HomeMy WebLinkAboutELECNOR BELCO ELECTRIC, INC. (CROSSWALK UPGRADES PHASE II [HSIPL-5060(186)])OZOZ g Z 8dd
INSURANCE NOT ON FILE
WORK MAY NQT PROCEED CITY OF SANTA ANA
CLERK OF COUNCIL CONSTRUCTION CONTRACT
DATE: PROJECT 17-6876
0 / �Zl n dud h js CROSSWALK UPGRADES PHASE II [HSIPL-5063(186)]
This CONSTRUCTION CONTRACT is made and entered into this 17`h day of March, 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 Fleenor
Belco Electric, Inc. (hereinafter "CONTRACTOR").
WITNESSETH:
The CITY and the CONTRACTOR, for the consideration hereinafter named, mutually agree as follows:
1. CONTRACTOR agrees to perform all the work and furnish all the materials at its own cost and
expense necessary to construct and complete in a good and workmanlike manner and to the
satisfaction of the City Engineer of the CITY, the Crosswalk Upgrades Phase II 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 Hundred Eighty-five Thousand Two
Hundred Ninety-five Dollars and No Cents ($285,295.00), as set forth and identified in the BID
PROPOSAL, which is attached hereto and incorporated herein as Exhibit "A."
The BID PROPOSAL contains a schedule of unit 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.
rev. 09/01/2017 Page 1 of 3
4. CONTRACTOR agrees to complete the WORK OF IMPROVEMENT within the time specified in
the Time for Completion of Improvements section of the BID PROPOSAL (Exhibit "A") including
commencing construction within the timeframe therein specified after issuance of a Notice to
Proceed.
5. The CONTRACTOR will pay, and will require all subcontractors to pay, all employees on the
WORK OF IMPROVEMENT a salary or wage at least equal to the prevailing salary or wage
established for such work as set forth in the wage determinations for this work in accordance with
applicable State and Federal law.
6. If applicable, the CONTRACTOR shall adhere to the CITY'S Community Workforce Agreement
(CWA), a pre -hire collective bargaining agreement, which establishes the labor relations policies and
procedures for CONTRACTOR to follow in the crafts persons employed to complete the WORK OF
IMPROVEMENT as more fully described in the CWA. The CWA may be found on the City's
website at:
htto://www.Santa-ana.ora/pwa/documents/CWA.ndf
7. CONTRACTOR shall, after award of this Contract, finnish 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 Punished
(Payment Bond). This Contract shall not become effective until such bonds are supplied to and
approved by the CITY.
8. CONTRACTOR shall, prior to the release of the performance and payment bonds or the retention
payment, furnish a warranty performance and payment bond (Warranty Bond). Said Warranty Bond
shall also be required as a condition of project acceptance. For projects up to Five Hundred
Thousand Dollars ($500,000), the Warranty Bond amount shall be the greater of Ten Thousand
Dollars ($10,000) or Twenty Percent (20%) of the final contract price. For projects above Five
Hundred Thousand Dollars ($500,000), the Warranty Bond amount shall be the greater of One
Hundred Thousand Dollars ($100,000) or Ten Percent (10%) of the final contract price.
9. CONTRACTOR shall, after award of this Contract, furnish Certificates of Liability Insurance and
Worker's Compensation Insurance as outlined in the General Provisions, to be approved by the
CITY.
//
Page 2 of 3
IN WITNESS WHEREOF, the parties hereto have executed this Construction Contract on the day and
year first above written.
ATTEST:
DAISY GOMEZ "-
Clerk of the Council
APPROVED AS TO FORM:
SONIA R. CARVALHO
City Attorney
By: /w, -f L
JCWfN FUNK
Assistant City Attorney
RECOMMENDED FOR APPROVAL:
M6,�' I S
NABIL SABA, PE
Acting Executive Director
Public Works Agency
CITY OF SANTA ANA
KRISTINE RIDGE
City Manager
CONTRACTOR:
Fleenor Belco Electric, Inc.
NAME: ALBERTO GARCIA
TITLE: President/CEO
Page 3 of 3
CALIFORNIA ALL- PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity
of the individual who signed the document to which this certificate is attached,
and not the truthfulness, accuracy, or validity of that document.
State of California
County of San Bernardino )
On 2/27/20 before me, Rebecca Wilks, Notary Public
( ere lose nrTam�e an�in e o e o leer
personally appeared Alberto Garcia de los Angeles
who proved to me on the basis of satisfactory evidence to be the person(s) whose
name(sr) Is re subscribed to the within instrument and acknowledged to me that
(EDshe/they executed the same in Is er/their authorized capacity(ies), and that by
Is er/their signature(s) on the instrument the person(--), or the entity upon behalf of
which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that
the foregoing paragraph is true and correct.
WI ESS my hand and official seal. _N EBECCA WhKS
Notary Public - California
San Bernardino County
Commission a 2300424
My Comm. Expires A,g 5. 2023 -
Notary PublitSignature V (Notary Public Seal)
ADDITIONAL OPTIONAL INFORMATII
DESCRIPTION OF THE ATTACHED DOCUMENT
City of Santa Ana Contract
(Title or description of attached document)
(Title or description of attached document continued)
Number of Pages _ Document Date
CAPACITY CLAIMED BY THE SIGNER
❑ Individual (s)
O Corporate Officer
President/CEO
(Title)
❑ Partner(s)
❑ Attorney -in -Fact
❑ Trustee(s)
❑ Other
w,nr:.,.NotaryClassescorn 800-873-9865
)N
INSTRUCTIONS FOR COMPLETING TIES FORM
TTris,jorm complies rcith crmre+nt CaliJdrnia stntruer regarding nalarp u'vrxling turd,
(fneeded, should be nomplered and attached to the document. Acknowledgments
from other states mat'
be completed for doratments beingsent to that state so long
as the hording does not require the C alffnrnia notary to violate Calrfotwia notary
laiv.
• State and County infie nration must be the State and Comity where the documrent
sigrrer(s) personally appeared before the notary public for acknowledgment.
• I)ate of notarization must be the darn that the signers) personally appeared which
mast also be the same date the aclusowledg rient is completed.
• The notary public nest print his or her name as it appears within his or her
consinissitn followed by a continental then your title (notary public).
• Print the name(s) of document signer(%) who personally appear at the time of
notarization.
• Indicate the correct singular or plural forms by crossing off incorrect forms (i.e.
he/shestthey- is hare) or circling the mrrect forms. Failure to correctly indicate this
information may lead to rejection of docmneru recording.
• The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges, re -seal if a
sufficient area permits, otherwise complete a different acknowledgment form.
• Signature of the notary public must match the signature on file with the office of
the county clerk.
Additional information is not required but could help to ensure this
acluiowledgaient is not iresused or attached to a different document.
Indicate title or type of attached document, number of pages and date.
Indicate the capacity claimed by the signer. if the claimed capacity is a
corporate officer, indicate the title (i.e. CFO, CFO, Secretary).
• Securely attach this document to the siened document with a staple.
City of Santa Ana Page 1
RE -BID - Crosswalk Upgrades - Phase II (RE -BID - 17-6876 (HSIPL 5063(186))), bidding on February 12, 2020 2:00 PM Printed 02/14/2020
Bid Results
EXHIBIT A
Bidder Details
Vendor Name
Elecnor Belco Electric, Inc.
Address
14320 Albers Way
Chino, CA 91710
United States
Respondee
John Wong
Respondee Title
Vice President
Phone
909-993-5470 Ext.
Email
jwong@elecinor.com
Vendor Type
CADIR
License#
738518
CA DIR
Bid Detail
Bid Format
Electronic
Submitted
February 12, 2020 1:42:12 PM (Pacific)
Delivery Method
Bid Responsive
Bid Status
Submitted
Confirmation#
202065
Ranking
0
Respondee Comment
Buyer Comment
Attachments
File Title
File Name
File Type
Bid Proposal
Bid Proposal to Agency.pdf
General Attachment
Ownership Affidavit
Ownership Aff to Agency.pdf
Ownership Affidavit (Notary
Public) - REQ Original Hard
Copy Submittal in Addition
Bid Band
Bid Bond to Agency.pdf
Bid Bond Guaranty (Notary
Public) - REQ Original Hard
Copy Submittal in Addition
Non -Collusion Affidavit
Non -Collusion Aff to Agency.pdf
Nan -Collusion Affidavit
(Notary Public) - REQ
Original Hard Copy Submittal
in Addition
Line Items
Type Item Code UOM City Unit Price Line Total Comment
Section 1
1 Furnish & Install Complete Functioning Carmanah RRFB System per Plan at the Intersection of Pomona St at Broadway — Sheet 2 of 15
LS 1 $11,000.00 $11,000.00
2 Remove all conflicting striping, R.P.M.'s and/or legends and Install new striping per plan at the Intersection of Pomona St at Broadway— Sheet 2 of
15
LS 1 $2,845.00 $2,845.00
3 Furnish & Install Complete Functioning Carmanah RRFB System per Plan at the Intersection of 10th St at Raft St — Sheet 3 of 15
LS 1 $11,900.00 $11,900.00
Planc'1141 , in,_
City of Santa Ana Page 2
RE -BID - Crosswalk Upgrades - Phase II (RE -BID - 17-6876 (HSIPL 5063(186))), bidding on February 12, 2020 2:00 PM Printed D2114/2020
Bid Results
EXHIBIT A
Type Item Code UOM City Unit Price Line Total Comment
4 Remove all conflicting striping, R.P.M.'s and/or legends and Install new striping per plan at the Intersection of 10th St at Railt St — Sheet 3 of 15
LS 1 $3,982.00 $3,982.00
5 Furnish & Install Complete Functioning Carmanah RRFB System per Plan at the Intersection of Willits St at Diamond St — Sheet 4 of 15
LS 1 $11,900.00 $11,900.00
6 Remove all conflicting striping, R.P.M.'s and/or legends and Install new striping per plan at the Intersection of Willits St at Diamond St— Sheet of
15
LS 1 $5,974.00 $6,974.00
7 Furnish & Install Complete Functioning Carmanah RRFB System per Plan at the Intersection of Pacific Ave at Adams St— Sheet 5 of 15
LS 1 $11,900.00 $11,900.00
8 Remove all conflicting striping, R.P,M: s and/or legends and Install new striping per plan at the Intersection of Pacific Ave at Adams St— Sheet 5 of
15
LS 1 $3,413.00 $3,413.00
9 Furnish & Install Complete Functioning Carmanah RRFB System per Plan at the Intersection of Nakoma Dr at La Verne Ave — Sheet 6 of 15
LS 1 $11,900.00 $11,900.00
10 Remove all conflicting striping, R.P.M.'s and/or legends and Install new striping per plan at the Intersection of Nakoma Dr at La Verne Ave — Sheet 6 of
15
LS 1 $3,129.00 $3,129.00
11 Furnish & Install Complete Functioning Carmanah RRFB System per Plan at the Intersection of Russell Ave at Sycamore St— Sheet 7 of 15
LS 1 $17,000,00 $17,000.00
12 Remove all conflicting striping, R.P.M.'s and/or legends and Install new striping per plan at the Intersection of Russell Ave at Sycamore St— Sheet 7 of
15
LS 1 $2,560.00 $2.560.00
13 Furnish & Install Complete Functioning Carmanah RRFB System per Plan at the Intersection of French St at 14th St - Sheet 8 of 15
LS 1 $11,900.00 $11,900.00
14 Remove all conflicting striping, R.P.M.'s and/or legends and Install new striping per plan at the Intersection of French St at 14th St— Sheet 8 of 15
LS 1 $3,129.00 $3,129.00
15 Furnish & Install Complete Functioning Carmanah RRFB System per Plan at the Intersection of Mcfadden Ave at Oak St — Sheet 9 of 15
LS 1 $14,000.00 $14,000,00
16 Remove all conflicting striping, R.P.M.'s and/or legends and Install new striping per plan at the Intersection of Mcfadden Av at Oak St —Sheet 9 of
15
LS 1 $500.00 $500.00
17 Furnish & Install Complete Func0oning Carmanah RRFB System per Plan at the Intersection of Sycamore St at Walnut Ave — Sheet 10 of 15
LS 1 $11,900.00 $11,900.00
18 Remove all conflicting striping, R.P.M.'s and/or legends and Install new striping per plan at the Intersection of Sycamore St at Walnut Ave — Sheet 10 of
15
LS 1 $3,698.00 $3,698.00
PlaneKiids, Ire.
City of Santa Ana Page 3
RE -BID - Crosswalk Upgrades - Phase II (RE -BID - 17-6876 (HSIPL 5063(186))), bidding on February 12, 2020 2:00 PM Printed 02/1412020
Bid Results
EXHIBIT A
Type Item Code UOM City Unit Price Line Total Comment
19 Furnish & Install Complete Functioning Cormanah RRFB System per Plan at the Intersection of Center St at Lingan Ln — Sheet 11 of 15
LS 1 $11.900.00 $11,900.00
20 Remove all conflicting striping, R.P.M.'s and/or legends and Install new striping per plan at the Intersection of Center St at Lingan Ln — Sheet 11 of
15
LS 1 $2,845.00 $2,845.00
21 Furnish & Install Complete Functioning Carmanah RRFB System per Plan at the Intersection of Santa Ana Blvd at Sycamore St— Sheet 12 of 15
LS 1 $17,000.00 $17,000.00
22 Remove all conflicting striping, R.P.M.'s and/or legends and Install new striping per plan at the Intersection of Santa Ana Blvd at Sycamore St— Sheet
12 of 15
LS 1 $5,974.00 $5,974.00
23 Furnish & Install Complete Functioning Carmanah RRFB System per Plan at the Intersection of 3rd St at Sycamore St — Sheet 13 of 15
LS 1 $11,000.00 $11,000.00
24 Remove all conflicting striping, R.P.M.'s and/or legends and Install new striping per plan at the Intersection of 3rd St at Sycamore St — Sheet 13 of
15
LS 1 $3,698.00 $3,698.00
25 Furnish & Install Complete Functioning Carmanah RRFB System per Plan at the Intersection of Broadway St at Borchard Ave — Sheet 14 of 15
LS 1 $11,900.00 $11,900,00
26 Remove all conflicting striping, R.P.M.'s and/or legends and Install new striping per plan at the Intersection of Broadway St at Borchard Ave —
Sheet 14 of 16
LS 1 $3,698.00 $3,698.00
27 Furnish & Install Complete Functioning Carmanah RRFB System per Plan at the Intersection of Russell Ave at Towner St — Sheet 15 of 15
LS 1 $22,000.00 $22,000.00
28 Remove all conflicting striping, R.P.M.'s and/or legends and Install new striping per plan at the Intersection of Russell Av at Towner— Sheet 15 of
15
LS 1 $4,324.00 $4,324.00
29 Install New Sign
30 Install New Sign & Post
31 Install New Post
32 Remove Sign
33 Remove Sign & Post
EA 147 $171.00 $25,137.00
EA 19 $285.00 $5,415.00
EA 1 $171.00 $171.00
EA 44 $18.00 $792.00
EA 31 $29.00 $899.00
P{cnredlids, Im:.
City of Santa Ana
RE -BID - Crosswalk Upgrades - Phase II (RE -BID - 17-6876 (HSIPL 5063(186))), bidding on February 12, 2020 2:00 PM
Bid Results
Type Item Code UOM City Unit Price
34 Relocate Sign
EA 4 $228.00
35 Mobilization
LS 1 $5,000.00
36 Labor Agreement Oversight
LS 1 $10,000.00
Subtotal
Total
Page 4
Printed 02/14/2020
EXHIBIT A
Line Total Comment
$912.00
$5,000.00
$10.000.00
$285,295.00
$285,295.00
fgnna nih's, Inc.
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAI. PROJECT NO: HSIPL 5063(186)
RE -BIB
EXHIBIT A
The lowest responsible bidder shall be selected based on the total base bid. The City reserves the
right to award the Base Bid, and any, all, or none of the add-altemate bid items (if any).
* The quantity for this bid item is shown for bid comparison only. This bid item shall not be
subject to the "25%" limit as stated in Section 3-2 of the Standard Specifications. The actual
amount for this item will be dictated by the actual quantity used, and the Agency reserves the
right to increase or decrease the quantity of this item accordingly.
f This bid item is considered a Specialty Item per Section 2-3.2 of the Standard Specifications.
TIME. FOR COMPLE'rION OF IMPROVEMENTS AND LIQUIDATED DAMAGES
The undersigned bidder hereby proposes to complete the Work for the total base bid amount shown
above, within eighty (80) working days after the commencement date stated in the Notice to
Proceed.
The liquidated damages amount, in lieu of the amount specified in Subsection 6-9 of the Standard
Specifications, shall be $1,000 per calendar day.
Name of Firm Elecnor Belcr,'E)eetric. Inc.
Signature of BIDDER
Tide Vice
(If an individual, so state. �f rm or -partnership, state the firm name and give the names of
all individual co-partners composipg4e firm. If a corporation, state legal name of corporation,
and names of President, Secretary, Treasurer and Manager, thereof.)
Alberto Garcia de los Angeles - President John Wong - Vice President
Jeroni Gervilla - Treasurer Pedro Enrile - Secretary
P-4 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
BID PROPOSAL
TO: CITY COUNCIL OF THE CITY OF SANTA ANA
FROM: Eiecnor Belco Electric, 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
Furnish & Install Complete Functioning
Carmanah RRFB System per Plan at the
I
Intersection of Pomona St at Broadway
I
$
$
llrjt?(i
— Sheet 2of157
Remove all conflicting striping,
R.P.M.'s and/or legends and Install new
2
striping per plan at the Intersection of
I
LS
$
$
Pomona St at Broadway — Sheet 2 of
Z ¢
1
.Z 0' t 5
15
Furnish & Install Complete Functioning
3
Carmanah RRFB System per Plan at the
Intersection of IOth St at Raitt St—
1
LS
$'I q0 o
S , 1 61 oc
Sheet 3 of 15
I
Remove all conflicting striping,
4
R.P.M.'s and/or legends and Install new
striping per plan at the Intersection of
1
LS
$ 3
$ Ice L
loth St at RaittSt—Sheet 3 of 1 S
I�
/
Furnish & Install Complete Functioning
5
Carmanah RRFB System per Plan at the
I
LS
$ k � q 00
Intersection of Willits St at Diamond St
t
—Sheet 4 of 15
Remove all conflicting striping,
R.P.M.'s and/or legends and Install new
6
striping per plan at the Intersection of
I
LS
�I,
S S of "11`�l
$
Willits St at Diamond St — Sheet 4 of
15
Furnish & install Complete Functioning
7
Carmanah RRFB System per Plan at the
I
LS
$
$ k � C, 00
Intersection of Pacific Ave at Adams St
6100
I
—Sheet 5 of 15
Remove all conflicting striping,
8
R.P.M.'s and/or legends and Install new
I
LS
S LA 13
$
stripinjq per plan at the Intersection of
P-1 of P-42 RE -BID
CITY OF-SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
Item
Description
Unit
Unit Price
Amount
Pacific Ave at Adams St — Sheet 5 of
15
Furnish & Install Complete Functioning
9
Cannanah RRFB System per Plan at the
I
LS
$ C� O v
$ C Q
`1
Intersection of Nakoa Dr at La Verne(
m
Ave — Sheet 6 of 15
Remove all conflicting striping,
10
R.P.M.'s and/or legends and Install new
striping per plan at the Intersection of
1
LS
$ Zj 1 ZG�
$
Nakoma Dr at La Verne Ave— Sheet 6
I
of 15
Furnish & Install Complete Functioning
11
Carmanah RRFB System per Plan at the
Intersection of Russell Ave at
I
LS
$
$ �-� 00 0
Sycamore St— Sheet 7 of 15
Remove all conflicting striping,
R.P.M.'s and/or legends and Install new
12
striping per plan at the Intersection of
I
LS
S Z.
Russell Ave at Sycamore St— Sheet 7 of
1
15
Fumish & Install Complete Functioning
13
Carmanah RRFB System per Plan at the
l
LS
$ 1 I C1 C Q
$ 1� goo
Intersection of French St at 14th St —
i
I
Sheet 8 of 15
Remove all conflicting striping,
14
R.P.M.'s and/or legends and Install new
I
LS
$ �J
$ Z-
striping per plan at the Intersection of
12�
French St at 14tb St— Sheet 8 of 15
Furnish & Install Complete Functioning
is
Cannanah RRFB System per Plan at the
I
LS
$ t l DCO
$ 1 �-i p o O
Intersection of Mcfadden Ave at Oak
St — Sheet 9 of IS
Remove all conflicting striping,
16
R.P.M.'s and/or legends and Install new
I
LS
$ s!?i)
$
striping per plan at the Intersection of
Mefa den Av at Oak St —Sheet 9 of 15
Furnish & Install Complete Functioning
17
Carmanah RRFB System per Plan at the
I
LS
$
$ to
Intersection of Sycamore St at Walnut
Ave —Sheet 10 of 15
Remove all conflicting striping,
R.P.M.'s and/or legends and Install new
�j
18
striping per plan at the Intersection of
I
LS
$
Sycamore St at Walnut Ave— Sheet 10
of 15
Furnish & Install Complete Functioning
19
Cannanah RRFB System per Plan at the
1
LS
$
Intersection of Center St at Linean Ln
— Sheet 1 I of 15
P-2 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
Item
Description
Unit
Unit Price
Amount
Remove all conflicting striping,
R.P.M.'s and/or legends and Install new
20
striping per plan at the Intersection of
Centers l at Linean Ln —Sheet I I of
1
LS
$ 2 C�7j Lt'rj
$
15
Furnish & Install Complete Functioning
21
Carmanah RRFB System per Plan at the
Intersection of Santa Ana Blvd at
I
LS
$ `� pU p
$ (� 0 0Gl
S eamore St — Sheet 12 of 15
/
Remove all conflicting striping,
R.P.M.'s and/or legends and Install new
22
striping per plan at the Intersection of
Santa Ana Blvd at Sycamore St—
1
rLS
$
5
$
Sheet 12 of 15
Fumish & Install Complete Functioning
23
Carmanah RRFB System per Plan at the
Intersection of3rd St at Sycamore St —
1
LS
$ `I
Sheet 13 of 15
1
Remove all conflicting striping,
24
R.P.M.'s and/or legends and Install new
LS
$ 2� C( Qr
$
striping per plan at the Intersection of
3rd St at S camore St — Sheet 13 of 15
1
Furnish & Install Complete Functioning
25
Carmanah RRFB System per Plan at the
Intersection of Broadway St at
I
LS
$ 1 G( [;(%
S 1 1 PL 00
Barchard Ave —Sheet 14 of 15
I
1
Remove all conflicting striping,
26
R.P.M.'s and/or legends and Install new
��
striping per plan at the Intersection of
1
LS
$ '7j �c(Q�
$ 3
Broadway St at Borchard Ave — Sheet
1
/
14 of 15
Furnish & Install Complete Functioning
27
Carmanah RRFB System per Plan at the
Intersection of Russell Ave at Towner
I
LS
$ p00
Z21
$ Z 0 0 D
7"
St —Sheet 15 of 15
Remove all conflicting striping,
28
R.P.M.'s and/or legends and Install new
LS
$
striping per plan at the Intersection of
(.t
�jZ�
$ 3 Z �i
Russell Av at Towner — Sheet 15 of 15
1
29
Install New Sign
147
EA
$ '�-I
$ •ZS 13
30
Install New Sign & Post
19
EA
$ 'Z 5
$ 5 LA IS
31
Install New Post
0
EA`'-j-
32
Remove Sign
44
EA
$
33
Remove Sign & Post
31
EA
$
P-3 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
Item
Description
ON
Unit
Unit Price
Amount
34
Relocate Sign
4
EA
$ 1,10
$ ct�Z
35
Mobilization
I
LS
$ SI0o6)
$ CJ'J 0oo
36
Labor Agreement Oversight
I
LS
$ 10,000.00
$ 10,000.00
TOTAL BASE BID $
The lowest responsible bidder shall be selected based on the total base bid. The City reserves the
right to award the Base Bid, and any, all, or none of the add -alternate bid items (if any).
* The quantity for this bid item is shown for bid comparison only. This bid item shall not be
subject to the "25%" limit as stated in Section 3-2 of the Standard Specifications. The actual
amount for this item will be dictated by the actual quantity used, and the Agency reserves the
right to increase or decrease the quantity of this item accordingly.
t This bid item is considered a Specialty Item per Section 2-3.2 of the Standard Specifications.
TIME FOR COMPLETION OF IMPROVEMENTS AND LIQUIDATED DAMAGES
The undersigned bidder hereby proposes to complete the Work for the total base bid amount shown
above, within eighty (80) working days after the commencement date stated in the Notice to
Proceed.
The liquidated damages amount, in lieu of the amount specified in Subsection 6-9 of the Standard
Specifications, shall be $1,000 per calendar day.
Name of Firm
Signature of BIDDER
John
Title Vice P esid n
(If an individual, so state. f qrm or -partnership, state the firm name and give the names of
all individual co-partners compo ' e firm. If a corporation, state legal name of corporation,
and names of President, Secretary, Treasurer and Manager, thereof.)
Alberto Garcia de los Angeles - President John Wong - Vice President
Jeroni Gervilla - Treasurer Pedro Enrile - Secretary
P-4 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
BIDDER'S STATEMENT
BIDDER understands and agrees that this Bid Proposal, Contract Documents and subsequent
Construction Contract Agreement shall constitute the entire agreement between BIDDER and the
AGENCY only after it has been accepted by the City Council, endorsed by the Clerk of the Council
with her signature and official seal noting hereon the action of approval of the Council, signed by
the Public Works Agency Executive Director or his/her duly authorized agent, and signed by the
City Attorney, denoting his approval of the form of this document, and its execution, and when it
or an exact copy of it has been either delivered to BIDDER or deposited with the United States
Postal Service properly addressed to the BIDDER with the correct postage affixed thereto.
BIDDER further agrees that upon delivery (as defined above) of the accepted agreement he/she
will furnish AGENCY all required bonds and certificate of liability insurance within ten (10)
business days or the funds, check, draft, or BIDDERS bond substituted in lieu thereof
accompanying this proposal shall become the property of the AGENCY and shall be considered
as payment of damages due to the delay and other causes suffered by AGENCY because of the
failure to furnish the necessary bonds and because it is distinctly agreed that the proof of damages
actually suffered is difficult to ascertain; otherwise said funds, check, drafts, or BIDDER'S bond
substituted in lieu thereof shall be returned to the undersigned.
BIDDER understands that a bid is required for the entire work, the estimated quantities set forth
in the bid schedule are solely for the purpose of comparing bids, and that final compensation under
the contract will be based upon the actual quantifies- of work satisfactorily completed. The
BIDDER also certifies that the bid is a balanced bid.
In accordance with Section 7028.15 of the California Business and Professions Code, the
undersigned certifies under penalty of perjury that the foregoing is true and correct.
Name of Firm Elecnor BelmElecVc. Inc.
Signature of BIDDER
John
Title Vice res e t
(If an individual, so state. I trm X co- artnership, state the firm name and give the names of
all individual co-partners composing t e firm. If a corporation, state legal name of corporation,
and names of President, Secretary, Treasurer and Manager, thereof.)
Alberto Garcia de los Angeles - President John Wong - Vice President
Jeroni Gervilla - Treasurer Pedro Enrile - Secretary
P-5 of P-42 RE -BID
UNANIMOUS WRITTEN CONSENT IN LIEU OF
2019 ANNUAL MEETING OF THE BOARD OF DIRECTORS
OF
ELECNOR BELCO ELECTRIC, INC.
January 1, 2019
The undersigned, being all of the rneinbers of the Board of Directors (the "Board") of Fleonor .Belco
Electric, Inc., a California corporation (the "Company"), in lion of holding a meeting of the Board, hereby
take the following actions and adopt the following resolutions by unanimous written consent:
WHEREAS, the Board has determined that it is in the Company's best interests to appoint a
revised slate of Officers of the Company,
NOW, THEREFORE, BE IT RESOLVED, that the following persons be, and hereby are,
elected to the offices sat forth opposite their respective names, to hold such offices until their respective
successors are elected and qualified at or before the next annual meeting of the Board, or until their earlier
respective deaths, resignations or removals;
President and Chief Executive Officer
Chief Financial Officer
Senior Vice President, General Counsel
and Assistant Secretary
Vice President for Construction
Secretary
Alborto Garcia Do Los Angeles
Jeronl Gervilla
Roger DeVito
John Wong
Pedro Brnfle
FURTHER RESOLVED, that Alberto Garcia De Los Angeles, Jeroni Gervilla, Alberto Garcia
and Roger DoVitc in their respective capacitios (listed above) subject to such supervisory powers of the
Board of Directors, hereby are authorized and directed to perform all the duties commonly incident to that
office; shall have authority to execute in the name of the Company contracts, leases and other written
instruments to be executed by the Cumpaay; and, shall perform such other duties as the Board of
Directors may from time to time determine.
FURTHER RESOLVED, that the President and Chief Executive Officer may delegate authority
to any Chief Financial Officer or Chief Operating Officer or Senior Vice President or Vice President as
and within their authority levels as set forth in, the Company's Bylaws, as the same may be amended from
time to time;
FURTHER RESOLVED, that Roger DeVito, in his capacity of Senior Vice President, is
hereby authorized and directed to;
I. Negotiate, sign, amend and terminate agreements In connection with the purpose of the Company,
for all contracts up to $250,000,00, and acting jointly with Alberto Garcia Do Los Angeles or
Jeronl Gervilla for all contracts in amounts greater than $230,000,00.
2. Execute, amend and finalize bid proposals in connection with the purpose of the Company, for• all
proposals up to $1,000,000,00, and acting jointly with Alberto Garcia Do Los Angeles or Jeroni
Gervilla for all proposals In amounts greater than $1,000,000,00.
S. Aating jointly with Alberto (lorcia De Loa Angeles or Jeroui tlervklle, execute, amend and fhmlize
purchoso grdeCs for materials and equipment hi connection with tho purpose ofdW Company.
d. Acting jointly with Alberto Garcia Do Los Angeles or Jemnl Gervilla, oxecute, amend and
terminate agreements for the lease of real estate to be used as offices or job related temporary
yards,
S. Acting jointly with Alberto Garolo Do Loa Angeles or 7oronl Garvilla, exeoute, amend and
temnlaute ittsmanee and/or bid bonds arrangements In 000neotlon with the purpose of the Company.
G, Acting joiatty with Alberto 0amla Da Los Angeles or Jamul Oervllla, hire, suspend, Impose
sanctions and dismiss the administrative personnel of the Company, setting fatk their
employment terms end conditions, obligations and remuneration.
7. Aating jointly with Alberto Garcia De Los Angeles or Jeronl Gervilla, settle and claims an behalf
of the Company.
AND IT IS MATH)EIt RESOLVHD, that all actions Iteratofom taken by the officers of that
Company on behalf of and in the name. of the Company, relating to the conduct of the business or the
Company, the expenditure of money, the making of contracts and all other acts taken or omitted In the
performance of their duties to the Company be, and tbo same hereby are, in all respects, approved, ratified
and affirmed, as of the date taken, done or omitted, respectively.
The actions taken by the Board Consent shalt have tho sane faros and effect as if taken by the
undersigned at it meeting of the Board of Dirsotors; duly oalled and eonatltuted pursuant to the Bylaws of
the Company end the laws of the State of California. This Board Consent may be executed In
counterparts, eagis of which sisal] be dammed an m1gknal, but all of which together shalt consthute ane and
the mane document,
IN WITN.LSS WiI)rLt1gO , the undersigned, being all of the membars of tho Board of Direelon
of Moamar20100 &leotric, Inc., have exeoutad those notions by written consent as of the dabs first written
above,
Lids Alolbar, Director
Alexander Arroln, Diroafor
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
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: Elecnor Belco Electric, Inc.
Business Address: 14320 Albers Way Chino CA 91710
Business E-Mail Address: Iwong(cDelecnor com
Telephone: 909-993-5470
State Contractor's License No. and Class: 738518 A B. C-10
License Expiration Date: 7/31/21
State Dept. of Industrial Relations (DIR)
Registration No.:
1000004804
State Dept. of Industrial Relations (DIR)
Registration Expiratio ate* 6/30/22
Signed: ,John
Title: Vice President
P-6 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
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 Elecnor Betco Electric. Inc.
Signature of BIDDER
Title vi
(if an individual, so state)
P-7 of P-42 RE -BID
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
OWNERSHIP AFFIDAVIT
STATE OF CALIFORNIA
COUNTY OF ORANGE
CITY OF SANFA ANA
John Wona
El INDIVIDUAL
❑ PARTNERSHIP
®CORPORATION
❑JOINT VENTURE
SS:
being duly sworn, deposes and says:
That he/she is the party making the foregoing proposal:
That he/she is a member of the co -partnership firm designated as:
RE -BID
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 copartnership.
That he is of:
Elecnor Belco Electric, Inc.
a corporation which is making the foregoing proposal:
That he is of:
one of the parties making the foregoing proposal as a joint venture, and the he/she has been
and is duly vested with the authority to execute instruments for an on behalf of the parties
making said bid who are:
that such a bid is genuine and not collusive or sham, and has not in any manner sought by collusion
to secure any advantage against the City of Santa Ana or any person interested in the proposed
coVact, for himself or any other person.
John
Bidder
I sworn to before me this 541^ day of {ebe AQwt 201�E__
0
IEAts. 0.6% LIM
Signature of officer Administering Oath (Notary Public)
A notary public or other officer completingrELISA BETH LIM
this certificate verifies only the Identity of Commission No. 2281937 �t
the Individual who signed the document to si NOTARY PUBLIC-CAUFO R Uk
which this certificate is attached, and not spa BERNARDINO COUNTY
the truthfulness, accuracy, or validity of t my Comm. E.wn MARCH 21. 2023
that document. L
8'
P-8 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
BID BOND
KNOW ALL PRESENT that,
Elacnor e i o FlPr1ric. Incas BIDDER, and
Fidelity andrJanogit romnan!r of hd-rolaud , as SURETY,
are held and firmly bound unto the CITY OF SANTA ANA, as AGENCY, in the penal sum of _
Ten Percent utamount Bid Dollars ($ ro°�, 1, which is ten percent (10%)
of the total amount bid by BIDDER to AGENCY for the above -stated project, for the payment of
which sum, BIDDER and SURETY agree to be bound, jointly and severally, firmly by these
presents.
THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas BIDDER is about to
submit a bid to AGENCY for the above -stated project, if said bid is rejected, or if said bid is
accepted and a contract is awarded and entered into by BIDDER in the manner and time specified,
then this obligation shall be null and void, otherwise it shall remain in full force and effect in favor
of AGENCY.
IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seal this
24th day of _ January , 20 20 .
BIDDER*
Subscribed and sworn to
Signature:
Notary Public in and for the County of State of
this day of
• Provide BIDDER/ SURETY name, address, and telephone number and the name, title, address,
and telephone number of authorized representative.
P-9 of P-42 RE -BID
RIWA-1
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 n\Cxn &'mapf-jivilo
Subscribed and sworn to (or affirmed) before me on this 154�A. day of Teb`UVA ,
20IV by 361nn WMn
proved to me on the basis of satisfactory evidence to be the person
.*who appeared
before me.
ELISA BETH LIM
Commission No. 2281917 T
ga NOTAFn`M8 r,CIWFCRNIA 2S
SAN BERNARDINO COUNTY
I5n Px h t.`YVt pubttC Air Comm, Byhn MARCH 21. 202a
Signature V (seal)
OPTIONAL INFORMATION
DESCRIPTION OF THE ATTACHED DOCUMENT
µitM1 D�- .SAtn4n QYM �V,I p,Utna
(Title descrption of attached document)
(Title or description of attached documenlcondnued)
Number of Pages _ Document Date
Additional Information
2015 Version .tivrw.NolaryClasses.rum 800-873-9865
INSTRUCTIONS
The wording ofall Jurals completed in California after January 1, 2015 must be in the form
as set fodh within this Jund. There are no exceptions. If a Jurat to be mmplefed does not
logos this Iona, fire notary must correct the verbiage by using ajurat stamp containing the
correct wording or attaching a separate jurat form such as this one with does contain the
proper wonting In addition, the notary must require an oath or aKrmah'on tram the
document signer regarding the truthfulness of the contents of the document. The
document must be signed AFTER the oath oraf5nnagon. If the document was previously
signed, it must be resignedin lronf oftha notarypublic dudng the juraf precess.
• State and county Information must be the state and county where the
document signer(s) personally appeared before the notary public.
• Date of notarization must be the date the signer(s) personally
appeared which must also be the same dale the jurat process Is
completed.
• Print the name(s) of the document signer(s) who personally appear at
the time of notarization.
• Signature of the notary public must match the signature on rile with the
office of the county clerk.
• The notary seal impression must be clear and photographically
reproducible. Impression must not cover text or lines. If seal impression
smudges, re -seal If a sufficient area permits, otherwise complete a
different jurat form.
Additional Information Is not required but could help
to ensure this jurat is not misused or attached to a
different document.
Indicate title or type of attached Document, number of
pages and date.
• Securely attach this document to the signed document with a staple.
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of Zafdo(miax
County of Hartford t
On January 24, 2020
before me, Bethany Stevenson, Notary Public
(insert name and title of the officer)
personally appeared Joshua Sanford
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
BETHANY STEVENSON
K
NOTARPPUBLIC= cT177301
MY COMMISSION �X iftSEPt.30;2M
Signature (Seal)
Notary Public
P
ZURWIl AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
POWER OF ATTORNEY
RNU W ALL MEN BY THESE PRESENTS: That (fie ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New
York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Illinois, and the FIDELITY
AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Illinois (herein collectively called the "Companies"), by
Robert D. Murray, Vim: Preakleut, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are
act forth on the reverse side hereof and are hereby certified to be in Atli three and effect on the dale hereof, do hereby nominate, constitute,
and appoint, Donna M, PLANETA, Joshua SANFORD, Allnee R. PERONDINE, Di uicile D. JOHNSON,
Micbelle Anne MCMAHON, Bethany STIOVENSON, Bryan M. CANESCIII, Kristopher PISANO, Rebeeca
M. STEVENSON, Nicholas TURECAMO and Tanya NCIUYEN, all of Hartford, Connecticut, EACH, its into and
lawful agent and Attorney -in. -Fact, to make, cxocutc, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all
band's and undertakings, and the execution of such bonds or undertakings in pursuance of these prosaats, shall be us binding upon said
Companies, us fully and amply, to all lntarts and purposes, as if they had been duly executed and acknowledged by the regularly elected
officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, Now York., the regularly elected effects of the
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its off" In Owings Mills, Maryland., and the regularly elected
effects of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland, in their own proper
persons.
The said Vice President does hereby cattily that the extract set forth an the reverse side thereof is a rate copy of Article V, Section S, or
lb By -Laws of said Companies, and is now in force.
IN WITNESS WHEREOF, the said Vice -President ban hereunto subscribed his/her names and affixed the Corporate Scats of the sold
ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and
FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this Ath day of October, AM, 20 M
Mesa erzl
8i€A :.iP,d
ATTEST:
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
P1DELrrY AND DEPOSIT COMPANY OF MARYLAND
y+u�� r, .......... ,
Irjo! 0�1err C3. Mjorray ry�
Vice Prarldent
By: Dawn B. Brawn
Secretary
State of Maryland
County ofSaltitnore
On this 4th day of October, A.D, 2019, before the subsunbor, a Nolory Public of the State of Maryland, duly commissioned and qualified, Robert D.
Murray, Via President and Down E, Brown, Socrolary of the Companies, to me personally known to be the individuals and affinces doscribod in and who
exenaW die preceding insrmment, and acknowledged the execution of same, and bolas by me duly sworn, depouoth and with, that he/she is the said officer of
the Company aforosuid, and that the soots affixed to Ate presetting in.moncat at the Corporate Seats of said C rtpsaies, and that (he said Corporate Seats and
the signatum as such afile" were duly affixed and subscribed to the said instumnua by the authority mid direction of the said Corporations.
IN TEST(MONY WIIP.REOR I have hereunto met my hard and affixed my Official Seal the day and your first above written.
r lnntrr
k � r,DDybe ' Gamlence A. Dunn Newry Publta
s"4 �nidtt!ta`" My Commisahm Expires: 3uly9,2023
?,ngttlPl.
w 0
EXTRACT FROM BY-LAWS OF THE COMPANIES
"Article V, Section 8, M,y,4 ;jp AK The Chief Executive Officer, the President, or any Executive Vice President or Vice president
may, by written inshument under the attested corporate goal, appoint attorneys -in -fast with authority to oxeotm bonds, policies,
recogniaanceg, stipulations, underhikings, or other like instruments on behalf of Ike Company, alld may allthoriVo any offioer or any such
attorney -in -fact to affix the corporate,, seat thoroto; and may with or without cause modify of revoke any such appointment or authority at nay
time."
CERTIFICATE
1, the undersigned, Vice President of the ZURICH AMERICAN INSDRANCE COMPANY, the COLONIAL AMERICAN
CASUALTY AND SURETY COMPANY, and the FIDELTI'Y AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the
foregoing Power of Altomoy is still in full foroe and effect on the date of this certificate; and .I do further certify that Article V, Section R, of
the By -Laws of the Companies is still in force.
This Power of Attorney and Certificate may be signed by facsimile under and by authority of the fnllowing resolution of the Board of
Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duty called and held on the 1 Sib day of December 19911,
RESOLVED: "That the signature of the President ur a Vice President and the attesting signature of a Secretary or an Assistnmt Secretary
and the Seal of the Company may be affixed by facsimile on any Power of Attorney .. Any such Power or any ct•.tti ficutc thereof bearing such
facsimile signature and seal shall be valid and binding on the Company."
This Power of Attorney and Crrlificalo may be signed by facsimile under and by authority of the following resolution of the Board of
Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held an the Sib day of
May, 1994, and the fallowing resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a
meeting duty called and held on the l0tb day of May, 1990,
RESOLVED: "That the facsimile or mechanically reproduced Settl of the company and facsimile or mechanically reprodueed signature
Or any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a
cortillod copy of any power of attorney issued by the Company, sball be valid and binding upon the Company with the same force and effect
as though manually afxod.
IN TESTIMONY W1181 F, I have berounte subscribed my name and affixed the corporate seals of the said Companies,
this..z lh :day of JQnuary..__..._.,::..::.:......, 2ozv
5 ej�j
Brian M. Hodges, Vice President
TO REPORT A CLAIM WITII REGARD TO A SURETY BOND, PLEASE SUBMIT A COMPLETE DESCRIPTION
OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BONA, THE BOND NUMBER, AND YOUR CONTACT
INFORMATION TO;
Zurich Surety Claims
1299 Zurich Way
Schaumburg, IL 60196-1056
yy{,1xW;nsnorfs(��aims�aurtuhrw cam
800-626-4577
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
LIST OF SUB -CONTRACTORS
Section 4100 et. seq. of the Public Contract Code requires listing of all subcontractors with the bid for all
subcontract work exceeding the following amount:
o Streets, highways including bridge projects:
'/;% of the bid or $10,000, whichever is greater
o Buildings, parks, or other projects: '/2% of the
bid
Section 1725.5 of the Public Contract Code requires all Subcontractors be registered with the State
Department of Industrial Relations (DIR).
BIDDER proposes to subcontract certain portions of the work to the firms listed below:
Name CIIY
Name
License #/Exp. 2�Tir CL7
License #/Exp.
DIR Reg. #/Exp. 10 000 o C ((
DIR Reg. #/Exp.
Location (14COi��i1�n-iitin 1 f •�
Location
Phone 61D61- -L�.
Phone
7 b
Type Of Work W �a �i_ ,rt '$
Type Of Work
Type
Amount $ 5 t 0
Amount $
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 $
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-10 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
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. City of Victorville 14343 Civic Dr. Victorville CA 92392
Name and Address of Owner.
Name and Telephone Number of person familiar with project.
$445,220 Traffic Signals & Fiber Optics March 2018
Contract Amount Type of Work Date Completed
2. City of Diamond Bar 21810 Copley Dr. Diamond Bar, CA 91765
Name and Address of owner.
Christian Malpica 909-839-7042
Name and Telephone Number of person familiar with project.
$389,928 Traffic Signals & Fiber Optics September 2018
Contract Amount Type of Work Date Completed
3. City of Mission Viejo 200 Civic Center Mission Viejo CA 92691
Name and Address of owner.
Phi11iD Nitollama 94-470-306
Name and Telephone Number of person familiar with project.
$357,100 Traffic Signals September 2018
Contract Amount Type of Work Date Completed
The following are the names, addresses, and telephone numbers of all brokers and sureties from
whom BIDDER intends to procure insurance and bonds.
Willis Towers Watson Zurich American Insurance Comoany
10 State House Square, Floor 11 777 S. Fiqueroa St Suite 3900
Hartford, CT 06103 Los Angeles CA 90017
Erin Kiernan 860-843-5404 Margaret Hentz 213-270-0757
P-11 ofP-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
ADDITIONAL REFERENCES
The following are the names, addresses, and telephone numbers for THREE public agencies for
which the BIDDER or Subcontractor has performed similar work in the past five years.
1 • City of Glendale 633E Broadway Glendale CA 91206
Name and Address of Owner.
Sarkis Oganesyan 818-548-3945
Name and Telephone Number of person familiar with project.
$600,000 Traffic Signal, Fiber & Interconnect March 2018
Contract Amount Type of Work Date Completed
2. City of La Mirada 15515 Phoebe Ave La Mirada CA 90638
Name and Address of owner.
Name and Telephone Number of person familiar with project.
$299,490 Traffic Signal Installation September 2017
Contract Amount Type of Work Date Completed
3. City of Azusa 213 E. Foothill Blvd.
and Address of owner.
Cady Howing 909-594-9702
Name and Telephone Number of person familiar with project.
$352,269
Contract Amount
Traffic Signal & Fiber Optics
Type of Work
December2017
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.
Willis Towers Watson Zurich American Insurance Company
10 State House Square Floor 11 777 S. Figueroa St, Suite 3900
Hartford, CT 06103 Los Angeles, CA 90017
Erin Kiernan 860-843-5404
Hentz 213-270-0757
P-12 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE H
FEDERAL PROJECT NO: HSIPL 5063(186)
NON -COLLUSION AFFIDAVIT
(Title 23 United States Code Section 112 and Public Contract Code Section 7106)
In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the
BIDDER declares that the bid is not made in the interest of, or on behalf of, any undisclosed
person, partnership, company, association, organization, or corporation; that the bid is genuine and
not collusive or sham; that the BIDDER has not directly or indirectly induced or solicited any other
BIDDER to put in a false or sham bid, and has not directly or indirectly colluded, conspired,
connived, or agreed with any BIDDER or anyone else to put in a sham bid, or that anyone shall
refrain from bidding; that the BIDDER has not in any manner, directly or indirectly, sought by
agreement, communication, or conference with anyone to fix the bid price of the BIDDER or any
other BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of that of any
other BIDDER, or to secure any advantage against the public body awarding the contract of anyone
interested in the proposed contract; that all statements contained in the bid are true; and, further,
that the BIDDER has not, directly or indirectly, submitted his or her bid price or any breakdown
thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will
not pay, any fee to any corporation, partnership, company association, organization, bid
depository, or to any member or agent thereof to effectuate a collusive or sham bid.
Note: The above Non -collusion Affidavit is part of the Proposal. BIDDERS are cautioned
false certification may subject the certifier to criminal prosecution.
Signed I— ,-
State of G
County of
Subscribed and sworn to (or affirmed) before me on this S#A day of -kby-W , 20_,)Zg by
J ah^ N cnd) proved to me on the basis of satisfactory evidence to be the personA
who appeared before me
r�ltsa p�2dt�1 Lim
Notary Public Signature
Mblic or other officer completingate vedfies only the identity ofal who signed the document tortificate is attached. and notess, accuracy. or validity ofent.
Notary Public Seal
ELISA BETH LIM
Commission No. 2281937
NOTARY PUBLIC-CALIFORNIA
SAN BERNARDINO COUNTY
My Gomm. Evpbes MARCH 21, i023
P-13 of P-42
RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE lI
FEDERAL PROJECT NO: HSIPL 5063(186)
NON-DISCRIMINATION CERTIFICATE
The undersigned contractor or corporate officer, during the performance of this contract, certifies
as follows:
1. The Contractor shall not discriminate against any employee or applicant for employment
because of race, color, religion, sex, or national origin. The Contractor shall take affirmative
action to ensure that applicants are employed, and that employees are treated during
employment without, regard to their race, color, religion, sex, or national origin. Such action
shall include, but not be limited to, the following: employment, upgrading, demotion, or
transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other
forms of compensation; and selection for training, including apprenticeship. The Contractor
agrees to post in conspicuous places, available to employees and applicants for employment,
notices to be provided setting forth the provisions of this nondiscrimination clause.
2. The Contractor shall, in all solicitations or advertisements for employees placed by or on behalf
of the Contractor, state that all qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, or national origin.
3. The Contractor shall send to each labor union or representative of workers with which he/she
has a collective bargaining agreement or other contract or understanding, a notice to be
provided advising the said labor union or workers' representatives of the Contractor's
commitments under this section, and shall post copies of the notice in conspicuous places
available to employees and applicants for employment.
4. The Contractor shall comply with all provisions of Executive Order 11246 of September 24,
1965, and of the rules, regulations, and relevant orders of the Secretary of Labor.
5. The Contractor shall furnish all information and reports required by Executive Order 11246 of
September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant
thereto, and will permit access to his/her books, records, and accounts by the administering
agency and the Secretary of Labor for purposes of investigation, to ascertain compliance with
such rules, regulations, and orders.
6. In the event of the Contractor's non-compliance with the nondiscrimination clauses of this
contract or with any of the said rules, regulations, or orders, the contract may be canceled,
terminated, or suspended in whole or in part and the Contractor may be declared ineligible for
further Government contracts or federally assisted construction contracts in accordance with
procedures authorized in Execution Order 11246 of September 24, 1965, and such other
sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of
September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise
provided by law.
P-14 of P-42 RE -BID
S.
— CiTY-OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
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.
Pursuant to California Labor Code Section 1735, as added by Chapter 643 Slats. 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 Chance}. /
Signed:
Title:
Firm:
Date: 2/5/2020
P-15 of P-42 RE -BID
-- -- CITYOFSANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
STATEMENT REGARDING APPRENTICESHIP REQUIREMENTS
The undersigned BIDDER is familiar with the requirements of Section 1777.5 of the State Labor
Code regarding employment of apprentices, and understands that contractors on contracts
exceeding $30,000 or 20 working days shall:
1. Apply to the joint apprenticeship committee administering the apprenticeship standards of the
craft or trade in the area of the site of the public work for a certificate approving the contractor
under the apprenticeship standards for the employment and training of apprentices in the area
or industry affected.
2. Employ the number of apprentices or the ratio of apprentices to journeymen stipulated in the
apprenticeship standards.
3. Contribute to the fund or funds in each craft or trade in which he/she employs journeymen or
apprentices on the public work, in the same amount or upon the same basis and in the same
manner as the other contractors, except contractors not signatory to the trust agreement shall
pay a like amounkto theAlifopda Apprenticeship Council.
Signed:
Title:
Firm:
Date: 2/5/2020
Inc.
P-16 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
STATEMENT REGARDING "ANTI -KICKBACK" REOUIREMENTS
The undersigned is submitting this proposal for performing by contract the work required by these
bid documents, agrees to comply with the Copeland "Anti -Kickback" Act (18 USC 74) as
supplemented in the Department of Labor regulations (29 CFR, Part 3). This act provides that
each contractor or subcontractor shall be prohibited from inducing, by any means, any person
employed in the construction or repair of public work, to give up any part of the compensation to
which he/she is otherwise erAled. /
Signed:
Title:
Firm:
Date: 2/5/2020
P-17 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE
In conformance with Public Contract Code Section 10162, the BIDDER shall complete,
under penalty of perjury, the following questionnaire:
Has the BIDDER, any officer of the BIDDER, or any employee of the BIDDER who has a
proprietary interest in the BIDDER, ever been disqualified, removed, or otherwise prevented from
bidding on, or completing a federal, state, or local government project because of a violation of
law or a safety regulation?
Yes No X
If the answer is yes, explain the circumstances in the following space.
P-18 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
BIDDER'S STATEMENT REGARDING REQUIRED FEDERAL CONTRACT PROVISIONS
(FORM FHWA-1273)
The undersigned, is submitting this proposal for performing by contract the work required by these
bid documents, agrees to comply with the required Federal Contract Provision (Form FHWA-
1273) as shown in the apkendix/ *e Spe3M Provisions of this project.
Signed
Title
Firm
Date 2/5/2020
P-19 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE H
FEDERAL PROJECT NO: HSIPL 5063(186)
EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION
The bidder Elecnor Belco Electric, Inc
proposed subcontractor hereby
certifies that he has X , has not _, participated in a previous contract or subcontract subject
to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and
that, where required, he has filed with the Joint Reporting Committee, the Director of the Office
of Federal Contract Compliance, a Federal Government contracting or administering agency, or
the former President's Committee on Equal Employment Opportunity, all reports due under the
applicable filling requirements.
Note: The above certification is required by the Equal Employment Opportunity Regulations of
the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and
proposed subcontractors only in connection with contracts and subcontracts which are
subject to the equal opportunity clause. Contracts and subcontracts which are exempt
from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only
contracts or subcontracts of $10,000 or under are exempt.)
Currently, Standard Form 100 (EEO-1) is the only report required by the Executive
Orders or their implementing regulations.
Proposed prime contractors and subcontractors who have participated in a previous contract or
subcontract subject to the Executive Orders and have not filed the required reports should note
that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such
contractor submits a report covering the delinquent period or such other period specified by the
Federal Highway Administration or by the Director, Office of Federal Contract Compliance,
U.S. Department of Labor. /
Signed
Title
Firm
Date 2/5/2020
P-20 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT
In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the
bidder hereby declares under penalty of perjury under the laws of the State of California that the
bidder has _ , has not X been convicted within the preceding three years of any offenses
referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any
other act in violation of any state or Federal antitrust law in connection with the bidding upon,
award of, or performance of, any public works contract, as defined in Public Contract Code
Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including
the Regents of the University of California or the Trustees of the California State University.
The term "bidder" is understood to include any partner, member, officer, director, responsible
managing officer, or responsible managing employee thereof, as referred to in Section 10285.1.
Note:
Signec
Title
Firm
The bidder must place a check mark after "has" or "has not' in one of the blank spaces
provided. The above Statement is part of the Proposal. Signing this Proposal on the
signature portion thereof shall also constitute signature of this Statement. Bidders are
cautioned that making a false certification may subject the certifier to criminal
prosecution.
Date 2/5/2020
P-21 ofP-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
PUBLIC CONTRACT CODE SECTION 10232 STATEMENT
In conformance with Public Contract Code Section 10232, the Contractor, hereby states under
penalty of perjury, that no more than one final unappealable finding of contempt of court by a
federal court has been issued against the Contractor within the immediately preceding two year
period because of the Contractor's failure to comply with an order of a federal court which orders
the Contractor to comply with an order of the National Labor Relations Board.
Note: The above Statement and Questionnaire are part of the Proposal. Signing this
Proposal on the signature portion thereof shall also constitute signature of this
Statement and Questionnaire.
Bidders are cautioned that making a false certification may subject the certifier to
criminal prosecution.
Signed
Title
Firm
Date
Elecnor
P-22 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
TITLE 49, CODE OF FEDERAL REGULATION PART 29 DEBARMENT AND SUSPENSION
CERTIFICATION
The bidder under penalty of perjury, certifies that except as noted below, he/she or any person
associated therewith in the capacity of owner, partner, director, officer, manager:
is not currently under suspension, debarment, voluntary exclusion, or determination of
ineligibility by any federal agency;
has not suspended, debarred, voluntarily excluded, or determined ineligible by any federal
agency within past three years;
has not been indicted, convicted, or had a civil judgment rendered against it by a court of
competent jurisdiction in any matter involving fraud or official misconduct within the past 3
years.
If there are any exceptions to this certification, insert the exceptions in the following space.
Exceptions will not necessarily result in denial of award, but will be considered in determining
bidder's responsibility. For any exception noted above, indicate below to whom it applies, initialing
agency, and dates of action.
Note: Providing false information may result in criminal prosecution or administrative sanctions.
The above certification is part of the Proposal.
shall also constitute signature of this Cc
jrt{fic4t
Signed
Title
this Proposal on the signature portion thereof
Firm Elecn`04elco Electric, Inc.
Date 2l5/2020
John
P-23 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
NON -LOBBYING CERTIFICATION FOR FEDERAL AID CONTRACTS
The prospective participant certifies, by signing and submitting this bid or proposal, to the best of
his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influence or attempting to influence an officer or
employee of Congress, or an employee of a Member of Congress in connection
with the awarding of any Federal contract, the making of any Federal grant, the
making of any Federal loan, the entering into of any cooperative agreement, and the
extension, continuation, renewal, amendment or modification of any Federal
contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriate funds have been paid or will be paid to
any person for influencing or attempting to influence an officer or employee of any
Federal agency, a Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with this Federal contract, grant,
loan, or cooperative agreement, the undersigned shall complete and submit Standard
Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions.
This certification is a material representation of fact upon which reliance was placed when
this transaction was made or entered into. Submission of this certification is a prerequisite for
making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person
who fails to file the required certification shall be subject to a civil penalty of not less than $10,000
and not more than $100,000 for each such failure.
The prospective participant also agrees by submitting his or her bid or proposal that he or
she shall require that the language of thi certification be included in all lower tier subcontracts,
which exceed $100,000 and that allAuZub-recipients shall certify and disclose accordingly.
Signed
Title
Firm
Date 2/5/2020
Inc.
a Standard Form LLL may be obtained from Caltrans and FHWA offices.
P-24 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
DISCLOSURE OF LOBBYING ACTIVITIES
DISCLOSURE OF LOBBYING ACTIVITIES nppmtea by OW
Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 G�fe-p0<5
I!.nnm ran M nr�FAn A.nrla
Type of Federal Action:
2- Status of Federal Action.-
3. Report Type:
a contract
❑ a. bid/ ofterfapplica6on
a. initial filing
. grant
b. initial award
b. material change
c. peralive agreement
c- postaward
For Material Change Only:
d.
e. ban arantee
y�r quarter
date of last report
ff, loan in race
4- Name and Add s of Reporting Entity:
5. If Reporting Entity in No. 4 is a Subawardee er Name
❑ Prom Snwwadef
and Address of Prime-
ifkno.-
Congires5ional District, dknown:
Conoro.,dcinal District. ifk
6- Federal DeparbnentlAgency:
Federal Program NZwJcription-
\
I-7.
CDA Number, if
8- Federal Action Number, iflvtown:
Award Amou ifknoam-
10. a. Name and Address of Lobby -mg Entity b. Ind
i - s Performing Services {ir+rJudirg address if(Jindividual,
last namQ Fiat name, M!): di from No, i0a)
(!a nam first name, MI):
ah7d�Cm�muabn s sfitlq Ynere
If- Amount of Payment (rheck aft fiat apply):
13. Type of Payment ( a8 that apply}
S ❑ achmt ❑ p
❑ a ra6ber
❑ a ane�me be
❑ ¢ cwhmwan
12 Fonn of Pa yment (cheek ay that apply .
❑ e-carn
❑ acantaylent eee
❑ 4lniinq epedry: nature
❑ e. deNied
value
❑ r-other, "My:
14. Brief Description of Ser4des Performed or to be Performed and Dates) of Servtoe, including oiti r(s),
employee(s), or Mem s) contacted, for Payment indicated in Rem 11:
fatcm Cownaavm sl One SF-LLLq lnr¢
15. Contin n Sheets SF-LLLA attached: Yea AP
Is. W b+,rl� N lam ++a�+4M y W al V IIc on
vx r roe. ,r mgry ina� r ...rsr .vrew+Signature:
ce ++. e.as.. ++etr w•.+.r r of unc lvx ,ti
Print Name: O rag
ITdie
:
Vie Pr ident
��a..ea a,a r. r�+aeaan .r n+e.w.,nmmea
Teiephone No_ 90 - 3-5470 Date: 2/5/2020
Federal Use Only:
AundnGglertLEa rtepmoxlen
Stai4aN Fmn LLJ. rtee. 79
P-25 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
INSTRUCTIONS FOR COMPLETION OF SF-LL DISCLOSURE OF LOBBYING
ACTIVITIES
INSTRUCTIONS FOR COMPLETION OF SFLLL, DISCLOSURE OF LOBBYING ACTNRIES
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a a gaFalna am malmanirnafe am
@feces ills conpkbta. altl revllwflire mleabll a b1o[rtfa1e Sena oamfalla regamg are Pape eafm:le a any alma ape" a fa& arlslan a
lrrarina10r1, anllrg suggeanac far rel'I^9 m16 b&ren. b the Once a&tiragememam InraJel. RaPerwr! Realr"Im PrOjat (1315-OW6). sly.
M f0a03.
P-26 of P-42 RE -BID
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
EXHIBIT 15-G CONSTRUCTION CONTRACT DBE COMMITMENT
1. Local Agency: City of Santa Ana 2. Contract DBE Goal: 7%
3. Project Description: Installation of RRFB.'YieId' markings, additional striping and skmage
RE -BID
Pomona Stand Broadway, 10th Stand Rain St, Wigits Stand Diamond St, Pacific Ave and Adams St, Nakoma Dr and La Verne
Ave, Russell Ave and Sycamore St, French St and 14th St, McFadden Ave and Oak St, Sycamore St and Walnut St, Center St
and Lingan Ln, Santa Ana BMtl and Sycamore St, 3rd St and Sycamore St, Broadway and Borchard Ave, and Russell Ave and
4. Project Location: Towner St.
5. Biddets Name: EleCnor Belco Electric, Inc. 6. Prime Certified DBE: ❑
8. Total Dollar Amount for ALL Subcontractors: ?74, 485. 00 9, Total Number of _AL_� Subcontractors:
7. Bid Amount: $285,295.00
10. Bid
Item
11. Desuiption of Work, Service, or Materials
12. DBE
Certification
13. DBE Contact Information
14. DBE
Number
Supplied
Number
(Must be certified on the date bids are opened)
Dollar
Amount
Various
Furnish RRFB System
40540
TEK Services LLC
1609 East McFadden Ave. #D
$44,835.00
Santa Ana, CA 92705
(714) 336-0536
60t of $74,725.00
Local Agency toCompletethis Section upon Execution of Award
$ 835.00
21. Local Agency Contract Number.
22. Federal -Aid Protect Number. HSIPL 5063(186)
15. TOTAL CLAIMED DBE PARTICIPATION
23. Bid Opening Date: February 12, 2020
15.7 %
24. Contract Award Date:
IMPORTANT: Identify all DBE firms being claimed for credit,
25. Award Amount:
regardless or tier. Names of the First Tier DBE Subcontractors and
their respective items) of work listed above must be consistent,
where applicable with the names and items of the work in the
Local Agency certifies that all DBE certifications are valid and information on
'Subcontract ist" submitted with your bid. Written confirmation of
this form is complete and accurate.
eac 'start E is required
2/14/2020
26, Local Agency Representative's Signature 27. Date
1 , Pr awes Sign ore 17. Date
J hn Won 909-993-5470
28. Local Agency Representative's Name 29. Phone
1 rtmes Name 19. Phone
Vice President
30. Local Agency Representative's Title
20. Preparees Title
DISTRIBUTION: 1. Original - Local Agency
2. Copy-Cellrans District Local Assistance Engineer (DLAE). Failure to submit to DLAE within 30 days of contract
execution may result in de -obligation of federal funds on contract.
3. Include additional copy with award package.
ADA Notice: For individuals with sensory disabilities, this document is available in altemate formats. For information call (916) 654-6410
or TDD (916) 654-3880 orwrile Record& and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
P-27 of P-42 RE -BID
Februrary 12, 2020
To: Elecnor Belco Electric, Inc.
14320 Albers Way
Chino, CA 91710
(909)993-5470
Re: Crosswalk Upgrades Phase II -Santa Ana
TEK Services LLC is pleased to provide you with the following materials and equipment for the referenced project:
Bid Item
City I
Description
Unit Price
Total
1
1 1
RRFB System
$ 4,570.00
$ 4570.00
3
1 IRRFBSystem
S 4,570.00
$ 4,570.00
5
1
RRF8System
S 4,570.00
$ 4,570.00
7
2
RRFB System
$ 4,570.00
$ 4,570.00
9
1
RRFB System
$ 4570.00
$ 4,570.00
11
1
RRFB System
$ 7,518.00
S 7,519.00
13
1
RRFB System
$ 4,570.00
S 4,570.00
15
1
RRFB System
$ 6,130.00
$ 6,130.OD
17
1
RRFB System
$ 4,570.00
$ 4,570.00
19
1
RRFB System
$ 4,570.00
$ 4570.00
21
1
RRFBSystem
$ 6,651.00
$ 6,651.00
23
1
RRFB System
$ 4570.00
$ 4,570.00
25
1
RRFB System
$ 4570.00
$ 4,570.00
27
1
RRFB System
$ 8,726.OD
$ 8,726.D0
Total
$ 74,725.00
Notes:
• TEK Services,LLC is Metro certified WBE/UDBE/SBE. Certification No. 40540.
• NAICS Work Codes C0686, C0600
• Quotation valid for 30 days subject to re -quote thereafter.
• Delivery 18- 22 Weeks after submittal approval.
• Terms: Net 30 Days, Pending Credit Verification.
• Sales tax is not included.
Thank you for the opportunity.
Sales Rep: Kim King
TEK Services LLC • 1609 East McFadden Ave. 4D • Santa Ana, California 92705 • 714-336-0536 • Fax: 714-694-0116
2N 312020 -- - UCP Web Applwtion - Ust - - -
,Skip to Main Content Back To Query Form (IicenseFgrm.htm).
Search Returned 1 Records
Thu Feb 13 09:19:58 PST 2020
Query Criteria
Certification Types: DBE
Firm ID: 40640
Firm ID
40540
DBA Name
TEK SERVICES, LLC
Firm Name
TEK SERVICES, LLC
Address Line1
5680 VAN GOGH WAY
Address LIne2
City
YORBA LINDA
State
CA
Zip Code1
92887
Zip Code2
Melling Address
LIne1
5680 VAN GOGH WAY
Mailing Address
Line2
Mailing City
YORBA LINDA
Mailing State
CA
Mailing Zip
Code1
92887
Mailing Zip
Code2
Certification
Type
DBE
Entail
kim.tekserv@Gmail.com
Contact Name
KIM KING
Area Code
714
Phone Number
336-0536
Extension
Alt Area Code
Alt Phone
Number
Extension
Fax Area Code
714
Fax Phone
Number
694-0116
Agency Name
LOS ANGELES COUNTY METRO TRANSPORTATION AUTHORITY (MTA)
Counties
19; 30; 33; 37;
Districts
07; 08; 11; 12;
DBE NAICS
423610; 423840;
ACDBE NAICS
Work Codes C0686 ELECTRICAL & SIGNALS SUPPLIER; C0600 MISC SUPPLIERS;
https:llucp.dot.ca.gov/quBrySubrnit.htm 112
2113/2020
UCP Web Application - List
Licenses
Trucks
Gender F
Ethnicity CAUCASIAN
Firm Type DBE
https:/Iucp.dat,ca,gov/querySubmlt.htm 212
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
INSTRUCTIONS — CONSTRUCTION CONTRACT DBE COMMITMENT
CONTRACTOR SECTION
1. Local Agency - Enter the name of the local agency that is administering the contract.
2. Contract DBE Goal - Enter the contract DBE goal percentage as it appears on the project
advertisement.
3. Project Location - Enter the project location(s) as it appears on the project advertisement.
4. Project Description - Enter the project description as it appears on the project advertisement (Bridge
Rehab, Seismic Rehab, Overlay, Widening, etc).
5. Bidder's Name - Enter the contractor's firm name.
6. Prime Certified DBE - Check box if prime contractor is a certified DBE.
7. Bid Amount - Enter the total contract bid dollar amount for the prime contractor.
8. Total Dollar Amount for ALL Subcontractors —Enter the total dollar amount for all subcontracted
contractors. SUM = (DBEs + all Non -DBEs). Do not include the prime contractor information in this
count.
9. Total number of ALL subcontractors —Enter the total number of all subcontracted contractors. SUM
= (DBEs + all Non -DBEs). Do not include the prime contractor information in this count.
10. Bid Item Number - Enter bid item number for work, services, or materials supplied to be provided.
11. Description of Work, Services, or Materials Supplied - Enter description of work, services, or
materials to be provided. Indicate all work to be performed by DBEs including work performed by the
prime contractor's own forces, if the prime is a DBE. If 100% of the item is not to be performed or
furnished by the DBE, describe the exact portion to be performed or famished by the DBE. See LAPM
Chapter 9 to determine how to count the participation of DBE firms.
12. DBE Certification Number - Enter the DBE's Certification Identification Number. All DBEs must
be certified on the date bids are opened.
13. DBE Contact Information - Enter the name, address, and phone number of all DBE subcontracted
contractors. Also, enter the prime contractor's name and phone number, if the prime is a DBE.
14. DBE Dollar Amount - Enter the subcontracted dollar amount of the work to be performed or service
to be provided. Include the prime contractor if the prime is a DBE. See LAPM Chapter 9 for how to count
full/partial participation.
15. Total Claimed DBE Participation - $: Enter the total dollar amounts entered in the "DBE Dollar
Amount" column. %: Enter the total DBE participation claimed ("Total Claimed DBE Participation
Dollars" divided by item "Bid Amount"). If the total % claimed is less than item "Contract DBE Goal,"
an adequately documented Good Faith Effort (GFE) is required (see Exhibit 15-H DBE Information -
Good Faith Efforts of the LAPM).
16. Preparer's Signature - The person completing the DBE commitment form on behalf of the
contractor's firm must sign their name.
17. Date - Enter the date the DBE commitment form is signed by the contractor's preparer.
18. Preparer's Name - Enter the name of the person preparing and signing the contractor's DBE
commitment form.
19. Phone - Enter the area code and phone number of the person signing the contractor's DBE
commitment form.
20. Preparer's Title - Enter the position/title of the person signing the contractor's DBE commitment
form.
P-28 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL -
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE H
FEDERAL PROJECT NO: HSIPL 5063(186)
LOCAL AGENCY SECTION
21. Local Agency Contract Number - Enter the Local Agency contract number or identifier.
22. Federal -Aid Project Number - Enter the Federal -Aid Project Number(s).
23. Bid Opening Date - Enter the date contract bids were opened.
24. Contract Award Date - Enter the date the contract was executed.
25. Award Amount —Enter the contract award amount as stated in the executed contract.
26. Local Agency Representative's Signature - The person completing this section of the form for the
Local Agency must sign their name to certify that the information in this and the Contractor Section of
this form is complete and accurate.
27. Date - Enter the date the DBE commitment form is signed by the Local Agency Representative.
28. Local Agency Representative's Name - Enter the name of the Local Agency Representative
certifying the contractor's DBE commitment form.
29. Phone - Enter the area code and phone number of the person signing the contractor's DBE
commitment form.
30. Local Agency Representative Title - Enter the position/title of the Local Agency Representative
certifying the contractor's DBE commitment form.
P-29 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
EXHIBIT 15-H DBE INFORMATION — GOOD FAITH EFFORTS
Federal -aid Project No(s). HSIPL5063 f 1861 Bid Opening Date Febmary 12.2020_
The City of Santa Ana established a Disadvantaged Business Enterprise (DBE) goal of 7 "/u for this
contract. The information provided herein shows the required good faith efforts to meet or exceed the DBE
contract goal.
Proposers or bidders submit the following information to document their good faith efforts within five (5)
business days from bid opening. Proposers and bidders are recommended to submit the following information
even if the Exhibit 10-01: Consultant Proposal DBE Commitments or Exhibit 15-G: Construction Contract DBE
Commitment indicate that the proposer or bidder has met the DBE goal. This form protects the proposer's or
bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet
the goal for various reasons, e.g., a DBE Firm was not certified at bid opening, or the bidder made a mathematical
error.
The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special
Provisions, please attach additional sheets as needed:
A. The names and dates of each publication in which a request for DBE participation for this
project was placed by the bidder (please attach copies of advertisements or proofs of
publication):
Publications Dates of Advertisement
DBE Goal Met
B. The names and dates of written notices sent to certified DBEs soliciting bids for this project
and the dates and methods used for following up initial solicitations to determine with
certainty whether the DBEs were interested (please attach copies of solicitations, telephone
records, fax confirmations, etc.):
Names of DBEs Solicited Date of Initial Follow Up Methods and Dates
Solicitation
LLC
2/4
0, 2/12/2020
P-30 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
C. The items of work made available to DBE firms including those unbundled contract work
items into economically feasible units to facilitate DBE participation. It is the bidder's
responsibility to demonstrate that sufficient work to facilitate DBE participation in order to
met or exceed the DBE contract goal.
Items of Work Bidder Normally
Performs Item (Y/N)
Furnish RRFB System N
Breakdown of
Items
various Bid Items
Amount Percentage
M Of
$74,725.00 26.1%
D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's
rejection of the DBEs, the firms selected for that work (please attach copies of quotes from
the firms involved), and the price difference for each DBE if the selected firm is not a DBE:
Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's
rejection of the DBEs:
DBE Goal Met
Names, addresses and phone numbers of firms selected for the work above:
TEK Services LLC 1609 East McFadden Ave. #D Santa Ana, CA 92705
(714) 336-0536
E. Efforts (e.g. in advertisements and solicitations) made to assist interested DBEs in obtaining
information related to the plans, specifications and requirements for the work which was
provided to DBEs:
DBE Goal Met
F. Efforts (e.g. in advertisements and solicitations) made to assist interested DBEs in obtaining
bonding, lines of credit or insurance, necessary equipment, supplies, materials, or related
assistance or services, excluding supplies and equipment the DBE subcontractor purchases or
leases from the prime contractor or its affiliate:
DBE Goal Met
P-31 ofP-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
G. The names of agencies, organizations or groups contacted to provide assistance in contacting,
recruiting and using DBE firms (please attach copies of requests to agencies and any
responses received, i.e., lists, Internet page download, etc.):
Name of Method/Date of Results
Agency/Organization Contact
DBE Goal Met
H. Any additional data to support a demonstration of good faith efforts:
DBE Goal Met
NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY
P-32 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
Exhibit 12-B Bidder's List of Subcontractors (DBE and Non -DBE) — Part I
PART
The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard
Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in
addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms.
Local Assistance Procedures Manual
Exhibit 12-B
Exhibit 12-B Bidder's List of Subcontractor (DBE and Non -DBE) Part 1
As of Match I, 2015 Contractors (and subcontractors) wishing to bid on public works contracts shall be registered with the State Division of Industrial Relations and
certified to bid on Public Works contracts. Plow register at: httOs't/wtvwdir Cagov/Public-Works/Contractor-Resistration.html
In accordance with Tide 49, Section 26.11 of the Code of Federal Regulations, and Section 4104 of the Public Contract Code of the State of California, as amended, the
following information is required for each subconmwwr who will perform work amounting to more than one half of one percent (0.5%) of Odrt@'Tjowl Ifg� Bid o 510,000
(whichever is greater). Photocopy this form for additional firms. Fedcrol Project Number. HSIPL-50o3(180�
Subcontractor Name and
Location
tine Item &Desripion
Subcontract
Mount
Perrentageof
aid Item Sub-
contracted
Contractor
License Number
DBE
(YIN)
DBE Celt
Number
Annual Grosi Reafpes
DIR Rest Number
h 1�15 C[.V41 PA
G�u-f��Pr(
.Z( 1l 1 �r t611t-lil(
r
i� to tyr 22 iq
�`IIl�J
,i$V
bl millon
4S million
410 million
Cllystate:
Uluomixr vl
�(�CCL03QAgeOfPtrra:
4 1S million
a.
Name:
% L 1�3 -b(Q
l l t
S$1 minion
<$5 million
City, State:
410milliun
415 Mlllon
eof Flrm: rs.
Name:
-
<$I million
S million
aty, State:
<510mililon
❑ 415million
eof Flrm: r.
Name:
-
❑ 41 million
4s mllllan
City. State:
sIomllllon
4IS million
e of Firm: yrs.
Name:
<SI mmlon
45 million
alv State:
<Smillion
bL5 million
e of FiV a
Name:
41 million
45 million
City, State:
<S10 million
415 nulllor,
e ofFl m:
Distribution: 1) original -Local Agency File 2)Copy-DUE w/Award rarnge
P-33 of P42 RE -BID
Page 1 of 2
January 2019
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
EXHIBIT 12-B BIDDER'S LIST OF SUBCONTRACTORS(DBE AND NON -DBE) PART II
PART H
The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a
subcontractor on this project. This is required for compliance with Title 49, Section 26 of the Code of Federal
Regulations. Photocopy this form for additional firms.
Local Assistance Procedures Manual
List
Exhibit 12•B
In accordance with Title 49, Section 26 of the Code of Federal Regulations, the Bidder shall list all subcontractor who provided a quote or bid but were not selected to
participate as a subcontractor on dlis proj=L Photocopy this form for additional firms. Federal Project Number: HSIPG5bS3TT$6}—
Subcontractor Name and
Location
Gne Item Description
Subcontract
Amount
Percentage of
Did Item Sub.
contracted
carousel
License Number
ME
(r/N)
DDECon
Number
Annual Gross Receipts
DIRRe Number
Name:
41 million
65 million
City, State:
LJ <$IOmilllon
dl5milllon
e of Firm: yrs.
Name:
❑ IMIIian
❑ 05 million
City, tale:
610mimmn
c$25mutton
Ageofnrm: yrs,
Name:
41 million
LJ 4S million
City, State:
❑ d10Mlllon
❑ c$35 Mllion
Arre of firm: Vol.
Name:
c$1 million
❑ 65 Mlllan
dty. Stale:
<$10MIIlon
EF e$15MIIlon
e of Firm: Vol.
Name:
❑ 41 million
❑ c$5 million
City, State:
610 Mllion
rT cSaSMlllon
A eof Nrm: rs.
Name.
i
c$I million
QSMlson
City, Stale:
420 Mllion
bl5mllllon
e of Firm:
Distribution: ll Original -Local Agency file 21 Copy DLAE w/ Award Package
P-34 of P-42 RE -BID
Page 2 of 2
.lanuarr 2019
CITY OF SANTAANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE 11
FEDERAL PROJECT NO: HSIPL 5063(186)
PROMPT PAYMENT OF FUNDS WITHHELD TO SUBCONTRACTORS
The undersigned, is submitting this proposal for performing by contract the work required by these
bid documents, certify to comply with the following:
The agency shall hold retainage from the prime contractor and shall make prompt and
regular incremental acceptances of portions, as determined by the agency, of the contract
work, and pay retainage to the prime contractor based on these acceptances. The prime
contractor, or subcontractor, shall return all monies withheld in retention from a
subcontractor within 30 days after receiving payment for work satisfactorily completed
and accepted including incremental acceptances of portions of the contract work by the
agency. Federal law (49CFR26.29) requires that any delay or postponement of payment
over 30 days may take place only for good cause and with the agency's prior written
approval. Any violation of this provision shall subject the violating prime contractor or
subcontractor to the penalties, sanctions and other remedies specified in Section 7108.5
of the Business and Professions Code. These requirements shall not he construed to limit
or impair any contractual, administrative, or judicial remedies otherwise available to the
prime contractor or subcontractor in the event of a dispute involving late payment or
nonpayment by the prime ontractor, deficient subcontract performance, or
noncompliance by a sub an acpdr.
Signed
Title
Firth Elecnor Belco Electric, Inc.
Date
2/sign2n
P-35 of P-42 RE -BID
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
EXHIBIT 16-B — SUBCONTRACTING REQUEST
RE -BID
Local Assistance Procedures Manual Exhibit 16-B
CONTRACTORNAME
COUNTY
I Rom
Busmss ADDRESS
CONTRACTNUMBER
CITY AND STATE
ZIPCODE
FEDERAL-AmPRO)ECTNUMBER
A. SUBCONrRACTOR
B. BID ITEM
C.PERCMrAGE OF
D. SuslzT'Eo
ECERTRTED
F. DEscarw WORK
G.DOLLARAmou NT
(Nxru,Bursness Addree% Phone)
NUMBER(S)
BNITEM
ATBronmE
DBE
WHEN I}$THAN
BASEDONTHEBN
SUBCONTRACTED
100% OF WORK IS
AMOUNT
SUBCONTRACTED
Yes No
Yes No
❑ ❑
❑ ❑
Yes No
Yes No
❑ ❑
❑ ❑
Yes No
Yes No
❑ ❑
❑ ❑
Yes No
Yes No
❑ ❑
❑ ❑
Yes No
Yes No
❑ ❑
❑ ❑
Yes No
Yes No
I certify that:
• The Standard Provisions for labor set forth in the contract apply to the subcontracted work.
• If applicable, Form FHWA-1273 of the Special Provisions has been inserted in the subcontracts and should be
incorporated in any lower -tier subcontract Written contracts have been executed for the above noted subcontracted
work.
Contractor Signature Date
This section is to be completed by the resident engineer.
1. Total of bid items
2. Conctracmr must perform with own fortes (line 1 %contract req. %)
3. Bid Items previously subcontracted (taken from previously approved 16-B)
4. Bid items subcontracted (this request)
5. Total bid items subcontracted (line 3 plus 4)
6. Balance of work contractor to perform Oine 1 minus 5)
S
5
S
5
Approved
RESIDENT ENGhNEER'SSIGNATURE. DATE „
Copy Olslnbution: OnginalContractor Copy- Resident Engineer Copy-OBEO. smallbushassadvocatoOdootcaeov or, tax to(916) 324-1949
Page I of 2
.January 2018
P-36 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSTPL 5063(186)
Local Assistance Procedures Manual
Exhibit 16-B
Subcontracting Request
INSTRUCTIONS FOR COMPLETING SUBCONTRACTING REQUEST FORM
All first -tier subcontractors must be included on a subcontractor request.
Before subcontracting work starts, the contractor will submit an original CEM-1201 for approval according to the
Standard Specifications. After approval, the RE returns the original to the contractor and complete the remaining
distribution as listed on the bottom of the form.
D. If subcontractor was listed at bid time per the Fair Practices Act, check yes, otherwise check no.
E. If subcontractor is a certified DBE contractor, check yes, otherwise check no.
F and G. When a portion of an item is subcontracted, describe the portion and show the percentage of the bid item
and value.
G. When an entire item is subcontracted, show the full bid item value.
THIS FORM IS NOT TO BE USED FOR SUBSTITUTIONS OF SUBCONTRACTORS AND UDBE, DVBE OR
SMALL BUSINESS ENTITIES.
Page 2 of 2
January 2018
P-37 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
DIFFERING SITE CONDITIONS
The undersigned, is submitting this proposal for performing by contract the work required by these
bid documents, certify to comply with the following:
a. Contractor's Notification
Promptly notify the Agency's Engineer if you find either of the following conditions:
1. Physical conditions differing materially from either of the following:
• Contract documents
• Job site examination
2. Physical conditions of an unusual nature, differing materially
from those ordinarily encountered and generally recognized as
inherent in the work provided for in the Contract
Include details explaining the information you relied on and the material
differences you discovered. If you fail to promptly notify the Engineer, you waive
the differing site condition claim for the period between your discovery of the
differing site condition and your notification to the Engineer.
If you disturb the site after discovery and before the Engineer's investigation, you
waive the differing site condition claim.
b. Engineer's Investigation and Decision
Upon your notification, the Engineer investigates job site conditions and:
1. Notifies you whether to resume affected work
2. Decides whether the ondition differs materially and is cause for an
adjustment q€4ime4ayment, or both
Signed
Title Vice
Firm Elecnor 8elco Electric, Inc.
Date 2/5/2020
John
P-3 8 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
BIDDER'S CERTIFICATE OF COMPLIANCE REGARDING "BUY AMERICA"
REQUIREMENTS FOR STEEL OR MANUFACTURED PRODUCTS
The undersigned, is submitting this proposal forperforming by contract the work required by these
bid documents, certify to comply with the `Buy America" requirements of Section 165 of the
Surface Transportation Assistance Act of 1982 and as shown in the special provisions of this
project. k n 11
Signed
Title
Firm
Date 2/5/2020
P-39 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE 11
FEDERAL PROJECT NO: HSIPL 5063(186)
NEPA COMPLIANCE FOR FEDERAL AID CONTRACTS
The undersigned, is submitting this proposal for performing by contract the work required by these
bid documents, certify to comply with the Categorical Exemption/Categorical Exclusion
Determination Form including and not limited to the National Environmental Policy Act (NEPA)
requirements and environmental commitments found in the annendix of the Contract Documents
of this
Signed
Title
Firm
Date 2/5/2020
P-40 of P-42 RE -BID
CITY OF SANTA ANA RE -BID
PROPOSAL
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE 11
FEDERAL PROJECT NO: HSIPL 5063(186)
TMP COMPLIANCE FOR FEDERAL AID CONTRACTS
The undersigned, is submitting this proposal for performing by contract the work required by these
bid documents, certify to comply with the Traffic Management Plan (TMP) commitments found
in the appendix of the Contract oc rents of this project.
Signed
Title
Firm
Date
P-41 ofP-42 RE -BID
MAYOR
Miguel A. Pulido
MAYOR PRO TEM
Juan Vilegas
COUNCILMEMBERS
Phil Bacerra
Cecilia Iglesias
David Penaloza
Vicente Sarmiento
Jose Solorlo
CITY OF SANTA ANA
PUBLIC WORKS AGENCY
20 Civic Center Plaza . M43 . P.O. Box 1988
Santa Ana, California 92702
W Ww.santa-ana orn
February 3, 2020
ADDENDUM No. ONE
SUBJECT: RE -BID Project 17-6876 Crosswalk Upgrades Ph II — HSIPL 5063(186)
CITY MANAGER
Kristine Ridge
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
Daisy Gomez
The following changes/revisions/clarifications have been made to the Contractor License Requirements for
the subject project:
Specifications:
Revise Notice of Inviting Bids, Page v as follows:
Contractor License Requirements: From the time of City Council contract award until work
completion, the Contractor shall possess a valid California Class "A" 'sr Class C-10
Contractor's license. All sub -contractors shall be properly licensed for their respective trades.
ALL OTHER ITEMS REMAIN.
FOR THE CITY OF SANTA ANA
Edwin "William" Galvez,
City Engineer
SANTA ANA CITY COUNCIL
,John Wong
Belco Electric, Inc.
Kl,9uel A POO. Juan Vill e3as V";Ae Sarnnenlo D..,d P=_nalozs Jess solono Pml Bacarra Cenha Iglesias
Mayor Mayor Pm Tam, Ward 5 Nlardl Wards Ward Wanda Wad 6
oulitln n5ana o'y nllepasmi,anlaananrn ,n,enlo8larla all pra dpenaloza trSanlaandDry Lu_l_sanra�ana� p4acarta�a.......ap, egr2SasEsanla-ana pn
4, CALIFORNIA NEM1 134PEF3_5ERVICE BUREAU
DAILY JOURNAL CORPORATION
Mailing Address: 915 E FIRST ST, LOS ANGELES, CA 90012
Telephone (213) 229-53001 Fax (213) 229-5481
Visit us Q WVVW,LEGALADSTORE.COM
EDUARDO FLORES
SANTA ANA/PUBLIC WORKS AGENCY
20 CIVIC CENTER PLAZA 4TH FL ROSS ANNEX
SANTA ANA, CA 92702
CNS 3332621
COPY OF NOTICE
Notice Type: BID NOTICE INVITING BIDS
Ad Description py17-6876 RE -BID CROSSWALK UPGR
To the right is a copy of the notice you sent to us for publication In the
ORANGE COUNTY REGISTER. Please read this notice carefully and call us
with any corrections. The Proof of Publication will be filed with the County
Clerk, if required, and mailed to you after the last date below. Publication
date(s) for this notice Is (are):
01/22/2020 , 01/29/2020
The charge(s) 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) 287AB66
THE DAILY RECORDER, SACRAMENTO
(916) 444-2355
THE DAILY TRANSCRIPT, SAN DIEGO
(619) 232-3486
THE INTER -CITY EXPRESS, OAKLAND
(510) 272-4747
III III II II II III I II I II II II I II II
* A 0 0 0 0 0 5 3 2 9 8 8 4
E II
CITY OF SANTA ANA RE -BID
BOND'S Bond No. 9342347
PROJECT NO.:49PW6
CROSSWALK UPGRADES PHASE II
FEDERAL PROJECT NO: HSIPL 5063(186)
PAYMENT BOND
KNOW ALL MEN BY THESE PRESENTS that Elecnor Belco Electric, Inc.
as CONTRACTOR, and Fidelity and Deposit Company of Maryland
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 Hundred Eighty Five Thousand Two
Hundred Ninety Five and 00/100 Dollars
($ 285,295.00 ), which is 100 percent of the total contract amount for the above stated
project, for the payment of which sum, CONTRACTOR and SURETY agree to be bound, jointly
and severally, firmly by these presents.
THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas CONTRACTOR has
been awarded and is about to enter into the annexed Contract Agreement with AGENCY dated
March 17, 2020 for Project No. 17-6876 Crosswalk Upgrades Phase II [HSIPL-5063 (186)]
if CONTRACTOR or any subcontractor fails to pay for any labor or material of any kind used in
the performance of the Work of Improvement to be done under said Contract Agreement, or fails
to submit amounts due under the State Unemployment Insurance Act with respect to said labor,
SURETY will pay for the same in an amount not exceeding the sum set forth above, which amount
shall insure to the benefit of all persons entitled to file claims under the State Code of Civil
Procedures; provided that any alterations in the work to be done, materials to be furnished, or time
for completion made pursuant to the terms of the contract documents shall not in any way release
either CONTRACTOR or SURETY, and notice of said alterations is hereby waived by SURETY.
IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seal this
5th day of March , 20 20 .
CONTRACTOR*
and
Subscribed and sworn to before me,
20
Signature:
of
Notary Public in and for the County of
�rresmenyf - - -- 1432U Albers Way, Cbinu, CA 91710,
Tel: (909) 993-5470 cxt 254
1299 Zurich Way, 5th Floor, Schaumbur , IL 60196-1056, Tel: (847) 605-6000
Los s CA 9QQI 2. Tel: 2
Donna M. Planeta, Attorney -in -Fact
this day of
State of
Rate of premium on this bond is $ 3.87 / Sliding Scale per thousand.
Total amount of premium charge is $ Premium Included on Performance Band . To be filled in by Surety
*Provide CONTRACTOR /ADMITTED SURETY name, address, and telephone number and the
name, title, address, and telephone member of authorized representative.
2 of RE -BID
CALIFORNIA ALL- PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity
of the individual who signed the document to which this certificate is attached,
and not the truthfulness, accuracy, or validity of that document.
State of California
County of San Bernardino
On 3-13-2020
before me, Rebecca Wilks, Notary Public
( ere msen name stun title o e o ¢err r
personally appeared Alberto Garcia
who proved to me on the basis of satisfactory evidence to be the person(S-) whose
name(&) Is re subscribed to the within instrument and acknowledged to me that
(5Dshe/they executed the same in Is er/their authorized capacity(ies), and that by
is erltheir signature(&) on the instrument the person(&), or the entity upon behalf of
which the person(s-) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that
the foregoing paragraph is true and correct.
WITNESS my hand and official seal. REB :CA wILKS
Notary Public - California 11
0,,,-
$an Bernardino q 5.j ty
Commission Al 2300424
My Comm, Expires Aa 5, 2023
Notary Public Signature (Notary Public Seal)
ADDITIONAL OPTIONAL
OF THE ATTACHED DOCUMENT
City of Santa Ana Payment Bond 9342347
(Title or description of attached document)
(Title or description of attached document continued)
of Pages Document Date
CAPACITY CLAIMED BY THE SIGNER
❑ Individual (s)
p Corporate Officer
President/CEO
(Title)
❑ Partner(s)
❑ Attorney -in -Fact
❑ Trustee(s)
❑ Other
svwvv.NotaryClasses.cotn 800-873-9865
INSTRUCTIONS FOR COMPLETING THIS FORM
This./bon complies with current Cohibrnia stones regarding notm)nraxhng and,
ifneeded, .shctld be completed and attached to The document. Acknowledgments
fi om other states may be completed for documents being sent to that state so long
as The aording does not require the CvIffmrtia norm), to violote CeIifornia notan+
lmr.
• State and County information must be the State and Comity where the document
signer(s) personally appeared before the notary public for acknowledgment.
• Date of notarisation must be the date that the signer(s) personally appeared which
must also be the same date the acknowledgment is completed.
• Tlhe notary public nmst print his or her name as it appears within his or her
conhmissitm followed by a courant and then your title (notary public).
• Prim the narne(s) of document simrer(s) who personally appear at the time of
notarization.
• Indicate the correct singular or plural forms by crossing off incorrect torms (i.e.
ho/slue/they, is /are) or circling the cancer forms. Failure to correctly indicate this
information may lead to rejection of docmnent recording.
• The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or tines. If seal impression smudges, re -seal if a
sufficient area permits other, , ise complete a different acknowledgment form.
• Signature of die notary public crust match the signature on file with the office of
the county clerk.
Additional infonnation is not required but could help to ensure this
acknowledgment is not misused or attached to a different document.
ee Indicate title or type of attached docrunent, number of pages and date.
Indicate tlhe capacity claimed by the signer. if the claimed capacity is a
corporate officer, indicate the title (i.e. CFO, CFO, Secretary).
• Securely attach this document to the signed document with a staple.
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
State of Oo&oax�gx
County of Hartford
On March 5, 2020
before me, Bethany Stevenson, Notary Public
name and title of the officer)
personally appeared Donna M. Planeta
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
Signature
Public
BETHANY STEVENSON
NOTARPPUBLIC- CT 177501
My COMMISSION EXPIRES SEPT. 30, 2023
(Seal)
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New
York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Illinois, and the FIDELITY
AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Illinois (herein collectively called the "Companies"), by
Robert D. Murray, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are
set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute,
and appoint, Donna M. PLANETA, Joshua SANFORD, Aimee R. PERONDINE, Danielle D. JOHNSON,
Michelle Anne MCMAHON, Bethany STEVENSON, Bryan M. CANESCHT, Kristopher PISANO, Rebecca
M. STEVENSON, Nicholas TURECAMO and Tanya NGUYEN, all of Hartford, Connecticut, EACH, its true and
lawful agent and Attomey-in-Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all
bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said
Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected
officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected
officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper
persons.
The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of
the By -Laws of said Companies, and is now in force.
IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said
ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and
FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 4th day of October, A.D. 2019.
ATTEST:
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
By: Robert D. Murray
Vice President
By: Dawn B. Brown
Secretary
State of Maryland
County of Baltimore
On this 4th day of October, A.D. 2019, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, Robert D.
Murray, Vice President and Dawn E. Brown, Secretary of the Companies, to me personally known to be the individuals and officers described in and who
executed the preceding instrument, and acknowledged the execution of same, and being by me duly swum, deposcth and saith, that he/she is the said officer of
the Company aforesaid, and that the seals affixed to the preceding instrument arc the Corporate Seals of said Companies, and that the said Corporate Seals and
the signature as such officer were duly affiixcd and subscribed to the said instrument by the authority and direction of the said Corporations.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written
�Pll ✓>,
t-M^.C�q,.�AQ.(�A�a+i\�
``a/`'tpitY
`',.�i4
Constance A. Dunn, Notary Public
,Mrs
My Commission Expires: July 9, 2023
nnnn+M
EXTRACT FROM BY-LAWS OF THE COMPANIES
"Article V, Section 8, Attomeys-in-Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President
may, by written instrument under the attested corporate seal, appoint attomeys-in-fact with authority to execute bonds, policies,
recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such
attorney -in -fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority at any
time."
CERTIFICATE
I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN
CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the
foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that Articic V, Section 8, of
the By -Laws of the Companies is still in force.
This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of
Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998,
RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary
and the Seal of the Company may be affixed by facsimile on any Power of Attorney... Any such Power or any certificate thereof bearing such
facsimile signature and seal shall be valid and binding on the Company."
This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of
Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held an the 5th day of
May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a
meeting duly called and held on the I Oth day of May, 1990.
RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature
of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a
certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect
as though manually affixed.
IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies,
this 5th day of March , 2020
v�Mq eu f��ipst,'a •,s's
�88AL 8 O INi —•— poi
Brian M. Hodges, Vice President
TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT A COMPLETE DESCRIPTION
OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BOND, THE BOND NUMBER, AND YOUR CONTACT
INFORMATION TO:
Zurich Surety Claims
1299 Zurich Way
Schaumburg, IL 60196-1056
www.rei)ortsfclaimsrz richna.com
900-6264577
0
Disclosure Statement ZURICH
NOTICE OF DISCLOSURE FOR AGENT & BROKER COMPENSATION
If you want to learn more about the compensation Zurich pays agents and brokers visit:
http://www.zurichn a producercompensation, com
or call the following toll -free number: (866) 903-1192.
This Notice is provided on behalf of Zurich American Insurance Company
and its underwriting subsidiaries.
U-GU-674-A CW (06111)
Page 1 of 1
CITY OF SANTA ANA RE -BID
BONDS Bond No. 9342347
PROJECT NO.: 17-6876
CROSSWALK UPGRADES PHASE lI
FEDERAL PROJECT NO: HSIPL 5063(186)
FAITHFUL PERFORMANCE BOND
KNOW ALL MEN BY THESE PRESENTS that ElecnorBelco Electric, Inc.
as CONTRACTOR, and Fidelity and Deposit Company of Maryland
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 Hundred Eighty Five Thousand Two
Hundred Ninety Five and 00/100 Dollars
($ 285,295.00 ), which is 100 percent of the total contract amount for the above stated
project, for the payment of which sum, CONTRACTOR and SURETY agree to be bound, jointly
and severally, firmly by these presents.
THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas CONTRACTOR has
been awarded and is about to enter into the annexed Contract Agreement with AGENCY dated
March 17, 2020 for Project No. 17-6876 Crosswalk Upgrades Phase ll [HSIPL-5063 (186)]
if CONTRACTOR faithftilly performs and fulfills all obligations in the performance of the Work
of Improvement to be done under said Contract Agreement in the manner and time specified
therein, then this obligation shall be null and void, otherwise it shall remain in full force and effect
in favor of AGENCY; provided that any alterations in the obligations or time for completion made
pursuant to the terms of the contract documents shall not in any way release either CONTRACTOR
or SURETY, and notice of such alterations is hereby waived by SURETY.
IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seal this
5th day of March , 2020
CONTRACTOR* ElEltriq Inc., dllrq�o
, 14320 Albers Way, Chino, CA 9171 Q,
1 c1: (999) 993-5470 ext 254
* Fidelity and Deposit Company of Maryland, 1299 zunch
SURETY Ann.: Mamaret Hentz. 777 Soudi Fieueroa St., Ste 3900 Los Aneele
Subscribed and sworn to before me,
, 20_
Signature:
Notary Public in and for the County of
State of
IL 60196-1056, Tel: (847) 605-6000
this day of
Rate of premium on this bond is $ 3.87 / Sliding Scale per thousand.
Total amount of premium charge is $ 1,021.00 To be filled in by Surety
*Provide CONTRACTOR /ADMITTED SURETY name, address, and telephone number and the
name, title, address, and telephone number of authorized representative.
1 of RE -BID
CALIFORNIA ALL- PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity
of the individual who signed the document to which this certificate is attached,
and not the truthfulness, accuracy, or validity of that document.
State of California
County of San Bernardino
On 3-13-2020
before me, Rebecca Wilks, Notary Public ,
l ere lose name an [l el'�o rye o�lmer)
personally appeared Alberto Garcia ,
who proved to me on the basis of satisfactory evidence to be the persons) whose
name(s) Is re subscribed to the within instrument and acknowledged to me that
(Eashelthey executed the same in is er/their authorized capacity(ies), and that by
is er/their signature($-) on the instrument the person(s), or the entity upon behalf of
which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that
the foregoing paragraph is true and correct.
REBECCA WILKS
WITNESS my hand and official seal. _ Notary Public - California
San Bernardino County 15
Commission k 2300424
My Comm. Expires Aug S. 2023
Notary Public Signature r (Notary Public Seal)
ADDITIONAL OPTIONAL INFORMATI
DESCRIPTION OF THE ATTACHED DOCUMENT
City of Santa Ana Perf Bond 9342347
(Title or description of attached document)
(Title or description of attached document continued)
Number of Pages Document Date
CAPACITY CLAIMED BY THE SIGNER
❑ Individual (s)
O Corporate Officer
President/CEO
(Title)
❑ Partner(s)
❑ Attorney -in -Fact
❑ Trustee(s)
❑ Other
%sN,rv.NataiyClasses.com 800-873-9865
INSTRUCTIONS FOR COMPLETING THIS FORM
DN This form complies with can?wu Cabibivia ,stahnes regarding nolam warding cord,
f needed, should be completed and attached to the document Acknowledgments
from other states may be completed for documents being seat to that state so long
as The warding does not require the California notan, to violate California notary
laro
• State and County information must be the State and County where the document
signers) personally appeared before the notary public for acknowledgment.
• Date of notarization must be tine date that the signer(s) personally appeared which
most also be the same date the acknowledgment is cornpleted.
• The notary public must print his or her name as it appears within his or her
conarnission followed by a corona and then your title (notary public).
• Print the mime(s) of document signer(s) who personally appear at the time of
notariomion.
• Indicate the correct singular or plural forms by crossing, off incorrect forms (i.e.
he/shettheyi is /are) or circling the correct forms. Fai ure to correctly indicate this
Metrication may lead to rejection of document recording.
• The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges, re -seal if a
sufficient area permits, otherwise cornplete a different acknowledgment form.
• Signature of fire notary public must match the signature on file with the office of
the county clerk.
Additional information is not required but could (help to ensure this
acknowledymrent is not misused unattached to a different document.
Indicate title or type of attached dochunent, number of pages and state.
Indicate the capacity claimed by the signer. If the claimed capacity is a
cotporate officer, indicate die title (i.e. CEO, CFO. Secretary).
• Securely attach this document m the signed document with a staple.
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
Comiecticut
State of OaNforxniax
County of Hartford )
On March 5, 2020
before me, Bethany Stevenson, Notary Public
name and title of the officer)
personally appeared Donna M. Planeta
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and icial seal. BETHANY STEVENSON
lIn NOTARPPUBLIC- CT 177501
I MY COMMISSION EXPIRES SEPT. $0, 423
Signature I I I (Seal)
Notary Public
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New
York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Illinois, and the FIDELITY
AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Illinois (herein collectively called the "Companies"), by
Robert D. Murray, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are
set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute,
and appoint, Donna M. PLANETA, Joshua SANFORD, Aimee R. PERONDINE, Danielle D. JOHNSON,
Michelle Anne MCMAHON, Bethany STEVENSON, Bryan M. CANESCHI, Kristopher PISANO, Rebecca
M. STEVENSON, Nicholas TURECAMO and Tanya NGUYEN, all of Hartford, Connecticut, EACH, its true and
lawful agent and Attomey-in-Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all
bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said
Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected
officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected
officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper
persons.
The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a live copy of Article V, Section 8, of
the By -Laws of said Companies, and is now in force.
IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said
ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and
FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 4th day of October, A.D. 2019.
INS
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ATTEST:
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
By: Robert D. Murray
Vice President
Ldl'tNl )ti _. -
By., Dawn E. Brown
Secretary
State of Maryland
County of Baltimore
On this 4th day of October, A.D. 2019, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, Robert D.
Murray, Vice President and Dawn E. Brown, Secretary of the Companies, to me personally known to be the individuals and officers described in and who
executed the preceding instrument, and acknowledged the execution of same, and being by me duly sworn, deposeth and saith, that he/she is the said officer of
the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and
the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year that above written.
I X . 11,0
Constance A. Dunn, Notary Public
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EXTRACT FROM BY-LAWS OF THE COMPANIES
"Article V, Section 8, Attomevs-in-Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President
may, by written instrument under the attested corporate seal, appoint attomeys-in-fact with authority to execute bonds, policies,
recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such
attorney -in -fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority at any
time."
CERTIFICATE
I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN
CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the
foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that Article V, Section 8, of
the By -Laws of the Companies is still in force.
This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of
Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998.
RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary
and the Seat of the Company may be affixed by facsimile on any Power of Attorney... Any such Power or any certificate thereof bearing such
facsimile signature and seal shall be valid and binding on the Company."
This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of
Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of
May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a
meeting duly called and held on the 10th day of May, 1990.
RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature
of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a
certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect
as though manually affixed.
IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies,
this 5th day of March , 2020
Brian M. Hodges, Vice President
TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT A COMPLETE DESCRIPTION
OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BOND, THE BOND NUMBER, AND YOUR CONTACT
INFORMATION TO:
Zurich Surety Claims
1299 Zurich Way
Schaumburg, IL 60196-1056
www.reDortsfclaims(a). urichna.com
800-626-4577
N
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c Project No. 17-6876 Crosswalk Upgrades Phase II
Project Number (HSIPL-5063(186))
To Elecnor Belco Electric. Inc.
CITY OF SANTA ANA
PUBLIC WORKS AGENCY
CONTRACT CHANGE ORDER
Change Order Number 01
Contractor
You are hereby directed to make the herein changes from the plans and specifications or do the following described work not included in the plans and
specifications on this contract.
NOTE: THIS CHANGE ORDER IS NOT EFFECTIVE I INTII APPROVED RY THE CITY nni INCII nR CITY AAANAr:PR
Unless otherwise stated, rates for rental of equipment cover only such time as equipment is actually used and no allowance will be made for idle time.
Change requested by PUBLIC WORKS AGENCY
EXTRA WORK AT AGREED PRICE
1. Per City's request, to compensate the contractor for additional striping, removal and installation
of Thermo Continental Crosswalk.
TOTAL AGREED PRICE = $4,711.20
The compensation both time and cost set forth in this change order comprises the total compensation due the
Contractor, all Subcontractors, and all Suppliers for all work performed per this change order, including impact on
unchanged work. By signing this change order, the Contractor acknowledges and agrees on behalf of himself, all
Subcontractors, and all Suppliers, that the stipulated compensation includes payment for all work contained in this
change order, plus all payment for interruption of schedules, extended field overhead, home office overhead, profit,
delay, and all impact, ripple effect or cumulative impact on all other work under this Contract. The signing of this
change order constitutes full mutual accord and satisfaction for all changes and work performed on this project, and
that the time and cost paid per this change order constitutes the total equitable adjustments owed the Contractor,
all Subcontractors, and all Suppliers for all work performed on this project. The Contractor on behalf of himself, all
Subcontractors, and all Suppliers agrees to waive all rights, without exception or reservation of any whatsoever to
file any further claim related to this project.
TOTAL COST THIS CHANGE ORDER: DECREASE $--------------- INCREASE $ 4711.20
e
By reason of this order the CONTRACT TIME completion will be adjusted as follows: None
We the undersigned contractor have given careful consideration to the change proposed and hereby agree, if this proposal is approved, that we will provide
all equipment, furnish all materials, except as may otherwise be noted above, and perform all service necessary for the work above specified, and will accept
as full payment therefor the prices shown above.
Accepted, Date 3/23/p Contractor Elecnor Belco Electric, Inc.
By Title Alberto Garcia, President/CEO
Approval
recommended by � � �` Date 4A A I -06 Z I
�.d UBLIC WORKS AGENCY IXECUTIVEDIRECTOR
Date G%`G6 7A
CITY ANAGER
y; / I 1 12I20APage 1 of 1
City Clerk