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HomeMy WebLinkAboutHYM ENGINEERING, INC. Y -- Recording Requested 13y, And When Recorded Mail To: Recorded in Official Records, Orange County Clerk of the Council,City of Santa Ana Hugh Nguyen, Clerk-Recorder 20 Civic Center Plaza,P.O.Box 1988 I IIIIII I III I III IIIII IIIII IIIII III IIIII IIIII IIIII IIII IIIIIIIII I I III III Santa Ana,CA 92702 NO F E E * $ R 0 0 1 2 8 2 8 2 9 7 $ 2021000327298 9:35 am 05/18/21 S RW11A N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.000.000.00 0.00 y NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN that the undersigned City of Santa Ana, California, a municipal corporation, with the address of City Hall, 20 Civic Center Plaza, Santa Ana, California, 92701, is the owner of the property hereinafter described, that said owner has caused A construction of HAZARD AVENUE PROTECTED BIKE LANES under contract entered into v M on MAY 5, 2020 with HYM ENGINEERING, INC. on which contract AMERICAN x w CONTRACTORS INDEMNITY COMPANY is surety. The property on which such work o improvement was placed is in the City of Santa Ana, County of Orange, State of California, and o z described as Project No. 18-6903 fCML-5063(182)1 located on: HAZARD AVENUE. The work a improvement on said property was accepted as completed on MARCH 26, 2021. a �Z x o CITY OF SANTA ANA A MUNICIPAL CORPORATION vA 0 w w by zF d Dated: tF Principal Civil En ineer-Jason Gabriel TITLE wa ------------------------------------------------------------------------------------------- 09 VERIFICATION I, the undersigned, say: I am the City Engineer - Edwin "William" Galvez of the City of Santa Ana, California; I executed the foregoing Notice of Completion acting on behalf of the owner of the property therein described; I make this verification on behalf of said corporation by authorization of the City Council of the City of Santa Ana; I have read said notice and know the contents thereof; and I declare under penalty of perjury that the facts therein stated are true. Executed on KAA Y at Santa Ana, Califo a City Engineer—Edwin"William"Galvez THIS NOTICE OF COMPLETION MUST BE RECORDED WITHIN TEN(10)DAYS AFTER COMPLETION INSURANCE NOT ON FILE WORK MAY NET PROCEED CITY OF SANTA ANA CLERK OF COUNCIL CONSTRUCTION CONTRACT DATE: @'.P�Ul,lrvirc� e I Oral u PROJECT 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FROM EUCLID..STREET TO HARBOR BLVD (CML-5063(182)) C-3 `" This CONSTRUCTION CONTRACT is made and entered into this 5s' day of May, 2020 by and f'between the City of Santa Ana, California, a charter city and municipal corporation organized and z existing under the Constitution and laws of the State of California (hereinafter "CITY"), and HYM Engineering, 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 Hazard Avenue Protected Bike Lanes from Euclid Street to Harbor Blvd 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 Eight Hundred Eighty-two Thousand Nine Hundred Nineteen Dollars and No Cents ($882,919.00), as set forth and identified in the BID PROPOSAL, which is attached hereto and incorporated herein as Exhibit "A." mv. 09/01/2017 Page I of 3 The BID PROPOSAL contains a schedule of unit price(s) or lump sum(s) based on approximate quantities only, and the City does not expressly or by implication agree that the actual amount of work will correspond therewith, but reserves the right to increase or decrease the amount of any class or portion of the work or to omit portions of the work as may be deemed necessary or advisable. 4. CONTRACTOR agrees to complete the WORK OF IMPROVEMENT within the time specified in the Time for Completion of Improvements section of the BID PROPOSAL (Exhibit "A") including commencing construction within the timeframe therein specified after issuance of a Notice to Proceed. 5. The CONTRACTOR will pay, and will require all subcontractors to pay, all employees on the WORK OF IMPROVEMENT a salary or wage at least equal to the prevailing salary or wage established for such work as set forth in the wage determinations for this work in accordance with applicable State and Federal law. 6. If applicable, the CONTRACTOR shall adhere to the CITY'S Community Workforce Agreement (CWA), a pre -hire collective bargaining agreement, which establishes the labor relations policies and procedures for CONTRACTOR to follow in the crafts persons employed to complete the WORK OF IMPROVEMENT as more fully described in the CWA. The CWA may be found on the City's website at: hhWiVwww.. santa-ana.ora/nwa/documents/C WA.ndf 7. CONTRACTOR shall, after award of this Contract, furnish two bonds to be approved by the CITY, one in the amount of One Hundred Percent (100%) of the Contract price, to guarantee the faithful performance of the work (Performance Bond), and one in the amount of One Hundred Percent (100%) of the Contract price to guarantee payment of all claims for labor and materials furnished (Payment Bond). This Contract shall not become effective until such bonds are supplied to and approved by the CITY. 8. CONTRACTOR shall, prior to the release of the performance and payment bonds or the retention payment, furnish a warranty performance and payment bond (Warranty Bond). Said Warranty Bond shall also be required as a condition of project acceptance. For projects up to Five Hundred Thousand Dollars ($500,000), the Warranty Bond amount shall be the greater of Ten Thousand Dollars ($10,000) or Twenty Percent (20%) of the final contract price. For projects above Five Hundred Thousand Dollars ($500,000), the Warranty Bond amount shall be the greater of One Hundred Thousand Dollars ($100,000) or Ten Percent (10%) of the final contract price. 9. CONTRACTOR shall, after award of this Contract, furnish Certificates of Liability Insurance and Worker's Compensation Insurance as outlined in the General Provisions, to be approved by the CITY. Page 2 of 3 IN WITNESS WHEREOF, the parties hereto have executed this Construction Contract on the day and year first above written, ATTEST: APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: J N FUNK Assistant City Attorney FOR APPROVAL: N % ABIL SABA, PE Acting Executive Director Public Works Agency CITY OF SANTA ANA KRISTINE RIDGE City Manager CONTRACTOR: HYM Engineering, Inc. NAME: t4mhom 5P.am TITLE: Pfttsly<-01 Page 3 of 3 CITY OF SANTA ANA — PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) BID PROPOSAL TO: CITY COUNCIL OF THE CITY OF SANTA ANA FROM: HYM Engineering, Inc. REQUIREMENT: The undersigned bidder declares that they have carefully examined the location of the proposed work, that they have examined the Contract Documents in its entirety and hereby proposes to furnish all material and do all the work required to complete the said work in accordance with said plans (if any) and the specifications for the unit price(s) or lump sum(s) set forth in the following schedule: Item Description 0tv Unit Unit Price Amount 1 Mobilization 1 LS $� $ 2 White Turn Lane Line ( Thin -mill) (COSA Detail 2) 295 LF $ li $ tt Y-� V.Z. S 3 12" White Thermoplastic Stop Bar/Limit Line (Thermoplastic) 180 SF $ $ / 4 ) Double Yellow (Thin -mill) (COSA Detail 655 LP $ I�� $ 5 Install Two way Leff Turn Lane (COSA Detail5) 5050 LF $ `� .- $ lls 6 Furnish and Install 2" PVC conduit and Stub -Out per plan 150 LF $ l $ 7 6" White Bike Lane Line ( CT Detail 39) 6200 LF $ S 6" Dashed White Bike Lane Line ( CT Detail 39-A) 3370 SF $ r $ 9 Install 6" White Chevron or Diagonal Snipe 230 LF $ oo %j, $ �+p 6 10 Install Street Legends and Arrows (Thermoplastic) ] 6 EA $ d ` $ FLU I 1 Remove Conflicting Striping (Grinding/Sandblasting) 1 L250 LF $ ?S_ $ I la Remove Legend (Grinding/Sandblasting) 17 EA $ Q� $ I p 12 Bike Lane Legend (Detail "A") -Green MMA 34 EA $ hv�j () $ �JG} 2r�,z -X 1'_ 13 Merging Area (Detail `B") - Green MMA 4000 SF $ 01 Q SIJ $ P-I ofP-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 IIAZARD AVENUE PROTECTED BIKE LANES FRT)RR AT. PRnTFf T Mn• f AaT -SMA1 rl Stm Item Description oty Unit Unit Price Amount 14 Bike Sharrow Panel (Detail "C") (Green MMA) 20 EA $ �/ '� $ 0l �� 15 Install Curb Marking 1394 LF $ po $ 16a Furnish and Install Type E Traffic Loop Detector (with DLC) 29 EA $ 2$p $ p1 Cl� 1 16b Furnish and Install Type D Traffic Loop Detector (with DLC) 13 EA $ �d $ 16c Furnish and Install Tyne O Traffic Loop Detector (with DLC) 7 EA $ $ ,z Y, /-�T 17 Furnish and Install Raised Curb Median Island Treatment (per plan Detail "L") 4 EA $ /coo ! $ ( oo a 18 12" White Thermoplastic Crosswalk Line, 11 O.C. (Thermoplastic) 1370 SF $ //// D 7" $ 19 Furnish and Install New Sign and Pole 27 EA $ 5V $ Cr �(SYJ 20 Furnish and Install New Sign(s), only 26 EA $ 20 $ 21 Furnish and Install New Sign(s), back-to- back, only 17 EA $ 2�- 22 Remove existing sign(s), only 12 EA $ $ 23 Remove existing sign(s) and Pole 13 EA $ 3p $ 7��p 24 Cement Median Island (8" height, Including Dowels) 482 CY $ Q�%� $ //JD 25 Traffic Control 1 LS $ fit? to $ 1 i pc to 26 SWPPP NO. 1 1 LS $ �� 0 $ rp vaa c� 27 Labor Agreement Oversight I LS $ 10,000 $ 10,000 TOTAL BASE BID $ 882.E ( 1 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 P-2 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) amount for this item will be dictated by the actual quantity used, and the Agency reserves the right to increase or decrease the quantity of this item accordingly, t This bid item is considered a Specialty Item per Section 2-3.2 of the Standard Specifications. TIME FOR COMPLETION OF IMPROVEMENTS AND LIQUIDATED DAMAGES The undersigned bidder hereby proposes to complete the Work for the total base bid amount shown above, within number (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 $1,600 per calendar day. Name of Firm HYM Engineering, Inc. Signature of BIDDER Title President (If an individual, so state, If a firm or co -partnership, state the firm name and give the names of all individual co-partners composing the firm. If a corporation, state legal name of corporation, and names of President, Secretary, Treasurer and Manager, thereof,) P-3 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) 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 quantities of work satisfactorily completed. The BIDDER also certifies that the bid is a balanced bid. In accordance with Section 7028.15 of the California Business and Professions Code, the undersigned certifies under penalty of perjury that the foregoing is true and correct. Name of Firm HYM Enalneerinci, Inc. Signature of BIDDER t:f--= � Title (If an individual, so state. If a firm or co -partnership, state the firm name and give the names of all individual co-partners cornposing the firm. If a corporation, state legal name of corporation, and names of President, Secretary, Treasurer and Manager, thereof.) P-4 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) 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: HYM Engineering, Inc, Business Address: 1559 W. Commonwealth Ave. Fullerton, CA 92833 Business E-Mail Address: ajeon@hymengineering.com Telephone: 714-523-23 72 State Contractor's License No. and Class: 918130, A, B License Expiration Date: 1 /31 /2021 State Dept. of Industrial Relations (DIR) Registration No.: 1000008232 State Dept, of Industrial Relations (DIR) Registration Expiration Date: 6/30/2021 Signed: Title: President P-5 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) 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 HYM Engineering, Inc. Signature of BIDDER) Title President (if an individual, so state) P-6 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) OWNERSHIP AFFIDAVIT STATE OF CALIFORNIA ) COUNTY OF ORANGE ) SS: CITY OF SANTA ANA ) Abraham Jaewoo Jeon being duly sworn, deposes and says: ❑ INDIVIDUAL That he/she is the party making the foregoing proposal: ❑ PARTNERSHIP That he/she is a member of the co -partnership firm designated as: and who has been and is duly vested with the authority to make and execute instruments for the co -partnership by: who constitute the other members of the co -partnership. ®CORPORATION That he is of: President a corporation which is making the foregoing proposal: ❑ JOINTVENTURE That he is of: one of the parties making the foregoing proposal as a jointvenmre, and the he/she has been and is duly vested with the authority to execute instruments for an on behalf of the parties making said bid who are: that such a bid is genuine and not collusive or sham, and has not in any manner sought by collusion to secure any advantage against the City of Santa Ana or any person interested in the proposed contract, for himself or any other person. Signature of Bidder Subscribed and sworn to before me this 25 day of Feb. 2020 Signature of officer Administering Oath (Notary Public) NISON KIM Natary public - California Orange County 9 r Commission # 2294196 My Comm. Expires Jul 18, 2023 ' P-7 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO,: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) BID BOND KNOW ALL PRESENT that, , as BIDDER, and , as SURETY, are held and firmly bound unto the CITY OF SANTA ANA, as AGENCY, in the penal sum of _ Dollars ($ ), 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 day of 20. BIDDER* SURETY* Subscribed and sworn to before me , 20_ 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-8 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) LIST OF SUB -CONTRACTORS Section 4100 et. seq, of the Public Contract Code requires listing of all subcontractors with the bid for all subcontract work exceeding the following amount: o Streets, highways including bridge projects: %z% of the bid or $10,000, whichever is greater o Buildings, parks, or other projects: ''/z% 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 ]aff License #/Exp, DIR Reg. #/Exp. 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 $ Signature of Bidder Name LtfX License #/Exp. DIR Reg. #/Exp. / Location Phone 4 01 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-9 of P-39 CITY OF SANTA ANA PROPOSAL. PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) 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 Anaheim / 200 S. Anaheim Blvd, Anaheim, CA Name and Address of Owner. David Sanchez / 714-765-5100 Name and Telephone Number of person familiar with project. $ 872,203.72 Improvement street and traffic signal improvement May, 2019 Contract Amount Type of Work Date Completed 2. City of Anaheim / 200 S. Anaheim Blvd. Anaheim, CA Name and Address of owner. Thomas Bekele / 714-765-4937 Name and Telephone Number of person familiar with project. _$ 166.917.50 Street Intersection improvement Aug. 2019 Contract Amount Type of Work Date Completed 3. City of Whittier / 13230 Penn Street Whittier, CA 90602 Name and Address of owner. Isaac Bravo / (562)567-9518 Name and Telephone Number of person familiar with project. $ 309,409.00 Improve trail walkway and fences and shade structure Oct. 2019 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. AMERICAN CONTRACTORS INDEMNITY COMPANY 801 S FIGUEROA STREET SUITE 700 LOS ANGELES. CA 90017 (800) 486-6695 CSBA — COMMERCIAL SURETY BOND AGENCY MAIN: (714) 516-1232 Orance CA 9PS67 P-10 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO; CML-5063 (182) 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. County of Orange / 601 N Ross St, Santa Ana, CA 92701 Name and Address of Owner. Name and Telephone Number $ 141,653.57 Contract Amount 2. Caltransl2 of person familiar with project. grading, CMU wall, steel structure and concrete Type of Work ne Way, Irvine. CA Name and Address of owner. Dennis Yum / (714) 641-4730 July. 2019 Date Completed Name and Telephone Number of person familiar with project. $ 484.935.00 Slope paving and Minor Concrete Work Aug. 2019 Contract Amount Type of Work Date Completed 3. Caltransl2 / 6681 Marine Way, Irvine, CA 92618 Name and Address of owner. Dennis Yum / (714) 641-4730 Name and Telephone Number of person $ 658,956.60 Contract Amount with project. Slope paving, Rock Blanket and Minor Concrete Work Sep. 2019 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. AMERICAN CONTRACTORS INDEMNITY COMPANY 801 S FIGUEROA STREET SUITE 700 X — COMMERCIAL S MAIN: (714) 516-1232 _Orange. CA 92867 P-11 ofP-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) 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 sharp 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 that making a false certification may subject the certifier to criminal prosecution. Signed State of California County of Orange Subscribed and sworn to (or affirmed) before me on this 25 day of Feb. , 202Q by Abraham Jaewoo Jeon , proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me — — HI50H KIM Notary luhllc - California a Oranse County Commission M 2294196 (/sl My Comm. Expires Jul 18, 202Y .r.�r Notary Public Signature Notary Public Seal P-12 ofP-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) NON-DISCRIMINATION CERTIFICATE The undersigned contractor or corporate officer, during the performance of this contract, certifies as follows: The Contractor shall not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. The Contractor shall take affirmative action to ensure that applicants are employed, and that employees are treated during employment without, regard to their race, color, religion, sex, or national origin. Such action shall include, but not be limited to, the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The Contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. 2. The Contractor shall, in all solicitations or advertisements for employees placed by or on behalf of the Contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. 3. The Contractor shall send to each labor union or representative of workers with which he/she has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the Contractor's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 4. The Contractor shall comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. 5. The Contractor shall furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his/her books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation, to ascertain compliance with such rules, regulations, and orders. 6. In the event of the Contractor's non-compliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, the contract may be canceled, terminated, or suspended in whole or in part and the Contractor may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Execution Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies involved as provided in Executive Order 11246 of September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law. P-13 ofP-39 CITY OF' SANTA ANA PROPOSAL PROJECT NO. 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) 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 Stats. 1939, and as amended, no discrimination shall be made in the employment of persons upon public works because of race, religious creed, color, national origin, ancestry, physical handicaps, mental condition, marital status, or sex of such persons, except as provided in Section 1420, and any contractor of public works violating this Section is subject to all the penalties imposed for a violation of the Chapter. Signed: Title: President Firm: HYM Engineering, Inc. Date: 2/26/2020 P-14 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE, PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) 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 j ourneymen stipulated in the apprenticeship standards. 3. Contribute to the fund or funds in each craft or trade in which he/she employs journeymen or apprentices on the public work, in the same amount or upon the same basis and in the same manner as the other contractors, except contractors not signatory to the trust agreement shall pay a like amount to the California Apprenticeship Council, Signed:'" Title: President Firm: HYM Engineering, Inc. Date: 2/26/2020 P-15 ofP-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) STATEMENT REGARDING "ANTI -KICKBACK" REQUIREMENTS The undersigned is submitting this proposal for performing by contract the work required by these bid documents, agrees to comply with the Copeland "Anti -Kickback" Act (18 USC 74) as supplemented in the Department of Labor regulations (29 CFR, Part 3). This act provides that each contractor or subcontractor shall be prohibited from inducing, by any means, any person employed in the construction or repair of public work, to give up any part of the compensation to which he/she is otherwise entitled, Signed:= Title: President Firm: HYM Engineering, Inc. Date: 2/26/2020 P-16 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO,: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the BIDDER shall complete, under penalty of perjury, the following questionnaire: Has the BIDDER, any officer of the BIDDER, or any employee of the BIDDER who has a proprietary interest in the BIDDER, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No X If the answer is yes, explain the circumstances in the following space, P-17 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) 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 appendix of the Special Provisions of this project. Signed-- -- Title President Firm HYM Engineering, Inc. Date 2/26/2020 P-18 ofP-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 1.8-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder HYM Engineering, Inc, proposed subcontractor tet!A � cars (' 0, a4i7 R Yl3P CQix nay+J/ , hereby certifies that he has _, has not x , 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 President Firm HYM Engineering, Inc. Date 2/26/2020 P-19 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) 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: 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. Signed Title President Firm HYM Engineering, Inc. Date 2/26/2020 P-20 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) 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 malting a false certification may subject the certifier to criminal prosecution. Signed Title President Firm HYM Engineering, Inc. Date 2/26/2020 P-21 ofP-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: l 8-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CMIL-5063 (182) 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. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Signed Title President Firm HYM Engineering, Inc. Date 2/26/2020 P-22 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO,: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) 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 this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub -recipients shall certify and disclose accordingly, Signed Title President Firm HYM Engineering, Inc. Date 2/26/2020 • Standard Form LLL may be obtained from Caltrans and FHWA offices. P-23 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) DISCLOSURE OF LOBBYING ACTIVITIES DISCLOSURE OF LOBBYING ACTIVITIES Appiovedby Okla Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1362 034&Dfi46 See reverse for Public burden disclosure. 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ® a. contract. ®a. bidioffer/application ® a. initial filing b. grant b. Initial award b. malarial change c. cooperative agreement c. post -award For Materiat Change Only: d. loan year quarter e. Man guarantee date of last report f loan insurance d. Name and Address of Reporting Entity: 5. N Reporting Entity In No. 4 is a Subawardee, Enter Name Prim ❑ sutumaro" and Address of Prime- Tier .. ffknown: N/A Con sessional District, ifkyrown: Congressional District, if known S. Federal Department/Agency: 7. Federal Program NamelDescription: N/A N/A CFDA Number. ffappllcable: 8. Federal Action Number, tfknowa: N/A 8_ Award Amount, ifknown: N/A f0, a. Name and Address of lobbying Entity b. Individuals Performing Services [including address if (lfindfvidual, fast name, firstrame, Mly d0larentfrom NO, 10a) (last name, first name, Mi): N/A N/A aaadi ConanWam Sae bSF"Aff. 11. Amount of Payment (check aNMat apply): 13. Type of Payment (checked thatapply): S N/A ❑ annul ❑ planned ❑ a. mini"" ❑tone Ornstee N/A 12. Form of Payment(cheak ay that applyy ❑a. calnlmon ❑ a. ama N /A ❑ d. ambelpattea ❑ e. mkleo: apedly: nature ❑ 9. aea nod value. ❑ Lomer. Rmaay: 14. Brief Description of Services Performed or to be Performed and Date(s) of Service, including officer(s), employee(s), or Member(s) contacled, for Payment Indicated in Item 11: N/A a!,= CAMnWma bYAP aSFLLLA yraaeua 15. Continuation Sheets SF-L atf ohed: yes No 16. i ..,acm r.pa.wd w uoMo �++.Xss M�a n�iwrwisu. st ue a a.mw fssa. xu. rrms.n. u .r 1 UAna, a sax Signature: ra am eon Print Name: .far�.a.n ~ arard iro, rra ,e,a.a.. r r,yY.d quarae m ar uea usa tu, iTelephoneNoz Title: President bMmeen W fn rrra.al ti«, Cuarw, rA.ahwsMy and MJ M.w1'.Va M .„a maaepney«mrxr«.1 Fw airs m.« 1i0gtW k ..haw.fdrvr, 714-523-2372 Oats• 26 2O2 Federal Use Only: . '.. Aanalrnd %r Local Reprow-dnn 5t31MM Fame LLL Res. 79 P-24 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.; 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO; CML-5063 (182) INSTRUCTIONS FOR COMPLETION OF_SF-LL, DISCLOSURE OF LOBBYING ACTIVITIES INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES 13110 doclOom rorin shah be noePteled by merepebrtg 0mly, x4lettYabaWaftlee•D Pone Federal redp(ent,at the tmllattan or reoept era Wetted fedem6 aCdM, of a damoalofmrga 40. a PMV"Oing. Pu61rm.R m tore 31 U.S.C. GOMM 1352. Tbe tlSg nr alarm is requlreaW saam paymantoragmM#Ittdto make pWilenti a ylltto ykigentry Mewed ogaatanipthgla tmuende an olncerIXemplayeeor myagenoy,a Memberar Congmse, an drier Or er�Pyeeot. Cong plgwedr ongress in comnecMewd, aCOV2reafttlefal'�aLdIM_ US, tmsd,4AL GMan161bn0aISN.oramdmMa Yd"whomrc tee on" an Ile "MIS lnaaaq,lam. Canptet@aA Items that apply for balm the, Imta lang and naiedil change report. 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S. t Mier to MI name, iiare66. city, Smea and ap euda or ire pone Feeeml redplent. bdUde CMgleSdOnW Glbe<t, t Mader. 6. Enter Ilse narreor tm Fedora agency narngIra aadnd ar I" co mrddlent. include at Ieastooe orga am onalem bean agencynew, t Innvrr. Fa' 01(anple. Department oy Tmnsp ntalM. Nnded SWISS Coast Guam T. Enteral@ Fttl4rapm¢arbnameoC ae6Wp11tatfar 1tYC CLaemtlFedearaCaM pmn L). t IndAYo,.ente matl/I Catalog of FMerd Cmneslb AsfiWMGm JCFCAFnuebarorgrazis,Wcpmt Neagrae b%pans,minroanW Omenis. a. Enter IN Rod eprtoPmm F6d9fa ldentlying number avaiametdr Ina Pedera moon aenleeOS teem 1 (e.g. Regve61 for PWposal (RFP) ntanber.. vlNlalon W Da (IM) nunber, gnat annencernem: namlxr, me contract, grant, or ban aeaa nuRber me opplicallor"Opaeat "W mnYter aeagrteabythe Fedora agency}. bdu4e ISSIne6„e.g.�'RFP-OEASfNl1.• 9. F6raar and Fedora acmana am Sens has been an aaaW IX loan camdanem by to Fedora aWROy.. 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SOnd Morino ds regarding is burden esbn ate or any Oliver aspect or, ins cWMIM e tr on, ig wggedlew far mat" min. Mireea, to the CRca Of MMagene 311a BlidgEll, PaPMrvlb ReebllM Project (0318{I046), Wast"nan.. aC 20603. P-25 of P-39 CITY OF SANTA ANA PROPOSAL PROJECTNO.; 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) EXHIBIT 15-G CONSTRUCTION CONTRACT DBE COMMITMENT 1, Local Agency: City of Santa Ana 2. Contract DBE Goal: 16% 3. Project Description: Hazard Avenue Protected Bike Lanes 4. Project Location: 6. Bidder's Name: HYM Enaineerina, Inc. 6. Prime Certified DBE: IA 7. Bid Amount: 410 8. Total Dollar Amount for ALL Subcontractors: 9. Total Number of ALL Subcontractors: �. 10. Bid 12. DBE 14. DBE Item 11. Description of Work, Service, or Materials Certification 13. DBE Contact Information Dollar Number Supplied Number (Must be certified on the date bids are opened) Amount 38719 i-r uyJ, �d�-6�f� 1%�$�$6gSi 00 bG oy� -- TI�'PS )5033 1 21. Local AgencyContract Number: 22. Federal -Aid Project Number: CML 5063 (182) 23. Bid opening Date: February 26, 2020 24. Contract Award Date: 25, Award Amount: Local Agency certifies that all DBE certifications are valid and information on this form Is complete and. accurate, 26. Local Agency Representative's Signature 27. Date 28.Local Agency Representative's Name 29. Phone 00. Local Agency Representative's Title 15. TOTAL CLAIMED DBE PARTICIPATION IMPORTANT: Identify all DBE firms being claimed for credit, regardless of flan Names of the First Tier DBE Subcontractors and their respective Item(s) of work listed above must be consistent, where applicable with the names and Items of the work in the "Subcontractor List" submitted with your bid. Written confirmation of each listed DBE Is required. 2/26/2020 16. Preparer's Signature 17. Date Abraham Jeon 714-523-2372 18. Preparer's Name 19. Phone President 20. Preparer's Title 1. unglnal - Local Agency 2.cnnv_Caliranc nlf,WIncmlA..f.-Cn.d..-rnine,c..u......_-.a..._,u_,., 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 alternate formats. For Information call (916) 664• 6410 or TDD (916) 654-3880 or write Records and Forms Management, It 20 N Street, MS-89, Sacramento, CA 958U. P-26 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) 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). S. 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 furnished by the DBE. See LAPM Chapter 9 to determine how to count the participation of DBE Gans. 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 connectors. 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 die 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. 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 contact 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,fer 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 fern. 30. Local Agency Representative Title - Enter the position/title of the Local Agency Representative certifying the contractor's DBE commitment form. P-27 ofP-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LADES FEDERAL PROJECT NO: CML-5063 (182) EXHIBIT 15-H DBE INFORMATION — GOOD FAITH EFFORTS DBE INFORMATION - GOOD FAITH EFFORTS Federal -aid Project No. _CML 5063 (182) Bid Opening Date February 26, 2020 The City of Santa Ana established a Disadvantaged Business Enterprise (DBE) goal of 16 % 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 1.5-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): 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 Callfornia Professional Engineering, Inc. 2/25/2020 email and phone 2/26/2020 Traffic Loops Crac it ing, Inc. -e—mail and phone 26/2020 P-28 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) 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 Concrete Bidder Normally Performs Item (Y/N) u Breakdown of Items Amount M Percentage Of Contract / /- 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: Names, addresses and phone numbers of firms selected for the work above: M 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: HYM sent email and send plan and specs. email again to know bidding status 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: P-29 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO,: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (l 82) H. 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 Caltrans District 12 Internet/2/25/2020 no need response because we can get ata fFern Internet H. Any additional data to support a demonstration of good faith efforts: NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. P-30 of P-39 efIfWJ p ai Rialto Off ca "'a ""N i Contractors License No. 374600 DIR Registration No.1000000306 2280 South Lilac Ave A General Engineering Bloomington Ca 92316 C-13 Fence, Wire, wood Phone: (909) 746-0356 Fax: (909) 746-0354 C-32 Highway Improvement Quotation Union Contractor / No minority Status TO: Current Date: 2/20/2020 For the Intended use of the General Contractor BldDate: 2/26/2020 JobName: Hazard Ave Protected Bike Lanes Location: Santa Ana Bid#: 47003 0 Phone: ( ) Fax: ( ) - Contract#: Job# Contact: Working Days: email: Liquidated Damages ITEM NO. DESCRIPTION I QUANTITY1 UNIT I UNIT PRICE TOTAI 02 White Turn Lane Line 295 LF 1.000 $295,00 03 12" White Thermo 180 SF 4.000 $720.00 04 Double Yellow Thermo 655 LF 1.000 $656.00 05 Two Way Left Turn Lane Thermo 5050 LF 1.000 $5,050.00 07 6" White Bike Lane Thermo 6200 LF 0.750 $4,650.00 08 6" Dashed Bike Lane Thermo 3370 LF 0.750 $2,627.60 09 Install 6" White Chevrons 230 LF 2.500 $575.00 10 Install Thermo Legends and Arrows 16 EA 85,000 $11360.00 11 Remove Conflicting Striping 11250 LF 0.760 $8,437.50 11A Remove Legends 17 EA 75.000 $1,276.00 12 Bike Lane Legend Detail A Green MMA 34 EA 850.000 $28,900.00 13 Merging Area Detail B Green MMA 4000 SF 9.850 $39,400.00 14 Bike Sharrow Panel Green MMA Detail C 20 EA 425.000 $8,600.00 15 Curb Marking 1394 LF 2.260 $3,136.50 18 12" White Thermo 1370 SF 4.000 $5,480.00 19 Furnish & Install New Sign & Pole 27 EA 300.000 $8,100.00 20 Furnish & Instal New Sign Only 26 EA 206.000 $5,330.00 21 Furnish & Install New Signs Back to Back 17 EA 205.000 $3,485.00 22 Remove Existing Sign 12 EA 15.000 $180.00 23 Remove Existing Sign & Pole 13 EA 25.000 $325.00 Subtotal $128,381,50 Page 1 of 4 Rk%bp eIR� Man# 2280 South Lilac Ave Bloomington Ca 92316 Phone: (909) 746-0356 Fax: (909) 746-0354 Contractors Llcense No. 374000 DIR Registration No. 1000000306 A General Engineering C-13 Fence, Wire, wood 0-32 Highway Improvement Quotation Union Contractor / No minority Status • EXCLUDE: Maintenance of temporary delineation Is. temporary paint, temporary tape, channelizers, etc... • ALL Bid Items shall NOT be adjusted or removed without written / or verbal permission. • EXCLUDE: Lead Compliance Plan • Retainage percentage on monthly progress payments to be no greater than the percentage retained by the Owner on Its payment to the Contractor. If Owner reduces the retainage percentages on payments to the Contractor, the Contractor shall likewise reduce the retainage percentage on payment to Chrisp Company. Full retention to be released no later than thirty, (30) Days after completion of Chrisp Companys work. Excessive or delinquent retalnage will be subject to the highest Interest rate allowed by law. • Chrisp Company shall be reimbursed the full amount for bonds upon submission to General Contractor. Retention shall not be held from bond reimbursement. • THIS QUOTATION IS BASED ON A STANDARD MONDAY THROUGH FRIDAY WORK WEEK, ADDITIONAL COSTS WILL OCCUR FOR WORK PERFORMED ON WEEKENDS • CHRISP COMPANY WILL USE EXISTING EMPLOYEE POOL TO PERFORM ALL WORK ON THIS PROJECT. IF THERE ARE ANY HIRING GOALS FOR THIS PROJECT THIS WILL BE EXCLUDED •'' General Contractor to Provide Clean Water Source At No Cost to Chrisp Company. Must be Located On Jobsite. Page 4 of 4 Date: Attn: Owner: Project: Bid Date: Traffic Loops Crackfilliog, Inc. 946 S. Emerald Street, Anahcim CA 92804 • Tel: (714) 520 4026 Fax: (714) 520 4027 License No. 652956 • Class C-10 & C-32 - SBE No. 0016691 • DBE & UDBE No. 38033 • Union Contractor DIR Registration No. 1000003794 • Expiration Date: 06/30/2022 Email: Trafficloops@sbeglobal.net or Estimating@ticine-ca.com 2/19/2020 Estimator Quotation City of Santa Ana Hazard Avenue Protected Bike Lanes, Project No. 18-6903, Federal Project No. CML 5063(182) 02/26/2020 @ 2:00 PM BID ITEM DESCRIPTION CITY. UNIT UNIT PRICE ITEM TOTAL 6 Flan ish and Install 2" PVC conduit and Stub -Out per 150 LF 72.00 10,800.00 17 Furnish and Install Type E Traffic Loop Detector 29 EA 375.00 10,875.00 18 Furnish and Install Type D Traffic Loop Detector 13 EA 460.00 5,860.00 19 Furnish and Install Type Q Traffic Loop Detector 7 EA 500.00 3,500.00 -Quote Is valid for 180 days from the date of this proposal. -By accepting our quote you agree to the Terms & Conditions shown on Page 2. TOTAL BID AMOUNT: $ 31,025.00 Our quote Includes: 1- Lay out, saw cut, wash, blow, dry, seal, and megg 2- Loop saw cut shall be filled with Hot Melt Sealant 3- Insurance coverage up to $1 million, general aggregate up to $2 million, umbrella up to $2 million 4- One move -in (We charge $1,200.00 per additional move -in) 5- Traffic control for TLC operations only Our quote excludes: 1- General Excess Liability for $5 million (If needed, cost for extra protection is $3,000.00) 2- Bond fee (If required, Prime Contractor to pay bond rate of 2%), permit fee, utilities fee, advance sign posting of any kind, or notifying residents 3- Weekend work 4- Traffic control plans 5- Concrete, asphalt patch All inclusions and exclusions are to be incorporated into our contract. If either party becomes involved in litigation or arbitration arising out of this contract, the court or arbitration panel shall award attorney's fees and costs to the prevailing party. Please call Mai -Lau Nguyen at (714) 520-4026 if you have any questions or need more information. Page 1 of 2 Traffic Loops Crackfilling, Inc. 946 S. Emerald Street, Anaheim CA 92804 • Tel: (714) 520 4025 Fax: (714) 520 4027 •quote Is valid for 180 days from the date of this proposal. -In case of discrepancy between the unit price and the total set forth for a unit basis Item, the unit price shall prevail.MM •10 days notice required for scheduling, -24 hours notice required for rescheduling. -Site must be ready with cat -track, permanent striping, grinding, asphalt, approvals, etc. prior to loop Installation.. Access to the Job site must be furnished by Contractor, the general contractor, lessee or other party ordering work. -Additional charges may Incur for the following: a) Site Is not ready (for TLC's scope of work) the day of scheduled work or delays b) Extra move -ins c) When minimum move -In requirements are not met (if noted In quote) -All changes to the original scope of work or proposed extra work must be directed by the Contractor In writing prior to TraffIc Loop Crackhlling, Inc. (TLC) before performing this work. No extra work or additional work will be performed without written authorhation. -This quote will not be valid If there are any changes or deletions of any Item post bid and will need revised pricing. -Total bid must be accepted (must use all line Items) unless otherwise noted or agreed to. If you need revised pricing far only a portion of the work,. contact Estimator. -TLC will not be Impacted by Liquidated Damages assessed by the Contractor /Agency due to an Inadequate amount of Urn to complete TLC operations. -Contractor to provide monthly progress payments for all completed work In accordance with the bid pricing schedule. Monthly payments must be received In full by TLC no later than 10 calendar days after the Contractor receives payment from Owner for our completed work. •Retention % Is to be withheld only as per the Owner's requirements. -Contractor hereby agrees that time shall be of the essence in regard to all payments provided for herein, and lfany payment Is not made when due, Contractor agrees to pay all collection costs and expenses Including costs of suit and any related attorney's fees and costs and also hereby waives the benefit of any statute of limitation that would prohibit an action of TLC to enforce the terms and conditions of this Contract Including but not limited to any right to recovery of attorney's fees and costs. The laws of the State of California shall control all aspects of this contract except as to lien matters, which will be governed by the laws of the state where the subject property Is located. -TLC requires a written contract, purchase order or signed quote prior to the start of work. -The language and terms used in this exhibit supersede any conflicting terms In the Subcontract Agreement. Page 2 of 2 If you are the apparent low, please Infm•m CPE, within 48 hours. Long lead materials apply. CAU ORNIA PROFESSIONAL ENGINEERING, INC. Estimate Number Project Name: Project #: Agency: Bid Due Date: Hazard Ave 18-6903 CITY OF SANTA ANA 212612020 19062 San Jose Avenue, La Puente, CA 91748 License # 793907 Exp: 04/30/2021 Classifications: A, C-10, C-20 LSBE Certified LA County #54567 Exp: 11/30/2020 SEE Certified DGS #54567 Exp: 11/30/2020 SMBE/DBE/UDBE Certified Caltrans #31277 DIR #1000377609 Exp,06/30/2020 Union Signatory Laborer's Local and IBEW Bid Due Time: 2:00 PM Conditions Set Forth: 1, Estimate based on one (1) mobilization unless noted otherwise. Additional mobilization at $3,500.00/ea. 2, If loop work: stubout must be existing & marked If not called out to be replaced per plans. Cat -tracking shall be approved prior. Should loop quantities be decreased, a minimum mobilization of $4,500.00 shall supersede. 3. One work day based on eight (8) standard consecutive work hours per day. At least 3-weeks notification required; subject to scheduling availability. 4. Quote valid for thirty (30) days. CPE reserves the rightto revise our quotation as necessary. S. Should HKA be the acting consultant/Inspectors on behalf of the Agency, CPE reserves the right to withdraw our bid. CPEis pleased topmvide this esilmateforthe hitended use ofthe Cenhwclnrtofurnish laborand/or material in striet accord.ince with the plans and specifreatlons ay follows: Ite Ne 9 Descrtpt"' ° v t rwiz ":� 3 3 7 ?,:< q i..,,S 4.�t JOM. �'.? SY RR �", ...(x.., 150 ;Unit Pr cep ,.,a o+� n.> 100.00 s $ x;.r.e".t 15,000.00 6 Furnish and Install 2" PVC conduit and stub -out LF per plan 16A Furnish and install type E traffic loop detector EA 29 265.00 7,685.00 (with DLC) 16B Furnish and Install type D traffic loop detector EA 13 275.00 3,575.00 (with DLC) 16C Furnish and Install type Q traffic loop detector EA 7 300.00 2,100.00 (with DLC) Exclusions: Bond & Bond Premium; Overtime and/or Nighttime Rates; All Permits; All Training Requirements; Signage; Lane Closure Request, Traffic Control, and TCP; Light Towers; CMS boards; Shoring; Water; Sidewalk & Surface Concrete; Regulatory Signs; Hauling Dirt, Debris, & Concrete Foundation Away; Handicap Ramps; Repaving Street; Repaving Potholes; Saw Cutting; USA Marking Removals; Irrigation Work; Dewatering; Striping; Survey; Fencing; Cold/Hot Mix; Temp. Asphalt; Inspection Fees; Testing; Temporary Loops; Temporary Signal; Compaction Testing, and/or High Voltage Line Conflicts, Unless Otherwise Noted Above. Standard Certificate of Insurance will be provided upon request. Any additional requirements will be billed at cost. Hot Mix Asphalt shall be provided by Contractor to CPE to backfill any potholes and/or excavations. If it is not provided and we utilize temporary Cold Mix, CPE will not be held liable for any claims that may derive from such pothole and/or excavated location, Terms: Unless other arrangements are made, payment Is due & payable wlthinin 30 days upon completion; 1.5% monthly Interest will apply thereafter. Bid based on entire bill of material and services and Is Inseparable unless written authorization Is provided by CPE. Acceptance TOTAL: $28r360.00 Ph: (626) 810-1338 J Fx: (626) 810-1322 1 Email: estlmatinq(n)cpengineeringinC,Com CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) 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 Exh(bit 12-0 Exhibit 12-B Bidder's List of Subcontractor (DBE and Non -DBE) Part 1 As of March 1, 2015 Contractors (and sub -contractors) wishing to bid on public %works contracts shall be ragiatered with the State Division of Inriustrial Relations and certiliedtobid art Public Works contracts. Please register at: httQS:/(www.dir.ca.g,ov(Pultllr.-WorkssLCoatractor-Repistratlon.litml In accordance with Title 49, Section 26.11 orthe 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 subcontractor %vllo will perform work inoculating culating to more than our balfof one percent (0.5%) of0re Total Base Did or $10,000 (whichever is greater). Photocopy this tarns for additional firms. federal Project Number: Subcontractor Name and Location Line Item & Description Subcontract Amount percentage of Did Item Sub. contracted contractor License Number DIE (YIN) DlEcert Number Annual Gross Receipts DIR Re Number Name; Trefac Loops Cmcallllinp, Inc. urns nee mndult and Stub -Out per plan 17. Furnish & Inetall Type E Tralac Locp Detector 16- Furnish &Install Type Traft Loop DeWtor 19-Furnish & Inslall Type Q e ctor $31,025.00 700% 652956 .. ±,., ° ^.� i �,)' i _,.;Sai;'4 <$l million <$5 million city,5tate; Anaheim, CA 1000003794 <$10 million <$IS million Age of Firm: rs. Name: + -,u3N; An ll! r, np ' <$l mllllon <$5 million < $10 million City, State: U <515 million Age of Firm: Wt. Name: k ` $ * _..,.,� s.. <$lmillion city,$tota'<$10 < 5million million ❑ <$15 million Age of Firm: yrs. Noma: t y ' t ' .3 1$1 million City, state: <$5 million <$10 million <$15 mllllon A -a of Firm: __. rs Name: 1 ! ° I <$I million cItY+State: <SSmlliipn <$10 million < 15 million Age of Firm: ,s. Name: 1 %y `4U <$I million City, State: 45 million <Slo Million U <$15 million Age of Flrm: Yrs. al vngmarurcar Agency ale <J Lapy-VLAt W/ AW8ra i'acx8ge Page I or January 2019 P-31 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) EXHIBIT 12-B BIDDER'S LIST OF SUBCONTRACTORS (DBE AND NON -DBE) —PART I PART The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal, Photocopy this form for additional firms. �S�ri>w4n9.tt�.tw.P.ep M't�ngaiygce_'tr�apugi AodNa�'ArNxdld#n, dda dii$.iidrt"Y.�wetioudo-w4owifso AmAddt F6Yf hW60 IBYdatSdp� 4111400, tjAebtdNamYrar gyp. (I:Ni DDEC°el3 Nain6'ir AAria� IG #a3 ak�pipl3g.,; f4 ' `;3apt a e-,f ,clj' q4 31 i� As�t3n �. is is k fld �tI 5 sx,FA�*' k `r�: 8 ' t �x ' r Si'S'X:f_ i7Af4 'S15lNIIIIdA. -�rJ f ji i 1 5e 1(x� E 3 i riat6 l ca e �sg 'mllila7l 'f'L 1 u rt ti ;33yy} �- #3 Ff $' 'i ' Ty+•£+' faA ." 5, ;,is4 k;,`• ttA t F�< , °ia r F } t rf ITSAj t �,�H$ ra.� fi#+ (fillldo YS1oMY [art 6Slsltfi I Ail . a .. s `b' ? =... ,V, ,t cryilie..•li"� _.a, a.. �'r % ,. �,,,jl 4$J. ill U}j,p A: PPitidi ta. r Name+ + . iY(y,8tata `! si Tizst� '� ,e '�F,�z�f-YllA 7 x �. �pe r ...... F 4 t5ldrrl I bn eJPPbSmYoII11Grt NamO n. �xhku r ter ti f tau:, aSTC F ��.jy i.-.,A4f')•<+Q,:.#�t OHM f6malidn d!`kJ�iif}IIIGR :RhtriD:UE[afii:3lQNa[iaaalk6raIlJpAnLYPIIe:DlCtiA4DLAl?VYIdiVerBkaek6He'-: .. _. P-31 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO,: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) 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 be 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 contractor, deficient subcontract performance, or noncompliance by a subcontractor. Signed Title President Firm HYM Engineering, inc. Date 2/26/2020 P-33 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO,: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) EXHIBIT 16-B — SUBCONTRACTING REQUEST Local Assistance Procedures Manual Exhibit 16-B cONTRACrORNAME HYM Engineering, Inc. COUNTY Orange ROUTE BUSINESS ADDRESS 1559 W. Commonwealth Ave. CONTRACrNUMBER 18-6903 CITY AND STATE Fullerton, CA fl ZIPCODE 92033 28 FEDERAL -AID PROJECT NUMBER CML-5063 182 A. SUBCONTRACTOR B. BIDITEM C. PERCENTAGEOF D. SUB LISTED E. CERTIFIED F. DESCRIBE WORK G. DOLLARAMOUNT (Name, Business Adthem Phorte) NUMB13R(3) BID ITEM ATB[DTIME USE WHEN LESS THAN BASED ON THE BID SUBCONTRACTED 100% OF WORK IS AMOUNT SUBCONTRACTED ;sr 1 ��/ Ig '/ Yes No Yes No -6kq r Z.07 / p M El / C/M 7# Yes No Yes No .� o.L. t ❑ ❑ ❑ ❑ �iQ/Sp C'OM A n," O-11 N, OX Yes No Yes 4WI 6914A Lai [No l Qg— 7g4 ^-Dji l/a /Y,l3 Yes No Yes No El 1:1 El El )19r d4 Yes No Yes No y� ❑ ❑ ❑ ❑ Yes No Yes No ❑ ❑ 1 ❑ ❑ 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. Contractor must perform with own forces (line 1 X contract mq. %) 3. Bid items previously subcontracted (taken from previously approved 16-B) 4. Bid items subcontracted (this request) 5. Total bid items subcontracted sine 3 plus 4) 6. Balance of work contractor to perform (line 1 minus 5) $ RESIDENT ENGWERRrS SIGNATURE DATE copy umtnouuon: unbnnai-�onrracror copy- xesident Engineer Copy- UBEU-sma116usinessadvocaCe¢7Aoot ca.eov or fax to(916) 324.1949 Page 1 of 2 January 2018 P-34 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO,: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) 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-35 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) 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 condition differs materially and is cause for an adjustment of time, payment, or both Signed Title President Firm HYM Engineering, Inc. Date 2/26/2020 P-36 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) BIDDER'S CERTIFICATE OF COMPLIANCE REGARDING "BUY AMERICA" REQUIREMENTS FOR STEEL OR MANUFACTURED PRODUCTS The undersigned, is submitting this proposal for performing 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. Signed Title President Firm HYM Engineering, inc, Date 2/26/2020 P-37 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) 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 appendix of the Contract Documents' of this project. Signed 7=:::� Title President Firm HYM Engineering, inc. Date 2/26/2020 P-38 of P-39 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 18-6903 HAZARD AVENUE PROTECTED BIKE LANES FEDERAL PROJECT NO: CML-5063 (182) 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 Documents of this project. Signed Title President Fir„, HYM Engineering, inc. Date 2/26/2020 P-39 of P-39 brm a@ COUNTY REGISTER - msspawrvTAng smmP my ,2190 Telephone {714) @ 00CENTER 6 1 Fax (714) 96.6059 PROOF OF PUBLIC A. &lateof Califorrila Pauntyof ORANGE {2015:5 CC:P) ss Notice'Type. 016 NOTICE INVfTINCt BIDS AidDescriplion '40 5903,HAZARDAVENUE PROTECTED DIKE LANES Executed on: 0211212020 At SANTAANA,tA. I cerllfy (or declare) under penalty of podury that the foregoing Is free and co0`0cG f (I I I I I I Signature I (I III tlllllllllllllllllllllllllllllllllllllllllllllllillylllll����llllllll Email * A 0 0 0 0 0. 5 3 4 2 4 4 1 t MAYOR Miguel A. Pulido MAYOR PRO TEM Vincente Sarmlenla COUNCIL MEMBERS Angelico Amozcua P. David Benavides Michele Martinez Roman A. Rayne - - -- - Recorded in Official Records, Grange County Hugh Nguan, Clark -Recorder p 1 '��II �I �I�I��II�I�II�III�� �� NO FEE j $ R 0 0 0 8 2 8 9 6 5 4 t 201685000339 8:49 am 04/12/16 323 304 Z01 0.00 60.00 0.00 0.00 0.00 0,00 0.00 0.00 CITY MANAGER David Cavazos CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Marie D. Huizaf Sal Tinajero CITY OF SANTA ANA PLANNING & BUILDING AGENCY 20 Civic Center Plaza (M-20). P.O. BOX 198B . Santa Ana, California 92702 (714) 667-2700 • Fax (714) 973.1481 www.santa-ana.org NOTICE OF EXEMPTION From the Requirements of the California Environmental Quality Act (CEQA) To: COUNTY CLERK From: City of Santa Ana County of Orange Planning & Building Agency P.O. Box 238 20 Civic Center Plaza M-20 Santa Ana, CA 92702 Santa Ana, CA 92702 Project Title: Hazard Avenue Class 11 Bicycle Lanes Date of Approval: 05/17/2016 Project Number(s): PWA-2016-366-CITY Project Location: 1 CityWide (Partial) City: Santa Ana County: Orange ER Number: ER-2016-36 Project Description: Construction to install road diet with protected/buffered bicycle lanes, sharrows, bicycle detection and lane narrowing along Hazard Avenue from Euclid Street to Harbor Boulevard. Applicant Name: Zdenek Kekula, City of Santa Ana Public Works Agency Applicant Address: 20 Civic Center Plaza M-43 SANTA ANA, CA 92702 Name of Public Agency Approving Project: City Council Name of Person or Agency Carrying Out Project: Kekula, Zdenek POSTED 'l"'E Exempt Status; ❑ Ministerial (Sec. 15268) FILED �� ❑ Declared Emergency (Sec. 15269 (a)) j 2o% ❑ Emergency Project (Sec. 15269 (b through a)) APR 12 2016 HUGH NGUYEN, CLERV-RFOORDER ❑ General Rule (Sec. 15061(b)(3)/(5)) ❑ Statutory Exemption: ORANGE COUNTY CLERK -RECORDER DEPARTMENT BY;_ _ -_A_AL__ pEPUTY Cl Categorical Exemption: 15301(c) ay; �Y) DEPUTY Reason(s) Why Project is Exempt From CEQA: 15301(c) consists of the operation, repair, maintenance or minor alteration of existing public facilities such as streets, sidewalks, gutters, bicycle and pedestrian trails. City Contact: Zdenek Kekula Telephone: (714) 647-5606 ) Signature; Title: 11Wr� Date: f� r SANTA ANA CITY COUNCIL Miguel A. Pulldo Vincente Sarmlento Michele Martinez Angelica Amezeus P. David Benavides Roman Reyna Sal TinaJew Mayor Mayor Pro Tom, Ward 1 Ward 2 Ward 3 Ward 4 Ward 5 Ward a MPulido%antglw� V$armlento soma-anaom', JyMarrn fa�sa to-ana om ezcue@santa-ena DG navidesro�sania-en oru g,2RReyna.(¢TsgEL,anaom STin j_psania- a,gLq CITY OF SANTA ANA BONDS PROJECT NO.: 18-6903 FAITHFUL PERFORMANCE BOND Bond #1001143631 Bond Premium: $15,893.00 KNOW ALL MEN BY THESE PRESENTS that HYM Engineering, Inc. as CONTRACTOR, and American Contractors Indemnity Company a corporation, organized and existing under the laws of the State, and duly authorized to transact business under the laws of the State of California, as SURETY, are held and firmly bound unto the City of Santa Ana, as AGENCY, in the penal sum of Eight Hundred Eighty Two Thousand Nine Hundred Nineteen & 00/100 Dollars ($ 882,919.00 ), 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 May 11, 2020 for Hazard Avenue Protected Bike Lanes if CONTRACTOR faithfully performs and fulfills all obligations in the performance of the Work of Improvement to be done under said Contract Agreement in the manner and time specified therein, then this obligation shall be null and void, otherwise it shall remain in full force and effect in favor of AGENCY; provided that any alterations in the obligations or time for completion made pursuant to the terms of the contract documents shall not in any way release either CONTRACTOR or SURETY, and notice of such alterations is hereby waived by SURETY. IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seal this 22nd day of May , 2020 . CONTRACTOR* HYM Engineering, Inc. SURETY* American Contractors Indemnity Company 801 S. Figueroa St., #700 Los Angeles, CA 90017 (310) 649-0990 Frank Morones Attorney -in -Fact Subscribed and sworn to before me, 20 Signature: Notary Public in and for the County of State of this day of Rate of premium on this bond is $ 18.00 per thousand. Total amount of premium charge is $ 15,893 To be filled in by Surety *Provide CONTRACTOR / ADMITTED SURETY name, address, and telephone number and the name, title, address, and telephone number of authorized representative. 1 of 3 + TOKIOMARINE HCC POWER OF ATTORNEY AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY KNOW ALL MEN BY THESE PRESENTS: That American Contractors Indemnity Company, a California corporation, Texas Bonding Company, an assumed name of American Contractors Indemnity Company, United States Surety Company, a Maryland corporation and U.S. Specialty Insurance Company, a Texas corporation (collectively, the "Companies"), do by these presents make, constitute and appoint: Daniel Huckabay, Arturo Ayala, Dwight Reilly, Shaunna Rozelle Ostrom, Michael D. Stong, Ben Stong or Frank Morones of Orange, California its true and lawful Attorney(s)-in-fact, each in their separate capacity if more than one is named above, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include riders, amendments, and consents of surety, providing the bond penalty does not exceed *****Twenty Million***** Dollars ( ***$20,000,000.00*** ). This PowerofAttorney shall expirewithout further action on April 23' , 2022. This Power of Attorney is granted under and by authority of the following resolutions adopted by the Boards of Directors of the Companies: Be it Resolved, that the President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney -in -Fact may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts, and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. IN WITNESS WHEREOF, The Companies have caused this instrument to be signed and their corporate seals to be hereto affixed, this 181 day of June, 2018. AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY UNITED STAf'g6 SURETY�OOryJPANY „U,1v3,n$jrECIAL,TY.It4SURANCE COMPANY o tAP 09_,S taY,GO URf,1F .\rtirvTn State of California ,%l„ ` g• g e + x a _ C. J f rd fib County of Los Angeles ''� , s )V-V( .l x� z' Y�"1 " - By: f - "2`"`,µ�k"`":,"° *�,Qr",r` n'•xw,,,Av° °ry,,,.�k,,,,' Daniel P. Aguilar, Vice President n,ne 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 On this Vt day of June, 2018, before me, Sonia O. Carrejo, a notary public, personally appeared Daniel P. Aguilar, Vice President of American Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Specialty Insurance Company who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Z7!dn11 T11o.tzrtxem uot1. ComrvhUmbl'l1pAM Signature r (seal) 1. Mr ccnn.ryt++aolr, mz: I, Kio Lo, Assistant Secretary American Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Specialty Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies, which is still in full force and effect; furthermore, the resolutions of the Boards of Directors, set out in the Power of Attorney are in full force and effect. In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Los Angeles, California this 22nd day of May , 2020 Corporate Seals A??"i*oR w ropv\ 'eSl80 pigs suer` {m u ^ Bond No. 1001143631 a4 " "t .�n«rn xt w t4a t Agency No. 8472 aq nspa„7`r ' rryory# `* y' m„k 'F* _ �* s ,' Kid Lo, Assikaiit Secretary n*�„o HGCSMANPOA0512018 visit tmhcc.com/surety for more information CALIFORNIA ALL-PURPOSEACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy. or validity of that document. State of California County of Orange--.—_—.--- } Qn.—�J_./_%_ _� before me, L. Clark, Notary Public L _ ._.__._....-._.............._.___..._..—'---- U it.. Here Insert Name and Title of the Officer personally appeared Frank Morones Names) of Signers) who proved to me on the basis of satisfactory evidence to be the person(&) whose names) is/are subscribed to the within instrument anti acknowledged to me that helshoiaAW-executed the same in hisA494t -^ authorized capacity(eas), and that by his/h - ignature(s) on the instrument the person(s), or the entity upon behalf of which the persons) 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. L. CL- - WITNESS my hand and official seat. Notary Public - California a --� Los Angeles County z z k' Comnussion # 2170352 s Signature----_� _ My Comm. Expires Nov 28, 2020 J Signature of Notary Public Place Notary Seal Above __ OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: _ Document Date: Number of Pages: _. Signei(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signers Name: -: Corporate Officer — Title(s): _----_-----..._ -i Partner — " Limited General i_ individual Attorney in Fact Trustee Guardian or Conservator Other: Signer Is Representing: -- n Corporate Officer — Title(s):----_-- Partner - '-; t_imited ;_ General Individual Attorney in Fact Trustee ' Guardian or Conservator ' + Other: Signer Is Representing: @2014 National Notary Association - www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) item fi5907 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange On May. 26, 2020 before me, Hison Kim, a Notary Public nsert name and title of the officer) personally appeared Abraham J. Jeon who proved to me on the basis of satisfactory evidence to be the person($) whose name(X)Dare subscribed to the within instrument and acknowledged to me thatODshe/they executed the same in is her/their authorized capacity(ieg), and that by ii /her/their signature(s) on the instrument the person(g), or the entity upon behalf of which the person(') acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature A? �__ —" NISON KIM Notary Public - California [[[ Orange County Commission # 2294196 My Comm. Expires Jul 18, 2023 (Seal) CITY OF SANTA ANA BONDS PROJECT NO.: 18-6903 PAYMENT BOND KNOW ALL MEN BY THESE PRESENTS that HYM Engineering, Inc. as CONTRACTOR, and American Contractors Indemnity Company a corporation, organized and existing under the laws of the State, and duly authorized to transact business under the laws of the State of California, as SURETY, are held and firmly bound unto the City of Santa Ana, as AGENCY, in the penal sum of Eight Hundred Eighty Two Thousand Nine Hundred Nineteen & 00/100 Dollars ($ 882 919.00 ), 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 May 11, 2020 for Hazard Avenue Protected Bike Lanes 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 famished, 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 22nd day of May 12020 . CONTRACTOR*HYM Engineering, Inc. 1559 W. Commonwealth Ave. Fullerton, CA 92833 (714) 523-2372 Abraham Jeon,, President re SURETY* American Contractors Indemnity Company �, 801 S. Figueroa St., #700 Los Angeles, CA 90017 (310) 649-0990 Frank Morones, Attorney -in -Fact Subscribed and sworn to before me, this day of 20 Signature: Notary Public in and for the County of State of Rate of premium on this bond is $ Included in performance bond per thousand. Total amount of premium charge is $ Included in performance bond . To be filled in by Surety *Provide CONTRACTOR I ADMITTED SURETY name, address, and telephone number and the name, title, address, and telephone number of authorized representative. 2 of 3 TOKIOMARINE POWER OF ATTORNEY AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY KNOW ALL MEN BY THESE PRESENTS: That American Contractors Indemnity Company, a California corporation, Texas Bonding Company, an assumed name of American Contractors Indemnity Company, United States Surety Company, a Maryland corporation and U.S. Specialty Insurance Company, a Texas corporation (collectively, the "Companies"), do by these presents make, constitute and appoint: Daniel Huckabay, Arturo Ayala, Dwight Reilly, Shaunna Rozelle Ostrom, Michael D. Stong, Ben Stong or Frank Morones of Orange, California its true and lawful Attorney(s)-in-fad, each in their separate capacity if more than one is named above, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include riders, amendments, and consents of surety, providing the bond penalty does not exceed *****Twenty Million***** Dollars ( ***$20,000,000.00*** ). This Power of Attorney shall expire without further action on April 2311, 2022. This Power of Attorney is granted under and by authority of the following resolutions adopted by the Boards of Directors of the Companies: Be if Resolved, that the President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Affomey-in-Fact may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts, and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. IN WITNESS WHEREOF, The Companies have caused this instrument to be signed and their corporate seals to be hereto affixed, this 1 sr day of June, 2018. AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY UNITED STATfi&SURET.YZOMPANY _.U,&-,SPECIALTY.-INSURANCE COMPANY State of California.: o �`V�a+-t_ County of Los Angeles '� : -�' , �� a� ' ri fBy: N.sY `" M' '�ai=x"v ` Daniel P. Aguilar, Vice President A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document to On this ls' day of June, 2018, before me, Sonia O. Carrejo, a notary public, personally appeared Daniel P. Aguilar, Vice President of American Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Specialty Insurance Company who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. sm,na.ex NutegP"W,0111i omia L Anre[cv4mnty WamnOonB PilHi9 Signature (seal) awcanr.,.nQm.,ao�xs, m:P I, Kio Lo, Assistant Secretary American Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Specialty Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies, which is still in full force and effect; furthermore, the resolutions of the Boards of Directors, set out in the Power of Attorney are in full force and effect. In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Los Angeles, California this 22nd day of May 2020 Corporate Seals Bond No. 1001143631 'r Agency No. 8472 i;,a a ?ice �? s '� *w� Kio Lo, Assi§W Secretary HCOSMANPOA0512019 visit tmhce.com/surety for more information CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of - Or On_��._�'--/-ZO before me, L. Clark, Notary ^Public Date Here Insert Name and Title of the Officer personally appeared Frank Morones Name(s) of Signers) who proved to ripe on the basis of satisfactory evidence to be the persons} whose name(s) islare subscribed to the within instrument and acknowledged to me that he/executed the same In hisA49 #rg ^uthorized capacity(ies), and that by his/ ef4heirr-signature(s) on the instrument the person(s), or the entity upon behalf of which the persona) 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, L. CLARK WITNESS my hand and official seat. Notary Public • California LoAngeles County i z s Commission # 2170352 n Signature----- < My Comm. Expires Nov 28, 2020 Signature of Notary Public Place Notary Seat Above ---�--- — - — — -- ----- OPTIONAL -- T hough this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this fern to an unintended docurrrent. Description of Attached Document Title or Type of Document: Number of Pages:._. Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) E>igner's Name: --_-_-- - Corporate Officer — Title(s): Partner — Limited General Individual Attorney in Fact Trustee j Guardian or Conservator Other': Signer Is Representing- --- --u� Signer's Name: ----------- F: Corporate Officer — Title(s): _...... _ 17, Partner — - Limited . t General Individual Attorney in Fact iJ Trustee Guardian or Conservator t Other: _.- __-- Signer Is Representing: _--.... k'."4":�{:�'�{r-"CX.`_i'�+`k`�r�ia'{Y�.its"S:4�Y_"4'�[.Tl$hr'•�M`•�+ek.-.{.. i'4'Lii.'. `4�i`C.``i+C .n✓T$%4�'. ..�CrTw {L �"T Arth`i�YY.9vYIv�G-�C1�+.ti.R-¢"f._`i''4.-ZV 02014 National Notary Association - www.NationalNotary.org •'1-800-US NOTARY (1-800-876-6827) Item 45907 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange ) On May. 26, 2020 before me, Hison Kim, a Notary Public (insert name and title of the officer) personally appeared Abraham J. ]eon who proved to me on the basis of satisfactory evidence to be the person(g) whose name(,$) Is are subscribed to the within instrument and acknowledged to me thatshe/they executed the same in Is her/their authorized capacity(ie§), and that by(j, her/their signature() on the instrument the person(A), or the entity upon behalf of which the person(.9) 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 •-- ���0�,4 HISON KIM Notary Public - California '• < Orange County Commission N 229b196 My Comm. Expires Jul 18, 2023 (Seal)"� CITY OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number Project No. 18-6903 Hazard Avenue Protected Bike Lanes (CIVIL Change Order Number 1 To HYM EngineeringInc. _ Contractor You am hereby directed to make the herein changes from the plans and specificallons or do the following described work not Included In the plans and specifications on this contract. NOTE: THIS CHANGE ORDER IS NOT EFFECTIVE UNTIL APPROVED BY THE CITY COUNCIL OR CITY MANAGER, Unless olhenvlse staled, rates for rental of equipment cover only such time as equipment is actually used and no allowance will be made for Idle time. Change requested by PUBLIC WORKS AGENCY EXTRA WORK AT AGREED UNIT PRICE To compensate Contractor for additional signs and surface mounted delineator per PCO #3. Dated January 21, 2021. UNIT ITEM # DESCRIPTION QUANTITY UNIT PRICE AMOUNT 28 1 Install Signs 2 EA $510.00 $1,020.00 29 Install Surface Mount Delineator 75 EA $204.45 $15,333.75 TOTAL AGREED PRICE = $16,353.75 Page 1 of 2 CITY OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number Project No. 18-6903 Hazard Avenue Protected Bike Lanes (CIVIL Change Order Number To HYM Engineering Inc. _....... Contractor You are hereby directed to make the herein changes from the plans and specifications or do the following described work not Included In the plans and specifications on this contract. NOTE: THIS CHANGE ORDER EFFECTIVE UNTIL APPROVED BY THE CITY COUNCIL OR CITY MANAGER, Unless otherwise stated, rates for rental of equipment cover only such lime as equipment is actually used and no allowance will be made for idle time. Change requested by PUBLIC WORKS AGENCY The compensation both time and cost set forth in this change order comprises the total compensation due the Contractor, all Subcontractors, and all Suppliers for all work performed per this change order, including impact on unchanged work. By signing this change order, the Contractor acknowledges and agrees on behalf of himself, all Subcontractors, and all Suppliers, that the stipulated compensation includes payment for all work contained in this change order, plus all payment for interruption of schedules, extended field overhead, home office overhead, profit, delay, and all impact, ripple effect or cumulative impact on all other work under this Contract. The signing of this change order constitutes full mutual accord and satisfaction for all changes and work performed on this project, and that the time and cost paid per this change order constitutes the total equitable adjustments owed the Contractor, all Subcontractors, and all Suppliers for all work performed on this project. The Contractor on behalf of himself, all Subcontractors, and all Suppliers agrees to waive all rights, without exception or reservation of any whatsoever to file any further claim related to this project. TOTAL COST THIS CHANGE ORDER: DECREASE $ By reason of this order the CONTRACT TIME completion will be adjusted as follows: 1 working day INCREASE $ 16,353.753 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 abovo, Accepted, Date t/L (spy I Contractor By t� v Title A Approval recommended by HYM Engineering Inc. dery WORKS AGENCY EXECUTIVE DIRECTOR Date Approved by �'/c'A; :iy/ Date CITYMANAGER S/G126z1 Page 2 of 2 MEMORANDUM Kristine Ridge To: City Manager Date: May 3, 2021 Nabil Saba, Executive Director From: Public Works Agency Project No. 18-6903; Hazard Avenue Protected Bike Lanes (CIVIL 182) Subject: Change Order No. 1 CONTRACTOR: HYM Engineering Inc. 1559 W. Commonwealth Ave. Fullerton, CA 92833 PROJECT DESCRIPTION: Project No. 18-6903; Hazard Protected Bike Lanes (CIVIL 182) CHANGE ORDER NUMBER: 1 CHANGE ORDER AMOUNT: $16,353.75 ACCOUNTING UNIT -ACCOUNT -ACTIVITY NUMBER: 05917660-66220-18690302028 03217662-66220-18690303028 JUSTIFICATION 1. As a result, of revising channelization plan to install delineators and to add signage along the Hazard Avenue project limits. (PCO #3) CONTRACT COST SUMMARY Original Contract Total Amount $882,919.00 AGREED PRICE $16,353.75 % of Contract Construction Contingency $88,340.00 10.0% Council Authorized budget $971,259.00 Amount % of Original Contract Total $882,919.00 Previous Change Orders $0 Change Order #1 $16,353.75 Increase 1.85% Adjusted Contract Total $899,272.75 1.85% Project 18-6903 Change Order No. 1 Page 2 of 2 SCHEDULEIMPACT One (1) additional working day. L- Saba, PE; Executive Director Works Agency APPROVED AS TO FUNDS AND ACCOUNTS: Kathryn Downs, CPA; Executive Director Finance & Management Services Agency Project 18-6903 Change Order No. 1 Page 2 of 2 SCHEDULEIMPACT One (1) additional working day. Saba, PE; Executive Director Works Agency APPROVED AS TO FUNDS AND ACCOUNTS: kLLp -a Kathryn Downs (May 11, 202114:26 PDT Kathryn Downs, CPA; Executive Director Finance & Management Services Agency