HomeMy WebLinkAboutSTEPHEN DORECK EQUIPMENT RENTALS, INC. (2) i
Recording Requested By, Recorded in Official Records, Orange County
And When Recorded Mail To: Hugh Nguyen, Clerk-Recorder
City of Santa Ana,Public Works Agency M22 II I I +�III��Ir I �II i�lII I I I I II �I
20 Civic Center Plaza,P.O.Box 1988 I I NO FEE
Santa Ana,CA 92702 * E R 0 0 1 3 7 1 5 8 1 7 $ *
2022000171399 4:24 pm 05105/22
48 414A N12 1
0.00 0.00 0.00 0.00 0.00 0.00 0.000.000.00 0.00
ITHIS SPACE FOR COUNTY RECORDERS USE ONLY
NOTICE OF COMPLETION
NOTICE IS HEREBY GIVEN that the undersigned City of Santa Ana, California, a
municipal corporation, with the address of City Hall, 20 Civic Center Plaza, Santa Ana,
California, 92701, is the owner of the property hereinafter described, that said owner has caused
c construction of THORNTON PARK WATER MAIN under contract entered into on JUNE
6, 2019, with STEPHEN DORECK_EQUIPMENT RENTALS, INC., on which contract
w NORTH AMERICAN SPECIALITY INSURANCE COMPANTY is surety. The property on
ma which such work improvement was placed is in the City of Santa Ana, County of Orange, State
c z of California, and described as Project No. 15-6448 located at: THORNTON PARK. The work
Aimprovement on said property was accepted as completed on AUGUST 3, 2 02 1.
a �
Ow
CITY OF SANTA ANA A MUNICIPAL CORPORATION
w
w By
H
qz Dated: Acting City En neer—Jason Gabriel
TITLE
O
Up ---------------------------------------------------------
VERIFICATION
I, the undersigned, say: I am the . City Engineer — Jason Gabriel of the City of Santa Ana,
California; I executed the foregoing Notice of Completion acting on behalf of the owner of the
property therein described; I make this verification on behalf of said corporation by authorization
of the City Council of the City of Santa Ana; I have read said notice and know the contents
thereof; and I declare under penalty of perjury that the facts therein stated are true.
Executed on L-?" ' , at Santa Ana, California
Actin ity Engineer—Jason
THIS NOTICE OF COMPLETION MUST BE RECORDED WITHIN TEN(10)DAYS AFTER COMPLETION
,THE REGISTER This space for filing stamp only
2196 TOWNE CENTER PL, ANAHEIM, CA 92806
Telephone (714) (714) 796-/ Fax (714) (714) 796-6
)6
PROOF OF PUBLICATION
(2015.5 C,C.P)
state of California )
County of ORANGE ) ss
Notice Type: BID- NOTICE INVITING BIDS
Ad Description:
THORNTON PARK NEIGHBORHOOD WATER MAIN IMPRV
I am a citizen of the United States and a resident of the State of California; I am
over the age of.eighleen 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 clly 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 11119/1905,
Case No. A21046. That the notice, of which the annexed Is a printed copy, has
been published in each regular and entire issue of said newspaper and not in
any supplement thereof on the following dates, to -wit:
04/03/2019, 04110/2019
Executed on: 04/10/2019
At SANTA ANA,CA
.1 certify (or declare) under penalty of perjury that the foregoing is true and
correct.
Signature
III IIIII II III II IIIIIIIIIIIIIIIII Ilillll II
Email 'k A 0 0 0 0 0 5 0 2 5 1 3 8
FILED
APR 17 19
OOAEMC CLERK, DERDWARTMEli
BY: L`SPLi n
MAYOR
Miguel A, Pulldo
MAYOR PRO TEM
Juan%Alleges
COUNCIL MEMBERS
Cecilia Iglesias
David Pensloze
Vicente Sarmlenio '
Jose Solorlo
CITY OF SANTAANA
PUBLIC WORKS AGENCY
20 Civic Center Plaza (M-36)
P.O. Box 1988 - Santa Ana, California 02702
(714) 647.6690 - Fax (714) 647-5923
www.sante-sina.org
NOTICE OF EXEMPTION
ACTING CITY MANAGER
Steven A Mendoza
CITY ATTORNEY
Sonia R, Carvalho
ACTING CLERK OF THE COUNCIL
Norma Mitre-Ramlrez
POSTED
APR 17 ,20119
0 NTYCLERK COROER DEPARTMENT
BY DEPUTY
From the Requirements of the California Environmental quality Act (CEQA)
Fee Exemption per California Government Code Section 6103
Ta COUNTY CLERK Prom; City of Santa Ana
County of Orange PUBLIC WORKS AGENCY
P.O, Box 238 20 Civic Center Plaza (M-36)
Santa Ana, CA 92702 Santa Ana, CA 92702
Project Title: Thomton Park Neigfic. Water Main7nlpr6veinsnis 15.6448 Date of Approval 06/0612017
ProjectNumber(s): PWA-2019.544-CITY
Project Location: 1 CityWide (Partial)
City- Santa Ana County: Orange ER Number: ER-201M7
2
project Description: The project consist of constructing an 8" water main and abandoning the existing water main. Necessary
appurtenances such as gate vatves, water services, fire hydrant assemblies, bends, tees will be
lgsaewwcsut existing asphalt pavement to place PVC pipe, slurry seal roadway, and striping
�IH F4 0l �e
Applicant Name: Public Works Agency D City of Santa Ana
Applicant Address: City of Santa Ana
Santa Ana, CA 92702
Name of Public Agency Approving Project City Council
Name of person or Agency Carrying Out Project; 'Public Works Agency
Exempt Statue: Recorded In Official Records, orange County
O Ministerial (sea 15268) Hu h Ngu an, Clark Recorder NO FE�
ElEmergency Project Seca16 69(b(througha)) IIII IIIIIRIIN�1111111111111NII1111�1111NNIIIIIIIII�INI�11
$ R 0 0 1 0 7 6 9 4 6
❑ general Rule (Sec. 16061(b)(3y(5)) 201985000368 8:40 am 04/17/19
❑ Statutory Exemption; 381 $04 201
14 Categorical Exemption: 15301(b) and (c) 0.00 60.00 0.00 0.00 0.00 0.00 0.00 0.00
Reason($) Why Project is Exempt From CECA:
16301(b) consist of replacement of exleting water mains, laterals, appurtenances, slurry and restrlping the street.
16301(c) siurry and restriping the street
City Contact Anderson Chryeostorno Telephone: ('i14) 647-6838 / +
Signature: '<—c 7i41ec 45sr$-Nt -r Ll I iNLKFDate: 0 I1C'17
SANTA ANA CITY COUNCIL
MlguA. politic Juan Vllledj Nnaente 6amllaMo ! Jose aado
' David Penalow ! Ceollla Iglaelan
M
Mayor I MaynrProlam,Werd6 Word I Word � Wards I Ward i word
ilsennlenloimaenta-ana oml aldl�la8r$eanM-ens era
i i '
AUG 2 S 2019 CITY OF SANTA ANA
0 CONSTRUCTION CONTRACT
0' Q wq zl PROJECT NO.15-6448
Mil art 2 THORNTON PARK NEIGHBORHOOD WATER MAIN IMPROVEMENTS
This CONSTRUCTION CONTRACT is made and entered into this 4"' day of June, 2019 by and
between the City of Santa Ana, California, a charter city and municipal corporation organized and
existing under the Constitution and laws of the State of California (hereinafter "CITY"), and Stephen
Doreck Equipment Rentals, Inc. (hereinafter "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 Thornton Park Neighborhood Water Main
Improvements Project (hereinafter referred to as the "WORK OF IMPROVEMENT") identified in
and in accordance with the Contract Documents prepared by the City's Public Works Agency and
approved by the City Council.
2. The complete Construction Contract consists of the "Contract Documents" as defined by the
Standard Specifications for Public Works Construction and which include the following:
• Notice Inviting Bids
• Information to Bidders
• Bid Proposal
• Bid Bond
• Contract Form
• Contract Bonds
• General Provisions
• Special Provisions
• Technical Provisions and Project Plans
• Community Workforce Agreement
• Appendices
In case of conflict between the Contract Documents, the precedence of documents shall be as
established in the Standard Specifications for Public Works Construction.
3. CITY agrees to pay and CONTRACTOR agrees to accept in full payment to complete the WORK
OF IMPROVEMENT the sum total amount not to exceed One Million Six Hundred Sixty Thousand
Three Hundred Seventy Dollars and No Cents ($1,660,370.00), as set forth and identified in the BID
PROPOSAL, which is attached hereto and incorporated herein as Exhibit "A."
The BID PROPOSAL contains a schedule of unit prices) 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.
rev. 09/01/2017 Page 1 of 3
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. If applicable, the CONTRACTOR shall adhere to the CITY'S Community Workforce Agreement
(CWA), a pre -hire collective bargaining agreement, which establishes the labor relations policies and
procedures for CONTRACTOR to follow in the crafts persons employed to complete the WORK OF
IMPROVEMENT as more fully described in the CWA. The CWA may be found on the City's
website at:
http//www s inta-�ina.org/i2waZdocuments/CWA.t)df
7. 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.
8. CONTRACTOR shall, prior to the release of the performance and payment bonds or the retention
payment, furnish a warranty performance and payment bond (Warranty Bond). Said Warranty Bond
shall also be required as a condition of project acceptance. For projects up to Five Hundred
Thousand Dollars ($500,000), the Warranty Bond amount shall be the greater of Ten Thousand
Dollars ($10,000) or Twenty Percent (20%) of the final contract price. For projects above Five
Hundred Thousand Dollars ($500,000), the Warranty Bond amount shall be the greater of One
Hundred Thousand Dollars ($100,000) or Ten Percent (10%) of the final contract price.
9. CONTRACTOR shall, after award of this Contract, furnish Certificates of Liability Insurance and
Worker's Compensation Insurance as outlined in the General Provisions, to be approved by the
CITY.
Page 2 of 3
IN WITNESS WHEREOF, the parties hereto have executed this Construction Contract on the day and
year first above written.
ATTEST:
.,
o
('%�
a 0 J►�`
DAISY GOMEZ I
Clerk of the Council
APPROVED AS TO FORM:
SONIA R. CARVALHO
City Attorney
By:.
HN FUNK
Assistant City Attorney
FOR APPROVAL:
, PE, PLS
Public W�o*s Agency
CITY OF SANTA ANA
I RISTINE RIDGE'
City Manager
CONTRACTOR:
Stephen Doreck Equip - nt Rentals, Inc.
/; ' "
NAME: Pablo Viramontes
TITLE: Vice President
Page 3 of 3
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Los Angeles )
On July 11, 2019 before me, Sylvia Sifuentes (Notary Public)
(insert name and title of the officer)
personally appeared Pablo Viramontes
who proved to me on the basis of satisfactory evidence to be the person(g) whose name(p) is/Mg
subscribed to the within instrument and acknowledged to me that he/0#/W#y executed the same in
his/)jpf/y0A4/ authorized capacity(j4), and that by his/IInf/their signature(j) on the instrument the
person(q), or the entity upon behalf of which the person(j) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
Signature (Seal)
Sylvi Si e es (kotary Public)
SYLVIA V. SIFUENTES
a Notary Public • California
YLos Angeles County
commission At2257818
My Comm. Expires Oct 8, 2022 +
City of Santa Ana
Page 2
Thornton Park Neighborhood Water Mein Improvements (15-6448), bidding on April 24, 2019
2:00 PM (Pacific)
Printed 0511412010
BidRssults
EXHIBIT A
Type
Item Code uoM City
Unit Price
Lino Total Comment
3
1" Water Service per City Standard Plan 1401
EA 201
$1,296.00
$260.295.00
4
2" Water Service per City Standard Plan 1402
EA 6
$6,216.00
$26,076.00
5
4" Water Service per City Standard Plan 1403E
EA 1
$26260.00
$26,250.00
6
Fire Hydrant Assembly per City Standard Plan 1405
EA 13
$8,526.00
$110,825.00
7
PCC Cross Gutter Replacement per Clly Standard Plan 1109
SF 1010
$39.00
$39,390.00
8
PCC Curb Ramp per City Standard Plan 1122
EA 2
$5.260.00
$10,600.00
9
2" Blow -Off Assembly per City Standard Plan 1414
EA 1
$4,565.00
$4,666.00
10
Sewer CCTVlnspectlon
LS 1
$16,750.00
$15,760.00
11
Slurry Seal Surfacing (REAS, Type ll)"t
TON 203
$910.00
$184,730.00
12
Traffic Striping
LS 1
$20,345.00
$20,346.00
13
As -Built
LS 1
$10,000.00
$10.000.00
14
1" Combination Air Valves per City Standard Plan 1415"
EA 3
$4,920.00
$14,760,00
15
Vertical Offsets per City Standard Plan 1413B"
EA 3
$4,335.00
$13,005.00
16
Labor Agreement Oversight
LS 1
$20,000.00
$20,000.00
Subtotal
$1,660.370.00
Asterisk Notes (Per Section 3.2 of Standard Specifications) - NOT part of Total Bid Calculation
17
" = The quantity for this bid Item Is shown for bid comparison only. This bld Item
shall not be subject to the
"25%" Emit as stated In Section 3-2 of
the Standard Spaclficatlons. The actual amount for this Item will be dictated by the
actual quantltly used, and
the Agency reserves the right to
Increase or decrease the quantity of this Item accordingly.
EA 0
0
0
PlanotBids, Inc.
City of Santa Ana
Page 3
Thornton Park Neighborhood Water Main Improvements (16-6448), bidding on April 24, 2019 2:00 PM (Paclfic) Primed 06/14/2019
Bid Results
EXHIBIT A
Type Item Code UOM Cry Unit Price I-Mo Total Comment
10 t ° This bid Item Is cansidemd a Specialty Item per Section 2-3,2 of the Standard Specifications.
EA 0 0 0
Subtotal 0
Total $1,000,370.00
PlanetBids, Inc.
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 15-6448
THORNTONPARK NEIGHBORHOOD WATER MAIN IMPROVEMENTS EXHIBIT A
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 one -hundred Cwenly (120) working day; after the commencement date stated in the
Notice to Proceed.
• 15 — Working Days for exploratory potholing and data gatherings
• 105 — Working Day for project construction
The liquidated damages amount, in lieu of the amount specified in Subsection 6-9 of the Standard
Specifications, shall be $2,500 per calendar day.
Name of Firm
Signature of BIDDER
Rentals, Inc.
Title Pablo Viramontes / Vice President
(If an individual, so state. If a firm or co -partnership, state the firm name and give the names of
all individual co-partners composing the firm. If a corporation, state legal name of corporation,
and names of President, Secretary, Treasurer and Manager, thereof.)
P-2 of P-16
City of Santa Ana
Thornton Park Neighborhood Water Mein Improvements (15.6448), bidding on April 24, 2019 2:00 PM (Pacific)
Bid Results
Bidder Details
Vendor Name
Stephen Doreck Equipment Rentals, Inc,
Address
9075 Telegraph Road
Pico Rivera, CA 90660
United States
Respondee
Pablo Viramontes
Reapondae Title
Vice President
Phone
662-949-4949 Ext.
Email
pabl0(@doreckeenstrtlnti0h.e0m
Vendor Type
SBE,CADIR
License #
665471
CA DIR
Bid Detail
Bid Format
Electronic
Submitted
April 24, 2019 1:30:20 PM (Pacific)
Delivery Method
Bid Responsive
Bid Status
Submitted
Confirmation #
176031
Ranking
0
Respondee Comment
Buyer Comment
Attachments
Page 1
Printed 06/14/2019
EXHIBIT A
File Title
File Name
File Type
Bid Proposal
Bid Proposal.pdf
General Forms
Ownership Affidavit
Ownership AMdavit.pdf
Ownership Affidavit (Notary
Public) - REQ Original
Hard Copy Submittal In
AddlUon
Bid Bond
Bid Bond.pdf
Bid Bond Guaranty (Notary
Public) - REQ Original
Hard Copy Submittal In
Addition
Non-Colluslon Affidavit
Non-Colluslon AMdavid.pdf
Non-Colluslon Affidavit
(Notary Public) - REQ
Original Hard Copy
Submittal In Addition
Line ttems
Type Item Code UOM oty Unit Price Line Total Comment
Base Old Proposal
1 Mobilization & Demobilization
L6 1 $73,300,00 $75,390.00
2 8" PVC Water Line per City Standard Plan 1160
LF 7550 $110.00 $830,600.00
PianatRids, Inc.
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 15-6448
THORNTON PARK NEIGHBORHOOD WATER MAIN IMPROVEMENTS
BID PROPOSAL
TO: CITY COUNCIL OF THE CITY OF SANTA ANA
FROM: _ Stephen Doreck Equipment Rentals, Inc.
REQUIREMENT:
The undersigned bidder declares that they have carefully examined the location of the proposed
work, that they have examined the Contract Documents in its entirety and hereby proposes to
furnish all material and do all the work required to complete the said work in accordance with
said plans (if any) and the specifications for the unit price($) or lump sum(s) set forth in the
following schedule:
Item
Description
Qty
Unit
Unit Price
Amount
l
Mobilization & demobilization
1
LS
$l3 :3qo pa
$ 3 390. 0o
2
8" PVC Water Line per City
Standard Plan 1150
7,550
LF
$ (�(7. 00
$ 930 :00.0
3
1" Water Service per City
Standard Plan 1401
201
EA
I �t4s oo
$ a,(oD d9S Q4
4
2" Water Service per City
Standard Plan 1402
5
EA
$� i� 00
$ ojr.eD
5
4" Water Service per City
Standard Plan 140313
1
EA
S^D.°°
$fib 50. 00
6
Fire Hydrant Assembly per City
Standard Plan 1405
13
EA
$ 015;4
$1l0
11 t
7
PCC Cross Gutter Replacement
1010
SF
$
$
per City Standard Plan 1109
31.60
39M. 0
8
PCC. Curb Ramp per City
Standard Plan1122
2
EA
$J,a +a,
$ JO 00.4°
9
2" Blow -Off Assembly per City
1
EA
$
$
Standard plan 1414
a
10
Sewer CCTV Inspection
1
LS
$ «
$ •'
1 *
Slurry Seal Surfacing
(REAS, Type IT)
203
TON
$ 60
$ ( 730 a
12
Traffic Striping
1
LS
$D
$ Oct
P-1 ofP-16
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 15-6448
THORNTON PARK NEIGHBORHOOD WATER MAIN IMPROVEMENTS
Item
Description
Qty
Unit
Unit Price
Amount
13
As -Built
1
LS
$10,000
$ 10`�pdi=
14*
1" Combination Air Valves per
City Standard Plan 1415
3
EA
$ ap,QO
$1 T76p400
15*
Vertical Offsets per City Standard
Plan 1413B
3
EA
$ 93Sr�
$ 13, Q bs do
16
Labor Agreement Oversight
1
LS
$20,000
$ �� 000 QO
TOTAL BASE BID (Items 1-16) s !�
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.
j' This bid item is considered a Specialty Item per Section 2-3.2 of the Standard Specifications,
TIME FOR COMPLETION OF IMPROVEMENTS AND r IQUI?3ATFD DAMAGES
The undersigned bidder hereby proposes to complete the Work for the total base bid amount shown
above, within one -hundred twenty (120) working days after the commencement date stated in the
Notice to Proceed.
15 — Working Days for exploratory potholing and data gatherings
105 — Working Day for project construction
The liquidated damages amount, in lieu of the amount specified in Subsection&-9 of the Standard
Specifications, shall be $2,500 per calendar day.
Name of Finn
Signaturb of BIi
Title Pablo virarrontes / vice President
(If an individual, so state. If it firm or co -partnership, state the firm name and give the names of
all individual co-partners composing the firth. If a corporation, state legal name of corporation,
and names of President, Secretary, Treasurer and Manager, thereof.)
P-2 of P-16
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Los Angeles 1
On April 24, 2019 before me, Sylvia Sifuentes (Notary Public)
(insert name and title of the officer)
personally appeared Pablo Viramontes
who proved to me on the basis of satisfactory evidence to be the person(y) whose name(A) isles'
subscribed to the within instrument and acknowledged to me that he/else/fly executed the same in
his/pt/y4h* authorized capacity(jrye)), and that by his/Nt/their signature(j) on the instrument the
person(j), or the entity upon behalf of which the person(j) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
]�+.►:`
• SYLVIA Y. SIFUENfES
"`.Ak-- .§y^ NaWryPublic'Californla
Signatur _ (Seal) AnwlesCounty
Commiulon x 2257815
Sylvia ifu me (Notary Public) Mycamm.CXplreapct8 2022
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 15.6448
THORNTON PARK NEIGHBORHOOD WATER MAIN IMPROVEMENTS
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 sea] 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 €rmish 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.
NameofFirm Stephen Doreck Equipment Rentals, Inc.
Signature of BIDDER
Title
Pablo Viramontes / Vice President
(If an individual, so state. Na firm or co -partnership, state the firm name and give the names of
all individual co-partners composing the firm, If'a corporation, state legal name of corporation,
and names of President, Secretary, Treasurer and Manager, thereof.)
P-3 ofP-16
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the Identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Los Angeles )
On April 24, 2019 before me, Sylvia Sifuentes (Nota Public)
(insert name and title of the officer)
personally appeared Pablo Viramontes
who proved to me on the basis of satisfactory evidence to be the person($) whose name(p) is/wp/
subscribed to the within instrument and acknowledged to me that he/$,U#/ executed the same in
his/,hpf/lW authorized capacity(jo#), and that by his/iWf/their signature(q) on the instrument the
person(j), or the entity upon behalf of which the person(q) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
.sera
SYLVIA Y. SIFNENI'ES
�s _ Notary Public CaINwnla
! Los lasCounty
Slgnatur (Seal) Cemmi7f an#2257818
My Comm; Bxplres Oct B, 2012
Sylvi Sifu es (Notary Public)
CITY OF SANTAANA
PROPOSAL
PROJECT NO.: 15-6448
THORNTON :PARK NEIGHBORHOOD WATER MAIN IMPROVEMENTS
CONTRACTOR'S LICENSING AND RECISTR61 ONSTATEMENT
The undersigned contractor; or corporate officer, declares under penalty of perjury that he/she
and all his/her subcontractors are registered with the State of California Department of. Industrial
Relations (DIR),, and that the following is true and correct.
Contractor's Name: Stephen Doreck Equipment Rentals, Inc.
Business Address: 9075 Telegraph Road, Pico Rivera, CA 90660
Business E-Mail Address: pablo@doreckconstructlon.com
Telephone: 562) 949-4949
State Contractor's License No. and Class: 665471-A
License Expiration Date: 02/29/2020
State. Dept. of Industrial Relations (DIR) 1000011335
iegisttation No.:
SState Dept. o£ Industrial Relations DIR) 06/3012019
:$egistration Expir b te:
Signed m
Title: Pablo Viramontes / Vice President.
P-4 of P-16
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Los Angeles )
On April 24, 2019 before me, Sylvia Sifuentes (Notary Public)
(insert name and title of the officer)
personally appeared Pablo Viramontes
who proved to me on the basis of satisfactory evidence to be the person(j) whose name(p) is/#Vff
subscribed to the within instrument and acknowledged to me that he/$##/tyW executed the same in
his/,afff/ h#p authorized capacity(jo#), and that by his/Mt/their signature(y) on the Instrument the
person(y), or the entity upon behalf of which the person(s) acted, executed the Instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
YLVIA V. arreS
Signatur&=T (Seal) ;E f NotaryPubllc-Ca�Nornla
S Ivi en es (Notary Public cQmemMfo�rs2s eia Y ( rY MY Comm, Expires Oct B, 2022
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 15-6448
THORNTON PARK NEIGHBORHOOD WATER MAIN IMPROVEMENTS
PREVAILING WAGE COMP IANCEAND MONITORING STATE
Contractor is aware of the requirements of California Labor Code Section 1720, of seq„ as well
as California Code of Regulations, Title 8, Section 16,000, et seq., ('Prevailing Wage Laws"),
which require the payment of prevailing wage rates and the performance of other requirements
on "public works" and "maintenance" projects. Since the services are being performed as part of
an applicable "public works" or "maintenance" project, as defined by the Prevailing Wage Laws,
and since the total compensation is $1,000 or more, Contractor agrees to fully comply with such
Prevailing Wage Laws,
City shall provide Contractor with a copy of the prevailing rates of per diem wages in effect at
the commencement of this Agreement. Contractor shall make copies of the prevailing rates of
per diem wages for each craft, classification or type of worker needed to execute the services
available to interested parties upon request, and shall post copies at the Contractor's principal
place of business and at the project site.
Contractor shall defend, indemnify and hold the City, its elected officials, officers, employees
and agents free and harmless from any claim or liability arising out of any failure or alleged
failure to comply with the Prevailing Wage Laws.
The undersigned certifies that the foregoing is true and correct.
Name of Firm Stephen Doreck EqulpMent Rentals, Inc.
,°Stgnatuee_ofBIDDER
Title .-Pablo Viramontes / Vice President
(if anindvidual, so state)
P-5 of P-I6
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Los Angeles )
on April 24, 2019 before me, Sylvia Sifuentes (Notary public)
(insert name and title of the officer)
personally appeared Pablo Viramontes
who proved to me on the basis .of satisfactory evidence to be the person(q) whose name(s) is AY#
subscribed to the within instrument and acknowledged to me that he/$,ifq/yi* executed the same in
his/hirillt"t authorized capacity(] ), and that by his/of/their signature(y) on the instrument the
person(y), or the entity upon behalf of which the person(]) acted, executed the instrument.
I certify under PENALTY OF (PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
3YLVIAK 31rurNrrs
Notary PU lk-Call twnia
LoshnppeeI county j
_. CommiU 04 M 2237+lt8
Slgnatur (Seal) MY eamm. Expire, on 3, 2022
Sylvia me (Notary. Public)
CITY OF SANTA ANA
PROPOSAL
PROJECT NO. 15-6448
THORNTON PARK NEIOHBORHOOD WATER MAIN IMPROVEMENTS
OWNER$12 AFFIDAVIT
6TATL Or CALIFORNIA
COUNTY OF ORANGE ) Ss:
CITY OF SANTA ANA )
Pablo Viramontes _,being duly sworn, deposes and says:
❑ INDIVIDUAL That Ire/sho is 'the party ranking the foregoing proposal:
EIrART'NCsRS1111' That hcishcisamemberofthe co•partuonihipfirmdesignated as:
and who has boon mid is duly vested with the authority to -make and executo iniat a ions
for the co -partnership by:
Who constitute the other members of the co -partnership.
CORPORATION That he is of: Stephen Doreck Equipment Rentals; Inc.
resi en
a corporation which is. making the foregoing proposal:
El JOINT VRNTURrs That he is of.
one: of the parties taking are &
been and is duly vested with the
parties staking said bid whoaro:
refusal as a Joint venture, and it
to execute instrumentsfor nit on
that such a bid is genuine and not collusive or sham, and has not in any manner sought by
collusion to secure any advantage against the City of Santa Ana or any person interested in the
prop��� t for or any other person.
Signature of Bidder
Aril
Sltbscrbed and: sw m to before the this 24th day of P 2019
Signat b offWcr Administering Oath (Notary Public)
Sylvia Sifuentes / Notary Public
P-6 ofP-16
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
vaFid_ity of that document.
State of California
County of Los Angeles
Subscribed and sworn to (or affirmed) before me on this lath
day of April 20 19 , by Pablo Viramontes
proved to me on the basis of satisfactory evidence to be the
person(s) who appeared before me.
SYWIA V. SIFUENTES
Notary Public • California
Los
s Commission N 2257818
My Comm. Expires Oct B, 2022
(Seal) Signatur
Sylvia S ue es ota Public)
CITY OF SANTA ANA Bond No. CSBA-10546
PROPOSAL
PROJECT NO.: 15-6448
THORNTON PARK NEIGHBORHOOD WATER MAIN IMPROVEMENTS
BID BOND
KNOW ALL PRESENT that
Stephen Doreck Equipment Rentals Inc. as BIDDER, and
North American Specialty Insurance Company as SURETY,
are held and firmly bound unto the CITY OF SANTA ANA, as AGENCY, in the penal sum of _
Ten Percent of Amount Bid Dollars ($ lo% ), 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
22nd day of April , 201k.
BIDDER*
J U t(h I Y'"
6 Hutton Center pave, Suite 850
to before me
, 20_
Signature:
Notary Public in and for the County of
orange, CA 92867 (714) 516-1232
this
State of
day of
Provide BIDDER/ SURETY name, address, and telephone number and the name. title,
address, and telephone number of authorized representative.
P-7 of P-16
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Los Angeles )
On April 24, 2019 before me, Sylvia Sifuentes (Notary Public)
(insert name and title of the officer)
personally appeared Pablo Viramontes
who proved to me on the basis of satisfactory evidence to be the person(g) whose name() is/Mft
subscribed to the within instrument and acknowledged to me that he/$ft#1 /j executed the same in
his/,frp//zjyf authorized capacity(YO/4), and that by his/t/ylr/their signature(j) on the instrument the
person(q), or the entity upon behalf of which the person(j) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
Signature
Sylvi SI e es (Notary Public)
. y SYLVIA V, SIFUENTES
3 Notary public • California
•� = Los Angeles County
7 Commission # 2257818
(Seal) My Comm, Expires Oct 8, 2022
�ww�
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Orange
On 4/22/2019 before me, Melissa Ann Vaccaro, Notary Public
(insert name and title of the officer)
personally appeared Arturo Ayala
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS m hand and official seal. =Notary
VACCARO
y 41394 m-California ¢OUNTY nf May 12,2U22
Signature W&Lcavv - -CC -o (Seal)
Melissa Ann Vaccaro
SWISS RE CORPORATE SOLUTIONS
NORTH AMERICAN SPECIALTY INSURANCE COMPANY Bond No. CSBA-10546
WASHINGTON INTERNATIONAL INSURANCE COMPANY
WESTPORT INSURANCE CORPORATION GENERAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a corporation duly organized and existing under
laws of the State of New Hampshire, and having its principal office in. the City of Kansas City, Missouri and Washington International Insurance
Company a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Kansas
City, Missouri, and Westport Insurance Corporation, organized under the laws of the State of Missouri, and having its principal office in the City of
Kansas City, Missouri. does hereby make, constitute and appoint.
DANIEL HUCKABAY, ARTURO AYALA, DWIGHT REILLY, SHAUNNA ROZELLE OSTROM, and FRANK MORONES
JOINTLY OR SEVERALLY
Its true and lawful Attorney(s)-hi-Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings
obligatory in the nature of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by
law, regulation, contract or otherwise, provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the
amount of: ONE HUNDRED TWENTY FIVE MILLION ($125,000,000.00) DOLLARS
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of
Directors of North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held
on March 24, 2000 and Westport Insurance Corporation by written consent of its Executive Committee dated July 18, 2011.
"RESOLVED, that any two of the President, any Senior Vice President, any Vice President, any Assistant Vice President,
the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named
in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and all contracts of surety, and that each or any of them
hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is
FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any
certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be
binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached."
By
Steveu error me res onto asr ngmn nerux .nx n ce company
11 &rSeuior Vice Prmitlent of North Arverieau Specialty InsuraneerCompxny
& senior Vice President of WWaottporrtt Insurance Corporation
Mil. A. Ito, Senior Vice P.,ident of Washington Intonational Insurance Company
& Sonia, Vice President of North American Specialty Ivaurmec Comp,.,
& Senior Vice President of Westport Insuranm Cmyorafion
IN WITNESS WHEREOF, North American Specialty Insurance Company, Washington International Insurance Company and Westport
Insurance Corporation have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized officers this
this 14TH day of JANUARY 120 19 .
North American Specialty Insurance Company
Washington International Insurance Company
State of Illinois Westport Insurance Corporation -
Comfy of Cook ss:
On this 14THday of JANUARY , 20 19, before me, a Notary Public personally appeared Steven P. Anderson , Senior Vice President of
Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Senior Vice President of
Westport Insurance Corporation and Michael A. Ito Senior Vice President of Washington International Insurance Company and Senior Vice President
of North American Specialty Insurance Company and Senior Vice President of Westport Insurance Corporation, personally known to me, who
being by me duly sworn, acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the
voluntary act and deed of their respective companies.
OFFICIAL SEAL
n. y KENNY
N.MPattie -stow of 111htN5
iAyCammissionErpns
MOMrut. Denny, Notary PuhHo�
I, Jeffrey Goldberg , the duly elected Vice President and Assistant Secretary of North American Specialty Insurance Company, Washington
International Insurance Company and Westport Insurance Corporation do hereby certify that the above and foregoing is a true and correct copy of a
Power of Attorney given by said North American Specialty Insurance Company, Washington International Insurance Company and Westport Insurance`
Corporation which is still in full force and effect.
IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 2211d day of April 2019
S p�
Ieffrey Goldberg, Vice Psident & Aevstent SCcremry of Washington hxemational hvwnmce Company &
North Amarican specialty Insmama Company & Vice hceddenl & As,Warf Seme.ry of Westport insimme Corporation
CITY OF SANTA ANA
PROPOSAL
PROJECT NO,: 15.6448
THORNTON PARK NEIGHBORHOOD WATER MAIN IMPROVEMENTS
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: %:%o of the bid or $10,000, whichever is greater
o Buildings, parks, or other projects: %z°/u of.the bid
Section 1725.5 of the Public Contract Code requires all Subcontractors be registered with the State
Department of Industrial Relations (DIR).
BIDDER proposes to subcontract certain portions of the work to the'6nns listed below:
Nance 1i l l l
License #/Exp,
DIR Reg. 4/Exp.
Location
Phone
Type Of Work
Amount$
Name
License #/Exp, w $" 3
DIR Reg.#/Exp•
License #
Location
Phone
Type Of Work n" leg
Amount $ -Is, 0
Name
License #/Exp.
DIR Reg. #/Exp.
License #
Location
Phone
Type Of Work
Amount $
Name
License#/Exp.
DIR Reg. #/Exp.
Location
Phone
Type Of Work
Amount $
91MAi[=
License 4/Exp.
DIR Reg. #/Exp.
License #
Location
Phone
Type Of Work
Amount $
Nance
License #/1xp,
DIR Reg.#/Exp.
License #
Location
Phone
Type of Work
Amount $
a'Si&ature of Bidder
Pablo Viramontes / Vice President
P-8 of P-16
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 15-6448
T14O.RNTON PARK. NEIGHBORHOOD WATER MAIN IMPROVEMENTS
The following are the names, addresses, and telephone numbers for THRE, E public agencies for
which the BIDDER has performed similar work within the past three years.
1 CITY OF MANHATTAN BEACH 1400 Highland Avenue Manhattan Beach, CA
Name and'1'elephone Number of person familiar with project. 7/2018
2,188,070.00 Water Main Replacement
Contract Amount Type of Work Date Completed
2: City of Alhambra 111 South First Street, Alhambra, CA 91801
Name and Address of owner.
Number of person familiar with project. 7/2017
Replacement of 4" and 14" Watermains
Type of Work Date Completed
3. City of El Segundo - 350 Main Street El Segundo, CA 90242
$496,400.21 Water Main Improvements 9/2014
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.
Commercial Surety Bond Agency 1411 N. Batavia Street Suite 201, Orange, CA 92867
Daniel Huckabay 714) 516-1232
Wright, Finnegan & Carter Ins 22800 Savi Ranch Pkwy Suite # 202, Yorba Linda, CA 92887
John Carter 714) 283.1999
P-9 ofP-16
CYTY OF SANTA ANA
PROPOSAL
PROJECT NO.: 15-6448
THORNTON PARK NEIGHBORHOOD WATER MAIN IMPROVEMENTS
ADDITIONAL REFERENCES
The following are the names, addresses, and telephone numbers for THREE public agencies for
which the BIDDER or Subcontractor has performed similar work in the past five years.
1. City of Lomita 24300 Narbonne Ave., Lomita, CA 90717
Name and Address of Owner.
person familiar with project.
Water Main Replacement 7/2014
Type of Work Date Completed
2 City of Paramount 16400 Colorado Street, Paramount, CA 90723
Nanneand Address of owner,
Christopher S. Cash 562) 220-2000
Nance and Telephone Number of er on fnmi((iar with pro eel.
1,196,462.00 S�nal Main ReplacemOt Project Phase 1 11/2013
Contract Amount Type of Work Date Completed
1 City of Torrance 20500 Madrona Ave,, Torrance, CA 90503
Name ana Haaress or owner:
Emmanuel Martin 310) 61`8.3059
Name and Telephone Number of person familiar with project. 12/2012
1,574,419.00 Ductile Iron Pipe
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.
Commercial Surety Bond Agency 1411 N, Batavia Street Suite 201, Orange, CA 92867
Daniel Huckabay 714) 516-1232
Wright, 1=innegan & Carter Ins 22800 Savi Ranch Pkwy Suite # 202, Yorba Linda, CA 92887
John Carter 714) 283-1999
P-10 of P-16
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 15-6448
THORNTON PARK NEIGHBORHOOD WATER MAIN IMPROVEMENTS
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 11.2 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 Affidavit is part of the Proposal.
cautioned that making a false certification may subject the c
Signed
State of California
County of Los Angeles
BIDDERS -are.
ertifier to criminal
Subscribed and sworn to (or affirmed) before me on this 24th day ofApril , 2079 by
Pablo Viramontes , proved to me on the basis of satisfactory evidence to be the
person(s) who appeared before me
Notaf I b i ignature Notary Public Seal
Sylvia Sifuentes / Notary Public
SYLA y, gl— p� N EN
544'
Notary Public• California
'#; �' Los Angeles County y
Commission B;2g7818
My Comm. Expires ect g, 2012
P-1I of P-16
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate
Is attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Los Angeles
Subscribed and sworn to (or affirmed) before me on this 24th
day of April 20 19 , by Pablo Viramontes
proved to me on the basis of satisfactory evidence to be the
person(s) who appeared before me.
SYLVIA V SIFUENrES
NotaryPubllC • California
C
Los Mgeles County
ommission M 2257S fa
MY Comm. Explres
Oa 8, 2022
(Seal) Signatur
Sylvia S' ue es otary Public)
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 15-6448
THORNTON PARK NEIGHBORHOOD WATER MAIN IMPROVEMENTS
0 1-DISCRI (NATION CERTIFICATE
The undersigned contractor or corporate officer, during the performance of this contract, certifies
as follows:
I. 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 workerswith which he/she
has a collective bargaining agreement or other contract or understanding, a notice to be
provided advising the said labor union or workers' representatives of the Contractor's
commitments under this section, and shall post copies of the notice in conspicuous places
available to employees and applicants for employment.
4. The Contractor shall comply with all provisions of Executive Order 11246 of September 24,
1965, and of the rules, regulations, and relevant orders of the Secretary of Labor.
5. The Contractor shall furnish all information and reports required by Executive Order 11246
of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or
pursuant thereto, and will permit access to his/her books, records, and accounts by the
administering agency and the Secretary of Labor for purposes of investigation, to ascertain
compliance with such rules, regulations, and orders.
6. In the event of the Contractor's non-compliance with the nondiscrimination clauses of this
contract or with any of the said rules, regulations, or orders, the contract may be canceled,
terminated, or suspended in whole or in part and the Contractor may be declared ineligible
for further Government contracts or federally assisted construction contracts in accordance
with procedures authorized in Execution Order 11246 of September 24, 1965; and such other
sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of
September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as
otherwise provided by law.
P-12 of P-16
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 15-6448
THORNTON PARK NEIGHBORHOOD WATER MAIN MROVEMENTS
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 onfvrcing such provisions, including sanctions for noncompliance; provided,
however, that in the event the Contractor becomes involved in, or is threatened with,
litigation with a subcontractor or vendor as a result of such direction by the administering
agency, the Contractor may request that the United States enter into such litigation to protect
the interests of the United States.
8. Pursuant to California Labor Code Section 1735, as added by Chapter 643 Stats. 1939, and as
amended, no discrimination shall be made in the employment of persons upon public works
because of race, religious creed, color, national origin, ancestry, physical handicaps, mental
condition, marital status, or sex of such persons, except as provided in Section 1420, and any
contractor of public works violating this Section is subject to all the penalties imposed for a
violation of the C or,
Signed: "`---
Ifitle: Pablo Viramontes / Vice President
Firm: Stephen Doreck Equipment Rentals, Inc.
Date: 04/24/2019
P-13 of P-16
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate Is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Los Angeles
on April 24, 2019 before me, Sylvia Sifuentes (Notary Public)
(insert name and title of the officer)
personally appeared Pablo Viramontes
who proved to me on the basis of satisfactory evidence to be the person(a) whose name(A) is/
subscribed to the within instrument and acknowledged to me that he/O#/t y executed the same In
his/j)q//t#* authorized capacity(10/4), and that by his/NIr/their signature(y) on the instrument the
person(j), orthe entity upon behalf of which the person(!) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct,
WITNESS my hand and official seal,
• SYLVIA V. SIFUENTES
Notary Public • California
Signatu (Seal) �! Los Angeles My oies County
County
Sylvia enes(Notary Public) My COMM. ExPiresOct 8,2022
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 15.6448
THORNTON PARK NEIGHBORHOOD WATER MAIN IMPROVEMENTS
STATEMENT REGARDING APPRENTICESHIP REOUIREMENTS
The undersigned BIDDER is familiar with the requirements of Section 1777.5 of the State Labor
Code regarding employment of apprentices, and understands that contractors on contracts
exceeding $30,000 or 20 working days shall:
1. Apply to the joint apprenticeship committee administering the apprenticeship standards of
the craft or trade in the area of the site of the public work for a certificate approving the
contractor under the apprenticeship standards for the employment and training of apprentices
in the area or industry affected.:
2. Employ the number of apprentices or the ratio of apprentices to journeymen stipulated in the
apprenticeship standards.
3. Contribute to the fund or funds in each craft or trade in which he/she employs journeymen or
apprentices on the public work, in the same amount or upon the same basis and in the same
manner as the other contractors, except contractors not signatory to the trust agreement shall
pay a:Jike amount tt th��A prenticeship Council
Title:. Pablo Viramontes / Vice President
Firm: Stephen Doreck Equipment Rentals, Inc.
Date: 04/24/2019
P• 14 of P-16
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the Identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Los Angeles )
On April 24, 2019 before me, _ Sylvia Sifuentes (Notary, Public)
(insert name and title of the officer)
personally appeared Pablo Viramontes ,
who proved to me on the basis of satisfactory evidence to be the person(q) whose name(p) istAvg
subscribed to the within instrument and acknowledged to me that he/$)fly/ty#y executed the same in
his/jl#//))fir authorized capacity(i0#), and that by his/iWt/their signature(j) on the instrument the
person(y), or the entity upon behalf of which the person(j) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
SVF.VIAV, $1rUENrE$
Notary Public • California
Signatutr:�r (Seat) , Los Angeles County
COMmSylvi -i a s(Notary Public) 'Explres Oct B�
My Comm7012+
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 15-6448
THORNTON PARK NEIGHBORHOOD WATER MAIN IMPROVEMENTS
STATEMENT REGARDING "ANU-KICKBACK" FO 7IREMENTS
The undersigned is submitting this proposal for performing by contract the work required by
these bid documents, agrees to comply with the Copeland "Anti -Kickback" Act (18 USC 74) as
supplemented in the Department of Labor regulations (29 CFR, Part 3). This act provides that
each contractor or subcontractor shall be prohibited from inducing, by any means, any person
employed in the construction or repair of public work, to give up any part of the compensation to
which`he/she is otheri5i �enjtitled.
Sned:!/G2 �—
`Titei Pablo Viramontes / Vice President
Firm: Stephen Doreck Equipment Rentals, Inc.
Date: 04/24/2019
P-15 ofP-16
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Los Angeles )
On April 24, 2019 before me, Sylvia Sifuentes (Notary Public)
(insert name and title of the officer)
personally appeared Pablo Viramontes
who proved to me on the basis of satisfactory evidence to be the person(a) whose name(p) is/0yf/
subscribed to the within Instrument and acknowledged to me that he/i ipltwy executed the same in
hislf/f/yjyr authorized capacity("), and that by hisAWEftheir signature(a) on the instrument the
person(j), or the entity upon behalf of which the person(q) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
SYLVIA V. SIFUENTES
NotaryPublic • CalNemla
Signaturet (Seal) _ Lomissio N2257ly €
Cammisslon 9 2257818
Sylvia nt (Notary Public) MyComm.ExpiresOct8,2022
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 15-6448
THORNTON PARK NEIGHBORHOOD WATER MAIN IMPROVEMENTS
PUBLIC CONTRACT CODE SECTION 10162 OU13STIONNAIRE
In conformanee with Public Contract Code Section 10162, the BIDDER shall complete,
under penalty ofperjury, 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-16 of P46
C. O� ��`� rnm u0m om D�Si`o
� Z`w as onaB
° o OR _ID
a M
m a
to
'
V
Off
f�li
N
6coo
d
�
�
o
O
O
O
p
LnIm
0
r nr-M-lo m%Dv 03�M oM 0m DNf1r r n
fD ^ m 0 of m 3 0 o y m` m o m n y o m m N
a. U m a< y J `� J OV OC o 00 OC m Ov
�p1 a+m =mm�P-Nin'�� 0 `»0',-4`m o
trnnZZ�d o aim m>.d._ N a.= Z.�. N
m rc 0r)3 am'>FnCL ,Do mo W o 0
'.y .. m O O c m m
2 7
0 10 9 0 ? o o n a KD
O O
9 m 3 fn
Z ° O O m m v ..
3 Z m
A � A -I r-h �
_-h m p< P< z \ V
j D D D D n
�^ o o G m
z m rn O
n O o
s s 3
CD
o�
v_
N a o 0 o m rDD '�^^- X
omh
N ` A V' v
N N On J 00
m O
O O O O O m T
W w w W w 9 1
O O 0.
O O O d r+ /^ 0
N 01 - J OD 0p O � {— �
O O
O•
V+
THE FINAL PREMIUM IS
PREDICATED ON THE CITY OF SANTA ANA
FINAL CONTRACT AMOUNT BONDS
PROJECT NO.: 15-6448
PAYMENT BOND
This bond was issued in three (3)
original counterparts
Bond No. 2290055
KNOW ALL MEN BY THESE PRESENTS that Stephen Doreck Equipment Rentals, Inc.
as CONTRACTOR, and North American Specialty Insurance Company
a corporation, organized and existing under the laws of the State, and duly authorized to transact
business under the laws of the State of California, as SURETY, are held and firmly bound unto
the City of Santa Ana, as AGENCY, in the penal sum of
One Million Six Hundred Sixty Thousand Three Hundred Seventy and 00/100 Dollars
($ 1,660,370.00 ), which is 100 percent of the total contract amount for the above stated
project, for the payment of which sum, CONTRACTOR and SURETY agree to be bound, jointly
and severally, firmly by these presents.
THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas CONTRACTOR has
been awarded and is about to enter into the annexed Contract Agreement with AGENCY dated
June 4th. 2019 for Project No.: 15-6448, Thornton Park Neighborhood Water Main Improvements
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
6th day of
,2019 .
Doreck Equipment Rentals, Inc.
T-
lCE P1�Si
Specialty Insurance Companv
Subscribed and sworn to before me,
20
Signature:
Notary Public in and for the County of
9075 Telegraph Road
6 Hutton Center Drive, Suite 850
Orange, CA 92867, (714) 516-1232
,this day of
State of
Rate of premium on this bond is $ See Performance Bond per thousand.
Total amount of premium charge is $ See Performance Bond . To be filled in by Surely
*Provide CONTRACTOR /ADMITTED SURETY name, address, and telephone number and the
name, title, address, and telephone number of authorized representative.
2of3
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Los Angeles )
On July 11, 2019 before me, Sylvia Sifuentes (Notary Public)
(insert name and title of the officer)
personally appeared Pablo Viramontes ,
who proved to me on the basis of satisfactory evidence to be the person(q) whose name(p) is/fflgy
subscribed to the within instrument and acknowledged to me that he/0#/** executed the same in
hisfty/k)y0if authorized capacity(MI), and that by his/Ifr/their signature(j) on the instrument the
person(q), or the entity upon behalf of which the person(q) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
SYLVI l
Notary Public - California
s Los Angeles County
Signature (Seal) Cmission# 2257818
SYIv Sfuetes (Notary Public) * MY�-
J
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Oranqe
On 6/6/2019 before me, Melissa Ann Vaccaro, Notary Public
(insert name and title of the officer)
personally appeared Shaunna Rozelle Ostrom
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
1�
SignatureW -,iZYAA� U (Seal)
<: MEu MM.#2SA 4:L394VACCAo
- COMM. #2241394 �
.4W<..e-; Notary Publ!uCalifomia r�
ORANGE COUNTY
.•,, My Comm. Expires May 12,2022
Melissa Ann Vaccaro
SWISS RE CORPORATE SOLUTIONS
NORTH AMERICAN SPECIALTY INSURANCE COMPANY Bond No. 2290055
WASHINGTON INTERNATIONAL INSURANCE COMPANY
WESTPORT INSURANCE CORPORATION GENERAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a corporationduly organized and existing under
laws of the State of New Hampshire, and having its principal office in the City of Kansas City, Missouri and Washington International Insurance.
Company a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Kansas
City, Missouri, and Westport Insurance Corporation, organized under the laws of the State of Missouri, and having its principal office in the City of
Kansas City; Missouri does hereby make, constitute and appoint:
DANIEL HUCKABAY, ARTURO AYALA, DWIGHT REILLY, SHAUNNA ROZELLE OSTROM, and FRANK MORONES
OR. SEVERALLY
Its true and lawful Attorney(s)-in-Fact, to make, execute, seal and deliver, for andon its behalf and as its act and deed, bonds or other writings
obligatory in the nature of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by
law, regulation, contract or otherwise, provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the
amount of'. ONE HUNDRED TWENTY FIVE. MILLION ($125,000,000.00) DOLLARS
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of
Directors of North American Specialty Insurance Company and Washington International hnsurance Company at meetings duly called and held
on March 24, 2000 and Westport Insurance Corporation by written consent of its Executive Committee dated July 18, 2011.
"RESOLVED, that any two of the President, any Senior Vice President, any Vice President, any Assistant Vice President,
the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named
in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and all contracts of surety, and that each or any of them
hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is
FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any
certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shallbe
binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached."
�yyMtUlllllllilq//// ng 1011MA4
1,
,
<'s,IaQ��Q Tv/, �� 0�'�oaPo�(/4,s.pr By
$ :YaQ TA L b. LSteven n ersen, en o me P rea ent as aagtorr tern mean ueurmme Company
gcT) SEAL 2 4 •n.� &Seruar Vitt President al North Amernan SPemnity lnsmance Cnmpvny
o=_ ao
=uP]12 1373 m my a� '� & Senior vren President or�w,e/s�tnarnm:ancecernm noon
jyh a
�/Nuw�WIN� MtleeA.I[e, Senor Vi¢Pmeident of Waeldng(on International rneumnco Company
& Senior Vice President of North American Specialty Insusnvre Company
& Senior Vim President of We,(nor( hrsurance Corporation
IN WITNESS WHEREOF, North American Specialty Insurance Company, Washington International Insurance Company and Westport
Insurance Corporation have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized officers this
this 14TIJ day of JANUARY 20 19
North American Specialty Insurance Company
Washington International Insurance Company
State of Illinois Westport Insurance Corporation
County of Cook ss:
On this 14THday of JANUARY 20 I9 before me, a Notary Public personally appeared Steven P. Anderson , Senior Vice President of
Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Senior Vice President of
Westport Insurance Corporation and Michael A. Ito Senior Pace President of Washington International Insurance Company and Senior Vice President
of North American Specialty Insurance Company and Senior Vice President of Westport Insurance Corporation, personally known to me, who
being by me duly sworn, acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the
voluntary act and deed of their respective companies.
OFFICWLSEAL y
M. KENNY
Notary Poblm-Statear 1p 6is
tnycnmmay0M1=grin
axldxlsnzr _ M» Kenny, Notary Public
I, Jeffrey Goldberg the duly elected Vice President and Assistant Secretary of North American Specialty Insurance Company, Washington
International Insurance Company and Westport Insurance Corporation do hereby certify that the above and foregoing is a five and correct copy of a
Power of Attorney given by said North American Specialty Insurance Company, Washington International Insurance Company and Westport Insurance
Corporation which is still in full force and effect. ,
IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 6th day of June 2019
F Qy.
Jeffrey Goldbe,g, Vice President & Assistant Secremry of Washington Intemanonal lnsmance Company &
Nosh Amenron Specialty Insurance Con,porty & Vicv Resident & Assistmn Secreloo, ofwestpon Innureece Cmprnndon
THE FINAL PREMIUM IS
PREDICATED ON THE
FINAL CONTRACT AMOUNT
KNOW ALL MEN BY'
as CONTRACTOR, and
CITY OF SANTA ANA
BONDS
PROJECT NO.: 15-6448
IVA-ty" • ' 1_I
This bond was issued in three (3)
original counterparts
Bond No. 2290055
Premium: $14,341.00
PRESENTS that Stephen Doreck Equipment Rentals. Inc.
a corporation, organized and existing under the laws of the State, and duly authorized to transact
business under the laws of the State of California, as SURETY, are held and firmly bound unto
the City of Santa Ana, as AGENCY, in the penal sum of
One Million Six Hundred Sixty Thousand Three Hundred Seventy and 00/100 Dollars
($1,660,370.00 ), which is 100 percent of the total contract amount for the above stated
project, for the payment of which sum, CONTRACTOR and SURETY agree to be bound, jointly
and severally, firmly by these presents.
THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas CONTRACTOR has
been awarded and is about to enter into the annexed Contract Agreement with AGENCY dated
June 4th, 2019 for Project No.: 15-6448, Thornton Park Neighborhood Water Main Improvements
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
6th day of June , 2019
Inc.
-V1
Subscribed and sworn to before me,
20
Signature:
9075 Telegraph Road
6 Hutton Center Drive, Suite 850
Orange, CA 92867, (714 516-1232
's day of
Notary Public in and for the County of State of
Rate of premium on this bond is $ 14.40 / $10.80 / $7.395 per thousand.
Total amount of premium charge is $ 14,341.00 . 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
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Los Angeles )
On July 11, 2019 before me, Sylvia Sifuentes (Notary Public)
(insert name and title of the officer)
personally appeared Pablo Viramontes
who proved to me on the basis of satisfactory evidence to be the person(j) whose name(p) is/Ayf/
subscribed to the within instrument and acknowledged to me that he/$X;<#/**y executed the same in
hisft/y/�i Of authorized capacity(M), and that by his/ifflf/their signature(j) on the instrument the
person(j), or the entity upon behalf of which the person(q) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
rVIAV, SIFUEMfES
Notary Pu61ic • CaAPornla
Si Los Angeles County
g natUr (Seal) Commission#2257g1g
Sylvi ent (Notary Public) y Comm, Expires Oct a, 2022
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Orange
On 6/6/2019 before me, Melissa Ann Vaccaro, Notary Public
(insert name and title of the officer)
personally appeared Shaunna Rozelle Ostrom
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
=,-Notary
Nvaccaao N
2241394 n
lloCaliforma
COUNTYnres May 12, 2022
Signature VJW� (Seal)
Me Issa Ann Vaccaro
SWISS RE CORPORATE' SOLUTIONS
NORTH AMERICAN SPECIALTY INSURANCE COMPANY Bond No. 2290055
WASI-IINGTON INTERNATIONAL INSURANCE COMPANY
WESTPORT INSURANCE CORPORATION GENE RAL POWER OF ATTORNEY
KNOW ALL MEN BY TIIESE PRESENTS, TUATNorth American Specialty Insurance Company, a corporation duly organized and existing under
laws of the State of New Hampshire, and having its principal office in the City of Kansas City, Missouri and Washington International Insurance
Company a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Kansas
City, Missouri, and Westport Insurance Corporation, organized under the laws of the State of Missouri, and having its principal off -ice in the City of
Kansas City, Missouri does hereby make, constitute and appoint
DANIEL HUCKABAY, ARTURO AYALA, DWIGIIT REILLY, SHAUNNA ROZELLE OSTROM, and FRANK MORONES
Y OR SRVF.RALLY
Its true and lawful Athuney(s)-in-Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings
obligatory in the nature of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by
law, regulation, contract or otherwise, provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the
amount of: ONE HUNDRED TWENTY FIVE MILLION ($125,000,000.00) DOLLARS
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the hoards of
Directors of North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held
on March 24, 2000 and Westport Insurance Corporation by written consent of its Executive Committee dated July 18, 2011.
"RESOLVED, that any two of the President, any Senior Vice President, any Vice President, any Assistant Vice President,
the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named
in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and all contracts of surety, and that each or any of them
hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is
FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any
certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be
binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached."
By
Steven emnr ,m P .00 en o ns ,n on nlnrnnl one nsumncc Cumpnny
st'&rScodoi Vim President of North Ame,'lean Speeinlly Insurance Coni,a,ry
& Senior Vice Preaidenl of Weslpurt Insmv.eo Corporafimt
BY :It�
Mike A. It., SeniorVice P.ddem of %,Ifl.ylnn adernntional Insmmae Company
&Snder'Vim Prnnidenr ornmlL Americ'tn Specially..fl.n sp Comrymy
& seam. er vim r.nniaem arwmlrorl unsnraae<cparanmt
IN WITNESS WHEREOF, North American Specialty Insurance Company, Washington International Insurance Company and Westport
Insurance Corporation have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized officers this
this 14TI-I day of JANUARY 20 19
North American Specialty Insurance Company
Washington International Insurance Company
State of Illinois Westport Insurance Corporation -
County of Cook as:
On this 14THday of JANUARY 2019 before me, a Notary Public personally appeared Steven P. Anderson , Senior Vice President of
Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Senior V ice President of
Westport Insurance Corporation and Michael A. Ito Senior Vice President of Washington International Insurance Company and Senior Vice President
of North American Specialty Insurance Company and Senior Vice President of Westport Insurance Corporation, personally known to me, who,
being by me duly sworn, acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the
voluntary act and deed of their respective companies.
arltclal stn.
b, KENNY
Nalary PabhE 5aancnf IDmpis
MyCo.M �dae&pyps
rpu4rsa:, M. Ketnny, Notary Public
I, Jefi'rey Goldberg the duly elected Vice President and Assistant Secretary of North American Specialty Insurance Company, Washington
International Insurance Company and Westport Insurance Corporation do hereby certify that the above and foregoing is a true and correct copy of a
Power of Attorney given by said North American Specialty Insurance Company, Washington International Insurance Company and Westport Insurance
Corporation which is still in full force and effect
IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this ball day of dune 2019
]annoy Goldkerp, Vioe Prasidem&Assiotmrt secretory nfWnshingian Ldomelional lnsumtme Company&
North American Spocwlly nnswvtce Company&Vice Prestdmf&Assisinm Socreury of Westport ksninnco Corpmalimr
CITY OF SANTA ANA
PUBLIC WORKS AGENCY
CONTRACT CHANGE ORDER
Project Number Project No. 15-6448 Thornton Park Water Main Change Order Number 1
To Stephen Doreck Equipment Rentals ,Inc. Contractor
You are hereby directed to make the herein changes from the plans and specifications or do the following described work not included in the plans and
specifications on this contract.
NOTE: THIS CHANGE ORDER IS NOT EFFECTIVE UNTIL APPROVED BY THE CITY COUNCIL OR CITY MANAGER.
Unless otherwise stated, rates for rental of equipment cover only such time as equipment is actually used and no allowance will be made for idle time.
Change requested by PUBLIC WORKS AGENCY
EXTRA WORK AT AGREED UNIT PRICE
UNIT
ITEM # DESCRIPTION QUANTITY UNIT PRICE AMOUNT
TOTAL AGREED PRICE = $145,876.55
�I�iCGwver.e� o� �xic-�-°�"7/Q,�,n�'»✓�� �Ocst�Mnr,
17 Install 16" Butterfly
Valves in Bristol
2
EA
$42,255.00
$84,510.00
Street
Perform 1" Grind and Cap With
18
Rubberized Asphalt In Lieu of Slurry
7,417
SF
$0.71
$5,266.07
Seal
19
Adjust Manholes to Grade
10
EA
$650.00
$6,500.00
20
Perform 2" Grind and Cap With
4,400
SF
$6.65
$29,260.00
Rubberized Asphalt
21
Cut In 8" Gate Valve
1
LS
$9,780.48
$9,780.48
22
Replace Traffic Loops at Bristol
3
EA
$420.00
$1,260.00
23
Install Speed Bumps
3
EA
$3,100.00
$9,300.00
Page 1 of 2
CITY OF SANTA ANA
PUBLIC WORKS AGENCY
CONTRACT CHANGe ORDER
Project Number Project No. 15-6448 Thornton Park Water Main Change Order Number 1
To Stephen Doreck Equipment Rentals Inc. Contractor
You are hereby directed to make the herein changes from the plans and specifications or do the following described work not included in the plans and
specifications on this contract.
NOTE: THIS CHANGE ORDER IS NOT FFFFr:TIVF I INTn
Unless otherwise stated, rates for rental of equipment cover only such time as equipment is actually used and no allowance will be made for idle time.
Change requested by PUBLIC WORKS AGENCY
The compensation both time and cost set forth in this change order comprises the total compensation
due the Contractor, all Subcontractors, and all Suppliers for all work performed per this change order,
including impact on unchanged work. By signing this change order, the Contractor acknowledges and
agrees on behalf of himself, all Subcontractors, and all Suppliers, that the stipulated compensation
includes payment for all work contained in this change order, plus all payment for interruption of
schedules, extended field overhead, home office overhead, profit, delay, and all impact, ripple effect or
cumulative impact on all other work under this Contract. The signing of this change order constitutes full
mutual accord and satisfaction for all changes and work performed on this project, and that the time and
cost paid per this change order constitutes the total equitable adjustments owed the Contractor, all
Subcontractors, and all Suppliers for all work performed on this project. The Contractor on behalf of
himself, all Subcontractors, and all Suppliers agrees to waive all rights, without exception or reservation
of any whatsoever to file any further claim related to this project.
TOTAL COST THIS CHANGE ORDER: DECREASE $ ---------- ---- INCREASE $ 145876.56 r
By reason of this order the CONTRACT TIME completion will be adjusted as follows: None
We the undersigned contractor have given careful consideration to the change proposed and hereby agree, if this proposal is approved, that we will provide
all equipment, furnish all materials, except as may otherwise be noted above, and perform all service necessary for the work above specked, and will accept
as full payment therefor the prices shown above.
Accepted, D/ate) 3 q Contractor Stephen Doreck Equipment Rentals, Inc.
BY Ne
i� �
A Q �Nrarn tl+e.5 i re-5aei+
Approval recommended b 4' ,
Date 2'C"2-I
P LIC WORKS AGENCY EXECUT/VEOIRECTOR /
Approved by `��,/j�. Date7�---
CITYMANAGER
Page 2 of 2