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EBS GENERAL ENGINEERING, INC (2)
Recording Requested By, And When Recorded Mail To: Recorded in Official Records, Orange County City of Santa Ana,Public Works Agency M22 #-high Nguyen, Clerk-Recorder 20 Civic Center Plaza,P.Q.Box 1988 I IIII 111111111Santa Ana,CA 92702 111IIIIIIIIJJIJ II I+I III IIJJ III III fI NO FEE * $ R 0 0 1 2 8 7 1 7 2 1 $ * 202100035737010:55 am 06/02/21 66 414A N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.000.000.00 0.00 T. e NOTICE OF COMPLETION NOTICE IS HEREBY G'IX-TEN 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 ov.,ner had caused e construction of GAS TAX LOCAL STREET IMPROVEMENTS under contract entered into U M on JANUARY 21, 2020- with EBS GENERAL ENGINEERING: on which contract v A SURETEC INSURANCE COMPANY is surety_ The property on which such work W O improvement %v.as placed is in the City of Santa Ana, County of Grange, State of California, and N F described as Project No_ 20-6956 & 20-6457 located at VARIOUS LOCATIONS_ The work A W improvement on said property was accepted as completed on MAY 372021_ � oZG O Cnn O rn CITY OF SANTA ANA,A MUNICIPAL CORPORATION W O By t Dated: As Principal Civil E aineer—Jason Gabriel A ] © Ce TITLE U C:. ------------------------------------------------------------------------------------------- W VERIFICATION I, the undersigned, say: I am the City Engineer— Edwin "William" Galvez of the City of Santa Ana, California; I executed the foregoing Notice of Completion acting on behalf of the owner of the property therein described; I make this verification on behalf of said corporation by authorization of the City Council of the City of Santa Ana; I have read said notice and know the contents thereof; and I declare under penalty of perjury that the facts therein stated are true. Executed on Cal �t.l 1 `�U� , at Santa Ana, Calif is City Engineer--Edwin Galvez THIS NOTICE OF COMPLETION MUST BE RECORDED WITHIN TEN(10)DAYS AFTER COMPLETION INSURANCE a ,;,_. WORK MAY Pr'" ^ UNXINSUP< -ES CLERKoFCOUNCIL --1efTY OF SANTA ANA DATE: CONSTRUCTION CONTRACT r. PROJECT 20-6956 & 20-6437 .,J GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 AND FLOWER STREET SEWER MANHOLE r� IMPROVEMENTS N ® This CONSTRUCTION CONTRACT is made and entered into this 21" day of January, 2020 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 EBS General Engineering Inc. (hereinafter "CONTRACTOR"). W ITNESSETH: The CITY and the CONTRACTOR, for the consideration hereinafter named, mutually agree as follows: CONTRACTOR agrees to perform all the work and fumish 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 Gas Tax Local Street Improvements FY 19/2U and Flower Street Sewer Manhole 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 Two Million Five Hundred Forty -Six Thousand One Hundred Fifty -Four Dollars and No Cents ($2,546,154.00), as set forth and identified in the BID PROPOSAL, which is attached hereto and incorporated herein as Exhibit "A." ,r, 09101rz017 Page I 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 htto:/,'www.santa-ana.ora,pwaldocuments/C WA.odf 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 Tear 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: CITY OF SANTA ANA DAISY GOMEZ T _ I� 1 E RIDGE Clerk of the Council City Manager APPROVED AS TO FORM: SONIA R. CARVALHO Cit :A FOR APPROVAL: /MGM �d!/ NAB1L SABA, PE Acting Executive Director Public Works Agency CONTRACTOR: EBS General Engineering Inc. NAME: omas Nanci TITLE: President Page 3 of 3 CITY OF SANTA ANA STREETPROJECT 206958 GAS TAX LOCAL O PROJECT 206437 FLOW STREET EWER NH RRMANHOLE IMPROVEMENTS PROPOSAL ADDENDUM ONE PROJECT NO.: 20-6956 GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 PROJECT 20-6437 FLOWER STREET SEWER MANHOLE IMPROVEMENTS BID PROPOSAL TO: CITY COUNCIL OF THE CITY OF SANTA ANA FROM: EBS General Engineering, 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(s) or lump sum(s) set forth in the following schedule: Item Description Qty Unit Unit Price Amount 1 Asphalt Rubber Hot -Mix (ARHM) 1,380 TN $ $ 109 150420 , 2 Crushed Miscellaneous Base (CMB) 290 TN $ $ 129 37,410 3 Coldmill (2") 38,530 SF $ $ 0.70 26,971 4 Coldmill (Y) 13,230 SF $ $ 0.90 11,907 5 Removal of V PCC at Various 1,680 CY $ $ Locations 138 231,840 6 Construct 6" PCC with (3-day) Cure 1,680 CY $ $ including Dowels 408 685,440 7 Crack Seal with Deere Super Gray* 15,750 LF $ $ 3.10 48,82 8 Construct PCC V-Gutter 4,730 LF $ 37 $ 175 O10 Longitudinal (T=8") 9 Construct PCC Sidewalk (T=4") 810 SF $ $ 10.50 8505 10 Construct PCC Driveway Approach 1,210 SF $ $ (T=6") 14 16,940 11 Construct PCC Curb Ramp 7,880 SF $ $ 16.20 127,656 12 Construct PCC Curb & Gutter (Type 110 LF $ $ A-2-6) 53 37,630 13 Construct Cross -Gutter 3,890 SF $ $ 19 73,910 P-1 ofP-18 CITY OF SANTA ANA PROJECT 206956 GAS TAX LOCAL STREET IMPROVEMETNS FY 19120 PROPOSAL PROJECT 206437 FLOWER STREET SEWER MANHOIE IMPROVEMENTS -- FKURUl- NU.: 2U-(3956 GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 PROJECT 20-6437 FLOWER STREET SEWER MANHOLE IMPROVEMENTS Item Description Qty Unit Unit Price Amount 14 PCC Grinding 50 LF $ $ 95 4750 15 Root Shave 5 EA $ $ 900 4500 16 Adjust Manhole Frame and Cover to 23 EA $ $ Finished Grade 995 22,885 17 Furnish and Install New Water 38 EA $ $- -Valve Frame and Cover to Grade 875 33,250 18 Construct New PCC Sewer Manhole 3 EA $ $ 19,242 57,726 19 Construct New PCC Drop Sewer 1 EA $ $ Manhole with two drop connections 40,127 40,127 20 Remove Existing Manhole Structure 3 EA $ $ 3292 9876 21 Bypass Pump Existing Sewer Flow 1 LS $ $ 19,227 19,227 22 Remove Existing Sewer Main and 130 LF $ $ Construct 8" PVC, Sewer Main SDR-26 453 58,890 23 Remove Existing Sewer Main and 16 LF $ $ Construct 15" VICE Sewer Main 1190 19,040 24 Signing and Striping 1 LS $ $ 17,270 17,270 25 Project Advertisement Sign 2 EA $ $ 1886 3772 26 Labor Agreement Oversight 1 LS $10,000 $101000 27 Traffic Control 1 LS $ $ 58,900 58,900 28 Changeable Message Signs (CMS)* 4 EA $ $ 2480 9920 29 Adjust Pull Box to Grade* 1 EA $ $ 2230 2230 30 Abandon Existing Sewer Manhole 1 EA $ $ Structure Per City STD Plan 1209 10,997 10,997 31 Remove Existing Gate Valve Vault 3 EA $ $ Structure and Construct New Gate 6590 19,770 Valve Riser, Valve Box Frame and Cover Per City STD. Plan 1410 P-2 of P-18 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 20-6956 PROJECT 2M956 GAS TAX LOCAL STREET IMPROVEMETNS FY 19120 PROJECT 205437 FLOWER STREET SEWER MANHOLE IMPROVEMENTS ADDENDUM ONE GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 PROJECT 20-6437 FLOWER STREET SEWER MANHOLE IMPROVEMENTS TOTAL BASE BID $ 2,035,574.00 ADD ALTERNATE I 32 Unclassified Excavation 3,240 CY $ 66 $ 213,840 33 AC Pavement 4,010 TN $ 74 $ 296,740 TOTAL ADD ALTERNATE I BID $ 510,580.00 ADD ALTERNATE II (REPLACES ADD ALTERNATE I) 34 Unclassified Excavation 970 Cy $ 66 $ 64,020 35 AC Pavement 2,510 TN $ 84 $ 210,840 36 Full Depth Reclamation with Foamed Asphalt including 3% asphalt binder and 1.5% cement 88,500 SF $ 2.45 $ 216,825 37 Remove 5.5" Pulverized Material 1,550 Cy $ 84 $ 130,200 TOTAL ADD ALTERNATE II BID $ 621,885 TOTAL BASE BID + ADD ALTERNATE I BID $ 2,546,154.00 The lowest responsible bidder shall be selected based on the low Total base bid + Add Alternate I. 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 P-3 of P-18 CITY OF SANTA ANA PROPOSAL PROJECT 206956GAS TAX LOCAL STREET IMPROVEMETNSFYI W20 PRO r SA1. PROJECT 206437 FLOWER STREET SEWER MANHOLE IMPROVEMENTS PROJECT NO.: 20-695 6 ADDENDUM ONE GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 PROJECT 20-6437 FLOWER STREET SEWER MANHOLE IMPROVEMENTS 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. f 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 100 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 $3,730 per calendar day. Name of Firm Signature of BIDDER Title Inc. (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-4 of P-18 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 20-6956 GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 PROJECT 20-6437 FLOWER STREET SEWER MANHOLE IMPROVEMENTS BIDDER'S STATEMENT BIDDER understands and agrees that this Bid Proposal, Contract Documents and subsequent Construction Contract Agreement shall constitute the entire agreement between BIDDER and the AGENCY only after it has been accepted by the City Council, endorsed by the Cleric 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 tinder penalty of perjury that the foregoing is true and correct. Name of Firm EBS General Engineering, Inc. Signature of BIDDER Title Thomas Nanci, 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-4 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 20-6956 GAS TAX LOCAL STREET IMPROVEMENTS FY 19120 PROJECT 20-6437 FLOWER STREET SEWER MANHOLE IMPROVEMENTS CONTRACTOR'S LICENSING AND REGISTRATION STATEMENT The undersigned contractor, or corporate officer, declares under penalty of perjury that he/she and all his/her subcontractors are registered with the State of California Department of Industrial Relations (DIR), and that the following is true and correct. Contractor's Name: EBS General Engineering, Inc. Business Address: 1345 Quarry Street, Ste 101 Corona CA 92879 Business E-Mail Address: bidsoebsgeneral.com Telephone: 951-279-6869 State Contractor's License No. and Class: 720016 A License Expiration Date: 3/31/20 State Dept. of Industrial Relations (DIR) Registration No.: 1000005295 State Dept. of Industrial Relations (DIR) Registration Expiration Date: 6/30/20 Signed: Title: Thomas Nanci, President P-5 ofP-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 20-6956 GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 PROJECT 20-6437 FLOWER STREET SEWER MANHOLE IMPROVEMENTS PREVAILING WAGE COMPLIANCE AND MONITORING STATEMENT Contractor is aware of the requirements of California Labor Code Section 1720, et seq., as well as California Code of Regulations, Title 8, Section 16,000, et seq., ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects. Since the services are being performed as part of an applicable "public works" or "maintenance" project, as defined by the Prevailing Wage Laws, and since the total compensation is $1,000 or more, Contractor agrees to fully comply with such Prevailing Wage Laws. City shall provide Contractor with a copy of the prevailing rates of per diem wages in effect at the commencement of this Agreement. Contractor shall make copies of the prevailing rates of per diem wages for each craft, classification or type of worker needed to execute the services available to interested parties upon request, and shall post copies at the Contractor's principal place of business and at the project site. Contractor shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. The undersigned certifies that the foregoing is true and correct. Name of Firm EBS General Engineering, Inc. Signature of BIDDER Title Thomas Nanci, President (if an individual, so state) P-6 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 20-6956 GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 PROJECT 20-6437 FLOWER STREET SEWER MANHOLE IMPROVEMENTS OWNERSHIP AFFIDAVIT STATE OF CALIFORNIA ) COUNTY OF ORANGE j SS; CITY OF SANTA ANA ) Thomas Near! , being duly swom, deposes and says: ❑ INDIVIDUAL That he/she is the party making the foregoing proposal: ❑ PARTNERSHIP That he/she is a member of the co -partnership firm designated as: and who has been and is duly vested with the authority to make and execute instruments for the co -partnership by:. who constitute the other members of the co -partnership. CORPORATION That he is of EBS General Engineering, Inc. a corporation which is making the foregoing proposal: L] JOINT V ENTURE That he is oC one of the parties making theforegoing proposal as ajoint venture, and the hetsheltas bcen. and is duly vested with the authority to execute instruments for an on behalrof 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 coltit olmself or any other person, Signature of Bidder Thomas Nanci,President Subscribed and sworn to before me this --�C? day of WC- — 20 a Signature of officer Administering Oath (Notary Public) A�wA►ALI`4 ✓'t OD%" WILLIAM E. ELLIS Notary public - California � "' _, Riverside County Commission M County 5 „o."��Ch Comm. Expires Oct 23, 2023 P-7 of P-17 BOND# 3-B PREMIUM: NIL CITY OF SANTA ANA PROPOSAL PROJECT NO.: 20-6956 GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 PROJECT 20-6437 FLOWER STREET SEWER MANHOLE IMPROVEMENTS KNOW ALL PRESENT that, EES GENERAL ENGINEERING INC. as BIDDER, and SURETEC 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 ($ to% ), 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 23RD day of DECEMBER ,2019. BIDDER* SURETY* Subscribed and sworn to before me this day of 20- Signature: Notary Public in and for the County of State of * Provide BIDDER/ SURETY name, address, and telephone number and the name, title, address, and telephone number of authorized representative. AUTHORIZED REPRESENTATIVE: CULBERTSON INSURANCE SERVICES, INC. 5500 E. SANTA ANA CANYON RD. #201;'" ANAHEIM, CA 92807 (714) 921-0530 P_*8 of P-1-7 ' CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT 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 RIVERSIDE ) On (2'�)D-Q before me, WILLIAM E. ELLIS, JR. Date Here Insert Name and Title of the Officer personally appeared THOMAS E. NANCI Name(s) of Signers) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(les), 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 WILLIPME. ELLIS under the laws of the State of California that 1 Notary public- California the foregoing paragraph is true and correct, County Commission R 230676bF WITNESS my hand and official seal. t•`' My Comm. Expires Ott 23, 2023 Signature Signature of Notary Pubtic Place Notary Seal Above Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: o Corporate Officer —Title(s): ❑ Corporate Officer —Title(s): o Partner . o Limited ❑ General o Partner - o Limited o General n Individual o Attorney in Fact ❑ Individual o Attorney in Fact ❑ Trustee ❑ Guardian or Conservator o Trustee ❑ Guardian or Conservator o Other: o Other: Signer is Representing: Signer is Representing: 0 2014 National Notary Association ' ywvw.NationaINotary,ora` 1-800-USNOTARY(1-800-87"827) Item#5907 C-16 JURAT FORM 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. STA'I'B OF CALIFORNIA COONT Y OF Orange Subscribed and sworn to (or affirmed) before me on this 23rd day of December 2019 by Spencer Flake proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. .• . R N SNt3RWOOD Cr`MM.� PUBLIC w NOiAHv HUaIIC • CAUFORNIA � A.RY SEAL) n ORANGE COUNTY. NOTARY PUBLIC SIGNATURE, Erin Sherwood M'+Cl)MM EXPIflES DULY pa.2�a OPTIONAL INFORMATION THIS OPTIONAL. INFORMATION SECTION IS NOT REQUIRED BY LAW BUT MAY BB BENEFICIAL TO PERSONS RELYING ON THIS NOTARIZED DOCUMENT, TITLE OR TYPE OF DOCUMENT DATE OF DOCUMENT When executing aiumt, a notary shall administer an oath of affirmation to the af6ant and shall determine, from satisfactory evidence, that the affiant is the person executing the document. The afflant shall sign the document in the presence of the notary. ti POA s: 510123 SnreTec Insurance Company MUTED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint Charles L. Flake, David L. Culbertson, Spencer Flake, Heather Willis its true and lawful Attorney -in -fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizarices, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for, providing the bond penalty does not exceed Ten Million and 00/100 Dollars ($10,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the CEO, seated with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney -in -Pact may do in the promises. Said appointment is made under and by authority of the following resolutions of the Board of Directors of the SnreTec Insurance Company: Be it Resolved, that the President, any Vice -President, any Assistant Vice-president, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s)-in-Pact to represent and set for and on behalf of the Company subject to the following provisions: Attorney -in -Fact may be given full power acid authority for and in the name of and of behalf bf the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seat of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it Is attached. (Adopted at a meeting held on 200 of April, 1999.) In Witness Whereof SURETEC INSURANCE COMPANY has caused these presents to be signed by its CEO, and its corporate seal to be hereto affixed this lath day of September, A.D. 2018 . C&I MXANY ay: ohn K Jr., CState of Texas , ss: PFtY County of Harris On this 28th day of September , A.D. 2018 before me personally came John Knox Jr., to me known, who, being by me duty swum, did depose and say, that he resides in Houston, Texas, that he is CEO of SURETEC INSURANCE COMPANY, the company described In and which executed the above instrument; that he knows d,o seal of said Company; that the seal affixed to said instrument is such corporate seat; that it was so affixed by order of the Board of Directors of said Company; and that he signed his name thereto by like order. 6-- Xeu*aa—vez. I, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Company, which is still in bill force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are In full force and effect. Given under my hand and the seal of said Company at Houston, Texas this 23RD day of DE MBERt10 A.D. I3r t ea , Assi tent ty Any Instrument issued in excess of the penalty stated above is totally void and without any validity, For verification of the authority of this power you may call (713) $12.0000 any business day between 6:30 am and 6:00 pm CST. CITY OF SANTA ANA PROPOSAL PROJECT NO.: 20-6956 GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 PROJECT 20-6437 FLOWER STREET SEWER MANHOLE IMPROVEMENTS LIST OF SUB -CONTRACTORS Section 4100 et. seq, of the 'Public Contract Code requires listing of all subcontractors with the bid for all subcontract work exceeding the following amount: o Streets, highways including bridge projects: %z% of the bid or $10,000, whichever is greater o Buildings, parks, or other projects: % % of the bid Section 1725.5 of the Public Contract Code requires all Subcontractors be registered with the State Department of Industrial Relations (DIR). BIDDER proposes to subcontract certain portions of the work to the firms listed below: Name Mike Prlich & Sons, Inc. License #/Exp. 760474 DIR Reg.#/Exp. 1000006538 Location Baldwin Park Phone 626-813-1700 Type Of Work Sewer Amount $ 204,840 Name Pavement Rehab Company License #/Exp. 1051374 DIR Reg.#/Exp. 1000064823 License # Location Costa Mesa Phone 714-238-1444 Type Of Work Crack Seal Amount $ 43,312.50 Name Pavement Recycling Systems, Inc License #/Exp. 569352 DIR Reg.#/Exp. 1000003363 License # Location Jurupa Valley Phone 951-682-1091 Type Of Work Cold Mill Amount $ 338,791 r Signature of Bidder Name Superior Pavement Markings License 4/Exp. 776306 DIR Reg.#/Exp. 1000001476 Location Cypress Phone 714-995-9100 Type Of Work Sign & Stripe Amount $ 14,221.90 Name License #/Exp. DIR Reg. #/Exp. License # Location _ Phone Type Of Work Amount $ Name License #/Exp. DIR Reg. #/Exp. License # _ Location _ Phone Type Of Work Amount $ P-9 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 20-6956 GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 PROJECT 20-6437 FLOWER STREET SEWER MANHOLE IMPROVEMENTS REFERENCES The following are the names, addresses, and telephone numbers for THREE public agencies for which the BIDDER has performed similar work within the past three years. 1. See attached reference list Name and Address of Owner. Name and Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed 2. Name and Address of owner. Name and Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed 3. Name and Address of owner. Name and Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed The following are the names, addresses, and telephone numbers of all brokers and, sureties from whom BIDDER intends to procure insurance and bonds. Culbertson Insurance Services• 5500E Santa Ana Canyon Rd., Ste 201 Anaheim CA 92807 714-921-0530 Brokers: 17991 Cowan Irvine CA 92614 (949) 756-4100 P-10 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 20-6956 CAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 PROJECT 20-6437 FLOWER STREET SEWER MANHOLE 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 rive years. 1 • See attached reference list Name and Address of Owner. 2. 3. Name and Telephone Number of person familiar with project. Contract Amount Type of Work Name and Address of owner. Name and Telephone Number of person familiar with project. Contract Amount Type of Work Name and Address of owner. Name and Telephone Number of person familiar with project. Contract Amount Type of W Date Completed Date Completed 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. See info on P-10 P-11 ofP-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 20-6956 GAS TAX LOCAL STREET IMPROVEMENTS FY 19120 PROJECT 20-6437 FLOWER STREET SEWER MANiiOLE IMPROVEMENTS NON-COLLyS1_QN 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 of- 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 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 (hereof, 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 niaki'Ag a false certification may subject the certifier to criminal prosecution. Signed State of California County of Thomas Nanci, President Subscribed and sworn to (or affirmed) before me on this '�o_._., day of K)e _, 20 , by _ proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me --gi�pp ,AA I.9, Notary Public Signattu� Notary Public Seal .rr. " > WILLIAME Eels Notary public � California Riverside County Commission N 2300 too `'.�.o." My Comm. Expires Oct 23, 2023 4 P-12 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 20-6956 GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 PROJECT 20-6437 FLOWER STREET SEWER MANHOLE IMPROVEMENTS 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. 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. The Contractor shall furnish all information and reports required by Executive Order 1 t246 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, 1.965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law. P-13 ofP-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 20-6956 GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 PROJECT 20-6437 FLOWER STREET SEWER MANHOLE IMPROVEMENTS 7. The Contractor shall include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontract or purchase order as the administering agency may direct as means of enforcing such provisions, including sanctions for noncompliance; provided, however, that in the event the Contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency, the Contractor may request that the United States enter into such litigation to protect the interests of the United States. 1. 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:.r Title: Thomas Nandi President Firm: EBS General Engineering, Inc. Date: 12/30/19 P-14 of P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 20-6956 GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 PROJECT 20-6437 FLOWER STREET SEWER MANHOLE IMPROVEMENTS STATEMENT REGARDING APPRENTICESHIP REQUIREMENTS The undersigned BIDDER is familiar with the requirements of Section 1777.5 of the State Labor Code regarding employment of apprentices, and understands that contractors on contracts exceeding $30,000 or 20 working days shall: 1. Apply to the joint apprenticeship committee administering the apprenticeship standards of the craft or trade in the area of the site of the public wort, 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: r Title: Thomas Nanci President Firm: EBS General Engineering, Inc. Date: 12/30/19 P-15 ofP-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 20-6956 GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 PROJECT 20-6437 FLOWER STREET SEWER MANHOLE IMPROVEMENTS STATEMENT REGARDING "ANTI -KICKBACK" REQUIREMENTS The undersigned is submitting this proposal for performing by contract the work required by these bid documents, agrees to comply with the Copeland "Anti -Kickback" Act (18 USC 74) as supplemented in the Department of Labor regulations (29 CFR, Part 3). This act provides that each contractor or subcontractor shall be prohibited from inducing, by any means, any person employed in the construction or repair of public work, to give up any part of the compensation to which helshe is otherwise entitled. Signed: i Title: Thomas Nanci._gident Firm: PIN Clanaral Fnainaarino_ Inc. Date: 12/30/19 P-16 of.P-17 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 20-6956 GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 PROJECT 20-6437 FLOWER STREET SEWER MANI30LE IMPROVEMENTS PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the BIDDER shall complete, under penalty of perjury, the following questionnaire: Has the BIDDER, any officer of the BIDDER, or any employee of the BIDDER who has a proprietary interest in the BIDDER, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No V If the answer is yes, explain the circumstances in the following space. P-17 of P-17 MAYOR Miguel A. Pulido MAYOR PRO TEM Juan VNlegas COUNCIL MEMBERS Phil Sacerra Cecilia Iglesias Oavid Penaloxa Vicente Sarmlento Jose Solorlo POSTED CITY OF SANTA ANA DECCenter Plaza ryln PUBLIC WORKS AGENCY D12 2019 PO, BOX 9188 Santa Ana, Calliifornia 92702 (714)047-500 DONGE COUNTY CLER (•RECORDER DEPARTMENT www,sonta•ana.org �I DEPUTY NOTICE OF EiCENl1'iI01V CITY MANAGER Kdaline Ridge CITYATfORNEY Sonia R. Caivalho CLERK OP THE COUNCIL Delay GQM02 FILED DEC 12 2019 HUGH NOUYEN, CLERFMCORDER aY:,,,,_,,,,,,,,,,,- �aePUTV From the Requirements of the California Environmental Quality Act 10EQA) Fee Exemption per California Government Code Section 6103 To: COUNTY CLERK From: City of Santa Ana County of Orange Planning &Building Agency I)t P.O. Box 238 20 Civic Center Plaza M-20 I Santa Ana, CA 92702 Santa Ana, CA 92702 izs- Project Title: Gas Tax Local Street Improvements FYI 9-20 Date of Approval: 12/1712019 Q Project Number(s): PWA-2010-1690-CITY t Project Location: 1 CityWide (Partial) O City; Santa Ana County: Orange ER Number: ER-2019.114 M Project Description: The construction will Include the repair of concrete street segments, sidewalk, curb & gutter, curb ramps repair necessary to improve facility's ADA transportation and all pedestrian users In the referenced neighborhood. City Project No 20-6956 Recorded Y111n Official Records, Orange County Applicant Name; City of Santa Ana H Illlhllll II I I11NI ullin C I111NIII ci IIiIIiNIIIII II �iII III AppllcantAddress: 20Civic Center Plaza, M-35 1 NO FEE Santa Ana, CA 92702 * g R 0 0 1 3 4 5 1 7 Name of Public Agency Approving Project: City Council 201985001239 4;01 pro 12/12/19 Name of Person or Agency Carrying Out Project: Thomas, Sean 340 Vitlndx Z01 0.00 60.00 0.00 0.00 0.00 0.00 0.00 0.00 Exempt Status: ❑ Ministerial (Sec. 16208) ❑ Declared Emergency (Sec. 15269 (a)) ❑ Emergency Project (Sec, 15269 (b through a)) ❑ General Rule (Sec. 15061(bx3)1(5)) ❑ Statutory Exemption: ❑ Categorical Exemption: 15301(b) Reason(s) Why Project Is Exempt From CEQA: 15301(b) consists of repair/maintenance of existing public facilities. City Contact: E rd Torres Associate Engineer Telephone: (714) 647-5016 Signature: �� __ Title: Date: is SANTA ANA CITY COUNCIL Miguel A Pulido Juan Vlllegss Vlnte,do sarmianto Jose solodo Phil aacena David Panel= Cocl%a Iglesias Mayor Mayor Pm7em, Ward 5 Ward Ward3 Word4 Wad Wards nwm Idna9eamaana.«a iyitaAaeEmaantawlm wa ma antoosa'^ a ana„ isdodoomaerda a a.am sip +�Saa4a+9a+sW �alRslaslJLaat�a-a^a.an CALIFORNIA NEWSPAPER SERVICE BUREAU DAILY JOURNAL CORPORATION Mailing Address: 915 E FIRST ST, LOS ANGELES, CA 90012 Telephone (213) 229-5300 / Fax (213) 229-5481 Visit us @ WWW.LEGALADSTORE.COM EDUARDO FLORES SANTA ANA/PUBLIC WORKS AGENCY 20 CIVIC CENTER PLAZA 4TH FL ROSS ANNEX SANTA ANA, CA 92702 CNS 3323099 NOTICE TO Cliv Council COPY OF NOTICE S13 wok°cf award n NOT C HEREBY GIVEN eran the Contractor shall that the City of possess a wild Santa Ana will California Class "A" receive Bids Contractor's license. electronically via All sub -contractors Notice Type: BID NOTICE INVITING BIDS Planetoids on or before 2:00 Pm, shall be properly licensed for their January 3, 2020. No respective trades. Ad Description PROJECT NO.: 20-6956 GAS TAX LOCAL STREET P late bids will be In accordance with IMPROVEMENTS FY 19/20 & PROJECT NO.: 20-6437 accepted. methoLof of otherbid the Pomiaions the FLOWER STREET SEWER MANHOLE IMPROVEMETS submittal will be abor Code, Prevoiring accepted for: wage rates apply. To the right is a copy of the notice you sent to us for publication In the Proiect No.: 20-6956 12/13, 12/10/19 ORANGE COUNTY REGISTER. Please read this notice carefully and call us GA STREET ORANGE COUNTY with any corrections. The Proof of Publication will be filed with the County IMPROVEMENTS REGISTER Clerk, if required, and mailed to you after the last date below. Publication PROJECT NO.: 20- date sor s notice s are () fthis tii: ( ) 6437 FLOWERSTRFFT 12113/2019 , 12/18/2019 The charges) for this order is as follows. An invoice will be sent after the last date of publication. If you prepaid this order in full, you will not receive an invoice. Daily Journal Corporation Serving your legal advertising needs throughout California. Call your local BUSINESS JOURNAL, RIVERSIDE (951) 784-0111 DAILY COMMERCE, LOS ANGELES (213) 229-5300 LOS ANGELES DAILY JOURNAL, LOS ANGELES (213) 229-5300 ORANGE COUNTY REPORTER, SANTA ANA (714) 543-2027 SAN FRANCISCO DAILY JOURNAL, SAN FRANCISCO (800) 640-4829 SAN JOSE POST -RECORD, SAN JOSE (408) 287-4866 THE DAILY RECORDER, SACRAMENTO (916) 444-2365 THE DAILY TRANSCRIPT, SAN DIEGO (619) 232-3486 THE INTER -CITY EXPRESS, OAKLAND (510) 272-4747 III III II fI II II I I II II I I I II III I II II * A 0 0 0 0 0 5 3 0 5 1 4 7 on how as a Pavement, cement crews ana equipment, implementing a construction safety Plan, adiusting utility covers, traffic control and all appurtenant work, and signing & striping. Pre -Bid Job Mee,o re- B0, ab Meefine. Contractor's cenLT se ltrements: From the 1 me of CITY OF SANTA ANA BONDII 4427865 BONDS PREMIUM: $24,918 PROJECT NO.: 20-6956 & 20-6437 FAITHFUL PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS that EBS GENERAL ENGINEERING, INC. as CONTRACTOR, and SURETEC INSURANCE COMPANY a corporation, organized and existing under the laws of the State, and duly authorized to transact business under the laws of the State of California, as SURETY, are held and firmly bound unto the City of Santa Ana, as AGENCY, in the penal sum of TWO MILLION FIVE HUNDRED FORTY-SIX THOUSAND ONE HUNDRED FIFTY-FOUR & NO/100 Dollars ($ 2, 546 ,154.00 ), 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. TEXAS 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 JANUARY 21, 2020 for GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 ** 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. ** AND FLOWER STREET SEWER MANHOLE IMPROVEMENTS IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seal this 23RD d y of JANUARY 20 20. 1345 QUARRY STREET, STE. 101 CONT R* EBS GENERAL ENGINEERING, INC. CORONA, CA 92879 PH. 951-279-6869 SURETEC BY: Subscribed and sworn to before me, 20 Signature: 3131 CAMINO DEL RIO N. #1450 COMPANY SAN DIEGO, CA 92108 PH. 619-400-4100 Notary Public in and for the County of State of this --day of Rate of premium on this bond is $ 14.40/$8.70/$6.90 per thousand. Total amount of premium charge is $ 24, 918 . 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. AUTHORIZED REPRESENTATIVE: CULBERTSON INSURANCE SERVICES, INC. 5500 E SANTA ANA CANYON RD., I1201 ANAHEIM, CA 92807 PH. 714-921-0530 1 of 3 CALIFORNIA JURAT 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 COUNTYOF Riverside Subscribed and sworn to (or affirmed) before me on this 28th day of January 2020 Date Month Year by Thomas Nanci Name of Signers proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. Signature: 4gnature of Notifry Public JE55ICA LICEA +r Notary Public - California Riverside County Commission N 2215630 My Comm. Expires Oct 27, 2021 Seal Place Notary Seal Above --------------------------------------------------- OPTIONAL --------------------------------------------------- Though this section is optional, completing this information can deter alteration of the document or fraudulent attachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Number of Pages: Signer(s) Other Than Named Above: JURAT FORM 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 ) Subscribed and sworn to (or affirmed) before me on this 23RD day of JANUARY 20 20 by CHARLES L. FLAKE , proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. LEXIE SHERWOOD (NOTARY SEAL) V ROTARY PUBLIC -CALIFORMU OTARY ORANGE COUNTY PUBLIC SIGNATURE Comm. Exp. JULY 27, 2021 OPTIONAL INFORMATION THIS OPTIONAL INFORMATION SECTION IS NOT REQUIRED BY LAW BUT MAY BE BENEFICIAL TO PERSONS RELYING ON THIS NOTARIZED DOCUMENT. TITLE OR TYPE OF DOCUMENT DATE OF DOCUMENT When executing a jurat, a notary shall administer an oath of affirmation to the affiant and shall determine, from satisfactory evidence, that the affiant is the person executing the document. The affiant shall sign the document in the presence of the notary. To order supplies, please contact McGlone Insurance Services, Inc. at (91 6) 484 0804. P0A n: 510123 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know Ali Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under • the laws of the State of Texas, and, having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint Charles I. Flake, David I. Culbertson, Spencer Flake, Heather Willis its true and lawful Attorney -in -fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for, providing the bond penalty does not exceed Ten Million and 00l100 Dollars ($10,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the CEO, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney -in -Fact may do in the premises. Said appointment is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved that the President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Anorney-tn-Fact may be given Rill power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and deliver, any andall bonds, recognizances, contracts, agreements or indemnity, and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate hearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20" of April, 1999.) In Witness Whereof, SURFTEC INSURANCE COMPANY has caused these presents to be signed by its CEO, and its corporate seal to be hereto affixed this lath day of September , A.D. 2018 . aS�RANpF SURETEC CE PANY wG(r By: ¢ 1 W John Kt Jr., CRb- State of Texas as: 7 ••.cz, . z County of Harris s •••-`' On this 28th day of September , A.D. 2018 before me personally came John Knox Jr., to me known, who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is CEO of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the sealof said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said. Company; and that he signed his name thereto by like order. RM , Stunt of l'nxasre:; 09-1n-202n 1241'17659 Xe ' avez, Notary Public �I F commission expires September I , 2020 I, M, Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said. Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. Given under my hand and the seal of said Company at Houston, Texas this 231tD day o£ J ARY 2020 _, A.D. X,A . Br tt eaty, Ass! tent Seereta Any instrument Issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 812-0000 any business day between 9:30 am and 6:00 pm CST. BOND# 4427865 CITY OF SANTA ANA BONDS PROJECT NO.: 20-6956 & 20-6437 PAYMENT BOND PREMIUM: INCLUDED IN PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS that EBS GENERAL ENGINEERING, INC. as CONTRACTOR, and SURETEC 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 TWO MILLION FIVE HUNDRED FORTY—SIX THOUSAND ONE HUNDRED FIFTY—FOUR & NO/100 Dollars ($ 2,546,154.00 ), 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. * TEXAS 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 JANUARY 21, 2020 for GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 ** 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. ** AND FLOWER STREET SEWER MANHOLE IMPROVEMENTS IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seal this 23RD day\tof JANUARY 20 20. 1345 QUARRY STREET, STE. 101 CORONA, CA 92879 PH. 951-279-6869 3131 CAMINO DEL RIO N. #1450 SAN DIEGO, CA 92108 PH. 619-400-4100 CHARLES L. FLAKE / ATTORNEY —IN —FACT Subscribed and sworn to before me, 20 Signature: Notary Public in and for the County of State of this _—day of Rate of premium on this bond is $ NIL per thousand. Total amount of premium charge is $ NIL . 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. AUTHORIZED REPRESENTATIVE: CULBERTSON INSURANCE SERVICES, INC. 5500 E SANTA ANA CANYON RD., #201 ANAHEIM, CA 92807 2 of PH. 714-921-0530 CALIFORNIA JURAT 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 COUNTYOF Riverside Subscribed and sworn to (or affirmed) before me on this 28th Date by Thomas Nanci Name of Signers day of January 2020 Month Year proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. Signature: l�f A7 Wti gnature of Notary Public JESSICA LICEA Notary Public - California Riverside County @ Commission 1 2115610 My Comm. Expass oct 21, 2021 Seal Place Notary Seal Above --------------------------------------------------- OPTIONAL --------------------------------------------------- Though this section is optional, completing this information can deter alteration of the document or fraudulent attachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Number of Signer(s) Other Than Named JURAT FORM 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 - ) Subscribed and sworn to (or affirmed) before me on this 23RD day of JANUARY 20 20 by CR&RLES L. FLAKE proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. LEXIE SHERWOOD / COMM. # 2203287 3 %,//� I' .il A. s..�..A VU' NOTARY POaLIC OCAUFORNIA n Tr —,l "u^/w /J'UUUU" (NOTARY SEAL) g ORANGECOUNN NOTARY PUBLIC SIGNATURE Comm. Exp. JULY 27, 2021 OPTIONAL INFORMATION THIS OPTIONAL INFORMATION SECTION IS NOT REQUIRED BY LAW BUT MAY BE BENEFICIAL TO PERSONS RELYING ON THIS NOTARIZED DOCUMENT. TITLE OR TYPE OF DOCUMENT DATE OF DOCUMENT When executing a jurat, a notary shall administer an oath of affirmation to the affiant and shall determine, from satisfactory evidence, that the afflant is the person executing the document. The affiant shall sign the document in the presence of the notary. To order supplies, please contact McGlone Insurance Services, Inc. at (91 6) 484 0804. roA it; 510123 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint Charles L. Flake, David L. Culbertson, Spencer Flake, Heather Willis its true and lawful Attorney -in -.fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for, providing the bond penalty does not exceed Ten Million and 001100 Dollars ($10,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the CEO, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney -in -Fact may do in the premises. Said appointment is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that die President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney -in -Fact may be given full power and authority for and in the time of and of behalf of the Company, to execute, acknowledge and deliver, any andall bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, andany such instruments so executed by any such Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed andeffected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20* of April, 1999.) In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its CEO, and its corporate seal to be hereto affixed this 28th day of September . A.D. 2018 , SURETEC A CE PANY (bmw ANQX q By: John K Jr., CState of Texas ss:k County of Harris... On this lath day of September , A.D. 2018 before me personally came John Knox Jr., to me known, who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is CEO of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the sealof said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said. Company; andthat he signed his name thereto by like order. _.._. NI 15 eze Motary public, Stale aF Texas ly Comrn. Expires 09-10-2020 ":�vk.•...•�,F`� h7atary [: 129117659 I, Xe ' ` avez, Notary Public i p commission expires September 1 , 2020 I, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. Given under my handand the seal of said Company at Houston, Texas this 23RD of NUARY 2020 A.D. A,,,ry eaty, Assi tact Secreta Any Instrument issued In excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 812-0800 any business day between 8:30 am and 6:00 pm CST. AC4'PO' CERTIFICATE OF LIABILITY INSURANCE of/ 3/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. r statement d. this cettiflcale does not confer rl hts to the certificate holder In lieu of such endorsements . PRODUC6R LIC #DE28842 1-949-756-. 100 Tnvensure Insurance Brokers, Inc. 17991 Cowan NAME:C Kathryn Lopez PHONE .949 956-4123 94g•756-4199 AC No: Aoo L klo oa®lnvansure.com INSURERS AFFORDING COVERAGE NAICN Irvine, CA 92619 INSVRERA: LIBERTY t4UT FIRR TNS CO 23035 INSURED RB8 General Enginearing, Ina, INSURERe: FIRST LIBERTY INS CORP 33588 INSURER C: LTH$RTY TN9 CORP 42904 INSURER O: 1345 Quarry St.., Suite 101 NSURER 6; Corona, CA 92879 INSURERF: lvyz`nml. Q VCI4Nr1Cr4IrINOmt$t:K:>UJB11L1 REVISION NUMBER• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ILm TYPE OF INSURANCE R POLICY NVMaER Mptgg F POLOCY LIMITS A X COMMERCIAL GENERAL LIABILITY X X TH2-Z91.454286-019AMM 09/28/19 09/28/20 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE 1�1OCCUR PREMISES E n ace E 100,000 X MED EXP(An one arson) $ 5,000 $2,500 Deductible PERSONAL B ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER.. O GENERAL AGGREGATE $ 2,000,000 GEN'L PRODUCTS•COMPIOPAGG $ 2,000,000 POLICY T je T 1-1 LOC �— $ OTHER: B AUTOMOBILEUASIUTY X X AS6-Z91-454286-029 09/28/19 09/28/ 0 COMBINED SINGLE I Ea am and E y,.000, 000 X ANYAUTO BODILY INJURY (Per parson) E OWNEDSCHEDULED BODILY INJURY (Per accident $ X HIRED X NON -OWNED AUTOSONLY AUTOS ONLY PROPERTY N ACC— War poon nl $ $ C X UMBRELLAUAB I X GCCUR TH7-Z91+454286-049 09/28/29 09/28/20 EACHOCCURRENCE $ 4,000,000 AGGREGATE_ $ 4,000,000 EXCESS LIAB CLAIMS•MADE DED I I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERB'LIABILITY % WC6.291.454286-039 09/28 /19 09/28/20 X OTH ST TUTS ER yy/N ANYPROPRIETOWPARTNERJEXECUTNE r"�1 E.L. EACH ACCIDENT $ 1, 000, 000 OFFICE"EMBEREXCLUUED7 Y (Mandatory In NH) it_JI NIA E.L. DISEASE• EA EMPLOYEE E 1,000,000 8 yes, OescI'No andar E.L. DISEASE •POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERAT ONS bet DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be altachad If more apace Is required) "Certificate holder is additional insured per forme CO2037 04 13 & CO2010 04 13, CA204S 10 13, GL Primary wording LC 24 20 11 18, Blanket GL waiver of aubrogation CG2404 05/09, Blanket FIC waiver of subrogation WC040306 4/84 & Auto Waiver of Subrogation CA 04 44 1D 13 apply per attached. GL Per Project Agg applies par attached LC 25 19 01 25. Auto Primary applies per attached AC 84 23 08 11. 30 Days Notice of Cancellation Applies RXoept 10 Days Notice for Non. Payment of Premium. Project 1107st. 20-6956 & 20-6437 Gas Tax Local Street Improvements PY 19/20 and Flower Street Sewer Manhole Improvements EBa820201 13Y I1I5K IVIANAUU.MFNI..nn5SH)' I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Management70 ,.,, ,„ ,f �� ACCORDANCE WITH THE POLICY PROVISIONS. 20 C1V1C Centel Plaza ,ill °I///-'"'17{`/111„lll,�',I/I� IAUTHORIZED REPRESENTATIVE Santa Ana,CA 92701 CnAaln[� + nr <e r-rYrrrTC"NX V8A � ,�..x6�C�-au..�f-- ACO 01988.2015 ACORD CORPORATION. All rights reserve) tball 25 (2018103) CORD name and logo are registered marks of ACORD ell 58392121 POLICY NUMBER: AS8—Z91-454288-029 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Xon 4 04 11111FAIII A ILO14• -. This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organlzation(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not after coverage provided in the Coverage Form. SCHEDULE Name Of Person(s) Or Organization(s): Any person or organization whom you agreed in writing as an additional Insured, but only for the coverage and minimum limits of insurance required by the written agreement, and In no event to exceed either the scope of coverage or the limits of insurance provided In this policy. Each person or organization shown In the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured' under the Who Is An Insured provision contained in Paragraph A.1. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph 0.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 110 13 REVIEWED & APPROVI t. By Risk MANAGEMENT nivisiop, Fj�3(�16 2020 ® Insurance Services Office, Inc., 2011 Page 1 of 1 Policy Number: AS6-Z91-464286-029 Issued by: THE FIRST LIBERTY INSURANCE CORPORATION THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, DESIGNATED INSURED - NONCONTRIBUTING This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIERS COVERGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage form. Schedule Name of Person(s) or Organizations(s): Any persons or organizations as required by a written contract or agreement entered into prior to an "occurrence" or offense. Regarding Designated Contract or Project: Each person or organization shown in the Schedule of this endorsement is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. The following is added to the Other Insurance Condition: If you have agreed that this policy will be primary and without right of contribution from any insurance in force for an Additional Insured for liability arising out of your operations and the agreement was executed prior to the "bodily injury" or "property damage", then this insurance will be primary and we will not seek contribution from such insurance. REVIEWED & APPROVED By Risk MANA.CCMEM IDi 11sioN ,1 f; I I WA AC 84 23 08 11 O 2010, Libedy N1ut�� Group of Com All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. POLICY NUMBER: AS6-Z91.454286.029 COMMERCIAL AUTO CA 04 4410 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. SCHEDULE Name(s) Of Person(s) Or Organlzation(s): Any person or organization for whom you perform work under a written contract if the contract requires you to obtain this agreement from us, but only if the contract is executed prior to the injury or damage occurring. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident' or the "loss" under a contract with that person or organization. I?EVIEWED & APPROVED By Risk MANAGCMFNr OhliSION FEB 6 20 t�r�=tir� CA 04 4410 13 ©Insur *hce Se cec., 2011 Page 1 of 1 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT — CALIFORNIA We have the right to recover our payments from anyone liable for an Injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2.0% of the California workers' compensation premium otherwise due on such remuneration. Schedule Additional premium is a percent of the California Manual Workers Compensation premium. Subject to a minimum premium charge of $ 250 Person or Oreanization Job Description Where required by contract or written Any agreement prior to loss and allowed by law. Issued by Cc 2 - First Liberty Insurance Corp. REVIEWED & APPROVE[ For attachment to Policy No. WC6-Z91-454286.039 By Risk MANAGCMC.N1 DIVISION premium $ Effective Date 09/28/2019 FE 6 020 WC 04 03 06 Ed. 04/1984 �-n �ji e g u>rw-ems POLICY NUMBER: TB2-Z91-454286-019 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ! 1 A • This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section 11 - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury' or "property damage" occurring after: CG 20 10 0413 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional Insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work' out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. REVIEWED & APPROVEO By Risk MAN1AG[MFPJf DivisioN ?E 6 020 ' � SO ropertfes, Inc., %2012 Page 1 of 2 13 SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations All Persons or organizations with whom you have All locations as required by written contract or entered into a written contract or agreement, prior to agreement entered into prior to an "occurrence" an "occurrence" or offense, to provide additional or offense. Insured status. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. REVIEWED & APPROVED By Rick MANAG-.MV.NT DivisiCM FE 0 a 2020 F AN ,I a" ZEALACM w JI1L�1Le1 a CG 2010 0413 0 Insurance S vices Office, Inc2012 Page 2 of 2 POLICY NUMBER: TB2-Z91-454236-019 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. M • •'q MAIN I • This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations All Persons or organizations with whom you have All locations as required by written contract or entered into a written contract or agreement, prior agreement entered Into prior to an `occurrence" or to an `occurrence" or offense, to provide additional offense. insured status Information re wired to com late this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the Insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured, CG 20 37 0413 B. With respect to the insurance afforded to these additional insureds, the following is added to $action IN — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. REVIEWED & APPROVEU By Risl; fvla1vAoCmFNT I)iVi$iON FE 6 02Q ©I sura ce Services Office, Inc., 2012 Page 1 of 1 Policy Number TB2-291-454286.019 Issued by LIBERTY MUTUAL FIRE INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT OR DESIGNATED LOCATION COMBINED AGGREGATE LIMITS — WITH TOTAL AGGREGATE LIMIT FOR ALL PROJECTS AND LOCATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Schedule nated Construction Project(s) or Designated you are performing ongoing operations. Total Aggregate Limit for all Projects and Locations locations' and all construction projects $ 15,000,000 A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I — Coverage A, and for all medical expenses caused by accidents under Section I - Coverage C, which can be attributed only to ongoing operations at a single designated construction project or a single designated "location": 1. A separate Designated General Aggregate Limit applies to each designated construction project and to each designated "location", and that limit Is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated General Aggregate Limit is the most we will pay for the sum of all damages under Section I - Coverage A, except damages because of "bodily injury" or "property damage" included in the "products - completed operations hazard", and for medical expenses under Section I - Coverage C regardless of the number of: a. Insureds: b. Claims made or "suits" brought: or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated General Aggregate Limit for that designated construction project or designated "location". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated General Aggregate Limit for any other designated construction project or designated "location". 4. The limits shown in the Declarations for Each Occurrence, Damage to Premises Rented to You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated General Aggregate Limit and the Total Aggregate Limit for all Projects and Locations. LC 25 19 0116 IMAI %t W &Wir'iROif D Page 1 of 2 Includes copyrighted mat8alfa(9(aMaWMNtf IDb*f$®,Nnc., with Its permission. F 0 2020 5. The Total Aggregate Limit for all Projects and Locations shown in the Schedule of this endorsement is the most we will pay for the sum of all damages caused by "occurrences" under Section I — Coverage A and all medical expenses caused by accidents under Section I — Coverage C which can be attributed only to ongoing operations at a designated construction project or designated 'location" shown in the Schedule of this endorsement, regardless of the number of construction projects, 'locations", 'occurrences" or accidents. 6. Each Designated General Aggregate Limit is subject to the Total Aggregate Limit for all Projects and Locations shown in the Schedule of this endorsement. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I — Coverage A. and for all medical expenses caused by accidents under Section I - Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project or single designated 'location": 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -Completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Designated General Aggregate Limit. C. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Prod ucts-Com plated Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated General Aggregate Limit. D. If the applicable construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. For the purposes of this endorsement, the Definitions Section is amended by the addition of the following definition: "Location" means any premises that you occupy for permanent operations as part of your business, but does not include any premises at which you are performing operations as part of a construction project. All premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad shall be considered a single "location". F. The provisions of Section III - Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. LC 25 10 01 15 ( Wp0r& fpt�tijRR��rtee Page 2 of 2 Includes copyrighted ny� ktf jp Atixw servMl ftt��, Inc., with its permission. E 0 020 Policy Number TB2•Z91.454286-019 Issued by Liberty Mutual Fire Ins, Co, THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY, OTHER INSURANCE AMENDMENT -SCHEDULED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART Schedule Name of Person(s) or Organization(s): If you are obligated under a written agreement to provide liability insurance on a primary, excess, contingent, or any other basis for any person(s) or organization(s) shown in the Schedule of this endorsement that qualifies as an additional insured on this Policy, this Policy will apply solely on the basis required by such written agreement and Paragraph 4. Other Insurance of Section IV — Conditions will not apply, Where the applicable written agreement does not specify on what basis the liability insurance will apply, the provisions of Paragraph 4.Other Insurance of Section IV — Conditions will apply. However, this insurance is excess over any other insurance available to the additional insured for which it is also covered as an additional insured for the same "occurrence", claim or "suit', REVIEWED & APPROVED ey Risk A4ANAorWN1T Ilivisiop, F3:VL1LL.AV—r-- -rTrrTTVV-IF LC 24 20 1118 © 2018 Liberty Mutual Insurance Page 1 of 1 Includes copyri tad mat riial of I Krance Servic uOffice, Inc., with Its permission. Policy No.'FB2-Z91-454286-019 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE As required by written contract or agreement entered into prior to loss. this The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions; We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above, CG 24 04 05 09 ZtVIErVIEL) c4 fil'NO' ;_i_ By Risltrfl[:lrnyn�p--..—.. ryrl:. '..i © Ins an a vic c 008 1 Cie Page 7 of 1 CITY OF SANTA ANA SPECIFICATIONS PROJECT NO.: 20-6956 OAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 PROJECT 20.6437 FLOWER STREET SEWER MANHOLE IMPROVEMENTS If a suspension of work is ordered by the Engineer, due to the failure on the pan of the contractor to carry out orders given or to perform any provision of the contract, the days on which the suspension order is in effect shall be considered working days. SECTION 7 - RESPONSIBILITIES OF THE CONTRACTOR 7-1 CONTRACTOR'S EQUIPMENT .AND FACILITIES Add the following to this subsection: Pursuant to the authority contained in Section 591 of the Vehicle Code, fire Department has determined that, such areas a s are within the tintits of the project andare open to public traffic, the Contractor shall comply with all the requirements set forth in Divisions 11, 12, 13, 14 and 15 of the Vehicle Code. Attention is directed to the statement in Section 591 that this Section shall not relieve hint or any person from the duty of exercising due care. The Contractor shall take all necessary precautions for safe operation of his/her equipment and the protection of the public from injury and damage from such equipment. 7 2 LABOR 7-2.2 Prevailing Wages Add the following to this subsection: Certified Payroll Records shall be submitted to the Engineer every two week, beginning with the actual start day of coustruction, and shall be consecutively unmbered until the completion of the work. Progress payments will be withheld pending receipt of any outstanding reports. The Contractor shall assure ttirit a qualified supervisor is present at all times when work is being perfonned. 7.3 LIABILITY 1NSURANCE Tha provisions of this subseah'on apply exrept as herein modified: The Contractor shall provide insurance coverage limits as detailed in the Certificate of Liability Insurance, The Certificate of liability Insurance is included in Appendix D of the Contract Doctaneuts. Professional Liability Insurance (mars and omissions) will only be required if Contractor employs a licensed professional such as an architect or engineer for a component of the work When occurs, Professional liability insurance, with a combined single limit of not less than $ 1,000,000 per claim with $2,000,000 in the aggregate. The Certificate of Liability insurance shall be provided by the successful BIDDER within ten (10) business days, after the successful BIDDER has received notice that the contract has been awarded. Failure to provide shall be just cause for the aim lment of the award and the forfeihue of the proposal guaranty. 10 (�v`CMT1 OV pN 6 zozo CITY OF SANTA AN SPECIFICATIONS PROJECT NO.: 20-6956 GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 PROJECT 20-6437 FLOWER STREET SEWER MANHOLE IMPROVEMENTS 7-4 WORKER'S CORfPENSATION EPSUILANCE Add the follownrg to this subsection. The Contractor shall furnish the Agency with satisfactory proof of Worker's Compensation Insurance. The insurance shall be taken out with a responsible insurance carrier authorized under the laws of the State of California and satisfactory to the Agency. For work that is sublet, floe contract shall require the subcontractor similarly provide Worker's Compensation lnsurrances for the subcontractor's employees. 7-5 PERMITS Add thefollowing to thts subsection: The contractor .shall comply with all Federal, State or local laws, ordinances, or rules and regulations related to the performance of the work, which include but are not limited to the following: a. Business License. Each Prime Contractor and Subcontractor shall obtaht and pay for a Santa Ana Business License. Detailed infomratiou concerning business license may be obtained from the Finance and Management Services Agency, C714) 647-5447, City Hall. b. Consmhction Water Permit. Each Primo Contractor or Subcontractor which desires to obtain water from AGENCY -owned fire hydrants for constriction or any other purpose shall fast obtain and pay for a permit from the Corporate Yard of the City of Santa Ana, at 220 South Daisy Avenue. Information concerning costs and conditions may be obtained from the AGENCY by calling (714) 647,3320_ Use of private water from a hose bib is not allowed For safety reasons., the AGENCY will not allow Contractor to stretch construction water hoses across open traffic lanes. Where required, Contractor shall use water truck. c. D^rosal Pemhit. In accordance with the procedures of the Orange County General. Services Administration (GSA), the cost for ire disposal of all materials at County landfill sites shall be bome by the Contractor. d Building and Electrical Permits. Fox projects involving building, stmctral construction, traffic signal or irrigation controller installation, due Prime Contractor shall obtain the necessary building and electrical permits from tie Planning Bc Building Agency. There will be no fees for these Permits. e. State Division of Industrial Safety Permits In accordance with. Section 6500 of the State Labor Code, permits are required for all excavations, which are five feet or deeper, or for all structures being built or demolished, which are more than three stories high f. RiSW of Entry Permit Contactor shall coordinate with the City and residentialproperty owners to obtain any right of entry permits required for any demolition and reconstruction. All permits and fees required by all other Agencies having jurisdiction over any part of the work shall he obtained and paid for by the Contractor, unless otherwise noted on the Plana or in the General Provisions. II 1ZFVICWED & MPP ROVOi Qy R14 FEB 6 20 AREat ACM. CERTIFICATE OF LIABILITY INSURANCE Pnapudax 7"M CERTIFICATE IS ISSUED AS A MATTER OF FOWCaON ONLY ANO CONFERS NO RIGHTS UPON THE OERTrFICATE NOLOER. ES NOT AMEND EXTEND OR MgmMOF103k INSURERS WORDING COVERAGE IIAMDN G'. �NeLWpR ~- 4yPCUC10SOPWSUIw+DNL191bU"ION OF Al C ACT R T Ill cocyfimYM1 Re eorHr PWKICH PHMOHDIOATlk WAY00ISUEDR:O MIy rE rw Yhff TUN OR CONODION OF ANY CO IXS D 0R OMCA OOCtNEtYi 4ATN TO Att T TO WNIDN TN48 CEDT/IGA C NAY BS Or S OR BUY eTAO TE BVSV ATS APYOAOCD DYYHEEENPlSDeD BY MD OL'JN-BAIR,ECT TO AL4 THE TER\tB.E%UUP9INY9 AND 4ON01110N5 OF 9u[]i PULN;;ES. ADmPEr.AfE LNNTS EIuhW NAY tNVE b[CN RCCux'D BY MD CW US. ._..._.__..�QeY dYL£ btIDU}ddl FaYYEtl41MTB 01101112DD2 ----. ilYnH ee4YRALUAdutt X L'OlNflSpnitlHlxPAt nA➢LT' CIAxp4VCE �dDJJP x1f111111 E4GtiOCRi1CFt1L.e .J. 1.0'JC,oCG PPE PW/N£ R,Bf B SUM NW E4TIMtxfl F�VaV ! PIPBUW.AMYPIIIM _EACd_ ! �R,OD OM .� dCM fnpMAnBCumAPREa ILM PPShK.T&. dUtYiM AM 2pDd AV�61NU0.8LNBAl1Y X k11'ANtd X"1222212 DW172D01 04OH2OPI2 �RNfLR lsln 1 Y,DDp.Q'0 k�x6�WR0nu1dR IPxpf�pM Npry MpdB NblMvxMN.TM pWLY 1MkMY P'�.uivvl�R ! _ .._------ SEE ATTACHED ADDITIONAL INSURED ENDORSEMENT COVERAGES DEPEND ON TYPE PPROf.TPi�YPUfAQH uPdatNn.An.w.TtxYrr kVDDXL y E L__ ! ! RnAASBwAUAa r AHrd _ �DaA�pNDE PD&�—_----__,. _ OF AGREEMENT/CONTRACT polti[gR6cawarsAnoNAwd rxPwrwlrlwP.m XXX53ii:kS1:13 Ofivirml QW(2007 X r ,. .ODE F.y[e�APB•W fkYhO,G _ t,000.0 I UCOADo RTMFN PrdkBBUPSt LteWity P"44,14 01fDU;Wt 0WIM002 V.44 O"rwwo I.OM.CDd W Q `t.ROMyYtM4L{4k8K4bRY5A8%n GT WMMpMMIIp'p4fL VRNffiOMf CarWY119N t I..dd f.. DtlfIxBVAY Ntl11B.Y Itl ppnEpNli IlttVbd tlyl-9xBx�gi. 1'rged!lNs.� CERTIFICATE elwn,vrnrTleAarredeetWaaeraunlee aecwucal.Ltc PePDRETFe puIBAyNw r•� City of Santa Ana W 8 tNWHX. IK IBBUW NlMiA YA L M4Y. DA 8 BY rI 20 Clvlc Center Plaza . Ross Annox (M• ) MD^�ETD „Ed6RnpdA a wBaRD a u oTxEBEir, � Santa Ana, GA 92701 AVRWNi6d PRPREBWtfirPa �` nMVw itviI-W L3 6 Al)[)IZGVEI; ''s, Ricle lk4 %NIArrMfNT nilliSION =C 2020 S ACORD CORPORATION IRS ADWEIMALMUMMMEW DOLL COMMD.tLCIAt, GhWFItA[, LIABILITY POLICY hnsuraace Coolliany This endorsement modifies such insurance as is afforded by the provisions of Policy # _ Mating to the following; L The City of Santa Are, 20 Civic Center Mass, Sou slAna, California 92701; its officers, employees, agents, volunteers and representatives are named as additional insureds C'additional insureds") with reprd to liability and defense of suits arising from die operations and uses parfottnod by or on behalf of die named insured. 2. With respect to claims arising on of die operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the bentilt of the additional losorads 9. This insurance applies separawly to each insured against whom claim is made or suit is brought excerpt with impact to the eompmny's limits of liability, The inclusion of any ptt'son or organisation as acn inured shall oaf affect ally right which such person or organization would have m a claimant If not so included. 4, With respect to the additional insureds, this insurance shall net be cancelled, or materially reduced 1p coverage or lionits except after thirty (30) days written notice leas been given to rile City of Santa Ana, 20 Civic Center Plaza, Santa Ana, Califomin 0-701. (Completion orthe fallowing, including aomtarslg tissue, is required to make tills endorsement effective.) Efective .._ , this endorsement feint as a part of Policy #._��___.—._----_...._._ IssuedtuA_-__ Named Insured ComtorsignedbY� Authorized Reprosentativo scViENVED & APPROVED +u p;sir a/I66inrrmrr4i Divisiory Ws Gaza stmdeaL, Dounry of.,— ..__ On...... RAis —_. Oalgre me, "....., —M + i GI Weenrilly known to Me * OR • proved to HOW To FILL *UT THE RIa.YPiJPOSI ACIGNY.SW1,00MnW i+Ys ttwlecesrAnaaawFlelsnespelfrrFi xNctrNbnn96ilawFOtUiYueaW i�� NO7AhGA�1DN. AauV ndiPLtWlm3 n1lW INWO �nhi�rtal6WnlNu14'b 11) RimLF11H94KWtlD G6,Y 6Y In mx I�tPodaM WYwb a�ll�R�nMNaraalabld Wyb'Y. dnandktlRwws aY10 t919A ((a+��CHeCK LIFT WX YsWy�x.kpar�ry -n G�uxlUmlw4WNaW1�a nif+AWrw vbvs. the Ot CAPACITY CLAIMED SY SIGNER IbRO'VMla JalM Mr Not#*Who IhWkiN it h"A 4hmovVbPFdWIv Q [NONOUAL 0 OnPOW6 t "41108 giraAhau Bx' a 13"'3rF'aWld = (6y��\ I dingir Ieal sOnlB), W0W•-�OuAm4its'CLkt6mATOA W nit OI wfllch the ^--•-^-^•-�•--Y_-:.•-- Ifte fnsirWNnnrd. , SHiNERIS REPRESENTIM: ndial 6pfll, Nalt'9rrWP.WMaahar+xmrW SECTION (4N O68C191rtNN1#OT161aR.A9rtvilwA YltjWrAWldtr�wNllr•aMo/ti; m}eiwlmM hmajat pf1Y1N(la Crytdtf, rtcF ia, tup>.aW alrow N9tlYy MtINvkAYYtyinvNWNawpnmlbi b Plxnlr.` (19) NANC OP POOH 0A MAL WMPrtY 99r vow k MPYMRM} M mm w IOgYI.h1 NNMtl MnNIIVYfwI iap'enpNN h/ wblrb7lndKt WmVU 65 tJMR NlaNJe IrnlYri iINt11lIM M M'91P1 liyein6rdabaW'pAaJaanm4lplr WRn, Rshah NP/T tegr.,waVarb M+kd YaR911bM:! PiWRId1aA` BPACI%i,R19ORISMuI Olq>rkn NYKA MIb NtI nal W(IM Uanly l IYa mMry. Nnwat, Wf o'+ak�Yly pP CWU6U OVrinaonaWla kla..a+flwM nlnW aRawq FUlanW amalle<11.iena nxmtlry IWlaeliiq nmayF FpM�hh IaTRYkd, man hlmltPtnb 1p 2xw'IkWaYbl P:anvn4 mrceq•do tl9awmh)¢wOM tonvrwtb mp"1.gyarf.W nunbl vW WMa WpWN)b nL]YITIAOxlYR94R40GUMPNr tr3rArxTpp, wNna m,�n«,•n.afara.�r 11, 1 1 r :. Nl;�i' 1111' t [111 RAMtl1 OR iAUlB N OOCIW brf NbrARWm. Oo aINwula c adWMY q a p4,a Ilnl nw tld"WoogRLoovcwNanfYWaHtowwig* al WDm0 1,W fMab9lFeYawafPawlK 4aoRWbl.e' Wants N nY/81R WnuY, YiW1WMCNYE' ((YW)BIO OYIERTNAN NAYpe NiRAC6R SnIa RW ;sttntr�ElnNm MN#k* dep amowb. McM1 IHmo�Fdab+al�aSdw WFUI:IY w NM apwf m odd�o wIIM�Mw-- W �� awAw, x.mr Wank 7+o a �lka COVyN1011TU iWW NAYWNALIaO1sAY A6ie9NYKa 9tJl hln hw Am_ R.Q Bo. f I01 Circ9a PWtCA911W]IM rYphat6:9U•]Y)a9f0 RlPwrr As required by Colifomla Labor Colo Section 1860 and 1861 the CAnhgolar cmMfies qa fotiowe: I am aware of the p oAsions of Soros 3700 of iho Labor code, whioh rogatras every employer to he, insured againat liability ter warktes compensation or to tmdcrtakc self•Insumnm in accetdance whit the provisions of the Code, and I will comply with such provisions bgfoo commencing the perfomrnnco of the work of this contract, Signed: riti0: Firm: Datm FHB 6 .020 .. A��' CITY OF SANTA ANA BONDII 4427865 BONDS PREMIUM: $24,918 PROJECT NO.: 20-6956 & 20-6437 FAITHFUL PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS that EBS GENERAL ENGINEERING, INC. as CONTRACTOR, and SURETEC INSURANCE COMPANY a corporation, organized and existing under the laws of the State, and duly authorized to transact business under the laws of the State of California, as SURETY, are held and firmly bound unto the City of Santa Ana, as AGENCY, in the penal sum of TWO MILLION FIVE HUNDRED FORTY-SIX THOUSAND ONE HUNDRED FIFTY-FOUR & NO/100 Dollars ($ 2,546, 154. 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. * TEXAS 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 JANUARY 21, 2020 for GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 ** 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. ** AND FLOWER STREET SEWER MANHOLE IMPROVEMENTS IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seal this 23RD d y of JANUARY 20 20, 1345 QUARRY STREET, STE. 101 CONT R* EBS GENERAL ENGINEERING, INC. CORONA, CA 92879 PH. 951-279-6869 3131 CAMINO DEL RIO N. $1450 INSURANCE COMPANY SAN DIEGO, CA 92108 PH. 619-400-4100 lm Subscribed and sworn to before me, 20 Signature: Notary Public in and for the County of State of this ---day of Rate ofpremium on this bond is $ 14.40/$8.70/$6.90 per thousand. Total amount of premium charge is $ 24.918 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. AUTHORIZED REPRESENTATIVE: CULBERTSON INSURANCE SERVICES, INC. 5500 E SANTA ANA CANYON RD., 11201 ANAHEIM, CA 92807 PH. 714-921-0530 1 of 3 CALIFORNIA JURAT 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 COUNTYOF Riverside Subscribed and sworn to (or affirmed) before me on this 28th day of January 2020 Date Month Year by Thomas Nanci Name of Signers proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. Signature: g ature of Notary Public ,. JESSICA LICEA Notary Public - California Riverside County Commission k 2215630 My Comm. Expires Oct 27, 2021 Seal Place Notary Seal Above --------------------------------------------------- OPTIONAL --------------------------------------------------- Though this section is optional, completing this information can deter alteration of the document or fraudulent attachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Signer(s) Other Than Named JURAT FORM A notary public or other officer completing this certificate verities 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 Subscribed and sworn to (or afF=ed) before me on this 23RD day of JANUARY 20 20 by CHARLES L. FLAKE proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. LEXIE SHERWOOD two COMM. # 2203287 3 �TO.l.�YS.E�) ,_� NOTARY PUBLIC - CAUFORNtA G) �Y PUBLIC SIGNATURE ('� ORANGE COUNTY Comm. Exp. JULY 27, 2021 OPTIONAL INFORMATION THIS OPTIONAL INFORMATION SECTION IS NOT REQUIRED BY LAW BUT MAY BE BENEFICLA L TO PERSONS RELYING ON THIS NOTARIZED DOCUMENT. TITLE OR TYPE OF DOCUMENT DATE OF DOCUMENT When executing a jurat, a notary shall administer an oath of af&rmation to the affiant and shall determine, from satisfactory evidence, that the affiant is the person executing the document. The affiant shall sign the document in the presence of the notary. To order supplies, please contact McGlone Insurance Services, Inc. at (91 t7 484 0804. POA p, 510123 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Texas, and. having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint Charles L. Flake, David L. Culbertson, Spencer Flake, Heather Willis its true and lawful Attorney -in -fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for, providing the bond penalty does not exceed Ten Million and 00/100-Dollars ($10,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the CEO, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney -in -Fact may do in the premises. Said appointment is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that the President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney -in -Fact may be given full power and authority for and in the time of and of behalf of the Company, to execute, acknowledge and deliver, any andall bonds, recognizances, contracts, agreements or indemnity, and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, andany such instruments so executed by any such Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed andeffected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20^ of April, 1999.) In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its CEO, and its corporate seal to be hereto affixed this lath day of September, A.D. 2018 . SV SURETECI CE PA RAWNY U�,,X.......... o0 wJ 9 �I By: 't John I Jr., C State of Texas ss: \W I Qe, M_ ? County of Harris •• • ••........ On this 28th day of September , A.D. 2018 before me personally came John Knox Jr., to me known, who, being by me duty sworn, did depose and say, that he resides in Houston, Texas, that he is CEO of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument; thathe knows the seal. of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said Company; and thathe signed his time thereto by like order. �,Jii7ir'<i �XENIft CNt1V CiZ iSMi�T fbBw �.Nolary Public, Srale of fuXas Corntn. Expires 09-10-2.020 %�"� data y ID 12911-1 _ 4 Xe,t avez, Notary Public ja commission expires September I , 2020 I, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. Given under my hand and the seal of said Company at Houston, Texas this 23RD day of J ARY 2020 A.D, . Brett ealy, Assi teat SeOreta Any Instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 812.0800 any business day between 8:30 am and 6:00 pm CST. BONDII 4427865 CITY OF SANTA ANA PREMIUM: INCLUDED IN BONDS PERFORMANCE BOND PROJECT NO.: 20-6956 & 20-6437 PAYMENT BOND KNOW ALL MEN BY THESE PRESENTS that EBS GENERAL ENGINEERING, INC. as CONTRACTOR, and SURETEC 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 TWO MILLIC FORTY-SIX THOUSAND ONE HUNDRED FIFTY-FOUR & NO/100 Dollars ($2.546.154. fl ), 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. * TEXAS 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 JANUARY 21, 2020 for GAS TAX LOCAL STREET IMPROVEMENTS FY 19/20 ** , 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. ** AND FLOWER STREET SEWER MANHOLE IMPROVEMENTS IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seal this 23RD day)of JANUARY ,20 20. 1345 QUARRY STREET, STE. 101 CORONA, CA 92879 PH. 951-279-6869 3131 CAMINO DEL RIO N. #1450 CHARLES L. FLARE / ATTORNEY -IN -FACT Subscribed and swom to before me, this _day of 20 Signature: Notary Public in and for the County of State of Rate of premium on this bond is $ NIL per thousand. Total amount of premium charge is $ NIL 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. AUTHORIZED REPRESENTATIVE: CULBERTSON INSURANCE SERVICES, INC. 5500 E SANTA ANA CANYON RD., #201 ANAHEIM, CA 92807 2 of PH. 714-921-0530 CALIFORNIA JURAT 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 Riverside Subscribed and sworn to (or affirmed) before me on this 28th Date by Thomas Nanci Name of Signers day of January 2020 Month Year proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. Signature: rf Y ' -�✓ LVti ignature of Notary Public .. JESSICA LICEA Notary Public - California Riverside County i M Commission Y 2215630 My Comm Expires Oct 21, 2021 Seal Place Notary Seal Above --------------------------------------------------- OPTIONAL --------------------------------------------------- Though this section is optional, completing this information can deter alteration of the document or fraudulent attachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Signer(s) Other Than Named Above: JURAT FORM 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 ) Subscribed and swom to (or affirmed) before me on this 23RD day of JANUARY 20 20 by CHART, S L. FLAKE proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. zc-a (NOTARY SEAL) NUiARY PUBLIC SIGNATURE OPTIONAL INFORMATION 3 f n LEXIE SHERWOOD COMM. If 2203287 NOTARY PUBLIC • CALIFORNU\ ORANGE COUNTY COMM. Exp. JULY 27, 2021 THIS OPTIONAL INFORMATION SECTION IS NOT REQUIRED BY LAW BUT MAY BE BENEFICIAL TO PERSONS RELYING ON THIS NOTARIZED DOCUMENT. TITLE OR TYPE OF DOCUMENT DATE OF DOCUMENT When executing a jurat, a notary shall administer an oath of affirmation to the affiant and shall determine, from satisfactory evidence, that the affiant is the person executing the document. The affiant shall sign the document in the presence of the notary. To order supplies, please contact McGlone Insurance Services, Inc. at (916) 484 0804. PoA q, 510123 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Texas, and, having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint Charles L. Flake, David L. Culbertson, Spencer Flake, Heather Willis its true and lawful Attorney -in -..fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for, providing the bond penalty does not exceed Ten Million and 00/100 Dollars ($10,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the CEO, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney -in -Fact may do in the premises. Said appointment is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that the President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attontey(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney -in -Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and deliver, any andall bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attomey-in-Fact shall be binding upon the Company as if signed by the President and sealed andeffected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20i° of April, 1999.) In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its CEO, and its corporate seal to be hereto affixed this gem day of September, A.D. 2018 . 5 RAN�F SURETEC I C) PANY w I *)Lv . By: John K Jc, CCountyState fHar ss: `� ? CounTycfHarris............... -•• On this lath day of September , A.D. 2018 before me personally came Sohn Knox Jr., to me known, who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is CEO of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the sealof said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of. said. Company; and that he signed his name thereto by like order. 4.�QFY 0r0rA •- e�'h Notary Public. Slate cf -IaxaS "• /-'^.fie:^ Comm. I'_xpiras 09-10-2020 Notary ID 72911 T659 _ A�_T Xe ' avez, commission expires September,20 1, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. Given under my handand the sea] of said Company at Houston, Texas this 23RD day of NUARY 2020 A.D, Br rt eaty, Assi tent Secrete Any instrument issued in excess of the penalty stated above is totally void and without any validity, For verification of the authority of this power you may call (713) 812.0800 any business day between 8:30 am and 6:00 pm CST.