outcome of claims: No CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENI-IACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) NON -COLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the BIDDER declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or share; that the BIDDER has not directly or indirectly induced or solicited any other BIDDER to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any BIDDER or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the BIDDER has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the BIDDER or any other BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of that of any other BIDDER, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, 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 Affidav` ,is part of the Proposal. BIDDERS arc cautioned that making a false tification may subject the certifiet to criminal prosecution. _ ,,� Signed State of California William W'Davenpor xec. VP, CFO, Trees. County of Subscribed and sworn to (or affirmcd) before me on this day of , 20 , by proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me Notary Public Signature "Please See Attached Jurat Notary Public Sea] P-12 of P-17 CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202 �c�s�-,sn �c;�. n^;.;;��:«��r�rsr.�.r,:eQrs..�,...,�� -� _.,:�cr�.m,�ssro..�,s .,, e��.�•�c>�.s C1 See Attached Document (Notary to cross out lines 1-6 below) 11 See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) Signature of Document Signer No. 1 Signature of Document Signer No. 2 (if any) A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of KRISTEN RENEE CTUPRYN Cammisslnn 1/ 1906022 _ Notary Public - Caiifamla z Orange Cnut tv t' my Comm Frni F Seal Place Notary Seal Above Subscribed and sworn to (oraffirmed) before me on this _ 7th — day of _.._.—C3ctober 20_16_.. by Date Month Year (1)_William ti. Davenport ._..__— (and Name(s) of Signers) proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. Signature Signature of Notary bile 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: _Non -Collusion Affidavit _ Document Date: 10-7-16 Number of Pages: _1 _.._ Signer(s) Other Than Named Above: 02014 National Notary Association - www.NationalNotary.oig - 1 -800 -US NOTARY (1-800-876-6527) Item #5910 CITY OF SANTA ANA PROPOSAL PROJECT NO,: 16.6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATFL- 5063(163) NON-DISCRIMINATION CERTIFICATE The undersigned contractor or corporate officer, during the performance of this contract, certifies as follows: The Contractor shall not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin, The Contractor shall take affirmative action to ensure that applicants are employed, and that employees are treated during employment without, regard to their race, color, religion, sex, or national origin. Such action shall include, but not be limited to, the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The Contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. 2. The Contractor shall, in all solicitations or advertisements for employees placed by or on behalf of the Contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. 3. The Contractor shall send to each labor anion or representative of workers with which he/she has it 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, 1.965, 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 riles, regulations, or orders, the contract may be canceled, terminated, or suspended in whole or in part and the Contractor may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Execution Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law. P-13 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL EN14ACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATFL- 5063(163) The Contractor shall include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontract or purchase order as the administering agency may direct as means of enforcing such provisions, including sanctions for noncompliance, provided, however, that in the event the Contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency, the Contractor may request that the United States enter into such litigation to protect the interests of the United States. 8. Pursuant to California Labor Code Section 1735, as added by Chapter 643 Stats. 1939, and as amended, no discrimination shall be made in the employment of persons upon public works because of race, religious creed, color, national origin, ancestry, physical handicaps, mental condition, marital status, or sex of such persons, except as provided ill Section 1420, and any contractor of public works violatin his Section is subject to all the penalties imposed for a violation of the Chapter. Signed: Title: William B. DaAeZnporl, EK44P, CFO, Treas. Firm: KDC Inc., dba Dyynalectric Date: P-14 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6$73 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECPNO: ATFL- 5063(163) 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: 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 mnnber of apprentices or the ratio of apprentices to journeymen stipulated in the apprenticeship standards. 3. Contribute to the fund or fluids 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 ec Tactors not signatory to the trust agreement shall pay a like amount to the California Ap euticeshi Council. Signed: Title: William B. Davenpo xec. CFO, Treas. Firm: KDC Inc., dba Dynalectric Date: P-15 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL. ENI,IACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) STATEMENT REGARDING "ANTI-KICTCBACK" REpUIRBMENTS 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 u 1lic work, to give up any part of the compensation to which he/she is otherwise entitled. Signed: Title: William Q. DKenport, Exec. VP, CFO, Treas. Firm: KDC Inc., db"a�Dynalectric Date: I G P-16 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the BIDDER shall complete, under penalty of perjury, the following questionnaire: Has the BIDDER, any officer of the BIDDER, or any employee of the BIDDER who has a proprietary interest in the BIDDER, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No X If the answer is yes, explain the circumstances in the following space. P-17 of P-17 MAYOR Miguel A. Pulido MAYOR PIRO TEM Vicente Sarmiento COUNCILMEMBERS Angelica Am ezcua P. David 6enavides Michele Martinez Roman Reyna Sal Tinajero September 29, 2016 M101=11MR11111 111119 Y OF SA CITNTA ANA 20 Civic Center Plaza M36 • P.O. Box 1988 M-36 Santa Ana, California 92702 (714)647--5013 Inrww Santa-ana. org CITY MANAGER David Cavazos CITY ATTORNEY Sonia R. Carvalho CLERK OF TFIE COUNCIL Maria D. Huizar PROJECT NO.Routes to School« Monte The following clarification is noted: « This project was originally advertised on August 26, 2016. Bids were due on September 26, 2016. Just prior to the bid opening it was determined that the plans may not been available long enough to allow for adequate review. Consequently bids were not opened and the project was re -advertised. « On the City web site for the Current Notices Inviting Bids for this project: Page v Notice Inviting Bids: Replace with the attached page v Notice Inviting Bids. (Project number was revised.) « The due date on the City website was corrected to show the due date of 10/10/16, not 10/16/16. The following changes have been made to Specifications for the subject project: «,. Page v Notice Inviting Bids: Replace with the attached page v Notice Inviting Bids. (Project number was revised.) All other terms and conditions remain the same. CITY OF SANTA ANA Edwin "William"a v7 E. City Engineer CANTA ANA CITY C W NCII. Migi,elA Aulirlo VioeMo- Sarnre lu bFcnalp MaiOnaz Nrgd,ca Flrt.easvm PD"d D.,,udes RomanReyna $nlIma'ere Mayar Mnyor Pro Tani Wartl l Wan12 WaN] Wani4 Wards Ward I'll)IW9 eLaArl1919 Via .11P e�san a.mr�oi5� ASAIrrpnezWva pg any rgg Akeza,sMeanla-na Muijgrdes,ad9la��nr RRgy Iafsa,ua3A S T-IWMII[itslna.: arca ;arg CITY OF SANTA ANA ADVERTISEMENT PROJECT NO.: 16-6873 SAFE ROUTES To SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATFL- 5063(163) CD Request for <project no> <project name> DO NOT CALL PURCHASING DIVISION UGARDING PUBLIC WORKS AGENCY PROJECTS. CALIFORNIA LABOR CODE: This project is subject to compliance monitoring and enforcement by the State of California Department of Industrial Relations, per Section 1771, .a.I. BIDDERS are required to inform themselves fully of the conditions relating to construction and labor under which the work will be performed. Any contract entered into pursuant to this notice will incorporate the provisions of the Calilbrnia State Lbor Code. In accordance with the California State Labor Code, prevailing wage rates apply. Copies of the prevailing rate of per diem wages are on file with the Public Works Agency and shall be made available to any interested party on request. A Contractor and any subcontractor must be registered with the Department of Industrial Relations prior to submitting a bid. "A contractor and tiny subcontractor shall not be qualified to bill on, be listed in a bidproposal, subject to the requirements of Section 4104 of the California Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualffred to perfoatin public work pursuant to Section 1725.5. Itis not a violation of'this section for an unregistered contractor to submit a bid that is authorized by Section 7029.1 tf the California Business and Professions Code or by Section 10164 or 20103.5 gf'the California Public Contract Code, provided the contractor is registered to perform public work pursuant to Section 1725.5 at the tune the contract is awarded. Information about registration can be found on the Department of Industrial Relations website at hu, ://www.dir.ca,gov/uublig_ .works/p b licwocks.hthil A bid will not be considered nor any contract or subcontract entered into without proof of the contract�lal 4d subcjuntractor's current registration to perform public work:. By: Director, Public Works Agency v Date: ( 3 Cil ( 6 Iynalectric An EMCOR Company ! Corporate Center Drive ilemitas, CA 907202530 GIF Dynalectric IF An EMCOR Company 4462 Corporate C'oorer Drive Los Armorer, CA 0D720-2536 "SEALED BID" FOR SAFE ROUTES i'O SCHOOL ENHANCEMENTS FOR MONTE VISTA ELEMENTARY (PROJECT NO. 16-5873) CITY OF SAN -A APIA PUBLIC WORKS RECEPTIONIST, 3C' FLOOR 20 CIVIC CENTER PLAZA, M-22 SANTA ANA, CA 927011°`.a Exhibit 3 CITY OF SANTA ANA CONSTRUCTION CONTRACT PROJECT N0, 16-6873 SAFE ROUTESTO SCHOOL ENHANCEMENTS FOR MONTE VISTA ELEMENTARY This CONSTRUCTION CONTRACT is made and entered into this 18`x' day of October. 2016 , 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 KDC INC. DBA DYNALECTRIC , hereinafter referred to as "CONTRACTOR", WITNESSETH: The CITY and the CONTRACTOR, for the consideration hereinafter named, mutually agree as follows: 1. 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 Safe Routes to School Enhancements for Monte Vista Elementary Project, hereinafter referred to as the "Work of Improvement" identified in and in accordance with the Contract Documents prepared by the City's Public Works Agency and approved by the City Council. 2. The complete Construction Contract consists of the "Contract Documents" as defined by the Standard Specifications for Public Works Construction and which include the following: • Notice Inviting Bids • Information to Bidders • Bid Proposal • Bid Bond • Contract Form • Contract Bonds • General Provisions • Special Provisions • Technical Provisions and Project Plans • Appendices In case of conflict between the Contract Documents, the precedence of documents shall be as established in the Standard Specifications for Public Works Construction. 3. CITY agrees to pay and CONTRACTOR agrees to accept in full payment to complete the Work of Improvement the sum total amount not to exceed $332,234 — Three Hundred Thirty two Thousand Two Hundred Thirty-four Dollars and no cents , as set forth and identified in the BID PROPOSAL, which is attached hereto and incorporated herein as Exhibit "A." Page 1 of 3 CITY OF SANTA ANA CONSTRUCTION CONTRACT PROJECT NO. 16-6873 SAFE ROUTES TO SCHOOL ENHANCEMENTS FOR MONTE VISTA ELEMENTARY The BID PROPOSAL contains a schedule of unit price(s) or lump sum(s) based on approximate quantities only, and the City does not expressly or by implication agree that the actual amount of work will correspond therewith, but reserves the right to increase or decrease the amount of any class or portion of the work or to omit portions of the work as may be deemed necessary or advisable. 4, CONTRACTOR agrees to complete the Work of Improvement within the time specified in the Time for Completion of Improvements section of the BID PROPOSAL (Exhibit "A") including commencing construction within the timeframe therein specified after issuance of a Notice to Proceed. 5. The CONTRACTOR will pay, and will require all subcontractors to pay, all employees on the Work of Improvement a salary or wage at least equal to the prevailing salary or wage established for such work as set forth in the wage determinations for this work in accordance with applicable State and Federal law. 6. CONTRACTOR shall, after award of this Contract, furnish 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. 7. CONTRACTOR shall, prior to the release of the performance and payment bonds or the retention payment, furnish a warranty performance and payment bond (Warranty Bond). Said Warranty Bond shall also be required as a condition of project acceptance. For projects up to $500,000, the Warranty Bond amount shall be the greater of $10,000 or 20% of the final contract price. For projects above $500,000, the Warranty Bond amount shall be the greater of $100,000 or 10% of the final contract price. 8. CONTRACTOR shall, after award of this Contract, furnish Certificates of Liability Insurance and Worker's Compensation Insurance as outlined in the General Provisions, to be approved by the CITY. Page 2 of 3 CITY OF SANTA ANA CONSTRUCTION CONTRACT PROJECT NO. 16-6873 SAFE ROUTES TO SCHOOL ENHANCEMENTS FOR MONTE VISTA ELEMENTARY IN WITNESS WHEREOF, the parties hereto have executed this Constriction Contract on the day and year first above written. ATTEST: MARIA D. HUIZAR Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney BY_� _._.._._..__._.. 7o Funk Assistant City Attorney CITY OF SANTA ANA: DAVID CAVAZOS City Manager RECOMMENDED FOR APPROVAL: Fred Mousavipour Executive Director, Public Works Agency CONTRACTOR: Page 3 of 3 COST ANALYSIS CONSTRUCTION OF THE PROJECT NO. 16-6873: SAFE ROUTES TO SCHOOL ENHANCEMENTS FOR MONTE VISTA ELEMENTARY Construction Contract $ 332,234.00 Contract Administration $ 21,200.00 Inspection and Testing $ 25,000.00 Contingencies $ 33,224.00 TOTAL ESTIMATED CONSTRUCTION COSTS $ 411,658.00 EXHIBIT 4 THE REGISTER This space for it ling stamp only 625 N GRAND AVE, SANTA ANA, CA 92701 Telephone (714) 796-7000 / Fax (714) 796-6059 PROOF OF PUBLICATION (2015.5 C.C.P.) State of Callfornla ) County of ORANGE ) ss Notice Type: BID - NOTICE INVITING BIDS Ad Descriptlon: SRS Enhancements for Monte Vista Elem I am a citizen of the United States and a resident of the State of California; I am over the age of eighteen years, and not a party to or interested in the above entitled matter. I am the principal clerk of the printer and publisher of the THE REGISTER, a newspaper published in the English language In the city of SANTA ANA, county of ORANGE, and adjudged a newspaper of general circulation as defined by the laws of the State of California by the Superior Court of the County of ORANGE, State of California, under date 11/19/1905, Case No. A21046. That the notice, of which the annexed is a printed copy, has been published in each regular and entire issue of said newspaper and not in any supplement thereof on the following dates, to-wlt: 09/26/2016, 10/03/2016 Executed on: 10/03/2016 At SANTA Al I certify (or declare) under penalty of perjury that the foregoing is true and correct. IIfIIII I VIIIIIIIII III VIIIIIII VIII VIIIIII II II II * A 0 0 0 0 0 4 2 2 7 0 1 5 CNS#: 2928843 PbSTED DEC 0 5 Mill ORANGE COUNTY '.gE IRDEROEPARTMEN' BY: MAYOR Miguel A. Pulldo MAYOR PRO 11W Sal Trialaro COUNCIL MEMBERS Angelloa Annezoun P, David BenavIdes Michele Martinez Roman A. Rayne Vincent R Sarmlento Recorded in Official Records, Orange County Hugh Nguyen, Clerk -Recorder NO FEE $ R 0 0 0 7 1 4 1 7 2 1 201485001140 9:25 am 12105114 281 OR02 Z01 0.00 GOLOO 0.00 0.00 0,00 0,00 0.00 0.00 �A �1111 IM CITY MANAGER David Cavazos CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Marta D. Hulzar PLANNING & BUILDING AGENCY 20 Civic Center Plaza (M-20) DEC 0 5 2014 P.O.BOX 1088 Santa Ann, California 92702 HUGU NGUYEN, CIL K -RECORDER (714) 667.2700 - Fax (714) 973-1461 www.annita-ari NOTICE OF EXEMPTION By*DEPUTY From the Requirements of the California Environmental Quality Act (CEI)' Fee Exemption per California Government Code Section 6103 To: COUNTY CLERK From: City of Santa Ana County of Orange Planning & Building Agency RO. Box 238 20 Civic Center Plaza M-20 Santa Ana, CA 92702 Santa Ana, CA 92702 Project Title: Safe Routes to School - Monte ®ate ofApproval: 1,1/18/2014 Project Number(s): PWA -2014 -1492 -CITY Project Location: 1 CityWide (Partial) Cftyo Santa Ana County: Orange ER Number: ER -2014-161 Project Description: This project will install new, left turn traffic signals at Raitt Street at McFadden Avenue; install curb extensions, upgrading wheelchair ramps and educational safety outreach programs. Applicant Name: Zdenek KekUl@ / City of Santa Ana Applicant Address: 20 Civic Center Plaza M-43 SANTA ANA, CA 92702 Name of Public Agency Approving Project: City Council Name of Person or Agency Carrying Out Project: Kelkula,Zdenek Exempt Status: • Ministerial (Sec, 15268) • Declared Emergency (Sec. 15269 (a)) • Emergency Project (Sec. 15269 (b through a)) • General Rule (Sec. 1506'1(b)(3)/(5)) * Statutory Exemption: * Categorical Exemption: 15301(c) Reason(s) Why Project is Exempt From CEQA: 15301(c) consists of operation, repair, maintenance or minor alteration of existing public streets, sidewalks, gutters, bicycle and pedestrian trails ans simillar facilities. City Contact: Zdenek Kekula Telephone: (714) 647-5606 Signature: C Date: Title: SANTA ANA CITY COUNCIL Miguel A Pulido Sal ripaiero vwcont F $arinfento Mirehelaelarunez Angelica AM04MIA P DoM tiensodes Rman Reyna Mayor Mayer Pro Tarn, V111M 6 Ward I Word 3 I/Vard'I "W'd 5 f IM 17 2017 Exhibit 3 0: Michael Ortiz CITY OF SANTA ANA PWA( /) CONSTRUCTION CONTRACT PROJECT NO. 16-6873 SAFE ROUTES TO SCHOOL ENHANCEMENTS FOR MONTE VISTA ELEMENTARY NOV 2 2 2016 This CONSTRUCTION CONTRACT is made and entered into this 181h day of October. 2016 , 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 KDC INC. DBA DYNALECTRIC , hereinafter referred to as "CONTRACTOR". WITNESSETH: The CITY and the CONTRACTOR, for the consideration hereinafter named, mutually agree as follows: 1, 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 S fe Routes to School Enhancements for Monte Vista Elementary Project, hereinafter referred to as the "Work of Improvement" identified in and in accordance with the Contract Documents prepared by the City's Public Works Agency and approved by the City Council. 2. The complete Construction Contract consists of the "Contract Documents" as defined by the Standard Specifications for Public Works Construction and which include the following: • Notice Inviting Bids • Information to Bidders • Bid Proposal • Bid Bond • Contract Form • Contract Bonds • General Provisions • Special Provisions • Technical Provisions and Project Plans • Appendices In case of conflict between the Contract Documents, the precedence of documents shall be as established in the Standard Specifications for Public Works Construction, 3. CITY agrees to pay and CONTRACTOR agrees to accept in full payment to complete the Work of Improvement the sum total amount not to exceed $332,234 — Three Hundred Thirty- two Thousand Two Hundred Thirty-four Dollars and no cents , as set forth and identified in the BID PROPOSAL, which is attached hereto and incorporated herein as Exhibit "A." Page I of 3 CITY OF SANTA ANA CONSTRUCTION CONTRACT PROJECT NO, 16-6873 SAFE ROUTES TO SCHOOL ENHANCEMENTS FOR MONTE VISTA ELEMENTARY The BID PROPOSAL contains a schedule of unit price(s) or lump sum(s) based on approximate quantities only, and the City does not expressly or by implication agree that the actual amount of work will correspond therewith, but reserves the right to increase or decrease the amount of any class or portion of the work or to omit portions of the work as may be deemed necessary or advisable. 4. CONTRACTOR agrees to complete the Work of hnprovement 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. 5. The CONTRACTOR will pay, and will require all subcontractors to pay, all employees on the Work of Improvement a salary or wage at least equal to the prevailing salary or wage established for such work as set forth in the wage determinations for this work in accordance with applicable State and Federal law. 6. 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 famished (Payment Bond). This Contract shall not become effective until such bonds are supplied to and approved by the CITY. 7. CONTRACTOR shall, prior to the release of the performance and payment bonds or the retention payment, furnish a warranty performance and payment bond (Warranty Bond), Said Warranty Bond shall also be required as a condition of project acceptance. For projects up to $500,000, the Warranty Bond amount shall be the greater of $10,000 or 20% of the final contract price. For projects above $500,000, the Warranty Bond amount shall be the greater of $100,000 or 10% of the final contract price. 8. CONTRACTOR shall, after award of this Contract, furnish Certificates of Liability Insurance and Worker's Compensation Insurance as outlined in the General Provisions, to be approved by the CITY. Page 2 of 3 CITY OF SANTA ANA CONSTRUCTION CONTRACT PROJECT NO. 16-6873 SAFE ROUTES TO SCHOOL ENHANCEMENTS FOR MONTE VISTA ELEMENTARY IN WITNESS WHEREOF, the parties hereto have executed this Construction Contract on the day and year first above written. ATTEST: / � �2�mznAel� N f y MARIA D. HUIZAR ffff Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney BY �� J019 Funk Assistant City Attorney CITY OF SANTA ANA: DAVID •S City Manager RECOMMENDED FOR APPROVAL: Director, Public Works Agency rnhrrn A rTnR Page 3 of 3 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 Exhibit A SAFE ROUTES TO SCHOOL ENRACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) BID PROPOSAL TO: CITY COUNCIL OF THE CITY OF SANTA ANA FROM: KDC Inc., dba Dynalectric 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 sums) set forth in the following schedule: Item Description Qty Unit Unit Price Amount 1 Traffic Signal Modification at McFadden 1 LS $ $ Ave and Raitt Street 7�?qS r "73I "-%%f - 2 GTT Opticom Emergency Vehicle System 1. LS $ 9, 411?Preemption $ 3 Install 2" PVC Conduit Per Plan * 100 LF 4 Install 3" PVC Conduit Per Plan * 2075 LF $ $ 5 an * Install 4" PVEBox* 400 LF &7- 7-6 6 Install No. 6 13 EA $ 72-7—' $ � 11 7 Install Traffic Signal Loop Detector (Type E Loop)LCG- 21 EA $ $ 8 Install Bicycle Loop Detector (Type D Circular Loop) 12 IIA $ 3 'V—.2 $ � �7 9 24 Strand SMFO Cable 3800 LF $ l 2 .3 $ ea 770 10 Fusion Splice 1 Strand SMFO 96 EA $�„ /76-50— $ 11 IP Communication System 1 LS $ $ 00& — 12 Signing and Striping 1 LS $ �26y �- $ � ZP✓y/'' 13 Construct 4" PCC Sidewalk 1,740 SF $ T?' $ P-1 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 Exhibit A SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) Item Description Qty Unit Unit Price Amount 14 Constnrction PCC Curb Ramp 1260 SF $I3•c�i $/'7 /fir'_" 15 AC Pavement 30 TN $ $ a 16 Fothole For Utilities Not Shown on Plans ] 0 EA _ 17 Pothole For Traffic Signal Equipment Utility Conflicts 4 S.A $ e7�3 z, $�.J j 3 a 18 Unclassified Excavation* 130 CY $ 19 PCC Curb and Gutter (Type A-2-8) 200 LF $ 20 PCC Driveway Approach (Commercial) 400 SF $ 21 Temporary Overhead Wiring 1 LS 22 Crosswalk Drainage System 1 LS $ $ --••�� P-2 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 Exhibit A SAFE ROUTES TO SCHOOL F,NHACEMENTS FOR.MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) TOTAL BASE BID The lowest responsible bidder, shall be selected based oil the total base bid. The City reserves the right to award the Base .Bid, and any, all, or none of the add -alternate bid items (if any). * The quantity for this bid item is shown 'for bid comparison only. This bid item shall not be subject to the "25%" limit as stated in Section 3-2 of the Standard Specifications. The actual 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. 1 This bid item is considered a Specialty I'ten a Per Section 2=3.2 of the Standard Specifications, TIME FOR COMPLETION OF IMPROVEMENTS AND LIQUIDATED DAMAGES The undersigned bidden- hereby proposes to complete the Work for the total base bid amount shown above, within 80 (eighty) working us after the commencement date stated iu the Notice to Proceed, The liquidated damages amount, in lieu of the amount specified in Subsection 6-9 of the Standard Specifications, shall be $1,000 per ealcndarjlay. Name of Firm KDC Inc., dba Dynalectric Signature of BIDDER Title William B. Davenport, Exec, VE FO, Trees, (If an individual, so state, If a firm or cc -partnership, state the firm name and give thc names of all individual co-partners composing tlic firm. If a corporation, state legal name of corporation _ and names of President, Secretary, Treasurer and Manager, thereof,) "Please See Attached P-3 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATFL- 5063(163) BID PROPOSAL TO: CITY COUNCIL OF THE CITY OF SANTA ANA FROM: KDC Inc., dba Dynalectric REQUIREMENT: The undersigned bidder declares that they have carefully examined the location of the proposed work, that they have examined the Contract Documents in its entirety and hereby proposes to furnish all material and do all the work required to complete the said work in accordance with said plans (if any) and the specifications for the unit price(s) or lump sum(s) set forth in the following schedule: Item Description Qty Unit Unit Price Amount 1 Traffic Signal Modification at McFadden Ave and Raitt Street 1 LS $ ��� %�/� $ % jl % 1J 2 GTT Opticmn Emergency Vehicle 1 LS $ ` 0� `i �l I $ J �� `f Preemption System ! 3 Install 2" PVC Conduit Per Plan * 100 LF $�..� $ Y 4 Install 3" PVC Conduit Per Plan * 2075 LF $ $ 5 Install 4" PVC Conduit Per Plan * 400 LF $ $ 6 Install No. 6 Pull Box * 13 EA $,-7 � _ $ � ,177- 7 Install Traffic Signal Loop Detector (Type E Loop) 21 EA $ $ / -- 8 Install Bicycle Loop Detector (Type D Circular 12 EA $ $ , Loop) 9 24 Strand SMFO Cable 3800 LF $ 2,3( $/ , 70 _ 10 Fusion Splice 1 Strand SMFO 96 EA $ /-7- $ /,&so 11 IP Communication System I LS $ $ 0/ COO 12 Signing and Striping I LS $ $ 13 Construct 4" PCC Sidewalk 1,740 SF $ $� P-1 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) Item Description Qty Unit Unit Price Amount 14 Constriction PCC Curb Ramp 1260 SF $ $ 15 AC Pavement 30 TN $ 238 00 $ % lCo y " 16 Pothole For Utilities Not Shown on Plans 10 EA $ $ 17 Pothole For Traffic Signal Equipment Utility Conflicts 4 EA $ //093-- $ 33 2 r 18 Unclassified Excavation * 130 CY $ /7/- 7/`19 $ 19 PCC Curb and Gutter (Type A-2-8) 200 LF $ $ 20 PCC Driveway Approach (Commercial) 400 SF S 21 Temporary Overhead Wiring 1 LS $S $ p 22 Crosswalk Drainage System 1 LS $ 7 �S":G' $ _ --77, (1 P-2 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) TOTAL BASE BID $ 7 �� 2—_3q- The _3q The lowest responsible bidder shall be selected based on the total base bid. The City reserves the right to award the Base Bid, and any, all, or none of the add -alternate bid items (if any). The quantity for this bid item is shown for bid comparison only. This bid item shall not be subject to the "25%" limit as stated in Section 3-2 of the Standard Specifications. The actual amount for this item will be dictated by the actual quantity used, and the Agency reserves the right to increase or decrease the quantity of this item accordingly. T This bid item is considered a Specialty Item per Section 2-3.2 of the Standard Specifications. TIME FOR COMPLETION OF IMPROVEMENTS AND LIQUIDATED DAMAGES The undersigned bidder hereby proposes to complete the Work for the total base bid amount shown above, within 80 (eighty) working dates after the commencement date stated in the Notice to Proceed. The liquidated damages amount, in lieu of the amount specified in Subsection 6-9 of the Standard Specifications, shall be $1,000 per calendar ay. Name of Firm KDC Inc., dba Dynalectric Signature of BIDDER Title William B. Davenport, Exec. VMFO, Treas. (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.) **Please See Attached P-3 of P-17 WRITTEN CONSENT OF THE SOLE DIRECTOR AND SOLE SHAREHOLDER OF KDC INC, Pursuant to sections 307(b) and 603 of the General Corporation Law of the State of California, and in lieu of annual meetings of the sole Shareholder and of the sole Director of KDC Inc., a California corporation ("the Corporation"), the undersigned sole Shareholder and sole Director of the Corporation do hereby consent to, and adopt, the following resolutions: RESOLVED, that the sole Director, pursuant to the Bylaws of the Corporation, does hereby fix the number of directors of the Corporation at one director; and RESOLVED, that R. Kevin Matz be and he hereby is, elected by, the sole Shareholder of the Corporation, the sole Director of the Corporation for a term of one year or until his successor shall have been elected and qualified or his earlier resignation or removal. RESOLVED, that all acts, contracts and agreements on behalf of the Corporation made, taken or authorized by the sole Director and the officers of the Corporation since the date of the last meeting of, or written consent in lieu thereof by, the sole Shareholder of the Corporation are hereby adopted, approved and ratified by the sole Shareholder. RESOLVED, that the following named persons be, and each hereby is, elected, by the sole Director, to the respective office indicated opposite such person's name below to serve as such until the next annual meeting or until their respective successor is elected and qualified or such officer's earlier resignation or removal: Officer Name Michael J. Parry R. Kevin Matz Joseph C. McCormick William B. Davenport Dusty Lord Wayne Gantt Matthew Thornton Susan Henri Mark M. Porto DATE: April 4, 2016 R. Kevin Matz, Di for Title Chief Executive Officer, President Vice President Asst. Vice President and General Counsel CFO, Executive Vice President and Treasurer Secretary Vice President Vice President — General Superintendent Assistant Secretary Assistant Secretary SOLESHAREHOLDER: Dyn Specialty Contracting Inc. R. Kevin Matz, cc Presi ent CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) 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 famish 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. Name of Firm KDC Inc., dba Dynalectric Signature of BIDDER Title William B. Davenport, Exec. VP, CFO, Treas. (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.) "Please See Attached P-4 of P-17 WRITTEN CONSENT OF THE SOLE DIRECTOR AND SOLE SHAREHOLDER OF KDC INC. Pursuant to sections 307(b) and 603 of the General Corporation Law of the State of California, and in lieu of annual meetings of the sole Shareholder and of the sole Director of KDC Inc., a California corporation ("the Corporation"), the undersigned sole Shareholder and sole Director of the Corporation do hereby consent to, and adopt, the following resolutions: RESOLVED, that the sole Director, pursuant to the Bylaws of the Corporation, does hereby fix the number of directors of the Corporation at one director; and RESOLVED, that R. Kevin Matz be and he hereby is, elected by, the sole Shareholder of the Corporation, the sole Director of the Corporation for a term of one year or until his successor shall have been elected and qualified or his earlier resignation or removal. RESOLVED, that all acts, contracts and agreements on behalf of the Corporation made, taken or authorized by the sole Director and the officers of the Corporation since the date of the last meeting of, or written consent in lieu thereof by, the sole Shareholder of the Corporation are hereby adopted, approved and ratified by the sole Shareholder. RESOLVED, that the following named persons be, and each hereby is, elected, by the sole Director, to the respective office indicated opposite such person's name below to serve as such until the next annual meeting or until their respective successor is elected and qualified or such officer's earlier resignation or removal: Officer Name Michael J. Parry R. Kevin Matz Joseph C. McCormick William B. Davenport Dusty Lord Wayne Gantt Matthew Thornton Susan Henri Mark M. Porto DATE: April 4, 2016 R. Kevin Matz, Di for Title Chief Executive Officer, President Vice President Asst. Vice President and General Counsel CFO, Executive Vice President and Treasurer Secretary Vice President Vice President — General Superintendent Assistant Secretary Assistant Secretary SOLESHAREHOLDER: Dyynn Specialty Contracting Inc. R. Kevin Matz, cc Presi ent CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063 (163) 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: KDC Inc., dba Dynalectric Business Address: 4462 Corporate Center Dr., Los Alamitos, CA 90720 Business E -Mail Address: bdavenport@dyna-la.com Telephone: 714-828-7000 State Contractor's License No. and Class: 550173 A, C10 License Expiration Date: 12/31/2016 State Dept. of Industrial Relations (DIR) Registration No.: 1000001129 State Dept. of Industrial Relations Registration Expiration Date: Signed: 06/30/2017 Title: William B. Davenport, ExecRP, CFO, Treas. P-5 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) 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 t ie and correct. Name of Firm KDC Inc., dba Dynalectric Signature of BIDDER Title William B. Davenport, Exec. VP, CFO, Trees. (if an individual, so state) P-6 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) OWNERSHIP AFFIDAVIT STATE OF CALIFORNIA ) COUNTY OF ORANGE ) SS: CITY OF SANTA ANA ) William B. Davenport, Exec. VP, CFO, Trees. , being duty 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 be is of: KDC Inc., dba Dynalectric a corporation which is malting the foregoing proposal: ❑ JOINT VENTURE That he is of one of the parties making the foregoing proposal as a joint venture, and the he/she has been and is duly vested with the authority to execute instruments for an on behalf of the parties making said bid who are: that such a bid is genuine Aa not collusive or sham, and has not in any manner sought by collusion to secure any aZ7antage against the City of Santa Ana or any person interested in the proposed contract, for self oi;any other person. Signature o tdder William B. Davenport, Exec. VP, CFO, Trees. Subscribed and sworn to before me this day of 20 _ Signature of officer Administering Oath (Notary Public) P-7 of P-17 "Please See Attached Jurat CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE .: ¢. .me.m .m .m .m me.m .m .m .nv� .w .m .m .a¢..i..� .mv�e..- m .a¢.m .m . .me.m a�•,m ,m .. ❑ See Attached Document (Notary to cross out lines 1-6 below) ❑ See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) Signature of Document Signer No. 1 Signature of Document Signer No. 2 (if any) A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California Subscribed and sworn to (or affirmed) before me County of Orange on this 7th day of October 20 16 by Date Month Year (1) William B. Davenport (and Name(s) of Signer(s) KRISTEN RENEE CZUPRYN proved to me on the basis of satisfactory evidence Commission # 1996022 to be the person(s) who appeared before me. z ;'m Notary Public - California z Orange County My comm. Expires Nov 25, 2016 Signatur AJ I If In BZA� Signature of lidary Seal Place Notary Seal Above OPTIONAL though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Ownership Affidavit Document Date: 10-7-16 Number of Pages: 1 Signer(s) Other Than Named Above: None 02014 National Notary Association - www.NationaiNotary.org • 1 -800 -US NOTARY (1-800-876-6827) i CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) 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: '/2% of the bid or $10,000, whichever is greater o Buildings, parks, or other projects: '/2% of the bid Section 1725.5 of the Public Contract Code requires all Subcontractors be registered with the State Department of Industrial Relations (DIR). BIDDER proposes to subcontract certain portions of the work to the firms listed below Name ��°i�/�Scv���cGi 2 C Name License #/Exp. (9/'{572, 3/g/ /7 License#/Exp. DIR Reg.#/Exp. 0(5 as C;) /&/0 % DIR Reg.#/Exp. Location _4/34// 0,a/47-)!5�'C, (°� Location Phone 7/ q - y'y'7- F5 r("' Phone Type Of Work &C-Psl Type Of Work Amount $ 1�'7�z ' Amount $ Name OAA,�6y C� �,, Z �,a,�� Name License #/Exp. 3q(�O », -3 9/ License #/Exp. DIR Reg. #/Exp. 1vvoao 3Z? j&2 DIR Reg. #/Exp License # 3 q4, o `ZS r License # Location f. , Location Phone --7/-(039-VS- O Phone Type Of Work Type Of Work Amount $ 37 -CO Amount $ Name �Xce 11 /fv Name License #/Exp. 4702'&' ' rj �/ /� License #/Exp. DIR Reg. #/Exp. /voanf;, 4 30 Ll DIR Reg. #/Exp. License # &Pe- o 0 License # Location La,q ge�c/ 64— Location Phone ��Z - Phone Type Of Work c r Type Of Work Amount $ RJ. Sj7ti - Amount $ Signature of offider Mjilliam B. Davenport, Exec. VP, CFO, Treas. P-9 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) REFERENCES The following are the names, addresses, and telephone numbers for THREE public agencies for which the BIDDER has performed similar work within the past three years. 1, "Please See Attached Name and Address of Owner. Name and Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed 2. Name and Address of owner. Name and Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed 3. Name and Address of owner. 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. Alliant Insurance Services, Inc. 333 Earle Ovington Blvd., Ste. 700 Uniondale, NY 11553-3610 Rita Sagistano 516-414-8900 P-10 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) ADDITIONAL REFERENCES The following are the names, addresses, and telephone numbers for THREE public agencies for which the BIDDER or Subcontractor has performed similar work in the past five years. 0 3. "Please See Attached Name and Address of Owner. Name and Telephone Number of person familiar with project. Contract Amount Name and Address of owner. Type of Work Naive and Telephone Number of person familiar with project. Contract Amount Name and Address of owner. Type of Work Telephone Number of person familiar with project. 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A$5626 TEL None is f r FAX 0W270.0161 07x100 �MALBNNIkklVO.836O0T0LEE7 (: Purdwle ONw NO. Db889FOP j C. wu93m1 1� ; G6ya18eMe Momo6 WaWlb 66V 8 40 EI taa)Aaka.sL 4Wk 3W �keNF MMIce. CA00161 -.TEL MMfa. CA8Wi - L Mm�. TE 0J6&TNI N8366 �,.. FAN: Norb &MIL ;. EM1UIL:MnYda11NN8a1nyavael 364087 ROCNPAEEL THREE 6NWAL LOCATI0N4 A6MNNbn CabDTW Proie6ebn11 P0N No.1 IxMOro el h1G16 � /Re6w a 0m"A"l Enpreeh6 948 O6ekaN Aw.,lMBE i' MOWeM. CA 04316 W Pomp, CA 6/740 I TEL Nww i'' TEL, 606.8101330 X106 r: FAN: 84Nm 1.- FAIC4246101344 I i i I i ; I L I � I I 1 I f I � � I t 1 I j ' 1 1 j I ; 1 i I I ' - Dynaleadc DynaMc0k 4482 Corpwato Center Dnw An 69 000 Company Lm Mw tm, CA 90720.2539 Phare: 714829.7000 Fax 7144842355 Bidder's Experience and Qualifications NO, I Project Name/Number:_Cerritos Ave. Widening Project #81 Project Description; gignal modification and street lighting Approx. Construction Date: From: 2/2014 To: 412014 Agency Name:___City of Cypress Contact Person: Warren Williams Telephone: (951) 3Z7-8781 Original Contract Amount: $4fi 85e1 Final Contract Amount: $4R,0RR _ If Final Amount is different from original, please explain (change orders, extra work, etc.): Did you file any claims against the Agency? Did the Agency file any claims against YOU/Contractor? If yes, briefly explain and indicate outcome of claims: _ Nn &U-2 Project Name/Number: Soto + Aleazar Project Description: Traffic signal 4r%ffiioations Approx. Construction Date: From: _ 8/2013 To: —2/2013 Agency Name: City of Los Angeles / USC Contact Person:_pgeria%Jlorgan Telephone: (323) 442-3721 Original Contract Amount:, 59 970Final Contract Amount.__$gLM 1 Aw dywla.cmn If Final Amount is different from original, please explain (change orders, extra work, etc.): Change order for purchasing signal gear, controller and poles (not part of original scope) Did you file any claims against the Agency? Did the Agency file any claims against you/Contractor? If yes, briefly explain and indicate outcome of claims: _ No No. 3 Project Name/Number: Highway Safety Improvement Program Project Description: 4 new signals and 1 left turn Approx. Constriction Date: From: 5/2p13 TO: 3/2044 Agency Name:_ City of Los Angeles Contact Person:_ Mat Talag Telephone: (213) 305-1312 Original Contract Amount: $fia5,735 Final Contract Amount: 35 If Final Amount is different from original, please explain (change orders, extra work, etc.): --Gktange orders-is-raver-ustii-pxice--iterxis-thatvatted-from-original quantities Did you file any claims against the Agency? Did the Agency file any claims against you/Contractor? If yes, briefly explain and indicate outcome of claims: ___No _ Np. 4 Project Name/Number: 2012-2013 Traf c $igna_i Rehabilitation #5223 Project Description:_ Roadwork and signal modification Approx. Construction Date: From: 272013 _ To: 6/2013 Agency Name: City of Newport Beach Contact Person:__ Mike St. Clair Telephone: (949) 283-7488 Original Contract Amount: $2 5ti7 Final Contract Amount: $197,847 If Final Amount is different from original, please explain (change orders, extra work, etc.): Did you file any claims against the Agency? Did the Agency file any claims against you/Contractor? If yes, briefly explain and indicate outcome of claims: ___No No -. -S Project Name/Number: Wilmington ATSAC (WO# E1907400) _ Project Description: Signals, street lights, fiber Approx. Construction Date: From: 812011 To: 1212013 Agency Name: City of Los Angeles Contact Person: Moises DelGado Telephone:. (M) 391-32>3.U_� Original Contract Amount: $7,943.056 _ Final Contract Amoum:__sco3o,62__ If Final Amount is different from original, please explain (change orders, extra work, etc.): Change orders and extra work Did you file any claims against the Agency? Did the Agency file any claims against you/Contractor? If yes, briefly explain and indicate outcome of claims: No No. 6 ProjectName/Number: MIA_ Universal PederJdan_Bddg0 — Project Description: Lighting Approx. Construction Date: From: 4/2014 To: 1/2016 Agency Name: Griffith Company c/o Los Angeles Metropolitan Transit Authority Contact Person: Wayne Gantt . Telephone: (310) 901-0062 Original Contract Amount: $324,580 --Final Contract Amount:j1nk0wn nn.going If Final Amount is different from original, please explain (change orders, extra work, etc.): Did you file any claims against the Agency? Did die Agency file any claims against you/Contractor? if yes, briefly explain and indicate outcome of claims: No CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) NON -COLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the BIDDER declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the BIDDER has not directly or indirectly induced or solicited any other BIDDER to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any BIDDER or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the BIDDER has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the BIDDER or any other BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of that of any other BIDDER, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, 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 Al cautioned that making a false prosecution. I/ Signed part of the Proposal. BIDDERS are >n may subject the certifiet to criminal State of California William 13:°DavenportPl='xec. VP, CFO, Trees. County of Subscribed and sworn to (or affirmed) before me on this day of , 20 , by , proved to me on the basis of satisfactory evidence to be the person (s) who appeared before me Notary Public Signature *"Please See Attached Jurat Notary Public Seal P-12 of P-17 CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT . , ,, ❑ See Attached Document (Notary to cross out lines 1-6 below) ❑ See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) Signature of Document Signer No. I Signature of Document Signer No. 2 (f any) A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange KRISTEN RENEE CZUPRYN _ Commission # 1998022 Zi Notary Public - California z � OOrange,z County ? - - -'r'®'�•w�wv�asN «rev^u m p Subscribed and sworn to (or affirmed) before me on this 7th day of October 20 16 by Date Month Year (1) William B. Davenport (and Name(s) of Signers) proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. ID Signature Signature of Notary Public Seal Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Non -collusion Affidavit Document Date: 10-7-16 Number of Pages: 1 Signer(s) Other Than Named Above: None 02014 National Notary Association • www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5910 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) 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 mules, 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 Govenmrent contracts or federally assisted construction contracts in accordance with procedures authorized in Execution Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law. P-13 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) The Contractor shall include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontract or purchase order as the administering agency may direct as means of enforcing such provisions, including sanctions for noncompliance; provided, however, that in the event the Contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency, the Contractor may request that the United States enter into such litigation to protect the interests of the United States. 8. Pursuant to California Labor Code Section 1735, as added by Chapter 643 Stats. 1939, and as amended, no discrimination shall be made in the employment of persons upon public works because of race, religious creed, color, national origin, ancestry, physical handicaps, mental condition, marital status, or sex of such persons, except as provided in Section 1420, and any contractor of public works violatin liis Section is subject to all the penalties imposed for a violation of the Chapter. Signed: Title: William B. D enport, E P, CFO, Treas. Firm: KDC Inc., dba Dynalectric Date: IDA -L2 1 if - P -14 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063 (163) 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: 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. 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 c9affactors not signatory to the trust agreement shall pay a like amount to the California Apprenticeship Council. Signed: Title: William B. Davenpo xec.'K, CFO, Treas. Firm: KDC Inc., dba Dynalectric Date: I I � P-15 of P-17 CITY Or SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) 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 ofdu�lic work, to give up any part of the compensation to which he/she is otherwise entitled. Signed: Title: William B. D&Genport, Exec. VP, CFO, Trees. Firm: KDC Inc., dba Dynalectric Date: l b ` - 1 VJ P-16 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(163) PUBLIC CONTRACT CODE SECTION 10162 OUESTIONNAIRE In conformance with Public Contract Code Section 10162, the BIDDER shall complete, under penalty of perjury, the following questionnaire: Has the BIDDER, any officer of the BIDDER, or any employee of the BIDDER who has a proprietary interest in the BIDDER, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No X If the answer is yes, explain the circumstances in the following space P-17 of P-17 MAYOR Miguel A. Pulido MAYOR PRO TEM Vicente Sarmiento COUNCILMEMBERS Angelica Amezcua P. David Benavides Michele Martinez Roman Reyna Sal Tlnajero September 29, 2016 ADDENDUM No. ONE CITY OF SANTA ANA 20 Civic Center Plaza M-36 a P.O. Box 1988 M-36 Santa Ana, California 92702 (714) 647-5013 www.santa-ana ora CITY MANAGER David Cavazos CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar SUBJECT: PROJECT NO. 16-6873: Safe Routes to School Enhancements For Monte Vista Elementary The following clarification is noted: This project was originally advertised on August 26, 2016. Bids were due on September 26, 2016. Just prior to the bid opening it was determined that the plans may not been available long enough to allow for adequate review. Consequently bids were not opened and the project was re -advertised. On the City web site for the Current Notices Inviting Bids for this project: Page v Notice Inviting Bids: Replace with the attached page v Notice Inviting Bids. (Project number was revised.) The due date on the City website was corrected to show the due date of 10/10/16, not 10/16/16. The following changes have been made to Specifications for the subject project: Specifications • Page v Notice Inviting Bids: Replace with the attached page v Notice Inviting Bids. (Project number was revised.) All other terms and conditions remain the same. CITY OF SANTA ANA I Edwin "William"Galvee' E. City Engineer SANTA ANA CITY COUNCIL Miguel A. Pulido Vicente Sarmiento Michele Martinez Angelica Amezcua P. David 0enavides i Roman Reyna Sal tnalero Mayor Mayor Pro Tem, Ward 1 Ward Ward3 Word4 Wards t Ward MPuI"tlo ansanta-ana oro I VSermnsa ienlongugaa ora I MMarlinezr�santa-ana oro AAmezwar�santa-ana.ory DaenavidesroZsanta ana.oro I RRavna(olsanta-ana ora i STinaierarrilsanla- I — — ana.ora CITY OF SANTA ANA ADVERTISEMENT PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063 (163) CD Request for <project no.> <project name> DO NOT CALL PURCHASING DIVISION REGARDING PUBLIC WORKS AGENCY PROJECTS. CALIFORNIA LABOR CODE: This project is subject to compliance monitoring and enforcement by the State of California Department of Industrial Relations, per Section 1771.4.a.1. BIDDERS are required to infann themselves fully of the conditions relating to construction and labor under which the work will be performed. Any contract entered into pursuant to this notice will incorporate the provisions of the California State Labor Code. In accordance with the California State Labor Code, prevailing wage rates apply. Copies of the prevailing rate of per diem wages are on file with the Public Works Agency and shall be made available to any interested party on request. A Contractor and any subcontractor must be registered with the Department of Industrial Relations prior to submitting a bid. "A contractor and any subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the California Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to pet form public work pursuant to Section 1725.5. Itis not a violation of this section for an unregistered contractor to submit a bid that is authorized by Section 7029.1 of the California Business and Professions Code or by Section 10164 or 20103.5 of the California Public Contract Code, provided the contractor is registered to perform public work pursuant to Section 1725.5 at the time the contract is awarded. Information about registration can be found on the Department of Industrial Relations website at http://www.dir.ca.gov/uublic- works/publicworks.html A bid will not be considered nor any contract or subcontract entered into without proof of the contract r id subepntxactor's current registration to perform public work. Date: 1/3c)116 Director, Public Works Agency CITY OF SANTA ANA Bond No. 1066058711 BONDS 82449545 PROJECT NO.: 16-6873 a t.u: ► KNOW ALL MEN BY THESE PRESENTS that KDC Inc. dba Dynalectric as CONTRACTOR, and Travelers Casualty and Surety Company of America & Federal Insurance Companv , a corporation, organized and existing under the laws of the State* and duly authorized to transact *CT & IN business under the laws of the State of California, as SURETY, are held and firmly bound unto the City of Santa Ana, as AGENCY, in the penal sum of Three Hundred ThirtyTwo wo Thousand Two Hundred Thirty Four and 001100 Dollars ($ 332,234.00 1, which is 100 percent of the total contract amount for the above stated project, for the payment of which sum, CONTRACTOR and SURETY agree to be bound, jointly and severally, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas CONTRACTOR has been awarded and is about to enter into the annexed Contract Agreement with AGENCY dated October 18, 2016 for Safe Routes to School Enhancements for Monte Vista Elementary Prosect No. 16-6873 if CONTRACTOR faithfully performs and fulfills all obligations in the performance of the Work of Improvement to be done under said Contract Agreement in the manner and time specified therein, then this obligation shall be null and void, otherwise it shall remain in full force and effect in favor of AGENCY; provided that any alterations in the obligations or time for completion made pursuant to the terms of the contract documents shall not in any way release either CONTRACTOR or SURETY, and notice of such alterations is hereby waived by SURETY. IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seal this 2nd day of Decembere , 20 16 . CONTRACTOR* 236-2276 Travelers C and pan% of America One Tower Square, Ialo,,d, IT 06183 & (732) 321-5600 (TR) & SURETY* Federal once alaH' U Halls Mill Road Whitehouse Station NJ 08889 (908) 903-3716 (FE) Camille Maitland, Attorney -m -Fact Alliant Insurance Services, Inc., 333 Earle Ovington Blvd, Suite 700, Uniondale, NY 11553 (516) 414-8900 Subscribed and sworn to before me, DonnaMarie Kissane , this 2nd day of December. 2016. DONNAMARIE A KISSANE Notary Public, I62 of New York 97783 Signatur . ,�..� /- t fle in Nassau C �( � ,%� Ouslified in Nassau County Commission Expires March 3, 2018 Notary Public in and for the County of Nasau State of New York Rate of premium on this bond is $ 5.51M per thousand. Total amount of premium charge is $ 1,827.00 To be filled in by Surety *Provide CONTRACTOR /ADMITTED SURETY name, address, and telephone number and the name, title, address, and telephone number of authorized representative. 1 of 3 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 Orange ) On 12/7/16 Date before me, Wendy Bowling, Notary Public Here Insert Name and Title of the Officer personally appeared William B. Names) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WENDY BOWLING Commission # 2006966 Z ; =.e Notary Public - California z Z t' Orange County My Comm. Expires Feb 10, 2017 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 Signat of Notary Public OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Faithful Performance Bond Document Date: 12/2116 Number of Pages: 1 Signer(s) Other Than Named Above: Camille Maitland Capacity(ies) Claimed by Signer(s) Signer's Name: William B. Davenport X1 Corporate Officer — Title(s): Exec. VP & CFO ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: KDC Inc. dba Dynaleotric KDC Inc. dba KDC Systems is Name ❑ Corpo Officer — Title(s): 11Pa tner — ted ❑ Ge ❑ Individual ❑ e in Fact ❑ Trustee Guardian of ❑ Other, r Is Representing: 02014 National Notary Association • www.Nationa]Notary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907 CITY OF SANTA ANA Bond No. 906605870 BONDS 82449545 PROJECT NO.: 16-6873 KNOW ALL MEN BY THESE PRESENTS that KDC Inc. doe Dynalectric as CONTRACTOR, and Travelers Casuals and Surety Company of America & Federal Insurance Company a corporation, organized and existing under the laws of the State*and duly authorized to transact 'CT & IN business under the laws of the State of California, as SURETY, are held and firmly bound unto the City of Santa Ana, as AGENCY, in the penal sum of Three Hundred Thirty Two Thousand Two Hundred Thirty Four and 00/100 Dollars ($ 332,234.00 1, which is 100 percent of the total contract amount for the above stated project, for the payment of which sum, CONTRACTOR and SURETY agree to be bound, jointly and severally, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas CONTRACTOR has been awarded and is about to enter into the annexed Contract Agreement with AGENCY dated October 18, 2016 for Safe Routes to School Enhancements for Monte Vista Elementary Project No. 16-6873 if CONTRACTOR or any subcontractor fails to pay for any labor or material of any kind used in the performance of the Work of Improvement to be done under said Contract Agreement, or fails to submit amounts due under the State Unemployment Insurance Act with respect to said labor, SURETY will pay for the same in an amount not exceeding the sum set forth above, which amount shall insure to the benefit of all persons entitled to file claims under the State Code of Civil Procedures; provided that any alterations in the work to be done, materials to be furnished, or time for completion made pursuant to the terms of the contract documents shall not in any way release either CONTRACTOR or SURETY, and notice of said alterations is hereby waived by SURETY. IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seal this 2nd day of December _,,,2016 e CONTRACTOR* KDC Inc. dha Travelers Casund Surety Cgr�ip�a�of America, One Tower Square, Hartford, CT 06183 & (732) 321-5600 (TR) & SURETY* Federal Insurance Company, Halls MITI Road, Whitehouse Station, NJ 08889 (908) 903-3716 (FE) Camille act Alliant Insurance Services, Inc, 333 Earle Ovington Blvd, Suite 700, Uniondale, NY 11553 (516) 414-8900 Subscribed and sworn to before me, DonnaMarie Kissane , this 2nd day of December 2016. D6NN MMARIE A KISSANE Notary Public State of New York No. OIX16297783 Signature: %-t e�Lr Qualified in Nassau County Commission Expires March 3, 2018 Notary Public in and for the County of Nassau State of New York Rate of premium on this bond is $ N/A per thousand. Total amount of premium charge is $ None - Included in Performances. To be filled in by Surety Bond Premium *Provide CONTRACTOR /ADMITTED SURETY name, address, and telephone number and the name, title, address, and telephone number of authorized representative. 2 of 3 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 �'1�L`�:i4K':C\:itM.ESQeIa^k�"R£y5"S`2�1�"ii'+&.:aruow.N nY �Y,�..:�.�Md"�d"Yid':K,.ti�M'4ca�i(r�':j�ti�."�G'S:Yk ri.:..."'.'^:'.._'"...:aY�'a�^&"M:cNP1;'Ac"�"e ti•�M2 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 1217/16 Date before me, Wendy Bowling, Notary Public Here Insert Name and Title of the Officer personally appeared William B. Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. :a WENOY BOWLING Commission # 2006966 #, Notary z Public - California z •.,.... , ,' W Orange County My Comm. Expires Feb 10, 2017 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 I Sig natur of Notary Public OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Payment Bond Document Date: 12/2/16 Number of Pages: 1 Signer(s) Other Than Named Above: Camille Maitland Capacity(ies) Claimed by Signer(s) Signer's Name: William B. DavenportSIP s Name: IN Corporate Officer — Title(s): Exec:. VP & CFO ❑ Corp -0 Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Partner — ' 'ted ❑ Ge ❑ Individual ❑ Attorney in Fact ❑ Individual ❑ in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Trustee Guardian of ❑ Other: ❑ Other, Signer Is Representing: KDC Inc, dba Dvnalectric 5ion6F Is Representing: KDC Inc. dha KDC Systems 02014 National Notary Association • www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 16-6873 SAFE ROUTES TO SCHOOL ENHACEMENTS FOR MONTE VISTA ELEMENTARY STATE PROJECT NO: ATPL- 5063(1.63) BID BOND I{NOW ALL PRESENT that, Dvnalectric , as BIDDER, and Travelers Casualty and Surety Company of America , as SURETY, are held and firmly bound unto the CITY OF SANTA ANA, as AGENCY, in the penal sum of _ Ten Percent of the Amount Bid Dollars ($ 10%of Amt. Bid ), which is ten percent (10%) of the total amount bid by BIDDER to AGENCY for the above -stated project, for the payment of which sum, BIDDER and SURETY agree to be bound, jointly and severally, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas BIDDER is about to submit a bid to AGENCY for the above -stated project, if said bid is rejected, or if said bid is accepted and a contract is awarded and entered into by BIDDER in the manner and time specified, then this obligation shall be null and void, otherwise it shall remain in full force and effect in favor of AGENCY. IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seal this _4th day of October , 2016. RTDT7T.R * SURETY* _Travelers Casualty and Surety Company of America One Tower Square, Hartford CT 06183-(732) 321-5600 Rita $agistanb,Ajtorney--Fact Alliant Insurance Services, Inc., 333 Earle Ovington Blvd, Suite 700, Uniondale, NY 11553 Subscribed and Sworn to before me DonnaMarie Kissane this 4th day of Qrtober 12016. OONNAMARIE A WSSANE // Notary P011% State of New York Signatureo&. /fill-_ /J 'kZ'W'j'&6_ No. 01K16291703 MStts1111ed in Messy County Notary Public in and for the Comity of Nassau -, State OffoEtWlrosNew YoorrkC183,20lS — Statk * Provide BIDDER/ SURETY name, address, and telephone number and the name, title, address, and telephone number of authorized representative. P-8 of P-17 CALIFORNIA•.: c rGMENT 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 Orange ) On 10-7-16 before me, Kristen Czupryn, Notary Public Date Here Insert Name and Title of the Officer personally appeared William B. Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. ......., KRISTEN RENEE CZl1PRYN Commission # 1996022 z 5"Notary Public - California z Orange County e My Comm. Expires Nov 25, 2016 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. d Signatur Signature of Not 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: Bid Bond _ Document Date: 10-4-16 Number of Pages: 1 Signer(s) Other Than Named Above: Rita Sagistano Capaeity(ies) Claimed by Signer(s) Signer's Name: William B. Davenport XI Corporate Officer — Title(s): Exec, Vp_& CFO ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: KDC Inc. dba Dynalectric KDC Inc. dba KDC Systems is Name ❑ Corpo Officer —Titles): 11Partner — b 'ted ❑ G ❑ Individual ❑ in Fact CI Trustee Guardian or ❑ Other - r Is Representing: 02014 National Notary Association • www.NationaiNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907 THE RED BORDER TRAVELERS POWER OF ATTORNEY Farmington Casualty Company St. Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surety Company of America St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St. Paul Guardian Insurance Company Attorney -In Fact No. 229701 Certificate No. 0 0 7 0 1 4 0 6 9 KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine htsurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut, that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc., is a corporation duly organized under the laws of the State of Wisconsin (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Thomas Bean, Rita Sagistano, Gerard S. Macholz, Susan Lupski, Robert T. Pearson, Camille Maitland, George O. Brewster, Colette R. Chisholm, Vincent A. Walsh, Lee Ferrucei, Desiree Cardlin, Nelly Renchiwich, and Mia Woo -Warren of the City of Uniondale , State of New York , their true and lawful Attorney(s)-in-Pact, each in their separate capacity if more than one is named above, to sign, execute, seat and aelniowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law, IN WITNESS WHEREOF, the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed, this 18th day of October 2016 Farmington Casualty Company Fidelity and Guaranty. Insurance Company Fidelity and Guaranty Insurance Underwriters, Inc. St. Paul Fire and Marine Insurance Company St. Paul Guardian Insurance Company St. Paul Mercury Insurance Company Travelers Casualty and Surety Company Travelers Casualty and Surety Company of America United States Fidelity and Guaranty Company G .1 zoo •` GCOYA*� ql AQa26WeMpOsstfa e arognrr ';t 9 e z o "� y ,,Gt 1�,senG `oi alS'BAL's ` coxy rI State of Connecticut City of Hartford ss. By: U Robert L. Raney, Senior Vice President On this the 18th day of October 1 2016 before me personally appeared Robert L. Rancy, who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. p,Tl� In Witness Whereof, I hereunto set my baud and official seal. My Commission expires the 30th day of June, 2021. 'O(Aillp Marie C. Teneaun, Notary Public 58440-5-16 Printed in U.S.A. TRAVELERS CASUALTY AND SURETY COMPANY OF AMWCA HARTFORD, cT. 06183 ATTORNEY-IN-FACT .M ST[FICATION PRINCIPAL'S ACKNOWLEDGMUNT---1F A CORPORATION Stale ofNcw Yark, County of ) ss. On this day of 20 before me personally appeared , to me known, who, being by me duly swum, deposes and says! That hclshc resides in the City of that he/she Is the of the corporation described in and which executed the within instrument; that helshe knows the seal of said corporation; that the seal affixed to said instrument is such corporate Seal; that it was so affixed by order of the Board of Directors of said corporation, and that he/she signed hisNer name thereto by like order, Slate of New York, County of PRINCIPAL'S ACKNOWLEDGMENT m -IF INDIV W VAL OR FIRM ow On Ilds day of , 20 , before me personally appeared to me known to he (fire individual)(one ofthe firm of ) described in and who executed the within instrument, and he/she thereupon duly acknowledged to me that he/she excepted the surae (as the act mid deed of said fin), SURETY CONIPANY'S ACH NOWLEDGMENT Stoic of New York, County of Nassau )sa. On this 2nd day of _ December 21116,befsmmepersonally appeared Camille Maitland to me known, who, being by me duly sworn, did depose and say:.. That he/she resides in W(Rf" Kings County, NY that ho/she is ARomcydn-Fact of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, the corporation described in Bad which executed the within instrument; that he/she knows the corporate seal of said Company; that the seal affixed to said insimment is such corporate seal; and that he/she signed said btstmment es Attorney -in -Fact by authority of ilia Board of Directors of said Company, and affiant did further depose and say that rho Superinlendent of limn nce of the State of New York has, pursuant to Chapter 882 of the Laws of tiro Slate of New York for the year 1939, constituting chapter 28 of the Consolidating Laws of the State of New York as the Insurance Law as amended, issued to TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA hisiber certificate that said Company Is qualifiad to become and be accepted as surety or guammur on all bonds, undertakings, recognburnes, guaranties, and other obtigeN as required or permitted by law, and that such cedifrcate has not been revoked, Notary Public Securities carried at $7,695A38 In the above statement are deposited with public authorities, as required by law TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA Radford, Connecticut 06183 DONNAMARIE A KISSANE Notary Public, State of New York FINANCIAL STATEMENT A$ OF DECEMBER 31, 2015 No. 01 KI6297783 AS FILED WITH THE INSURANCE DEPT, OF THE STAT9 OF NEW Qualified in Nassau County -Y.ORK CAPITAL STOCK $ 6,400,000 Commission Expires March 3, 2018 ASSETS LIABILITIES&SURPLUS CASH AND INVESTED CASH g 54,650,001 UNEARNED PREMIUMS ; 862,1337,464 BONDS 3,500,572,830 LOSSES 735,720,271 STOCKS 24S,90Litt LOSS ADJUSTMENT EXPENSES 278.900,105 INVESTMENT INCOME DUE AND ACMUM 43,005,720 COMMISSIONS 35,790,014 OTHER INVESTED ASSETS 31500,975 TAMES, LICENSES AND BEES 11,751,717 PREMIUMBAIUWCES 20D,aao,913 OTHER EXPENSES 39,468,087 NET DEFERRED TAX ASSET 05,751,198 - CURRENT FEDERAL AND FOREIGN INCOME TAMES 1s,1safelo REINSURANCERECOVERABLE 22,532,988 REMITTANCES AND ITEMS NOT ALLOCATED 4,995,722 SECURITIES LENDING REINVESTED COLLATERAL ASSETS 11,772,170 AMOUNTS WRHHeUU I RETANEO UY COMPANY FOR OTHERS 33,959,553 RECEIVABLES FROM PARENT, SUBSIDIARIES AND A}Fh1ATES 29,659,492 RETROACTIVE REINSURANCE RESERVE ASSUMED 890,144 OTHERASSETS $686,697 POLICYHOLDER DIVIDENDS e,D80,m1 PROVISION FOR REINSURANCE 3,830,904 ADVANCEPFlEM1UM_ 1,672,635 PAYABLEFORSECURITIES 8,000,000 PAYARLE FOR SECURITIES LENDING 11,772,176 - CEDED REINSURANCE NET PREMIUMS PAYABLE 26,0.38,220 ESCHEAT WiLTTY 664,927 - OTHER ACCRUED EXPENSES AND LIASILiTIE$ 1,am 550 TOTALUADILITIES $ 2.OAi,307,801 CAPITAL STOCK i 6,480,000 PND IN SURPLUS 433,807,708 OTHER SURPLUS 5.8!0.712,028 TOTAL SURPLUSTO POLICYHOLDERS i l,fas.be5,786 TOTALASSETS i 4,184,903,769 TOTAL LWBILITIES B SURPLUS i 4,138.37.7,769 Securities carried at $7,695A38 In the above statement are deposited with public authorities, as required by law IcChubb POWER Federal Insurance Company Attn: Surety Department OF Vigilant Insurance Company 15 Mountain View Road Surety ATTORNEY Pacific Indemnity Company Warren, NJ 07059 tOF0.1B® 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 Thomas Bean, George 0. Brewster Desiree Cardlin Colette R, Chisholm, Susan Lupski Gerard S. Macholz Camille Maitland Robert T Pearson, Nelly Renchiwich, Ca Sagistano, Vincent Walsh and folia Woo -Warren of Uniondale, New Vork --- ------ -- --------------------------- each as their true and lawful Attorney. in- Fad 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 COMP614Y, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and affixed their corporate was on this 20 dayof July, 2015. Q auV e_ Dawn M. Chloros, Assistant Secretary as. County of Somerset On this 200' day of July, 2015 before me, a Notary Public of New Jersey, personally came Daum M. Chloros, 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 Dawn M, Chloros, being by me duly sworn, did depose and say that she 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 sold Companies; and that she signed said Power of Attorney as Assistant Secretary of said Companies by like authority; and that she is acquainted with David B. NODS, Jr„ and knows him to be Vice President of said Companies; and that the signature of David B. Noris, Jr., subscribed to said Power of Attorney is in the genuine handwriting of David B. Noris, Jr„ and was thereto subscribed by authority of said By. Laws and In deponents presence. NOIaNSI Seal KATHERINE J. ADELAAR NOTARY PUBLIC OF NEW JERSEY NOTJVj No. 2818888 Me►.e... Commission Expires Jury 19, 2018 y rYBI Notary Public `JERS CERTIFICATION Extractfrom the By. Lem of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY: 'Except as otherwise provided in these By -Laws or by law or as otherwise directed by the Board of Directors, the President or any Vice President shall be authorized to execute and deliver, in the name and on behalf of the Corporation, all agreements, bonds, contracts, deeds, mortgages, and other instruments, either for the Corporation's awn account or in a fiduciary or olhercapactty, and the seal of the Corporation, if appropriate, shall be affixed thereto by any of such officers or the Secretaryor an Assistant Secretary, The Board of Directors, the President or any Vice President designated by the Board of Directors may authorize any other officer, employee or agent to execute and deliver, in the name and on behalf of the Corporation, agreements, bonds, contracts, deeds, mortgages, and other instruments, either for the Corporation's own account or in a fiduciary or other capacity, and, if appropriate, to affix the seal of the Corporation thereto. The grant of such authority by the Board or any such othcer may be general or Confined to specific instances," I, Dawn M. Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the 'Companies") do hereby cartify that (i) 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 the U.S. Virgin Islands, and Federal Is licensed in Guam, Puerto Rim, and each of the Provinces of Canada except Prince Edward Island; and (iii) the foregoing Pourer of Attorney is true, correct and in full force and effect Given under my hand and seals of said Companies at Warren, NJ this 2nd day of December, 2016 \tLR4 Dawn M. Chloros, Assistant Secretary IN THE EVENTYOU 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 Form 1540. 02258 U GEN CONSENT(rev. 07-15) AOKNOWLEDQM W OF SURETY COMPANY STATE OF N".Xt:r:......... x COUNTY OF ....i;l�sMu........ j as On this .,,,December 2; 2016 before me personally Cam= .... Camille Maitland to me knovm, who, bft by me duly sworn, did depose and say; that he he resides In Kings co minty ..................... Stade of ........NX.................., that he/acre Is the Attemey-kt-Foot of the F eiel Insurance companY........................................ the corporation described In which executed the above Irishnetrh that be/she knows 'ft seed of salt Corporation; that the Simi afBced to Saki InStruntent to such corporate Seat; thtd Is was so IttSaed by the Bard of More of Woe CDIPMRWW, and that hW* stgned NOur nsnre thereto by Ike talo; and this sherd did finch hr.depose and say that the Strperldendmrht of Mstuance of the Skte of New York ha, pinsuant to Seallolh 1111 of the bratnance Law of the Sklte of Now York, towed 10 ..... Fgds37si)nsul4e.99111O rY........................ I ...... I...... (Sti" Wher Cadbooate of YohtrplcatW evldericirm the quaNRoaft of said Cwnpany era! Its sufttclency ander any law of the State of Now dk ee surety and queraft and the propriety of and appraft-ft as such; that such Cargloate has not been revoked. i) J Wyntaw ksitsm tt DONNAMARIE A KISSANE Notary Public. Slate of New Yolk No. 011<I6287783 Qualified in Nassau County Commission Expires March 3, Zola Form 15-10-0313A(R.v. 3/16) FEDERAL INSURANCE COMPANY STATEMENT OF ASSETS, LIABILITIES AND SURPLUS TO POLICYHOLDERS Statutory Basis DECEMBER 31, 2015 (in thousands of dollars) LIABILITIES AND ASSETS SURPLUS TO POLICYHOLDERS Cash and Short Term Investments ................ $ 687,917 Outstanding Losses and Loss Expenses..... $ 12,174,848 United States Government, State and Unearned Premiums ..................................... 3,726,665 Municipal Bonds ......................................... 9,544,097 Dividends Payable to Stockholder............... 1,400,000 Other Bonds .................................................. 454915238 Ceded Reinsurance Premiums Payable....... 3295694 Stocks........................................................... 692,901 Provision for Reinsurance............................ 35,560 Other Invested Assets ................................... 2,187,839 Other Liabilities............................................. 1,295,093 TOTAL INVESTMENTS ............................... 17,603,992 TOTAL LIABILITIES .................................... 18,961,860 Investments in Affiliates: Chubb Investment Holdings, Inc ................ 3,679,770 Capital Stock ................................................ 20,980 Pacific Indemnity Company ........................ 2,930,246 Paid -In Surplus............................................. 3,106,809 Executive Risk Indemnity Inc ...................... 1,267,144 Unassigned Funds ....................................... 10,150,916 Chubb Insurance Investment Holdings Ltd.... 1,020,650 CC Canada Holdings Ltd ............................ 590,955 Great Northern Insurance Company .......... 469,230 SURPLUS TO POLICYHOLDERS .............. 13,278,705 Chubb Insurance Company of Australia Ltd. 404,845 Vigilant Insurance Company ....................... 306,232 Chubb European Investment Holdings SLP.. 294,200 Other Affiliates ............................................ 566,480 Premiums Receivable ................................... 1,659,749 Other Assets ................................................. 1,447,072 TOTAL LIABILITIES AND SURPLUS TOTAL ADMITTED ASSETS ...................... $ 32,240,565 TO POLICYHOLDERS............................. $ 32,240,565 Investments are valued in accordance with requirements of the National Association of Insurance Commissioners. At December 31, 2015, investments with a carrying value of $546,611,273 were deposited with government authorities as required by law. State, County & City of New York, — as: Dawn M. Chloros, Assistant Secretary of the Federal Insurance Company being duly sworn, deposes and says that the foregoing Statement of Assets, Liabilities and Surplus to Policyholders of said Federal Insurance Company on December 31, 2015 is true and correct and is a true abstract of the Annual Statement of said Company as filed with the Secretary of the Treasury of the United States for the 12 months ending December 31, 2015. Subscribed and sworn to before me this March 11, 2016. JEANETiE SHIPSEY Assistant Secretary Notary Public, State of New York Notary Public No. 02SH5074142 Qualified in Nassau County Commission Expires March 10, 2019 Form 15-10-0313A(R.v. 3/16) POWER OF ATTORNEY TRAVELERSJ Farmington Casualty Company St. Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surety Company of America St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St. Paul Guardian Insurance Company Attorney -In Fact No. 229701 Certificate No. 007014068 I{NOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut, that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc., is a corporation duly organized under the laws of the State of Wisconsin (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Thomas Bean, Rita Sagistano, Gerard S. Macholz, Susan Lupski, Robert T. Pearson, Camille Maitland, George O. Brewster, Colette R. Chisholm, Vincent A. Walsh, Lee Femicci, Desiree Cardlin, Nelly Renehiwich, and Mia Woo -Warren of the City of Uniondale , State of New York , their true and lawful Attomey(s)-in-Fact, each in their separate capacity if more than one is named above, to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in thein business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF, the Companies have caused this instrument to be signed and theircorporate seals to be hereto affixed, this 18th day of October 2016 Farmington Casualty Company Fidelity and Guaranty', Insurance Company Fidelity and Guaranty Insurance Underwriters, Inc. St. Paul Fire and Marine Insurance Company St. Paul Guardian Insurance Company St. Paul Mercury Insurance Company Travelers Casualty and Surety Company Mravelers Casualty and Surety Company of America United States Fidelity and Guaranty Company yP� `' esQp71i9 v e s yy. ros.1N r J�,. epi !,nsu`y yS g rax ax° any�mpn EtAyNb, ° % n g MCa1PoAA1tp� "° ° t wvoRar m W I8A2f 0 S 1977 �' ^�'-n¢- mJ x-... EI a HAcoxxHo, aa'"!an. a'saono z°b4^rt�f"�et � 19514:'t�e!�i SE1tGJao SEAL r w�no OO,t� Aa n� /,Y Id° ia^„`w '4�+s ..+ s........rNc�I '.a n �hyti ° gtw' State of Connecticut City of Hartford ss. B Robert L. Raney, Senior Vice President On this the 18th day of October 2016 before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., St. Paxil Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Comparty, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. p.TL7 In Witness Whereof, I hereunto set my hand and official seal.,'��i1vw My Commission expires the 30th day of June, 2021. 7k pugua 14 58440-5-16 Printed in U.S.A. WARNING: THIS POWER OF ATTORNEY Maric C. Ten'eault, Notary Public TRAVELERS CASUALTY ANDYSURETY COMPANY OF AMERICA HARTFORD, CT. 06183 ATTORNEY-IN-FACT JUSTIFICATION PRINCIPAL'S ACKNOWLEDGMENT --IFA CORPORATION State ofNcw York, County of ) $s•. On this day of 20 before me personally appeared to me known, who, being by on duly swum, deposes end says, ThathrAhc resides in the City of that he/she is the of UK corporation described in and whits executed the within Instrument; that hefshe knaves the seal of said corporation; that the seal affixed to said instrument Is such ccWtale seal; that it was so affixed by order of the Board of Directors of said wrpurallon, and that he/she signed hislser Rama thereto by like order. State ofNcw York, County of PRINCIPAL'S ACKNOWLEri07ENT---IF INDIVIDUAL OR FIRM ) ss. On this day of , 20 , before me personally appeared to me Imorm to be (the individual) (one of the Rnn or ) described in and who executed the within instrument, and he/she thereupon duly acknowledged to me that he/she executed the some (as the act and deed ofsaid firm), SURETY COMPANTS ACKNOWLEDGMENT State of New York, County of Nassau ) ss. On this 2nd day of _ December ,2016,beforomcpaaonallyappe4milCamdleMaitland to me known, who, being by me duly sworn, did depose and say; That helehasesides in a(iiYAjifol( Kings County, NY that he/she is Attomey-In-Fact of TRAVELERS CASUAL'T'Y AND SURETY C01)7PANY OF AMERICAt die corporation doscrBKd in and which executed the within Instrument; that he/she knows the Corporate SCSI of said Company; that fie SCSI affixed Io $Sid inehumcnt is such corporate seal; Gond that he/shC signed said instrument as Attomey-in-Fact by auihorflyof the Board of Dimclors of said Company; and aDisnt did further depose and Say that the Superintendent of Insurance of the State afNew York has, pursuant to Chapter 882 of the Laws of the Slate of New York for the year 1939, constituting chapter 28 of the Consolidating Laws of the State of New York 05 the Insurance Law as amended, issued to TRAVELERS CASUALTY AND SURETY COMPANY OF AAtERICA his/her certificate that said Company is qualified to become and be accepted as surety or guarantor on all bonds, undertakings, mcognizaaces, gurnsualCs, and other oblige - s requtrcd ae permitted by lases mid that such certificate hes not been revoked 1 Notary Poblic TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA DCNNAMARIE A KISSANE Hartford, Connecticut 86183 Notary Public, State of Now York FINANCIAL STATEMENT AS OF DECEMBER 31, 2018 No. 01KI6297783 AS FILED WITH THE INSURANCE DEPT. OF THE STATE OF NEW Y Qualified in Nassau County CAPITAL STOCK $ 6,480,000 Commission Expires March 3, 2018 ASSETS LIABILITIES & SURPLUS CASH PND INVESTED GSH $54,SSU,B09 UNEARNED PREMIUMS 5 052,033,400 BONDS 3,500,572,630 LOSSES 739,725,171 STOCKS 24S,9111,111 LOSSADJUSTMENTPY,PENSES 270,930,106 INVESTMENT INCOME DUE AND ACCRUED 43,935,720 COMMISSIONS 30,096,014 OTHER INVESTED ASSETS 316001975 TAXES, LICENSE$ AND FEES 11,361,717 PREMNJMBALMICES 200,900,993 OTHER EXPENSES 39;466,097 NET DEFERRED TAX A599T 05,751,196 CURRENT FEDERALAND FOREIGN INCOME TAXES 1S,969,62o REINSURANCE RECOVERABLE 22,5321990 REMITTANCES AND ITEMS NOTALLOCATED 4,995,722 SECURITIES LENDING REINVESTED COLLATERAL ASSETS 11,772,170 AMOUNTS WITHHELD I RETAINED BY COMPANY FOR OTHERS 33,959,553 REMYABLES FROM PARENT, SUBSIDIARIES AND AFFR,IATES 29,099,492 RETROACTIVE REINSURANCE RESERVE ASSUMED 099,144 OTHERASSET$ 6,805,697 POLICYHOLDER DIVIDENDS 0,000,1el PROVISION FOR REINSURANCE 3,634,004 ADVANCEPREMIUM 110721035 PAYABLE FOR SECURITIES 0,600,9D9 - PAYABLE FOR SECURITIES LENDING 91,772,170 - CEDED REINSURANCE NET PREMIUMS PAYABLE 20,010,320 ESCHEAT LIABILITY 694,921 OTHER ACCRUED EXPENSES AND LIABILITIES ION 050 TOTALLIASILITIES SS 29pt CAPITAL STOCK S 6,400,000 PND IN SURPLUS 433,803,703 OTHER SURPLUS I a93,312,028 TOTAL SURPLU6TOPDUCYHOLOERS i 2,100,595,709 TOTALASSETS S 4,1114,9121,160-^ 1 TOTAL L"LlfIES&SURPLUS Z$4 ,104,903,769 Securities carded at $7,695„538 In the above statement are deposited with public authorities, as required by law. Chubb POWER Federal Insurance Company Attn: Surety Department OF Vigilant Insurance Company 15 Mountain View Road ic _ Surety ATTORNEY Pacific Indemnity Company Warren, NJ 07059 Know All by These Presents, That FEDERA COMPANY, a New York corporation, and PACIFIC appoint Thomas Bean, George O. Brewster Camille Maitland, Robert T Pearson, Nelly Uniondale, New York --- ..... each as their true and lawful Attorney. in- Fad to execute under such designation in their names end 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 COMP614Y, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and affixed their corporate seals on this 20 dayof July, 2015. CR L 1 ' 1 1 QMjQv V(g Dawn M. Chloros, Assistant Secretary �F. STATE OF NEW JERSEY as, County of Somerset On this 20d' day of July, 2015 before me, a Notary Public of New Jersey, personalty came Dawn M. Chloros, to me known to be Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNr Y COMPANY, the companies which executed the foregoing Power of Attorney, and the saM Dawn M. Chloros, being by me duly swam, did depose and say that she 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 she signed said Power of Attorney as Assistant Secretary of said Companies by like authority: and that she is acquainted with David B. Norris, Jr„ and knows him to be Vice President of said Companies; and that the signature of David B. Name, 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 KATHERINE J.ER WJ O N NOTARY PUBLIC OF NEW JERSEY t10TA$ No. 2916685 COMMIS81on Expires July 16, 2019 L Notary Public CERTIFICATION Extract from the By. Laws of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY: 'Except as otherwise provided in these By -Laws or by law or as otherwise directed by the Board of Directors, the President or any Vice President shall be authorized to execute and deliver, in the name and on behalf of the Corporation, all agreements, bonds, contracts, deeds, mortgages, and other instruments, either for the Corporation's own account or in a fiduciary or other capacity, and the seal of the Corporation, if appropriate, shall be affixed thereto by any of such officers or the Secretary or an Assistant Secretary, The Board of Directors, the President or any Vice President designated by the Board of Directors may authorize any other officer, employee or agent to execute and deliver, in the name and on behalf of the Corporation, agreements, bonds, contracts, deeds, mortgages, and other instruments, either for the Corporation's own account or in a riduolsry or other Capacity, and, if appropriate, to affix the seal of the Corporation thereto, The grant of such authority by the Board or shy such officer may be general or confined to specific Instances." I, Dawn M, Chloros, 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, (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 the U.S. Virgin Islands, and Federal is licensed in Guam, Puerto Rico, and each of the Provinces of Canada except Prince Edward Island; and (iii) the foregoing Paver of Attorney Is true, correct and in full form and effect Given under my hand and seals of said Companies at Warren, NJ this 2nd day of December, 2016 =ir u '— Dawn M. Chloros, Assistant Secretary IN THE EVENTYOU 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 Fom115-10-02258-U GEN CONSENT (rev. 07-15) ACkNOWLEDQMENT OF SURETY COMPANY STATE OF ..Nt .Y9. 4.......... COUNTY OF ....Masxeu........ On this ....December 2:2016 .,, before me person* Oxine ...�Camille Maitland,.., .. 110 me known, who. b thlg by me duty swam, did depose and $ay; that heithe resides In ... ,......Kinds County ...................... $tete of ........N%.. .......... that he/she Is the AltIXnalhhl-Fact of the Federal Insurance,Comp.Q"y..................... I., ....... I........ the co"raikm deaadbed In wMch executed the ebwo MaUumenC drat hatehe known'tha seal of said w ration; that the not eftw to said Instrument is such auporate Beak dW Is was so alAxed by the Dowd of DlreaWre of sold ctioNewn; and that hePolte sWad h(sdter norms #hereto by Me arida; and the stiteltt did hntlror.depoee etul say diat the $uperbivindest or trreurence of the Skit of New York has, p inuld to 800on 1111 of the toatnum Law of the $tete of New oatlon evldencNl®lite quaNnconat of saki CanpenY Brtd ks suilblertoy under any lauv of the $tete of New odt as surety and ptteretRor, and the propriety of ax1aroviig n such; and dmt such certpfaste on txiett revokad. Notary PubAa NY DONNAMARKISSANE Notary Public, 81 attee of Now York No. 01 KI6297783 Qualified in Nassau Courtly Commission Expires March 3, 2010 Form 15-10-0313A (Rev. 3/16) FEDERAL INSURANCE COMPANY STATEMENT OF ASSETS, LIABILITIES AND SURPLUS TO POLICYHOLDERS Statutory Basis DECEMBER 31, 2015 (in thousands of dollars) LIABILITIES AND ASSETS SURPLUS TO POLICYHOLDERS Cash and Short Term Investments................ $ 687,917 Outstanding Losses and Loss Expenses..... $ 12,174,848 United States Government, State and Unearned Premiums..................................... 3,726,665 Municipal Bonds......................................... 9,544,097 Dividends Payable to Stockholder............... 1,400,000 Other Bonds.................................................. 4,491,238 Ceded Reinsurance Premiums Payable....... 329,694 Stocks........................................................... 692,901 Provision for Reinsurance............................ 35,560 Other Invested Assets................................... 2,187,839 Other Liabilities............................................. 1,295,093 TOTAL INVESTMENTS ............................... 17,603,992 TOTAL LIABILITIES.................................... 18,961,860 Investments in Affiliates: Chubb Investment Holdings, Inc................ 3,679,770 Capital Stock................................................ 20,980 Pacific Indemnity Company ........................ 2,930,246 Paid-In Surplus............................................. 3,106,809 Executive Risk Indemnity Inc...................... 1,267,144 Unassigned Funds....................................... 10,150,916 Chubb Insurance Investment Holdings Ltd.... 1,020,650 CC Canada Holdings Ltd ............................ 590,955 Great Northern Insurance Company .......... 469,230 SURPLUS TO POLICYHOLDERS.............. 13,278,705 Chubb Insurance Company of Australia Ltd. 404,845 Vigilant Insurance Company ....................... 306,232 Chubb European Investment Holdings SLP.. 294,200 Other Affiliates............................................ 566,480 Premiums Receivable................................... 1,659,749 Other Assets................................................. 1,447,072 TOTAL LIABILITIES AND SURPLUS TOTAL ADMITTED ASSETS ...................... $ 32,240,565 TO POLICYHOLDERS............................. $ 32,240,565 Investments are valued in accordance with requirements of the National Association of Insurance Commissioners. At December 31, 2015, investments with a carrying value of $546,611,273 were deposited with government authorities as required by law. State, County & City of New York, — ss: Dawn M. Chloros, Assistant Secretary of the Federal Insurance Company being duly sworn, deposes and says that the foregoing Statement of Assets, Liabilities and Surplus to Policyholders of said Federal Insurance Company on December 31, 2015 is true and correct and is a true abstract of the Annual Statement of said Company as filed with the Secretary of the Treasury of the United States for the 12 months ending December 31, 2015. Subscribed and sworn to before me this March 11, 2016. pcu anm. JEANETTE SHIPSEY Assistant Secretary �� Notary Public, State of New York Notary Public V No. 02SH5074142 Qualified in Nassau County Commission Expires March 10, 2019 mmmmmmmi Form 15-10-0313A (Rev. 3/16) WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER AM POWER OF ATTORNEY Fidelity and GuarantyInsurance Company TRAVELERSJ Farmington Casualty Company St. Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surety Company of America St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St. Paul Guardian Insurance Company Attorney -In Fact No. 229701 Certificate No. 006912623 I{NOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut, that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc, is a corporation duly organized under the laws of the State of Wisconsin (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Thomas Bean, Rita Sagistano, Gerard S. Macholz, Susan Lupsld, Robert T. Pearson, Camille Maitland, George O. Brewster, Colette R. Chisholm, Vincent A. Walsh, Lee Ferrucei, Desiree Cardlin, Nelly Renchiwich, and Mia Woo -Warren of the City of Uniondale , State of New York , their true mid lawful Attomey(s)-in-Fact, each in their separate capacity if more than one is named above, to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF, the Companies have caused this insu'ume it to be signed and llr&itrcorporale seats to be hereto affixed, this day of July 2016 28th Farmington Casualty Company St. Paul Mercury Insurance Company Fidelity and GuarantyInsurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surety Company of America St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St. Paul Guardian Insurance Company 1^T�Y^y+y b 1a48Po$pjTF 'srt.0P..O.sO..._P.AaC$ i.FOa nao (r -ORS bCGpin -`�)fsWN,�F.Yw,Al.5 % UT84989Afu oJm Amp, State of Connecticut City of Hartford ss. By: ,✓✓ lyf Robert L. Raney, Senior Vice Piesidera On this the 28th day of July 2016 , before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc, St. Paul Fire and Marine Insurance Company, Sl. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, and that lie, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. �.T!} n e � �� In Witness Whereof, I hereunto set my hand and official seal. f1j3TNi' i7d w" �+ • V��J My Commission expires the 30th day of Juno, 2021. p�Ip i Marie C.'reneaun, Notary Public 58440-5-16 Printed in U.S.A. TRAVELERS CASUALTY AND SURETY COMPANY OF AIVIF)RICA IIARTFORD, CT. 06183 ATTORNEY-IN-FACT ASTiFICATION PRENCIPAL'S ACKNONLEDGWWr---IF A CORPORATION State of New York, County of ) as. On this day of , 20 , before me personally appeared , to me known, who, fixing by me duly swam, deposes and says: Thal lic/she resides in the City of , that he/she is do of the curpormion elcumibed in and which executed the within instrument; that hdshe knows the seal of said comwstlon; that the seat affixed to said instrument is such cwperafc seal; that it was so affixed by order of the Board of Directors of Bald corporation, and that he/she signed his/her name thereto by like order, PRINCIPAL'SACKNOIVI,EDGAIENT.. MINDIVIDUALORFIRM Slate of New York, County of ) sl - On this day of '20 , before an personally appeared to me known to be (the individual) (one aftre firm of ) described In and who executed the within instrument, and he/she thereupon duly acknowledged tome that helshe executed the same (as the act and deed ofsaid firm). SURETY COAfPANY'S ACKNOWLEDGMENT State of New York, County of Nassau )$r. On this 4th dayof October ,.2016 , before me personally appeared Rita Sagistano to me known, who, being by me duly sworn, did deposit and say; That he/she resides in the lf. County Of Nassau, NY tial he/she is Attorney -In -Fact of TRAVELERS CASUALTY AND SURETY CONIrANY OF AhfERICA, the corporation described in and whidl cou euted lire within inswmem; that he/sho knows the corporate seal of said Compsny; that the seal affixed to said instrument is such corporate seal; and that he/she signed said instrument as Attorney -in -Fact by a clarity of the Boom of Directors of said Company, and affiant did further depose and say that the Superintendent of Insurance of the Slate of New York has, pursuant to Chapter Sgt of the Lam of the Slate of New York for the year 1939, constituting chapter 28 of the Consolidating Laws of the State of New York as the Insurance Law as amended, issued to TRAVELERS CASUALTY AND SURETY COAIPANV OF AAIERICA Welber certificate HIM said Company is qualified to become and be accepted as surety or guarantor on all bonds, undertakings, recognl7anca. guaranties, and other Doli 'ons sequined or permitted by law; and Ilial such certificate has not been revoked. olaryPoblic t°e�� TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA Hanford, Connecticut G6183 FINANCIAL STATEMENT AS OF DECEMBER 31, 2015 AS FILED WITH THE INSURANCE DEPT, OF THE STATgQF NEW YOR6 CAPITAL STOCK 5 6,480,000 UONNAMARFE A KISSANE Notary Publlc, State of New York No. 01KI6297763 Qualified In Nassau County CromrT116SI0R Expires March 3, 2099 ASSETS _ LIABILITIES g SURPLUS CASH AND INVESTED CASH i ,64,6&0,801 UNEARNED PREMIUMS ; 562,633,464 BONDS 3,500,572,658 LOSSES 755,725,171 STOCKS 245,801,111 LOSS ADAISTMIsW EXPENSES 278,980,100 INVESTMENT INCOME DUE AND ACCRUED 43,905,720 COMMtWONS 35,398,814 OTHER INVESTED ASSETS 3,600,878 TAXES, LICENSES AND FEES 11,351,717 PREMIUM BALANCES 200,980,813 OTHER EXPENSES 39,468,067 MET DEFERRED TAX ASSET 85,751,198 CURRENT FEDERAL AND FOREIGN INCOME TAXES 15,168,820 REINSURANCE RECOVERABLE 22,532,988 REMITTANCES AND ITEMS NOT ALLOCATED 4,905,722 SECURITIES LENDING REINVESTED COLLATERAL ASSETS 11,172,178 AMOUNTS WITHHELD r RETAINED BY COMPANY FOR OTHERS 33,058,553 RECEIVABLES FROM PARENT, SUBSIDIARIES AND AFFILIATES 29,659,492 NETR0AGNVE REINSURANCE RESERVE ASSUMED 699,144 OTHERASSETS 5,685,697 POLWHOLOER DIVIDENDS 8,080,161 PROVISION FOR REINSURANCE 3,034,904 ADVANCEPIJEMIUM 1,572,635 PAYABLE FOR SECURITIES 8,00D,000 PAYABLE FOR SECURITIES LENDING 11,772,178 CEnED REINSURANCE NET PREMIUMS PAYABLE 26,035,328 ' ESCHEAT LIABILITY 664,12 OTHER ACCRUED EXPENSES AND LIABILITIES 1658650 • TOTAL LIABILITIES S 2ACa-8 • CAPITAL STOOK 5 6,489,000 PAID IN SURPLUS 433,803,700 OTHER SURPLUS 1,865.312.023 TOTAL SURPLUS TO PCIUMHOLDERS F 2.103.695.790 TOTALASBETS S 4,184,Btl3.789 TOTAL LIABILITIES&SURPLUS 6 4,184,903,769 Socuritles carried at $7,695,536 In the above statement am deposited with public authorities, as required by law. nalectric An EMCOR Company orate Center Drive os, CA 90720-2539 Dynalectrlc An EMCOR Company 4462 Corporate Center Drive Los Alamitos, CA 90720-2539 "SEALED BID" FOR SAFE ROUTES TO SCHOOL ENHANCEMENTS FOR MONTE VISTA ELEMENTARY (PROJECT NO. 16-6873) CITY OF SANTA ANA PUBLIC WORKS RECEPTIONIST, 3RD FLOOR 20 CIVIC CENTER PLAZA, M-22 SANTA ANA, CA 92701 20.4.6 OCT'40 PM 1-:4