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HomeMy WebLinkAboutR.J. NOBLE COMPANY (3) Recording Requested By, And When Recorded Mail To: Recorded in Official Records, Orange County City of Santa Ana Hugh Nguyen, Clerk-Recorder Public Works Agency, M_22 I IIII$Ifl lllllllllllllllll IIIIIII IIl IIII Illl lllfllll III III NO SEE 20 Civic Center Plaza Santa Ana, CA 92701 1 8 1 5 1 7 9 $ 20200003170831:25 pm 07/06/20 65 414A N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.000.000.00 0.00 NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN that the undersigned City of Santa Ana, California, a municipal corporation, with the address of City Hall, 20 Civic Center Plaza, Santa Ana, California, 92701, is the owner of the property hereinafter described, that said owner has caused a construction of BRISTOL REHABILITATION FROM 17TH STREET TO SANTA CLARA U 00 AVENUE under contract entered into on OCTOBER 1, 2019_, with R.J. NOBLE a � COMPANY , on which contract WESTERN SURETY COMPANY is surety. The property Wo 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. 18-6909 located at: BRISTOL STREET: 17TH STREET TO SANTA CLARA AVENUE . The work improvement on said property was ow accepted as completed on MARCH 25, 2020. EA 0 CITY OF SANTA ANA,A MUNICIPAL CORPORATION WO � F F Z b y a rA 12�Za C Dated: ` Senior Civil Engineer—Michael Ortiz 0. TITLE a ------------------------------------------------------------------------------------------- VERIFICATION 1, 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 "PJ � Santa Ana, California (Signature of individual sw aring that the contents of Notice of Completion are true.) THIS NOTICE OF COMPLETION MUST BE RECORDED WITHIN TEN(10)DAYS AFTER COMPLETION THE REGISTER This Apace raw filing st Orlynly 2190 TOWNE CENTER PL, ANAHEIM, CA 92806 Telephone (714) 796-7000 1 Fax (714) 796-6059 CNSSi 3266691 PROOF OF PUBLICATION (2015.5 C.C.P.) state of California ) County of ORANGE ) ss Notice TWO: BID - NOTICE INVITING BIDS Ad Description: I M909 BRISTOL ST REHABILITATION FROM 17TH TO SANTA CLARA I am a citizen of the United Stales 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, Stale of California, under date 11/19/1905, Case No. A21046, That the notice, of which the annexed is a printed copy, has boon published in each regular and entire issue of said newspaper and not In any supplement thereof an the following dates, to -wit: 06121/2019, 06/2812019 Executed on: 06/28/2019 At SANTA ANA,CA 1 certify (or declare) under penalty of perjury the( the foregoing Is true and correct. A- 4 MAYOR Miguel A. Puliclo MAYOR PRO TSM Juan villegas COUNCIL MEMBLF Coolie Iglesias David Paneloza VicenteSarmlenla Jose Solodo POSTED JUN 26 2019 ......w naev.wa, v, alibo vvunly HIu d � en, reer 11111111U Ip NO FEEIl8 2 5 20198500063411:52 am 06/26/19 323 304 Z01 0.00 60.00 0.00 0.00 0.00 0.00 0.00 0.00 CITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Center Plaza (M-20) P.O. BOX 1980 *Santa An, Callfomlo 02702 (714) 087-2700 • FAX (714) 9Ml461 www,sonta-ana.org CITY MANAGER Kdailne Ridge CITYA7 ORNEY Sonia R. Carvelho ACTING CLERK OF THE COUNCIL Norms MltmRamirez NOTICE OF EXEMPTION From the Requirements of the California Environmental Quality Act (CEQA) Fee Exemption per California Government Code Section 6103 TV. COUNTYCLERK From: CityofSantaAna County of Orange PUBLIC WORKS AGENCY P.O. Box 238 20 Civic Center Plaza M.36 Santa Ana, CA 92702 Santa Ana, CA 92702 prajoct Title. Bristol Street Rehabilitation: 18-6909 Date of Approval 061912018 ProjectNumbor(s): PWA-201 R-901 -CITY ProjectLocallon: 1 CityWida(Partial) City: Santa Ana County: Orange ERNumber: ER-2019-51 Project Description: Reconstructionlreaurfacing of existing pavement and replacementfinstallation of missing or damaged,ta curbs, gutters, sidewalks, driveway approaches, and wheelchair ramps within this segment of roadway. j Applicant Nams: City of Santa Ana Public Works Agency Applicant Address: 20 Civic Center Plaza M-36 3 SANTA ANA, CA 92702 Name of public Agency Approving Project: City Council 13 Name of Person or Agency Carrying Out Project: Public Works Agency FILED d ` Exempt Status: UI Cl Ministerial (Sec. 18268) L3 Declared Emergency (Sec, 16269 (a)) JUN 2 6 2019 CI Emergency Project (Sao.15269 (b through a)) 13 General Rule (Soo, 15061(b)(3y(5)) URMOO CDUW" CLEM411E0IX109K 02PART1,1ENr CJ Statutory Exemptlom eY: DEPUTY * Categorical Exemptlon: 15301(c) Reason(s) Why Project Is Exempt From CE61A: 15301(c) consists of existing highways and streets, sidewalks gutters, bicycle and pedestrian trails, and similar facilities, City Contact: nderson Chrysostomo Telephone: (714) 647.5838 Signature. M_ _ Title: 06 %26 f z-o 1 i SANTA ANA CITY COUNCIL Wawa A. Pdldo r Juan VNHpas Vhaente Sarrnlnnb I Jane sdorlo Vacant David Penalora Cacltla loleelas 1021W I Mayan Pre Tem,WaiV6 Ward? I wawa I Ward Wa1d2 Warde tadtM,al'g OCT 15 2030 CITY OF SANTA ANA CONSTRUCTION CONTRACT PROJECT 18-6909 BRISTOL STREET REHABILITATION FROM 17TH STREET TO SANTA CLARA AVENUE PROJECT This CONSTRUCTION CONTRACT is made and entered into this I" day of October, 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 R.J. Noble Company (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 Bristol Street Rehabilitation From 171h Street to Santa Clara Avenue 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 Six Hundred Fifteen Thousand Five Hundred Fifty Dollars and No Cents ($615,550.00), as set forth and identified in the BID PROPOSAL, which is attached hereto and incorporated herein as Exhibit "A." rev. 09/01/2017 Page 1 of 3 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. 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: hM://www.santa-ana.org/pwa/documents/CWA.pdf 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: M11:1 GOMEZ Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: I,(", 1.'L J N FUNK Assistant City Attorney RECOMMENDED FOR APPROVAL: AD WEISS, PE, PLS Executive Director Public Works Agency CITY OF SANTA ANA KRIST� GE City Manager CONTRACTOR: R.J. Noble Company x NAME: TEV dtENDOZA TITLE: SECRETARY Page 3 of 3 GOMEZ Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: I,(", 1.'L J N FUNK Assistant City Attorney RECOMMENDED FOR APPROVAL: AD WEISS, PE, PLS Executive Director Public Works Agency CITY OF SANTA ANA KRIST� GE City Manager CONTRACTOR: R.J. Noble Company x NAME: TEV dtENDOZA TITLE: SECRETARY Page 3 of 3 CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 �03�nrno®E ItfP[iH€ raiara�rB� A notarypublic 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 validityof that document. State of California l County of ORANC117 1} On 09/04/19 before me, J. DE IONGH, NOTARY PUBLIC Date Here Insert Name and Title of the Ofrcer , STEVE MENDOZA personally appeared Nome(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 heisheli" executed the same in hisfhefMteir authorized capacity(ies), and that by his/hef;4hair signature(s) on the instrument the person(s), or the entity upon behalf of which the persons) acted, executed the instrument. J. DE IONGH . Commission # 2128504 a °-d Notary Public - California - z Orange County My Comm. Expires Oct 28. 2019 r, Place Notary Seal and/or Stamp 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 OPTIONAL of Notary Public Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: Number of Pages: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: �eee®e®sreeee 02018 National Notary Association City of Santa Ana Bristol Street Rehabilitation from 17th St to Santa Clara Ave (18-6909), bidding on July 9, 2019 2:00 PM (Paclflc) Bid Results Bidder Details Vendor Name R.J. Noble Company Address 15505 E. Lincoln Ave Orange, CA 92865 United States Respondee Jennifer De longh RespondesTitle Contract Administrator Phone 714-637-1550 Ext. 311 Email stevemendoza@tinoblecompany.com Vendor Type License # 782908 CA DIR Bid Detail Bid Format Electronic Submitted July 9, 2019 1:48:14 PM (Paci0c) Delivery Method Bid Responsive Bid Status Submitted Confirmation # 184041 Ranking 0 Respondee Comment Buyer Comment Attachments File Title 18-6900 Bristol General does Ownership Afrdavlt Bristol Bristol Bid Band non collusion affidavit Line Items Type Item Code Base Bid Items 1 Unclassified Excavation File Name 18-6909 Bristol Rehab General docs07092019134522.pdf IM909 Bristol Ownership Affidnvit 7-9. 1907092019104340.pdf 18-6900 Bdstol bid bond 7.0-1907092019104631.pdf 18.6909 Bristol Non Collusion Affidavit 7-9- 1907092019104747.pdf uoM City Unit Price CY 230 2 AC Pavement TN 900 PlanatBide, Inc. Page 1 Printed 08120019 EXHIBIT A File Type General Attachments Ownership Affidavit (Notary Public)- REQ Original Hard Copy Submittal in Addition Bid Bond Guaranty (Notary Public) - REQ Original Hard Copy Submittal in Addition Non-Colluslon AHldevit (Notary Public) - REQ Original Hard Copy Submittal In Addition Line Total Comment $125.00 $28,750.00 $85.00 $76,500.00 City of Santa Ana Page 2 Bristol Street Rehabilitation from 17th St to Santa Clara Ave (18-0000), bidding on July 9, 2019 2:00 PM (Pacific) Printed 00/26/2019 Bid Results EXHIBIT A Type Item Code UOM City Unit Prioe Line Total Comment 3 Cold MITI (2") SF 8600 $0.35 $3,010.00 4 Cold MITI (3") SF 114000 $0.25 $28,600.00 8 Asphalt Rubber Hot Mlx (ARHM) TN 1400 $86.00 $119,000.00 6 Asphalt Rubber Aggregate Membrane(ARAM) SY 13800 $7.50 $10000.00 7 PCC Sidewalk (4") SF 600 $6.40 $3,840.00 a PCC Curb Ramp SF 4100 01.50 $47,150.00 9 PCC Curb and Gutter (Type A-2-8) SP 100 $38,00 $3,800.00 . 10 Cross -Gutter (Arterial Street) LF 2200 $11.60 $25.300.00 11 Concrete Bus Pad SF 1100 $15.00 $16,600.00 -----12_.._ Adjust Water Valve Frame and Cover to Finished Grade SF 10 $1,000.00 $10,000.00 13 Adjust Sewer and Drainage Manhole to Finished Grade EA 7 $1.000.00 $7,000.00 14 Furnish and Install #6 Pullbox EA 12 $70oOD $8p00.00 15 Adjust Survey Monument to Finished Grade EA 3 $1,000,00 $3,000.00 16 Furnish and Install Trafilc Loops Dt EA 12 $240.00 $200.00 17 Fumish and Install Traffic Loops Et EA 31 $220.00 $6,820.00 18 Construction Sign EA 2 $800.00 $1,600.00 PlanetBids, Inc. - City of Santa Ana Page 3 Bristol Street Rehabilitation from 17th St to Santa Clara Ave (10-6909), bidding on July 9, 2010 2:00 PM (Padfic) Printed 0312612019 Bich Results EXHIBIT A Type Item Code UOM taty, Unit Price Line Total Comment 19 Signing and Striping LS 1 $105,000.00 $105.000.00 20 Labor Agreement Oversight LS 1 $15,000.00 $15,000.00 Subtotal $615,550.00 Asterisk Notes (Per Section 3-2 of Standard Specifications) • NOT park of Total Bid calculation 21 "= The quantity for this bid Item Is shown for bid oompadson only. This bid Item shall not be subject to the "25%" limit as stated In Section 3.2 of the Standard Speciflcations. This bid Item shall not be subject to the "260/" limit as stated In Section 3.2 of the Standard Specifications. 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 22 t = This bid Item Is considered a Specialty Item per Section 2.3.2 of the Standard Specifications. ea 0 0 0 Subtotal 0 Total $015,55o.00 PlanetBids, Inc. CITY OF SANTA ANA PROPOSAL EXHIBIT A PROJECT NO.: 15-6909 BRISTOL REHABILITATION FROM 17TH ST TO SANTA CLARA AVE TOTAL BASE BID I s 615,550.00 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-altemate 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 number 40 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 $2,000 per calendar day. Name of Firm R.J. NOBLE COMPANY Signature of BIDDER x Title STEVE MENDOZA, SECRLTARY (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 PROPOSAL PROJECT NO.: 18-6909 BRISTOL REHABILITATION FROM 17TH ST TO SANTA CLARA AVE "W•• TO: CITY COUNCIL OF THE CITY OF SANTA ANA FROM: R.J. NOBLE COMPANY 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 I Unclassified Excavation 230 CY $ $ 28,750.00 125.00 2 AC Pavement 900 TN $ $ 85.00 76,500.00 3 Cold Mill (2") 8,600 SF $ $ 035 3,010.00 4 Cold Mill (3") 114,000 SF $ S 0,25 28,500.00 5 Asphalt Rubber Hot Mix (ARHM) 1,400 TN $ $ 85.00 119,000.00 6 Asphalt Rubber Aggregate Membrane 13,800 SY $ S (ARAM) 7.50 103,500,00 7 PCC Sidewalk (4") 600 SF $ $ 6,40 3,840.00 8 PCC Curb Ramp 4,100 SF $ $ 11.50 47,150.00 9 PCC Curb and Gutter (Type A-2.8) 100 LF $ $ 38.00 3,800,00 10 Cross -Gutter (Arterial Street) 2,200 SF $ $ 11.50 25,300.00 11 Concrete Bus Pad 1,100 SF S $ 15.00 16,500.00 12 Adjust Water Valve Frame and Cover to 10 EA S $ Finished Grade 1,000.00 10,000.00 13 Adjusts wer and DrainageManhole to 7 EA S $ Finished Grade 7,000.00 14 Fumishand Install #6 Pullbox 12 EA H700.00 $ 8,400.00 P-1 ofP-16 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18.6909 BRISTOL REHABILITATION FROM 17TH ST TO SANTA CLARA AVE Item Aeacrption Qty Unit Unit Price Amount IS Adjust Survey Monument to Finished 3 EA $ $ Grade 1,000.00 3,000.00 16 Fumish and Install Traffic Loops D t 12 EA $ S 240.00 2,880.00 17 Furnish and Install Traffic Loops E t 31 EA S $ 220.00 1 6,820.00 18 Construction Sign 2 EA S $ 800.00 1,600.00 19 Signing and Striping I LS $ S 105,000,0 105,000.00 20 Labor Agreement Oversight I LS S 15,000 $ 15,000 TOTAL BASE BID S 615,550,00 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 LIOUIDATED DAMAGES The undersigned bidder hereby proposes to complete the Work for the total base bid amount shown above, within number 40 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 $2,000 per calendar day. Name of Firm R.J. NOBLE COMPANY Signature of BIDDER X Title STEVE MENDOZA, SECRLTARY (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 PROPOSAL PROJECT NO.: 18-6909 BRISTOL REHABILITATION FROM 1.7Tn ST TO SANTA CLARA AVE BIDDER'S STATEMEN BIDDER understands and agrees that this Bid Proposal, Contract Documents and subsequent Construction Contract Agreement shall constitute the entire agreement between BIDDER and the AGENCY only after it has been accepted by the City Council, endorsed by the Clerk of the Council with her signature and official seal noting hereon the action of approval of the Council, signed by the Public Works Agency Executive Director or his/her duly authorized agent, and signed by the City Attorney, denoting his approval of the form of this document, and its execution, and when it or an exact copy of it has been either delivered to BIDDER or deposited with the United States Postal Service properly addressed to the BIDDER with the correct postage affixed thereto. BIDDER further agrees that upon delivery (as defined above) of the accepted agreement he/she will furnish AGENCY all required bonds and certificate of liability insurance within ten (10) business days or the funds, check, draft, or BIDDERS bond substituted in lieu thereof accompanying this proposal shall become the property of the AGENCY and shall be considered as payment of damages due to the delay and other causes suffered by AGENCY because of the failure to furnish the necessary bonds and because it is distinctly agreed that the proof of damages actually suffered is difficult to ascertain; otherwise said funds, check, drafts, or BIDDER'S bond substituted in lieu thereof shall be returned to the undersigned. BIDDER understands that a bid is required for the entire work, the estimated quantities set forth in the bid schedule are solely for the purpose of comparing bids, and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. The BIDDER also certifies that the bid is a balanced bid. In accordance with Section 7028.15 of the California Business and Professions Code, the undersigned certifies under penalty of perjury that the foregoing is true and correct. Name of Firm R.J. NOBLE COMPANY Signature of BIDDER X Title STEVE MENDOZA, SECRETARY (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-16 ASPHALT PAVING • ENGINEERING CONTRACTORS LIC. A-782908 R.J. NOBLE COMPANY A CALIFORNIA CORPORATION 15505 E. LINCOLN AVENUE ORANGE, CA 92865 CORPORATE OFFICERS: MICHAEL J. CARVER, PRESIDENT CRAIG PORTER, SENIOR VICE PRESIDENT AUSTIN CARVER, VICE PRESIDENT OF OPERATIONS KASONDRA GONZALEZ, VICE PRESIDENT OF MARKETING STEVE MENDOZA, SECRETARY JAMES N. DUCOTE, TREASURER JACOB BREEDLOVE, ASSISTANT SECRETARY ORANGE: 15505 E. LINCOLN AVE • RO.BOX 620. ORANGE, CALIFORNIA 92656-6620 • (714) 637-1550 • FAX (714) 921-3347 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6909 BRISTOL REHABILITATION FROM 17Tn ST TO SANTA CLARA AVE 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: R.J. NOBLE COMPANY Business Address: 15505 E. UNCOLN AVENUE, ORANGE, CA 92865 Business E-Mail Address: stevemendoza@rjnoblecompany.com Telephone: 714.637-1550 State Contractor's License No. and Class: 782908 CLASS A & C-12 License Expiration Date: 08/3l/2020 State Dept. of Industrial Relations (DIR) Registration No.: 1000004235 State Dept. of Industrial Relations (DIR) Registration Expiration Date: O6/30/2022 Signed: X Title: STEVE MENDOZA, SECRETARY P-4 of P-16 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6909 BRISTOL REHABILITATION FROM 17T" ST TO SANTA CLARA AVE PREVAILING WAGE COMPLIANCE AND MONITORING STATEMENT Contractor is aware of the requirements of California Labor Code Section 1720, et seq., as well as California Code of Regulations, Title 8, Section 16,000, et seq., ("Prevailing Wage Laws'), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects. Since the services are being performed as part of an applicable "public works" or "maintenance" project, as defined by the Prevailing Wage Laws, and since the total compensation is $1,000 or more, Contractor agrees to fully comply with such Prevailing Wage Laws. City shall provide Contractor with a copy of the prevailing rates of per diem wages in effect at the commencement of this Agreement. Contractor shall make copies of the prevailing rates of per diem wages for each craft, classification or type of worker needed to execute the services available to interested parties upon request, and shall post copies at the Contractor's principal place of business and at the project site. Contractor shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. The undersigned certifies that the foregoing is true and correct. Name of Firm R.J. NOBLE COMPANY Signature of BIDDER X Title STEVE MENDOZA, SECRETARY (if an individual, so state) P-5 of P-16 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6909 BRISTOL REHABILITATION FROM 17TH ST TO SANTA CLARA AVE OWNERSHIP AFFIDAVIT STATE OF CALIFORNIA ) COUNTY OF ORANGE ) SS: CITY OF SANTA ANA ) STEVE MENDOZA being duly sworn, deposes and says: ❑ INDIVIDUAL That he/she is the parry 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. I3CORPORATION That he is of SECRETARY OF R.J. NOBLE COMPANY a corporation which is making 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 and not collusive or sham, and has not in any manner sought by collusion to secure any advantage against the City of Santa Ana or any person interested in the proposed contract, for himself or any other person. X A '' 0= Signature 61013idderSTEVE MENDOZA, SECRETARY Subscribed and swprn to . ore me this 9TH day of JULY _ 2019 X ; /a Signature of officef #ldministering Oath (Notary Public) J. DE IONGH IIj J. DE IONGH e a Commission # 2128504 cyp-,✓n Notary Public - Califoima z\ Orange County !— My Comm. Expires Oct 28, 201 q f, P-6 of P-16 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6909 BRISTOL REHABILITATION FROM 17Tu ST TO SANTA CLARA AVE KNOW ALL PRESENT that, R.J. NOBLE COMPANY , as BIDDER, and Western Surety 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 $ 10% ° _ ( ), 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 24th day of June 2019. r 111 W R. J. NOBLE COMPANY, 15505 E. Lincoln Avenue, Orange, Ca 92865 714-637-1550 SURETY* Western Suresy.Eor[pany„ 2020 Main Street, Suite 0 Attorney -in -fact Subscribed and sworn to before me , 20_ Signature: Notary Public in and for the County of Irvine, CA 92614 949-486-7917 , State of this 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 CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 ®@r®iiBli@eE tBeta3€ .. �iAr®� A notarypublic or other officer completing this certificate verifies onlythe 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 GRANGE On 06/25/19 before meJ. DE IONGH, NOTARY PUBLIC , , Date STEVE MENDOZA Here Insert Name and Title of the Officer personally appeared 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/shelt" executed the same in hislher/t ei authorized capacity(ies), and that by his/perkhei; signature(s) on the instrument the person(s), or the entity upon behalf of which the persons) acted, executed the instrument. _ J. DE IONGH Commission # 2126.i6 ; _ Voiary Public - Calllo: na 0!.,og° Ccunry Place Notary Seal and/or Stamp 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 OPTIONAL of Notary Public Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: C2018 National Notary Association Number of Pages: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: 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 JUN 2 4 2019 before me, Michele A. Fedoruk, Notary Public (insert name and title of the officer) personally appeared James Scott Salandi, Attorney -in -Fact who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/aces subscribed to the within instrument and acknowledged to me that he/stt&fD tc executed the same in his/blaM/4 mir authorized capacity(k*, and that by his/Vte3r/tbtetr 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. MICHELEA. rEOORUK Q Notary Public - California Orange County Commission N 2238042 My Comm. Expires Apr 14, 2022 Signature (Seal) Western Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT Know Ali Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint James Scott Salandi, Leonard Zifniflsky, David Jacobson, Individually of Irvine, CA, its true and lawhrl Attorney(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts - and to bind It thereby as Hilly and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney, pursuant to the authority hereby given, are hereby ratified and continued. This Power of Attorney is made and executed pursuant to and by authority of the By -Law printed on the reverse hereof, duly adopted, as indicated, by dse shareholders of the corporation. In W(hress Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 18th day of June, 2015. ar>. WESTERNN SURETYJ COMPANY aul T. Bmfhd, Vice President State of South Dakota i County of Minnehaha s sa On this 18th day of June, 2015, before me personally came Paul T. Bruflat, to me known, who, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is the Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said Instrument is such corporate seal; that it was so affixed pmsuent to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation. My commission expires ; +4444444441,s1�444444444 t 3 S. EIGH 1# February 12, 2021 r, si` a �0�DAW,C�!h; h.44�444444444444444444 � S. Bich, Notary Public CERTIFICATE I, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is stilt in force, and Rather certify that the By -Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my now and affixed the seal of the said corporation this day of J U N 2 4 2019, ,,.,"`- WESTERN SURETY COMPANY rj�� Porm F42ae-7.2a12 L. Nelson, Assistant Secretary CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6909 BRISTOL REHABILITATION FROM 17Tn ST TO SANTA CLARA AVE 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: %% of the bid or $10,000, whichever is greater o Buildings, parks, or other projects: %% of the bid Section 17255 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 AMERICAN PAVEMENT SYSTEMS License #/Exp. DIR Reg.#/Exp. 1000000207 06/30/22 Location 1012 1ITH ST STE 1000,MODE8I'O, CA 95354 Phone 209-522-2277 Type Of Work ARAM Amount $ $99,912.00 Name NOBESTINC License #/Exp. 35962207/31/20 DIR Reg. #/Exp, 1000011529 6/30/20 License 4 359622 Location 7600 ACACIA AVE., GARDEN GROVE, CA 92841 Phone 714.892-5583 Type Of Work CONCRETE Amount$ $126,300,00 Name CL SURVEY License #/Exp. 8231 NO EXP DIR Reg. #/Exp, 1000007166 6/30/20 Location 1269 POMONA RD. STE 1087, CORONA, CA 92882 Phone 909-484.4200 Type Of Work SURVEY Amount $ $7 500.00 Name SMITHSON ELECTRIC License #/Exp. 614518 03/31/21 DIR Reg.#/Exp. 1000001610 06/30/20 License # 614518 Location 1938 E. KATEL,LA AVE, ORANGE, CA 92867 Phone 714-997-9536 Type Of Work LOOPS Amount $ $9,115.00 Name SUPERIOR PAVEMENT Name License #/Exp. License #/Exp. DIR Reg, #/Exp. 1000001476 06/30/20 DIR Reg. #/Exp. License N 776306 License # Location 5312 CYPRES ST, CYPRESS, CA 90630 Location Phone 714-995-9100 Phone Type Of Work STRIPING Type Of Work Amount $ $24,3OEM-Amount $ X / .li^7r--^ Signature,,of RidMr STEVE MENDOZA, SECRETARY P-8 of P-16 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6909 BRISTOL REHABILITATION FROM 17Tn ST TO SANTA CLARA AVE 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. CITY OF LAKE FOREST, 25550 COMMERCENTRE DRIVE STE. 100, LAKE FOREST, CA 92630 Name and Address of Owner. DOUG ERDMAN 949-282-5233 Name and Telephone Number of person familiar with project. $1,443,200.00 RESURFACING PROJECT 08/2017 Contract Amount Type of Work Date Completed 2. CITY OF RIVERSIDE, 3900 MAIN STREET, RIVERSIDE, CA 92522 Name and Address of owner. STEVE HOWARD 951-826-5567 Name and Telephone Number of person familiar with project. $5,872,373.05 STREET WIDENING 06/2017 Contract Amount Type of Work Date Completed 3 CITY OF TUSTIN, 300 CENTENNIAL WAY, TUSTIN, CA Name and Address of owner. EDDY JAN 714.573.3157 Name and Telephone Number of person familiar with project. $1,629,018.86 STREETREHABILITATION 10/2018 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. PATRIOT RISK AND INSURANCE SERVICES 2415 CAMPUS DR SUITE 200, IRVINE, CA 92612 SCOTT SALANDI 949-486-7917 LAURIE SYLVESTER 949-486-7900 P-9 of P-16 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6909 BRISTOL REHABILITATION FROM 17Tu ST TO SANTA CLARA AVE 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 TUSIN, 300 CENTENNIAL WAY, TUSTIN, CA 92780 Name and Address of Owner, BENNY'TENKEAN 714-573.3161 Name and Telephone Number of person familiar with project. $22.6 MILLION TUSTIN RANCH ROAD RECONSTRUCTION 0412014 Contract Amount Type of Work Date Completed 2, CITY OF ORANGE, 300 E. CHAPMANAVE., ORANGE, CA 92866 Name and Address of owner. ALAN TRUONG 714-744-5573 Name and Telephone Number ofv�rrson familiar with project. $1,559,443.59 it0 DREHABILITATION 03/2014 Contract Amount Type of Work Date Completed 3 CITY OF MISSION VIEJO, 200 CIVIC CENTER DRIVE, MISSION VIEJO, CA 92691 Name and Address of owner. JOE AMES 949-470.8419 Name and Telephone Number of person familiar with project. $1,504,975.00 PAVEMENT REHABILITATION 08/2013 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. PATRIOT RISK AND INSURANCE SERVICES 2415 CAMPUS DR. SUITE 200, IRVINE, CA 92612 SCOTT SALANDI 949-486-7917 BONDS LAURIE SLYVESTER 949.486-7900 INSURANCE P-10 ofP-16 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6909 BRISTOL REHABILITATION FROM 17TH ST TO SANTA CLARA AVE 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 6x 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. BIDDERS are cautioned that making a false certification may subject the certifier to criminal prosecution. Signed State of Cantornia County of ORANGE Subscribed and sworn to (or affirmed) before me on this 9TH day of JULY 201`>, by SIEVE MENDOZA proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me x Notary Public Si n. t e Notary Public Seal J. DE IONGH J. DE IONGH .�+�*;, Commission # 21Tsd01 .�� Notary Public - Calitornla 2 Orange 0 County F� My Comm. Expires Oct 28, 2019 er P-1 I of P-16 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6909 BRISTOL REHABILITATION FROM IITn ST TO SANTA CLARA AVE 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 union or representative of workers with which he/she has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the Contractor's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 4. The Contractor shall comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations; and relevant orders of the Secretary of Labor. 5. The Contractor shall furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his/her books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation, to ascertain compliance with such rules, regulations, and orders. 6. In the event of the Contractor's non-compliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, the contract may be canceled, terminated, or suspended in whole or in part and the Contractor may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Execution Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law. P-12 of P-16 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6909 BRISTOL REHABILITATION FROM 17Tn ST TO SANTA CLARA AVE The Contractor shall include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of September 24,1965, so that such provisions will be binding upon each subcontract or purchase order as the administering agency may direct as means of enforcing such provisions, including sanctions for noncompliance; provided, however, that in the event the Contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency, the Contractor may request that the United States enter into such litigation to protect the interests of the United States, 8. Pursuant to California Labor Code Section 1735, as added by Chapter 643 Stats. 1939, and as amended, no discrimination shall be made in the employment of persons upon public works because of race, religious creed, color, national origin, ancestry, physical handicaps, mental condition, marital status, or sex of such persons, except as provided in Section 1420, and any contractor of public works violating this Section is subject to all the penalties imposed for a violation of the Chapter. Signed: x S� ✓ Title: STEVE b ENDOZA, SECRETARY Firm: R.J. NOBLE COMPANY Date: 07/09/2019 P-13 of P-16 Cil'Y OF SANTA ANA PROPOSAL PROJECT NO.: 18-6909 BRISTOL REHABILITATION FROM 17Tn ST TO SANTA CLARA AVE STATEMENT REGARDING APPRENTICESHIP REQUIREMENTS The undersigned BIDDER is familiar with the requirements of Section 1777.5 of the State Labor Code regarding employment of apprentices, and understands that contractors on contracts exceeding $30,000 or 20 working days shall: 1. Apply to the joint apprenticeship committee administering the apprenticeship standards of the craft or trade in the area of the site of the public work for a certificate approving the contractor under the apprenticeship standards for the employment and training of apprentices in the area or industry affected. 2. Employ the number of apprentices or the ratio of apprentices to journeymen stipulated in the apprenticeship standards. 3. Contribute to the fund or funds in each craft or trade-in which he/she employs journeymen or apprentices on the public work, in the same amount or upon the same basis and in the same manner as the other contractors, except contractors not signatory to the trust agreement shall pay a like amount to the California Apprenticeship Council. Signed: X (��-- Title: STEVE NDOZA, SECRETARY Firm: R.J. NOBLE COMPANY Date: 07/09/2019 P-14 of P-16 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6909 BRISTOL REHABILITATION FROM 17Ta ST TO SANTA CLARA AVE RDINO ANTI -KICKBACK" REOUIREMENTS The undersigned is submitting this proposal for performing by contract the work required by these bid documents, agrees to comply with the Copeland "Anti -Kickback" Act (18 USC 74) as supplemented in the Department of Labor regulations (29 CFR, Part 3). This act provides that each contractor or subcontractor shall be prohibited from inducing, by any means, any person employed in the construction or repair of public work, to give up any part of the compensation to which he/she is otherwise entitled. Signed: X �Z&_= Title: STEVE MENDOZA, SECRETARY Firm: R.J, NOBLE COMPANY Date: 07/09/2019 P-15 ofP-16 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6909 BRISTOL REHABILITATION FROM 17T" ST TO SANTA CLARA AVE IC CONTRACT CODE SECTION 10162 OUESTION 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 If the answer is yes, explain the circumstances in the following space. P-16ofP-16 DESIGNATION/CERTIFICATION OF ASPHALT -RUBBER BINDER APPLICATOR(S) BIDDER proposes to have Asphalt -Rubber BINDER for ARAM (application) applied by: American Pavement Systems 1012 11th Street Suite 1000 Modesto, CA 95354 This section shall be completed even if the bidder plans to apply Asphalt -Rubber binder with its own equipment and labor forces. Name above must be the actual company applying the Asphalt -Rubber binder on the roadway. Bidder shall attach to this form copies of all required local air pollution control district or air quality management district final permit to operate (PTO) documents (not temporary, experimental, research, and/or authority to construct (ATC)) which allow the operation of the specific equipment to be used to control emissions during the application of Asphalt -Rubber binder on the roadway (the Application). The Application, in a manner conforming with these project specifications, has been indisputably determined to be in non-compliance with California air quality regulations limiting opacity of emissions, unless a permitted emission control device is used during the Application to directly remove emissions occurring during the Application. It is for that device, which may be described as an air filter, custom air pollution control system, portable air pollution control, opacity control unit, emission control unit consisting of collection hood and 3-stage oil mist filter system, or other similar description for which a copy of a final PTO must be provided from the local air pollution control district or air quality management district. If the bidder fails to fully complete this portion of the bid and provide the foregoing documentation, the bid is non -responsive and shall be rejected. CERTIFICATION UNDER PENALTY OF PERJURY I certify under penalty of perjury under the laws of the State of California that I have read and understand the requirements contained in this form, I further certify that all information provided in response to this form is true and accurate to the best of my knowledge and belief. David Pimley, Chip Seal Division Manager Pav4�7,1 Print Name, Title Signature of Bidder 7/3/2019 Date W011 DESIGNATION/CERTIFICATION OF ASPHALT -RUBBER AND AGGREGATE MEMBRANE CONTRACTOR AND/OR SUBCONTRACTOR(S) Bidder proposes to have the ARAM installed by: American Pavement Systems 1012 11th Street Suite 1000 Modesto, CA 95354 This section shall be completed even if the apparent low bidder plans to produce and install ARAM with its own forces. Name of Contractor and/or Subcontractor(s) shall be the actual company(ies) applying the binder and aggregate. For any bid to be considered responsive, perfonnancc criteria must be demonstrated on five separate projects performed by the same contractor or subcontractor(s) designated above, and with equivalent aggregate and binder proposed for the ARAM in this bid. Two years shall have elapsed since completion of the ARAM surface on each project and the projects shall be located in Southern California. To be considered a valid representative project, bidder must submit the name of the project, owner agency, agency representative's name and phone number, and a list of streets with limits totaling at least I mile (based on full width) in length for each project and the date the project was actually performed. A project will be considered a valid representative project if an asphalt emulsion spray application was originally placed with or without an application of sand, within 15 calendar days of the application of ARAM. Any other cover coat or course on the ARAM will cause the ARAM to be considered invalid as a representative project. ARAM on all projects must show insignificant raveling (loss of rock) and insignificant flushing (binder migration to the surface) at time of inspection by the Agency. Bidder shall verify any proposed representative projects prior to listing a subcontractor with such projects, or the bid will be considered non -responsive. If the Bidder cannot list in the space provided five projects that meet the criteria specified herein that were performed by the proposed ARAM contractor or subcontractor(s), the bid shall be considered non -responsive. Representative ARAM Projects Name of Project No.I Caltrans 11-2M4404- Route 111 Agency Caltrans Date Completed 2015 Agency contact Daniel Hernandez Phone 760-355-8666 Approx. Length of ARAM (Full width) 2.4 miles Name of Project No. 2 Caltrans 11-2M7804 - Route 8 Date Completed 2016 Agency Caltrans Agency Contact Daniel Hernandez Phone 760-355-8666 Approx. Length of ARAM (Full width) 12.9 miles Name ofProjectxo.3 Caltrans 11-2M6504 -Route 86 Agency Caltrans Date Completed 2016 Agencycontact Daniel Hernandez Phone 760-355-8666 Approx. Length of ARAM (Full width) 24.7 miles Name of Project No.4 Caltrans 11-2M8604 -Route 78 Agency Caltrans Date Completed 2016 Agency contact Daniel Hernandez Phone 760-355-8666 Approx. Length of ARAM (Full width) 30.7 miles Name of Project No.5 Caltrans 11-2M9604 - Route 78 Date Completed 2017 Agency Caltrans Agency contact Daniel Hernandez Phone 760-355-8666 Approx. Length of ARAM (Full width) 26.7 miles pa.,ed66 Chip Seal Division Manager 7/3/2019 Signature of Bidder Title r END OF CONTRACTOR'S CERTIFICATION OF QUALIFICATION 1 South Coast Air Quality Management District 21865 Conley Drive, Diamond Bar, CA 91765-4178 a (909) 396-2000 • www,agmd,gov DATE: 07/1712018 EQUIPMENT LOCATEDAT: VARIOUS LOCATIONS IN SCAQMD s, > ? CORONA,CA 92879�% •� LEGAL OWNER CO. ID: 173474 ti `• OR OPERATOR AMERICAN PAVEMENT SYSTEMS, INC. 1012 11TH ST SUITE 1000 MODESTO,CA,95354 PERMIT/APPLICATION RENEWAL PERMIT/ EQUIPMENT DESCRIPTION NEXT RENEWAL APPL NBR DATE BILLING YEAR: 2018 G24559 Asphalt -Rubber Spraying 07/16/2019 G24560 Asphalt -Rubber Spraying 07/16/2019 G41967 ASPHALT BLENDING, 07/16/2019 G41968 HEATERIFURNACE (<5 MMBTU/HR) GAS -LPG 07/16/2019 SOUTH COAS'i AIR QUALITY MANAGEMENT UISl'RICT lag, I �n'�rrr. I errant rNn. MR,� 21865 Copley Drive, biamarul Bar. CA 91765 <,+HStt PERMIT TO OPERATE l._ This Initial permit must ba renewed ANNUALLY unless the equipment is moved. or changes ownership- .. If the billing fur the annual renewal fee (Rule 301 J) is not reeeived by the expiration date. contact the Mitrict. Legal Owner or Openaor: Egnipmenl Location: Equipment Description : AMERICAN PAVEMENT SYSTEMS, INC. 1012 11 TH ST, SUITFi 1000 MODM- 170, CA 95354 VARIOUS LOCATIONS IN SCAQMD PORI ABLE RUBBERIZED ASPHALT SPREADER NO 2 CONSIS HNG OF: ID 173474 HOLDING TANK, RUBBERIZED ASPHALT BINDER, 3,100 GALLON CAPACITY, WI -I I THREC TURBINE MIXERS, 20 H.P. EACH, A I IYDRAUTAC tMETERING PUMP, 20 H.P., AND TWO PROPANE FIRED RANSOME BURNERS, MODEL. 04, 800,000 BTU PER HOUR TOTAL. 2. RUBBERIZED ASPHALT BINDER SPRAY BAR, 12'-0" W. 3, ASPHALT SPREADER FILTRATION ENCLOSURE, 8%0" W. X 7%0" L. X 6'•0" H., 1VITH 24 FILTER CARTRIDGES, WIT W. X 2'-0" L. X W-41" D., AND 12 FILTER CARTRIDGES, EACH 2'•0'" W. X 24W L.. X I'A" D., 3,000 SQ. FT. TOTAL FILTER ARFA, TWO 15-H.P. TUBEAXIAL FANS, AND A CAPTURE HOOD, W-O" W. X W-10" L. Conditions: 1_ OPERATIDNOFTHISEQUIPMENTISHALLBF. CONDUCTED INACCORDANCE WHIT ALL DATA AND SPECIFICAITONS SUBMITTED WITH THE APPLICATION UNDER 1FTIICI[I HIS PERMIT IS ISSUED UNLESS OTITERW ISE NOTEU BELOW. 2. IBIS EQWPMIJW 1` SHALL. BEPROPHRLY MAINTAINED AND KEPT IN GOOD OPERATING CONDITION Al AI.I, TIMES. 3. THIS EQUIPMENT SITr1LI, BE OPFRAILD IN A 'd,ANNER TO M NIMFZE FMISSIONS INTO TI IE ATMOSPHERE TO THE MAXINTUM EXTENT POSSIBI.F. 4. IT IE APPIAC'ATION TEMPERAIURE OfVIERUBBERIZED ASPHALT I11NDER SHALL NOT EXCEED 400 DEGREES FAHREMIEIT. COMPLIANCE "qTH THIS CONDITION MAYBE DEMONS 'FRAI11.) BY MONITORING THE TEMPhRA FORE OF THE RUBBERIZED ASH HAI: F W TIIE I WLWN0 TANK OR AT 1 Hh Mk I ERtNG PLINIP. 5_ FHE OPERATOR SHALL INS ALL. AND p4.AIN'fAIN h "TEA1PliRAT(JRF MONi FORINCi DEVICE TO DEMONSTRATE COMPLIANCE WIUI Tll%TEMTIE RAT URI:•. LIDIIT IN CONDITION NO.4. ORIGINAL. �j SCUM COAST AIR C),UAL I IY MANAC,ENALNT DISTRICT " Z 1865 Conley Drive, Diamond Ear, CA 91765 ~~ PERMIT TO OPERATE loge 3 j 1cmol No. 6214559 I_.- AN 3ffiS32. 6. "CITE AMOUNT OF RL.IIJBEMZED ASPHALT BINDER PROCESSED BY THIS EQUIPMENT SHALL NOT' EXCEED 1 ?5 TONS IN ANY ONE OPERATING DAY. 7. CI{Li AMOUNT OF PROPANE USED TO FIRE THE BURNERS IN 11-0$ EQUIPMENT SHALL NOT EXCEED SASO GALLONS IN ANY ONE CALENDAR MONTH PURCHASE RECORDS SIIALI. BE USEI) TO DEMONSTRAT'E COMPLIANCE WITH THIS CONDITION, ST'HLiITOI.DINGTANKCOVM(S)MIALLREMAINCLOSEDFORALLOPERATWNSEXCITTDURING CHAMANG 9. THE OPERA FOR S1IALL CEASE OPLRAIION, OP THIS EQUIPIIMN1 IF THE VISIBLE EMISSIONS EKCEFDTIEs L,1�1171N ItULI'sAgl. IO_ A MCCI IANICA1, GAUCili SHALL EE INSTALLED AN I) MAINTAINLD TO INDICATIb, IN INCIIES OF WATER COLUMN, THE STATIC PRESSUREDIFFERENT IA1. ACROSS 111E FILTERCAR TRIDOI-S. it. WHINFiVER THIS EQUIPMENT IS IN OPERAI ION, -11li STATIC PRESSVRr D I F FIE R ENTIA 1, AC14USS THE FILTCR CARTR117GES SHAL1. NOT EXCEED 3.1 INCI IES OF WATER COLIINrIN. Q. RECORDS SHALL BE MAW TAMED TO DEMONSTRATE COMPLIANCE WI"1`H I HE ABOVE PERMIT CONDITIONS- THE RECORDS SHALL RE KEPT IN THE ASPHALT SPREADER VEHICLE FOR AT LEASI' TIIT.. LAS'r'LWO YEARS AND SI IALI.I3E NMADI? AVAILAIiI_li'TD EHEHUC1' PERSONNEL UPON REQUEST. 13. UPON TIIE FTI H DAY An ERPI.ACF.MENT OF THIS EQIJIPlv1EN"I INI'OOPFRATION AT A SITE, THE DISTRICT SHALL HE NOTIFIED VIA TBUTIMNE AT 1,177 56995 OF THE EXACT NATIAM, OF'I IIL: PROJECT AS FOLLOWS: A THE PERMIT NUNIBER OF THL PORTABLE EQUIPMENT, E. THE NAME AND III10NE NUMBLR OF A CONTACI PERSON, C. II I1a LOCA I IO'N WHI-REI I IF. PORI A111..1i F(JI lIP!,WN I IS OPFRATLD. 1) ll IL E.S IIMA I L) l'IAMF. TIIE POR"I ABLE EQ1.II1'NMENT WIl.l_ CIF LOCATED AT TI W SITE, E- DESCRIPIION OF'TIIFPROJECT,AND I . IF LOCATED WITHIN LESS THAN ILI M1L1:OF I HE NEAREST SENSITIVE RLC'EPIOR DEFINED AS FONG TERM IILALTH CARE FACILITIES, REHABE.I I Al ION CL•V'I ENS. CONVALESCEN I ("INI ERS. RE: TIREMENI HOMES, RLSIDENCES, SCI IDOLS. PLAYURO"NDS.CIIILDCARLCENrHR%AND ATIII.LTICPAC JIIhS. OR1C1NAL SOUTH COAST AIRQUALITYMANAGEMLNT DISTRICT b-F z Z 1865 Copley Drive, Diamond Bar, CA Q 1765 PERMIT TO OPERATE NOTICE. 1 uy;e 3 c,nill So. (;24$59 tin SUM IN ACCORDANCE IVITII RULE 206,'I"1 [IS PERMIT T'0 OPFRAT E OR COPY SIIALL BE POSTED ON OR WIT IINS A•IG1 RSOFTHEEQIJINMENT. THIS PERMIT' DOES NOT AUTIIORIZE THE EMISSION OF AIR CONTAMINANTS IN EXCIdSS OF TIIOSI, ALLOWED BY DIVISION 26 OF TIME HEALTH AND SAFETY CODE OF T'FIE SI'ATG OF CALIFORNIA OR THIS RULES OF THE Alit QUALITY THIS PERMIT CANNOT HE CONSIDERED AS PERMISSION TO VIOLATE EXISTING LAWS, ORDINANCES, REGULATIONS OR STATUTES OF OTHER GOVERNMENT AOENCIFS. EXECUTIVE 01:110ER By Dorris M.Bailcy/MP03 3012013 ORIGINAL .,._...u..._,_N_.— ._.... _. ___. _ ... ... j SOUTH COAST AIRQUALI'IY MANAGL'MLNT DISTRICT I113jit I ____— Ua _. I ermil , A 2,1865 Copley Drive, Diamond Bar, CA 91765 t a4srn o- •,,, PERMIT TO OPERATE w This initial permit must be renewed ANNUALLY unless the equipment is moved, nr changes ownership. If [lie billing for the Inmual renewal fee (Rule 301.1) is not received by the expiration date, coquet the District. ID 113:I)a Legal Owner or Operator: AMERICAN PAVEMENT SYSTEMS, INC. 1012 11 TI t ST, SUITE. 1000 MODESTO, CA 95354 Equipment Location: VARIOUS LOCATIONS IN SCAQMII) Equipmenl Description: PORTABLE RUBBERIZED ASPIIAi.'1' SPREADER NO. I CONSISTING OF: HOLDING TANK, RUBBERIZED ASPI IALT BINDER, 3,100 GALLON CAPACITY, WITH 1-I11(FE TURBINE 111XFRS, 20 N.P. EACH, A HYDRAULIC METERING PUMP, 20 FLP„ AND TWO PROPANE. FIRED RANSOM . BURNERS, MODE(. H4, 800,000ITO PER HOUR TOTAL. 2, RUBBERIZED ASPHALT BINDER SPRAY BAR, IY-0" W. 3. ASPHALT SPREADER HLTRATION FNCLOSIJRE, 6'-0" W. X T'-0" L. X 6'-0" IT., WITH 24 FILTERCARTRIDGFS, FAC II 2'-0" W, X 2%0" L. X 0'.4" D., AND 12 FII; I'ER CART'RIDCiL'S, EACH 2'-0" W. X 2'•0" I.. X' 11.0" D., 3,000 SQ. FT. TOTAL FILTER AREA, TWO IS-ILP. TUTWAXIAI, FANS, AND A CAP PAZE HOOD, S'4' W. X 0%10" L. Conditions ; I. OPERATION OI"IBIS EQUIPMENT SHALL BE CONDUCTED IN ACCORDANCE 11'ITI I ALI. DATA AND SPECIFICATION'S SUBMITTED WITH APPLICATION UNDER WHICH 1'HIS PERMIT IS ISSUED UNLESS OTHERWISE NOTED BELOW. 2, TI IIS EQIJIPMFNT SHALT. BF PROPFRt. V MAINTAINFFI AND KFP"I IN GOOD OPERATING CONDII ION AT ALL., TIMES. 3. IBIS L.QIJIPMIFNT SIIALL LlE OPLRATED IN A MANNER TO MINIMIZI EMISSIONS INTO T1IE ATMOSPHERE TO THE MAXIMUM FX I FIN 'F POSSIBLE. 4, T116 APPLICATION "H'MPF.RA'l URI-. OL 111E ltLIBDIiICILFI) ASPHALT DINDLR SIIALL NOT EXCEED IIlt1 DF.CLItLiLS 1'AIIRItNIIEIT. COMiPI.1ANCh Wi111 THIS CONDITION MAY III:: DLMONSTRATED BY MONITORING 1 HF "EkiM1PInRA'I URL Of'CIIF, RUfSIiFKIZ}G ASPII:ACP IN T'lIE HOLDING "IANF:OR A'I' THE MtF'fERING PUMIP. 5 TI IF. OPERATOR SHALT. INSTALL AND MAINTAIN A TEMPURAT'URE MONITORING DEVICE DEMONS 'IRA'IFCOMPLIANCE \41'1'FlTHETF:MPrAA1URELIMITINCONDITION No ,l. ORI(ANAL SOUTH COASTAIR QUALITY MANAGEMENI' DIS'I'RIC[ Y Y 21865 Copley Drfve. Diamond Liar, CA 91765 Pr mu s,,. < )lstn c PERMIT TO OPERATE 6 11II? AMOUNTOF RUBBERIZED ASPHALT BINDER PROCESSED BY THIS EQUIPMENT SHALL NOT EXCEED 125TONS IN ANYONE OPERATING DAY. 7. THE ANIOUNI OF PROPANE USED TO FIRE TIII? BURNERS IN THIS EQUIPMENT SHALL. NOT EXCEED $,080 GALL.CINS IN AN}' ONE CAI.EN'DAR N10NT'l1. PI)RCI IASI? RECORDS SHALL LIE 1JSI!D I'D DEMONSIRATE COMPLIANCtIi NC'rl'H'I'1115 CONm IION. 8. flit: HOLDING TANK COVEA(S) SHALL, REMAIN CLOSED FOR ALL OPERATIONS EXCEPT DURING CHARGING.. 9. THE" OPERATOR SI IAI.L CEASE OPERATION OF 1-1 HS EQUIPNENT IF T}IF. VISIBLE EMISSIONS EXCISED TI IE LIMIT IN RULE 801. 10, A NIECIIANICAL GAUGE SHALL BF INSTALLED AND MAINTAINED'I'0 I:NDICA'IF. IN INCHES OF WAFER COLUMN. THE STATIC PRESSURE DIFFERENTIAI, ACROSS TI IF FILTER CARTRIDGES, 11. WHENEVER THIS EQUIPMENT IS IN OPERATION, Tl Ir. STATIC PRI:SSIJRE IJIFI'ERENI`(AI. ACROSS THE FILTER CARTRIDGES SHALT. N'OI' EXCEED 3.1 INCHESOF WATER COLUMN. 12, RECORDS SHALL 13E MAINTAINED TO DEMONSTRATE COMPLIANCE" WITH THE ABOVE PERMIT CONDITIONS. THE RECORDS 81IALL 13F KEPT IN THE,ASPHALT SPREADER VEI IICLI? FOR A1' LEASTTHE LASTTWO PEARS AND SHALL RE MADE. AVAILABLE• TO DISTRICT PERSONNEL UPON REQUEST. 13, UPON I I IE I'll 111 DAY AFTFR PLACEMENT OF THIS EQUIPMENT INTO OPERATION AT A SITE, 1111: DIS'I RICT SI IAL L BE NOTIFIED VIA TELIcPl IONS AT 1.877.81 U-6995 OF 'rllr: I XAC I NAI URF OFTlIF PROJECT AS FOLLOWS: A. THEPERMITNUMBFIROFTIIFPORTABLEEQLIIPNIENT, 13. 111E NAN1E AND PT-IONL NUMBER OF A CONIACT PERSON. C. IHL LOCA1 ION ICI IERE TI1E PORTABLE EQUIPMENT IS OPERAI W, D. TIIF ESTINIAI I VI Ih111 IHE PORTABLE EQUIPMENT WILL PSI: LOCA rED AT I IIfL SITE, C DFSCRIP'LION OF `I I IF PROTLC 1,.AND F. IF I,OCA'l1A) WITHIN LESS TITAN 1;4 MILE 01: 111L NLARESI SENSII IVE RI:(`FPIOlt DI, FINED AS LONG 1 ERM IIEAL'FtI CARE FACILITIES, REHABILITATION CI: NTBRS, CONVALESCENT C'ENFERS, R1 FIREMENT IIONIES, RESIDENCES, SCIIGOLS, PIA 141ROIINDS. C'IIILDCAR[: CENTLKS. AND A"rH111 It' FACILITIES. ORIGINAL SOULLH COAST AIR QUlALITY MANAGUMEN I'DISTRICT I aX<3 71865 Copley Dtim Diamond tsar. CA 01769 rsrmu yo. ;�' csicti PERMIT TO OPERATE MIN eaasal NOTICE IN ACCORDANCE WI I II RULE 206, IT [IS NANIll' TOOPI RATE' OR COPY SHALL 13E POS I ED ON Olt W1 I IIIN 3 METERS OF TIII; I;QIIIPMLNI'. IIi1S I'1 Ri 111' 17O1i5 NOT AUfL11ORl7.F:'Pllli F MISSION Of AIR CONTAMINANTS IN UXC ESS OI' THOSI: ALL.Ol1`ED RY DIVISION 26 OI THE I[rAC'I'll ANI) SAFf51`Y COU)1? ()I.,Tl If" S1'A"Uli ()P CALIFORNIA OR THE RULLS OL' TLIF AIR QUALITY iMANAGBIL'NT IM I RIC".T. THIS ITRMIT CANN61- BE CONSIDERED AS PERMISSION TO VIOLME EXISTING LAWS, ORDINANCPS, R IULAIIONS OR S'1r11'lf'1`I�S OF OTHER GOVERN\IFN'U A(IFNC.IES- GXIiCU1'IV[i OFFICER 13) Dorris M 13ailap,AIP03 Sr73t2.013 ORIGINAL. I ENGINEERING CONTRACTORS 15505 E LINCOLNAVENUE • P.O. BOX 620, ORANGE, CA 92856 (714)637-1550 TO: CITY OF SANTA ANA PUBLIC WORKS AGENCY M-22 20 CIVIC CENTER PLAZA ROSS ANNEX 3RD FLOOR SANTA ANA, CA 92701 ATTN: VICTOR SO SEALED BID BOND FOR PROJECT.: 18-6909 BRISTOL STREET REHABILITATION FROM 17TH ST TO SANTA CLARA AVE BID DATE: 07-09-19 BID TIM E: 2:00 PM CITY OF SANTA ANA BONDS Executed in Duplicate PROJECT NO.: 18-6909 Bond No. 30079985 BRISTOL REHABILITATION FROM 17TH ST TO SANTA CLARA AVE PAYMENT BOND KNOW ALL MEN BY THESE PRESENTS that R.J. NOBLE COMPANY as CONTRACTOR, and __ Western Surma Chan r�_____— 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 six hundred fifteen thousand five hundred fiftyand 00/00—------ --------- ----------- —----- --------- ------ ------------- — — — — Dollars ($ 615 550.00 ), 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 dc.Toaee I, Zolq for Bristol St Rehabilitation from 17th St to Santa Clara Ave 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 7th day of October 12019. R. J. NOBLE COMPANY, 15505 E. Lincoln Avenue, Orange, Ca 92865 714-637-1550 CONTRACTOR* X ZYU&a® SURETY* Subscribed Signature: sworn to before me, 20 SECRETARY 2020 Main Street, Suite 750, Irvine, CA 92614 949486-7917 Notary Public in and for the County of Rate of premium on this bond is $ Total amount of premium charge is $ N/A N/A this State of day of perthousand. To be filled in by Surety *Provide CONTRACTOR I ADMITTED SURETY name, address, and telephone number and the name, title, address, and telephone number ofauthorized representative. 2 of 3 CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 t�vi9 omm.. 11MR11191Baft A notarypublic 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 1 Countyof DRANCIF 1} On 10/08/19 before me, J. DE IONGH, NOTARY PUBLIC Date Here Insert Name and Title of the Officer STEVE MENDOZA personally appeared Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the persons) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/staeA4W executed the same in hisAieA eir authorized capacity(ies), and that by his/her#wk signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. J OE IONG14 _ e commission # 2128504 Notary Public - California ' Orange County p, . My Comm. Expires Oct 2€, 2C i Place Notary Seal and/or Stamp 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. OPTIONAL of Notary Public Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signers) Signer's Name: Cl Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: Number of Pages: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Trustee ❑ Other: Signer is Representing: �Be�98er®IeeeeB 02018 National Notary Association ❑ Attorney in Fact ❑ Guardian or Conservator 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 OCT 0 7 2019 On before me, Michele A. Fedoruk, Notary Public (insert name and title of the officer) personally appeared James Scott Salandi, Attorney -in -Fact who proved to me on the basis of satisfactory evidence to be the person(s) whose name(S) is/am subscribed to the within instrument and acknowledged to me that he/silrelklw executed the same in his/koW"It authorized capacity(ise), and that by his/hici thak signature(s) on the instrument the person(s), 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 m hand and official seal. :., MICHEEEA.rroonuK y .; Notary Public - California Orange County $ Commission p 2238042 My Comm. Expires Apr 14, 2022 Signature (Seal) Western Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT Know An Met By These Prnanota, That WESTERN SURETY COMPANY. a South Dakota corporation, Is a duly organized and existing empomtion having its principal office in the City of Sioux Falls, and Slate of South Dakota, and that it dots by virtue of the signature and seal herein affixed hereby make, Ixmsttuto and appoint James Scutt salandi, Leonard Zbninsky, David Jacobson, Individually of Irvine, CA, its true sad law&I Anorney(s)-in-Fact with Hill power and authority hereby confermd to sign, seal and execute for and on its behalf bonds. undertakings and other obligatory instruments of sirotar ranuo - In Unlimited Amolu ds - and to bind it thereby as tally and to the same extent as if such Instruments were sighed by a duly autlmrimd officer of the corporation and all the acts of said Alforaey. Furanant to the autlm ilty hereby given, we hereby ratified and cordtrmtd. This Power of Attorney is made and oucuted purnmet to and by authority of the By -Lbw printed an the reverso hereof, duly adopted, as indicated. by the sharelmldem of the cmporedon. In Wibaess Whermr, WPSTER14 SURETY COMPANY has caused these presents to be signed by its Vice President and its empmate seat to be hereto affixed on this 18tr day of Juno, 2015. e WESTERN SURETY COMPANY o •@6AV � 4e -!OWW T. )1ruflat, vice Presidem Stmt of South Dakota i Courtly of M unchdm f as On this lSth day of Juno, 2015, before rear personally cane Paul T. Bmflm, to nor known, who, being by me duly sworn, did depose and say. that he resides in tho City of Sioux Falls, Side of South Dakota; that he is the Vice•Prasident of WESTERN SURETY COMPANY described in and which executed the above ha mrment; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was an affixed pmranamt to axthmily given by the Board of Di ect= of said rwrpmation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the set and deed of said corporation. My commission expires +++++r.vwrw------nor- +k Feivawy 12, 2021 �OFttIwOW CERTIFICATE S. Eich, Notary Public I, L. Nelson, Assistant Secretory of WESTERN SURETY COMPANY do hereby entity that the Power of Attorney herch above sot forth is at in farce, nod f enher cetify that the By-law of the corporation primed on the reveme hereof is stt,�rA. In whereof I have hermmo subscribed my nurse and affixed the sort of the said corporation tale __day of :J I u 7 e WESTERN SURETY COMPANY Q�vopq' dF I- Nelson, Assistant Secretary Farm F�2an-7•xnla ' Uuqlmgwdmo Mp 30 awqvgqqo mipo m AMMY 3o wamod `silugsimpim sa. Wd `spuoq 6ua 3o 4jq)W^ 0 R m; .4essaoan;ou sc leas a;modroo aqZ 'Amduwo MUjo amen a p m s8unpq Knm m 'sawllod `ipmq Dose[ o; 6luMUM aneq H" ogm sluge jo aoed uc s&wow pgoddg Gam lams i. aq# m 4A=lna5 misread �� `�7maaS Y�P!saTd aolp file `.pwpfeaid aqy •ezuoiprte Gam awyoaua 3o PnoEl MB weo o mlBo Res Aq m `pmplsaJd aoT� hue m `.mmaeasZ °.SmlawaS'7usI V pue `An4 mos YuaMwd mD 6q Auedmoo a& 3o amen owmdmo aq3 iq Pole aq liege uopsmdmo mI13a auoAsSggo mglo m tauiaJid3o sxannod `s8mge7.wprm 's pd `spuoq Ild I uOW.S •doeduwo agl;o ssr ppmgs a # Aq paldops .Sine msZ-6g &RmoIIo3 ovio °(ipoWv Agpus o; wmsjnd palnam pug apam ec A MIMV JO mmod MU AAIF ETWOO )UHHas xastsa A 110 S U(YIOHHHVHS Mil AS (IHJAOQd meZ-8g Mop MqM CITY OF SANTA ANA Executed in Duplicate Bond No. 30079985 BONDS PROJECT NO.: 18-6909 BRISTOL REHABILITATION FROM 17Tn ST TO SANTA CLARA AVE FAITHFUL PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS that R.J. NOBLE COMPANY as CONTRACTOR, and ___ Western Surety 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 six hundred fifteen thousand five hundred fifty and 00/00-------- —---------- ----- — — — --- — — ——------ -- --- -- --- — Dollars ($ 615,550.00 ;, 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 Ql ,Td)SER 1 , Z019 for Bristol St Rehabilitation from 17th St to Santa Clara Ave 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 7th day of October 20 19 R. J. NOBLE COMPANY, 15505 E. Lincoln Avenue, Orange, Ca 92865 714-637-1550 CONTRACTOR" SURETY* WesVr ES2ompany, 2020 Main Street, Suite 750, Irvine, CA 92614 949486-7917 Salandi, Attorney -in -fact Subscribed and sworn to before me, `; 20_ Signature: this day of Notary Public in and for the County of State of Rate of premium on this bond is $ N/A per thousand. Total amount of premium charge is $ N/A To be filled in by Surety *Provide CONTRACTOR /ADMITTED SURETY nine, address, and telephone number and the name, title, address, and telephone number of authorized representative. 1 of 3 CALIFORNIA 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 DRANGE On 10/08/19 before me, J. DE IONGH, NOTARY PUBLIC , Date Here Insert Name and Title of -the Officer STEVEMENDOZA personally appeared Name(s) ofsigner(s) who proved to me on the basis of satisfactory evidence to be the persons) whose name(s) is/afe subscribed to the within instrument and acknowledged to me that he/sheAhey executed the same in his herAhei authorized capacity(ies), and that by his/hadtheir signature(r) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. J. DE IONGH ' Commission # 2128504 _ Nolary Public - California Orange County My Comm. Expires Oct 28. 20 i' -�,ra art Place Notary Seal and/or Stamp 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. Signatur Signature of Notary Public Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer - Title(s): ❑ Partner - 0 Limited ❑ General ❑ Individual ❑ Trustee ❑ Other: Signer is Representing: Cl Attorney in Fact o Guardian or Conservator Signer's Name: ❑ Corporate Officer - Title(s): ❑ Partner - ❑ Limited ❑ General Cl Individual ❑ Trustee ❑ Other: Signer is Representing: �ereee368ees 02018 National Notary Association 0 Attorney in Fact ❑ Guardian or Conservator 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 OCT 0 7 2019 before me, Michele A. Fedoruk, Notary Public (insert name and title of the officer) personally appeared James Scott Salandi, Attorney -in -Fact who proved to me on the basis of satisfactory evidence to be the person(s) whose name($) is/aNX subscribed to the within instrument and acknowledged to me that he/sftxfty executed the same in hislhoftwk authorized capacity(les), and that by his/kvK tkak signature(a) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the i nstrument. 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. MICNELE A. FEDORIIR O Notary Public - California Orange County Commission p 2278042 My Comm. Expires Apr 14. 2022 Signature (Seal) CITY OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number Project No. 18-6909 Bristol Street Rehabilitation from 171h St. to Change Order Number 1 Santa Clara Ave. To R.J. Noble Company Contractor You are hereby drected 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 UNTILAPPROVED BY THE CITY COUNCILOR 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 EXTRA WORK AT AGREED UNIT PRICE 1. Added cost for extra signage, striping, and traffic loops. (PCO #2) TOTAL AGREED PRICE = $2,984.03 Page 1 of 2 CITY OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number Project No. 18-6909 Bristol Street Rehabilitation from 17t6 St. to Change Order Number 1 Santa Clara Ave. To R.J. Noble Company Contractor You are hereby directed to make the herein changes from the plans and specifications or do the following described work not Included In the plans and specifications on this contract NOTE: THIS CHANGE ORDER IS NOT EFFECTIVE UNTIL APPROVED BY THE CITY COUNCIL OR CITY MANAGER Unless otheivAse stated, rates for rental of equipment cover only such lime as equipment is act.24 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 $ 2,984.03 By reason of this order the CONTRACT TIME completion will be adjusted as follows: 3 non-eompensable working days We the undersigned contractor have given careful consideration to the change proposed and hereby agree, if this proposal Is approved, that we will provide all equipmsnl, fumish all materials, except as may otherwise be noted above, and perform all service necessary for the work above specified, and will accept as full payment therefor the prices shown above. Accepted, Date Contractor R.J. Noble Company By Title Approval recommended by I J h h Date 2 %41 Zd Zp PUBLIC WORKS AGENCY EXECUTIVEURECTOR Approved by Date CITYh6VAGER Page 2 of 2